National Health Institutes (NIH) Funded Project 1R21HD097763-01
EVALUATING THE EFFICACY OF A SERVICE DOG TRAINING PROGRAM FOR MILITARY VETERANS WITH PTSD
This study addresses gaps in evidence-based alternative interventions for PTSD, a critical need given the meager successes of standard therapies. Posttraumatic stress disorder (PTSD), a serious public health epidemic, affects approximately 20% of the 18.5 million U.S. veterans, and places them at higher risk for impaired biopsychosocial functioning. Increases in PTSD symptom severity (PTSDSS) cause an inability to regulate emotions, control impulsive behaviors, and function within family and society oftentimes leading to homelessness, divorce, and spousal/child abuse. Anecdotal evidence suggests that training service dogs (SDs) may be rehabilitative for veterans with PTSD, but evidence of efficacy is lacking. We hypothesize that veterans with PTSD who train SDs for fellow veterans will show a reduction in PTSDSS and decreases in stress-related biological and psychosocial outcomes. If the SDTP is successful in reducing PTSDSS in veterans with PTSD and without stressing the dogs it may prove to be a cost-effective rehabilitative opportunity for other at-risk populations.
Patient-Centered Outcomes Research Institute (PCORI) Funded Projects
All Hands on Deck: Community Convening to Improve Research on Veteran Suicide Prevention
Research indicates that low social support and isolation are risk factors for veteran suicide. Despite the importance of social connectedness, there is little research indicating the effectiveness of including concerned significant others (CSOs), e.g., family members, spouses, close friends, and peers in veteran suicide prevention efforts. Integrating social support into treatments for veterans has demonstrated positive results; yet this strategy has not typically been studied within veteran suicide prevention. This project will host “All Hands on Deck: Community Convening to Improve Research on Veteran Suicide Prevention” to facilitate discussions with 200 stakeholders to design innovative engagement strategies with CSOs to improve veteran suicide prevention research. Facilitated groups will discuss ways to engage concerned significant others in PCORI on veteran suicide comparative effectiveness research on (1) firearms safety and (2) crisis response and safety planning research. A Stakeholder Advisory Board will be formed to guide the project to design, plan and run the Convening. After the Convening, the Project leads and board will co-author and disseminate a CSO Engagement Guide to support PCORI in veteran suicide prevention.
This project is funded through a Patient-Centered Outcomes Research Institute (PCORI) Eugene Washington PCORI Engagement Award (EACC-18).
VETERAN’S ACTION LEAGUE 2.0: Developing a National Veteran-Centered Chronic Pain Research Agenda
Dr. Cheryl Krause-Parello and her colleagues from Maryland, Rutgers, Ohio State, Rush, Augusta, Duke, Loyola, and George Mason universities, are studying chronic pain and working to find solutions for veterans. According to the Dept. of Veterans Affairs, chronic pain is a serious health and societal concern in the U.S. affecting 40-70% of veterans, making it one of the leading causes of disability and creating significant negative impacts upon the lives of millions of veterans. The veteran population may pose greater challenges to treat based on military history and injury. Pain-reducing medication, like opioids, are a common treatment. This project moves away from “Take two aspirin and call me in the morning,” giving veterans an active voice in chronic pain management and treatment options.
This program was funded through a Patient-Centered Outcomes Research Institute (PCORI) Eugene Washington PCORI Engagement Award (10454-IC).
Social and Chronic Pain: Veterans sharing a path in developing a patient-centered response to the COVID-19 pandemic
With a large population of veterans experiencing chronic pain on a daily basis, interventions for pain management and relief are difficult, if not impossible, for many to achieve. Neurological and psychological evidence has shown that socially distressing circumstances–such as social distancing and isolation due to the coronavirus pandemic–may increase the susceptibility to chronic pain. In order to address the needs of veterans’ living with chronic pain, the Veterans’ Action League (VAL) 2.0 was created to provide veterans with a platform to actively voice their unique needs and challenges regarding chronic pain management and treatment options that are most important to them. With an enhancement award from the Patient-Centered Outcomes Research Institute (PCORI), Dr. Cheryl Krause-Parello and her colleagues from Florida Atlantic University, Rutgers, Augusta, Ohio State, and University of Rochester were given the opportunity to advance VAL 2.0 amidst the COVID-19 pandemic to continue engaging veterans in patient centered outcomes research (PCOR) and comparative effectiveness research (CER). Veterans and key stakeholders will collaborate to explore and discuss past successful interventions, dilemmas veterans and stakeholders are facing during the pandemic, and methods to increase veterans’ social engagement and engagement capacity in PCOR/CER as full partners in the search for chronic pain treatment interventions that are meaningful to the veteran population in times of social distancing and isolation. View Social and Chronic Pain Project details This project is funded through a Patient-Centered Outcomes Research Institute® (PCORI®) Eugene Washington PCORI Engagement Award (10454-IC).
Operation PCOR: Training Veterans as Partners in PTSD Research
C-P.A.W.W. has been awarded through an Eugene Washington PCORI Engagement Award to develop, pilot and evaluate a nationally accessible, asynchronous, veteran-driven, online research training program designed specifically to prepare and train veterans to function as full partners in the research enterprise. To develop this, the National Advisory Board (NAB), which consists of veterans and researchers, will set training priorities, goals and objectives, inform curriculum development and teaching strategies, and evaluate the quality, teaching strategies, and learning outcomes of the training program. Operation PCOR will also develop 'VetResearchHub'. This is a web-based platform where veterans who have completed the Operation PCOR training can enlist as trained research partners and join forces with researchers on PTSD-related Patient Centered Outcomes Research (PCOR) and Comparative Effectiveness Research (CER). View Operation PCORI Details This program was funded through a Patient-Centered Outcomes Research Institute (PCORI) Eugene Washington PCORI Engagement Award (5548-FAU-IC).
Veterans' Action League: Building Capacity to Engage Veterans in PCOR and CER Activities
This funded project aimed to give veterans an active voice in Patient-Centered Outcomes Research and Comparative Effectiveness Research activities and processes. The six-state project (OH, CA, FL, TX, PA, NY) engaged veteran leaders, pairing them with a Collaborative Academic Research Member in each state. Through these partnerships, veterans and researchers dynamically engaged their communities to discuss salient current issues in veteran health care, generate innovative ideas for progress-- both within the research realm and at the community level-- and establish the necessary infrastructures to support innovative and efficacious PCOR and CER action. View Veterans' Action League Project Details This program was funded through a Patient-Centered Outcomes Research Institute (PCORI) Eugene Washington PCORI Engagement Award (3302-FAU-IC).
Stakeholder-Driven Veteran's Suicide Protection Advisory Group – Tier III
C-P.A.W.W.’s research was funded through a PCORI contract to continue building upon the work and success of Tiers I and II. In Tier III we developed a veteran-centered comparative effectiveness research (CER) study to compare two veteran-driven interventions that protect veterans from suicide. Throughout the 12-month project our project leads, Veterans’ Suicide Protection Advisory Group (VSPAG), and academic researchers participated in engagement activities to draft a Letter of Intent and a research proposal that is veteran-driven. View Tier III Details This project was funded through a Patient-Centered Outcomes Research Institute (PCORI) Pipeline-to-Proposal Award (3406820), administered on behalf of PCORI by Trailhead Institute.
Stakeholder-Driven Veteran's Suicide Protection Advisory Group – Tier II
C-P.A.W.W.'s active community engagement project aimed at identifying protective factors against veteran suicide was funded for its second phase. Tier II of the project focused on expanding community engagement initiatives established in Tier I. The team also focused on refinement of an innovative comparative-effectiveness-research (CER) question. View Tier II Details This project was funded through a Patient-Centered Outcomes Research Institute (PCORI) Pipeline-to-Proposal Award (3406820), administered on behalf of PCORI by Trailhead Institute.
Stakeholder-Driven Veteran's Suicide Protection Advisory Group – Tier I
C-P.A.W.W. was funded for a Pipeline to Proposal Tier I contract work which is to identify protective factors to reduce future suicides through engaging veterans, their friends and family members, and service providers. During the nine-month Tier I contract, monthly activities were conducted that included building community partners and key stakeholder relationships to gather information on protective factors for suicide. This group became the Executive Partnership Team (EPT) who then conducted a needs assessment related to protective factors for suicide. From there, a formalized Veteran’s Suicide Protection Advisory Group was formed and drafted plans on identifying protective factors which led to a stakeholder-veteran–based suicide prevention and intervention model useful in future comparative effectiveness research. This project was funded through a Patient-Centered Outcomes Research Institute (PCORI) Pipeline-to-Proposal Award (3406820), administered on behalf of PCORI by Trailhead Institute.
Military-Focused AAI Research
Military Veterans and Shelter Dogs: One Rescue at a Time
C-P.A.W.W. received the Collaborative Research Award from the International Society for Anthrozoology (ISAZ) and the WALTHAM Foundation to conduct a study in partnership with Animal House Rescue & Grooming and MaxFund Animal Adoption Center. The research team investigateD the effects of walking shelter dogs upon a cohort of veterans. We examined salivary cortisol and alpha-amylase levels, heart rate variability, and blood pressure pre-dog walk, immediately post-dog walk, and 30 minutes post-dog walk in a group of reintegrating veterans with and without post traumatic stress disorder. We took concurrent psychosocial measures throughout the course of the study to assess quality of life, relationships, animal bonding, perceived stress, and pet attitude. Additionally, we collected HRV data from the shelter dogs as a biological stress measure.
Working Dogs for Wounded Warriors: Understanding Patient Stress in Aeromedical Evacuation and the Impact of Animal Assisted Intervention
Dr. Krause-Parello was the associate investigator of this study investigating the biobehavioral and psychobiologic interface among animal-assisted intervention and stress indicators, salivary cortisol, alpha-amylase, and IgA, as well as blood pressure and pulse, in wounded warriors undergoing aeromedical evacuation from Ramstein, Germany to the Aeromedical Staging Facility at Andrews Air Force Base.
Veterans and Service Dogs: An in Depth Exploration on Restoring Independence
This study explored the relationship between military veterans and their service dogs. A qualitative study was conducted to explore potential constructs relating to the impact of service dogs on veterans. Many veterans reintegrating into civilian life have service connected conditions (e.g., PTSD, TBI). The overarching aim was to explore the impact of service dogs on veterans’ health and reintegration into civilian life.
Canine Visitation and Hospitalized Older Veterans: An Innovative Approach to Impacting Stress Indicators
This study investigated the effects of canine interaction on stress responses (salivary cortisol, salivary alpha-amylase, immunoglobulin A, blood pressure, and heart rate) in senior veterans receiving palliative care at the VA Eastern Colorado Healthcare System in Denver, CO.
Examining Stress Indicators in Sexually Abused Children: Canine Companionship during Forensic Interviews
The purpose of this study was to examine the effect of a facility dog present during the forensic interview process for child sexual abuse allegations. Biological stress indicators salivary cortisol, alpha-amylase, and immunoglobulin A and blood pressure and heart rate were recorded. This study took place in Virginia.
Canine Companions during Forensic Interviews: Examining Stress Indicators in Sexually Abused Children
The purpose of this pilot study was to investigate the effects of AAI (by way of a therapy dog) as a stress reduction modality on stress indicators salivary cortisol, alpha-amylase, and immunoglobulin A and blood pressure and heart rate in children during forensic interviews for sexual abuse allegations. This study took place in Texas.
The Effects of Canines Visitation on Older Adults and their Caregivers Living in the Community
This study examined the effect of pet visitation on blood pressure and pulse in older adults and their caregivers with Dr. Krause-Parello as principal investigator.
Measuring Cortisol and Immunoglobulin A in Human Saliva
As principal investigator, Dr. Krause-Parello examined the relationship among stress, pet interaction, and health (using in vivo and in vitro measurements).
Relationships Among Loneliness, Human Social Support, Pet Attachment Support, and Subjective Well-being in Older Adults
The goal of this project was to study the relationships among loneliness, social support, pet attachment support, and subjective well-being in older adults. Dr. Krause-Parello was the principal investigator.