ABOUT OUR WORK
This research is executed through a unique, adaptive, and collaborative, international clinical research network. This network directly affects force readiness by advancing clinical practice and informing health policy for military personnel. In collaboration with partners from the Department of Defense (DoD), academia, government, and industry, these investigations support a broad clinical research portfolio within the Military Health System. From observational, longitudinal cohort studies to field-based interventional trials to evaluation of long term health outcomes, we conduct protocols that address critical knowledge gaps in the control and prevention of infectious disease in the military. Study outcomes have far-reaching implications for public health and disease prevention beyond military communities.
The Infectious Disease Clinical Research Program (IDCRP) was founded in 2005 under an interagency agreement between USU and the National Institute of Allergy and Infectious Diseases (NIAID). The program’s work is executed through a unique, adaptive, and collaborative, international clinical research network. This network directly affects force readiness by advancing clinical practice and informing health policy for military personnel.
In collaboration with partners from the Department of Defense (DoD), academia, government, and industry, IDCRP supports a broad clinical research portfolio within the Military Health System. From observational, longitudinal cohort studies to field-based interventional trials to evaluation of long-term health outcomes, IDCRP conducts protocols that address critical knowledge gaps in the control and prevention of infectious disease in the military. Study outcomes have far-reaching implications for public health and disease prevention beyond military communities. More information about IDCRP can be found here.
The CHSR is a requirements-driven initiative developed in direct response to the 2014 Military Health System (MHS) Review to address healthcare service utilization rates, provider practice, patterns of care, financing structures and readiness for the MHS. As an approximately $53 billion per year health system, health services research capacity is an essential contribution to informing and reforming the overall MHS. Our goal is to ensure evidence-informed policy and decision-making for the MHS. We aim to accomplish this goal through the three components: Research, Education and Training, and Support Services.
- Education and Training : Providing training opportunities for those who support military Health Services Research (HSR), educating students and faculty in HSR methods, and supporting researcher access to grants and awards.
- Research: Conducting research that measurably supports the MHS strategic goals and objectives and contributes to learning and policy across the MHS; expanding USU's HSR capacity, and becoming recognized as the though leader for military HSR across MHS, DoD, and the Nation.
- Direct Support Services: Responding to requirements and ad hoc queries generated from organizations and units within DoD and the MHS, particularly emerging HA/DHA priorities, and establishing enduring relationships with MHS CHSR customers.
WARRIOR STRONG PROGRAM
The Warrior Strong Study. PMB investigators Karen Schwab, PhD; Ann Scher, PhD
Deployment Related Mild Traumatic Brain Injury (mTBI): Incidence, Natural History, and Predictors of Recovery in Soldiers Returning From OIF/OEF (AKA Warrior Strong Study).
Traumatic brain injury (TBI) is a significant health issue which affects service members and veterans during times of both peace and war. The high rate of TBI and blast-related concussion events resulting from current combat operations directly impacts the health and safety of individual service members and subsequently the level of unit readiness and troop retention. The impacts of TBI are felt within each branch of the service and throughout both the Department of Defense (DoD) and the Department of Veterans Affairs (VA) health care systems. TBI has been called the signature wound of war and is a critical area of study.
The Warrior Strong Study will provide evidence on the long term outcomes of mTBI in Service members returning from Afghanistan and Iraq. In addition, the study will provide evidence on mTBI incidence, and symptom patterns. Self-reported assessments at baseline and follow-ups will be combined with data on health care utilization and military job performance. The work, symptoms, and family interaction outcomes of returning soldiers screening positive for mTBI, combined mTBI and PTSD, and soldier controls will be compared at 3 months, 6 months, and at one year.
While this longitudinal study is in its early stages and promises to provide much needed information on impact of mTBI, early results have defined the trajectory of mTBI impact 12-months following return from deployment, as well as elucidating important interactions between mTBI and PTSD to aid in classification and diagnosis.
For more information, please see:
A Clinical Evidence-Based Approach to Examine the Effects of mTBI and PTSD Symptoms on ANAM Performance in Recently Deployed Active Duty Soldiers: Results From the Warrior Strong Study. Title in the Journal of Head Trauma Rehabilitation
COMPARATIVE EFFECTIVENESS AND PROVIDER INDUCED DEMAND COLLABORATION (EPIC)
The EPIC project is a multidisciplinary and joint collaboration between USU and the Brigham and Women’s Hospital (BWH). The project seeks to establish a health services research (HSR) cell at USU, focused on health services research, health policy analysis, and health economics issues; expand and strengthen USU collaboration with Walter Reed National Medical Center, as well as other military treatment facilities by extending HSR support to clinicians; and building an expansive scope of research projects performed by the collaboration.
An overarching goal of EPIC is to understand variations and drivers in healthcare utilization within the MHS and beyond, and identify areas for value optimization and better health outcomes.
The six main areas of research and evaluation include: Epidemiology, Comparative Effectiveness, Quality & Practice Improvement, Disparities, and Health Economics & Geographic Variation, and other areas of interest to DoD decision makers and MHS Senior Leadership including Wounded Warrior Care. The analyses capitalize on the unique provider compensation system of the MHS, in which patients are cared for both by military providers in a salaried system (direct care) and by civilian providers in a fee-for-service system (purchased care). In addition to performing comparative effectiveness research on health conditions where clinical equipoise exists between treatments of differing resource intensity, the analyses will characterize the variation of utilization between the direct and purchased care.
The study population includes all those eligible for care from the military health system including active duty military personnel, their families, retirees, and surviving family members as well as other beneficiaries across both the direct and purchased care systems. The study employs a variety of health service research analytical approaches appropriate for health services research.
THE MILLENNIUM COHORT STUDY
In response to concerns about the health effects of deployments following the 1991 Gulf War, the Congress and the Institute of Medicine recommended that DoD conduct prospective epidemiological research to evaluate the impact of military exposures, including deployment, on long-term health outcomes. The Millennium Cohort Study, the largest prospective health study in the military with more than 200,000 participants, meets this critical need. Although the original designers of the Millennium Cohort Study could not foresee the post-2001 military conflicts, the project is perfectly positioned to address health outcomes related to these operations. As force health protection continues to be a priority for the future of the United States military, the Millennium Cohort Study will be providing critical information towards enhancing the long-term health of future generations of military members.
Two of the founders and longstanding co-investigators of the Millennium Cohort Study are professors in the USU Department of Preventive Medicine and Biostatistics. Since the beginning of the study, Dr. Tomoko (Tonie) Hooper has been a staunch advocate for the long-term utility of the Millennium Cohort. Study for training a new generation of DoD public health professionals in epidemiologic research by establishing an analytic cell at USU to facilitate student-run projects examining and analyzing study data. Dr. Hooper actively engages DoD stakeholders such as the Murtha Cancer Center and the Joint Pathology Center to identify opportunities for collaboration and linkage of cancer registries and other critical databases with Millennium Cohort data. Dr. Gackstetter was instrumental in bringing the lessons learned from DoD’s response to Gulf War Illness to the foundational discussions of the Millennium Cohort Study, including the study design, survey content, and the development of survey questions on deployment, injury, and motor vehicle crashes. Together, Drs. Hooper and Gackstetter have been indispensable contributors to the Millennium Cohort Study, with active collaboration on approximately 50 research projects and co-authorship on over 30 publications (and counting) focused on mortality, environmental exposures, suicide, psychological health, chronic medical conditions, and health behaviors.