Research has shown that maintaining functional independence is the biggest priority for an older individual who seeks medical care. By targeting the priorities valued most by patients, we can proactively design personalized care that the Veterans Health Administration prioritizes in its strategic goals.

To do this, we focus on optimizing cognition and mood (the Mind), optimizing physical functioning (Mobility), and optimizing long-term engagement in healthy behaviors (Motivation).

REPPAIR includes separate research projects that focus on the 3 M’s among different groups of Veterans. While each study is separate, the information received from each study is combined into a single data repository that will be a very useful platform for future research serving Veterans. REPPAIR is also designed to serve as a vital platform for advancing the careers of research trainees and creating a data repository accessible for VA researchers to support future RR&D research.

Become a REPPAIR Participant

REPPAIR seeks individuals who are:

1. Currently enrolled in a REAP-REPPAIR qualifying study (see below)
2. 50 years or older, and
3. Have one of these health conditions of interest: COPD, PTSD, slow walking speed

To find out if you are eligible for one of our studies or if you would like further information about our studies, please contact:

Announcements

Congratulations to Haijng Hallenbeck, PhD, who received RR&D’s VA Boston REAP Pilot Research Award!
Dr. Haijing Hallenbeck is a second-year postdoctoral fellow at National Center for PTSD, Dissemination and Training Division, at VA Palo Alto. She received her PhD in clinical psychology at Washington University in St. Louis and completed her predoctoral internship at VA Palo Alto. In graduate school, Dr. Hallenbeck used smartphone technology to better understand depression in everyday life through ecological momentary assessment (EMA). As a postdoctoral fellow, Dr. Hallenbeck is studying comorbid PTSD and depression and its impact on psychosocial functioning. She hopes to leverage technology to better assess and treat symptoms as well as functioning. For example, in her REAP pilot “Active and Passive Monitoring of Symptoms of PTSD and MDD and Psychosocial Functioning,” she is testing an assessment approach that includes EMA as well as passive data collection from smartphones and wearables (i.e., data related to location, social communication, physical activity, and sleep). Dr. Hallenbeck hopes that this approach will ultimately highlight opportunities for early intervention, which could be delivered in-the-moment with the aid of technology. To explore these questions, she has pursued advanced statistical training, including in multilevel modeling, structural equation modeling, and machine learning.

Our Team

Our team represents collaborators from a variety of research centers at VA Boston Healthcare System including the New England Geriatric Research Education and Clinical Center (NEGRECC), the National Center for Posttraumatic Stress Disorder (NCPTSD), Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), Center for Healthcare Organization and Implementation Research (CHOIR), and Neuroimaging Research for Veterans Center (NeRVe).

The Principal Investigators:

Research

All REPPAIR related research studies focus on the 3M’s:

Mind - this includes measures that are part of a comprehensive neuro-cognitive and mood assessments as well as the assessment of neuroimaging.

• Mini-Montreal Cognitive Assessment (MoCA)
  Please refer to the MoCA website at https://mocacognition.com/ for more information on the MoCA
• D-KEFS Verbal Fluency Test
  Homack, S., D. Lee, and C.A. Riccio, Test Review: Delis-Kaplan Executive Function System. Journal of Clinical and Experimental Neuropsychology, 2005. 27(5): p. 599-609.
• Hopkins Verbal Learning Test-Revised
  Benedict, R.H.B., et al., Hopkins Verbal Learning Test – Revised: Normative Data and Analysis of Inter-Form and Test-Retest Reliability. The Clinical Neuropsychologist, 1998. 12(1): p. 43-55.
• Oral Trail Making Test
  Mrazik, Yuspeh, Drane, Klingler, Huthwaite, & Dildine: The Oral Trail Making Test: Demographic Influences & Validation with the Written Trail Making Test. Presented at the 21st Annual Meeting of the National Academy of Neuropsychology, San Francisco, November 2001.
• Wais-IV Digit Span Test
  Blackburn HL, Benton AL. Revised administration and scoring of the digit span test. J Consult Psychol. 1957 Apr;21(2):139-43. doi: 10.1037/h0047235. PMID: 13416432.

Mobility - this includes measures of physical functioning using performance-based, patient-reported, and accelerometry assessments.

• Activity Measure for Post-Acute Care- basic mobility (AMPAC)
  Haley, S. M., Andres, P. L., Coster, W. J., Kosinski, M., Ni, P., & Jette, A. M. (2004). Short-form activity measure for post-acute care. Archives of Physical Medicine and Rehabilitation, 85(4), 649-660. doi: 10.1016/j.apmr.2003.08.098
• Short Physical Performance Battery (SPPB)
  Guralnik JM, Simonsick EM, Ferrucci L, Glynn RJ, Berkman LF, Blazer DG, Scherr PA, Wallace RB. A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission. J Gerontol. 1994 Mar;49(2):M85-94. doi: 10.1093/geronj/49.2.m85. PMID: 8126356.
• Gait Assessment
  Brach JS, Berthold R, Craik R, VanSwearingen JM, Newman AB. Gait variability in community-dwelling older adults. J Am Geriatr Soc. 2001 Dec;49(12):1646-50. doi: 10.1046/j.1532-5415.2001.t01-1-49274.x. PMID: 11843
• Actigraphy

Choi, L et al. Validation of Accelerometer Wear and Nonwear Time Classification Algorithm. Medicine & Science in Sports & Exercise: February 2011 - Volume 43 - Issue 2 - p 357-364 doi: 10.1249/MSS.0b013e3181ed61a3

Mood & Motivation - this includes a comprehensive assessment of behavioral health factors linked to engagement with physical activity, rehabilitation, and social activities.

• Trans-theoretical Model (TTM) (4 Measures)
  1. TTM: Exercise Stage of Change
  2. TTM: Confidence
  3. TTM: Decisional Balance
  4. TTM: Process of Change
  Nigg, C. R., & Riebe, D. (2002). The Transtheoretical Model: Research review of exercise behavior and older adults, (pp. 147-180). In P. Burbank & D. Riebe (Eds.), Promoting exercise and behavior change in older adults: interventions with the Transtheoretical Model. New York, NY: Springer Publishing Company.
• Patient Health Questionnaire (PHQ)-2
  Kroenke K, Spitzer RL, Williams JB. The Patient Health Questionnaire-2: Validity of a Two-Item Depression Screener. Medical Care. 2003;41:1284-92.
• Generalized Anxiety Disorder (GAD)-7 item scale
  Spitzer RL, Kroenke K, Williams JB, Löwe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006;166:1092-7.
• Duke Social Support Index- 11 item scale
  Koenig et al. (1993). Abbreviating the Duke Social Support Index for use in chronically ill older adults. Psychosomatics, 34, 61-69. PMID: 8426892
• Primary Care Post Traumatic Stress Disorder- DSM 5
  Prins, A., Bovin, M. J., Kimerling, R., Kaloupek, D. G., Marx, B. P., Pless Kaiser, A., & Schnurr, P. P. (2015). The Primary Care PTSD Screen for DSM-5 (PC-PTSD-5). [Measurement instrument].

The REPPAIR data repository includes data from the following studies...

Resources

Pilot Proposals / Trainees

Please return soon for information specific to FY24 awards!

Description:

The Rehabilitation Promoting Prevention and Improved Resilience (REPPAIR) REAP promotes multidisciplinary research aimed at understanding the complex relationships between Mobility, the Mind (cognition/mood), and Motivation (long-term engagement) in Veterans. REPPAIR focuses on innovations in the development of personalized rehabilitative care treatments that optimize the functional status of Veterans. It emphasizes rehabilitation as preventative care.

The award will support novel investigation that advances the REPPAIR theme: “The 3 M’s Mobility, Mind, and Motivation” among older adults with or without chronic disease. The award is intended to support collection of preliminary data to prepare for future submission of a successful VA RR&D Career Development Award.

The award provides a maximum of $30,000. The scope of the project should generally allow for completion within a one-year time frame.

Funding decisions will be based on the proposal’s significance, innovation, relevance to the REPPAIR mission, and potential for future VA RR&D CDA funding.

Eligibility:

All faculty, postdoctoral fellows, students, and research staff in the VA community who anticipate submission of a VA RR&D Career Development Award are invited to apply.

Application Instructions:

Applicants should submit (1) abstract of up to 350 words, (2) a 3-page proposal (Arial 11 font, 0.5" margins, single spaced) that includes: title, specific aim, research plan, innovation, relevance to REPPAIR theme, IRB status/plan if applicable, and potential for future VA RR&D CDA funding, (3) biosketch on the VA template, (4) mentor letter of support, and (5) 1-year budget and budget justification.

How to Submit the Application:

Please email your application as a single PDF to Emma Fitzelle-Jones at

emma.fitzelle-jones@va.gov

Key Dates:

Application due date: Information coming soon
Notification on or before: Information coming soon
Earliest funding start date: Information coming soon

Questions:
Please address all questions to Marilyn Moy, MD, MSc, associate director of the REPPAIR REAP, at marilyn.moy@va.gov.