Search

BACKGROUND:: Suicidal self-directed violence among Veterans experiencing homelessness remains a significant public health concern. To prevent suicide in this population, concerted clinical and research efforts remain necessary. OBJECTIVE:: This paper serves as a consensus statement by the recently-formed Department of Veterans Affairs (VA) Suicide Prevention among Veterans Experiencing Homelessness Workgroup. We provide a brief overview of current initiatives to prevent suicide among Veterans experiencing homelessness. We also discuss methods of studying this complex subset of the Veteran population, as well as future research endeavors necessary to inform gaps in understanding. CONCLUSIONS:: Veterans experiencing homelessness are a complex subset of the Veteran population whose risk for suicide may be exacerbated by a number of factors (e.g., multimorbidity, rurality). While the VA has implemented a number of initiatives to prevent suicide among Veterans experiencing homelessness (e.g., universal screening for suicidal ideation and recent suicide attempts, Suicide Prevention Gatekeeper Training), there is a continued need to understand how best to tailor these initiatives to Veterans experiencing homelessness. Moreover, because Veterans experiencing homelessness often access a number of services within the community (e.g., community-based clinics, homeless shelters), collaboration between the VA and community is necessary.

US Military Veterans experience higher rates of food insecurity compared to civilians, but the impact of the COVID-19 pandemic on Veterans is unclear. We conducted a nationwide survey of injured post-9/11 Veterans' food security, Coronavirus exposure, and nutrition habits. Of 193 Veterans, 63 (32.6%) were food insecure. Food insecurity was associated with Hispanic ethnicity (p = 0.02), prior homelessness (p = 0.003), combat service (p < 0.0001), and food-related worries (p = 0.003). Food insecure Veterans were more likely to report anxiety about stigma related to COVID-19 infection (p = 0.007). Nutrition assistance initiatives should attend to emergent psychosocial factors, beyond well-established economic factors, that increase risk for food insecurity. [ABSTRACT FROM AUTHOR]

To use the International Classification of Functioning, Disability and Health (ICF) to operationalize "nutritional functioning" in military veterans with mild brain injury, by 1) evaluating physical and psychosocial functioning in relation to nutrition, and 2) assessing how veterans' experiences shape their use of food. A convergent mixed methods study comprised of semi-structured interviews and quantitative surveys. Interview guides were developed using the ICF as a framework. Outpatient polytrauma rehabilitation centers at 3 VA medical centers: Palo Alto, California, San Antonio, Texas, and Tampa, Florida. Veterans who served after 9/11, met diagnostic criteria for polytrauma (mild brain injury and 1+ comorbidity), and had received care at 1 of the 3 rehabilitation centers were eligible. 37 veterans completed all surveys and participated in an interview. None. Themes from survey responses and semi-structured interview data were pooled into core constructs, and influencing factors. Nutritional functioning is characterized by 5 core constructs, including food background, nutrition knowledge, meal aptitude, resource navigation, and navigation to/of food spaces. Nutritional functioning is also shaped by 5 influencing factors, including injuries and health conditions, ideological and cultural exposures, relationships, current beliefs, and current behaviors. We were able to identify previously unexplored factors that shape how this population conceives of nutrition in their daily lives. In addition to daily struggles arising from their injuries, Veterans strongly identify with military cultural expectations. These expectations not only influence how injured Veterans view nutrition and health, but also shape their perceptions of their injuries and their core identities. As a result, nutritional functioning comprises far more than economic concerns or adequate food access. The results of this study are being used to create a measure of nutritional functioning that can be used to develop integrative nutrition interventions aimed at improving injured veterans' psychosocial functioning. This presentation is based on work supported, in part, by the Department of Veterans Affairs, but does not necessarily represent the views of the Department of Veterans Affairs or the US Government. [ABSTRACT FROM AUTHOR]

Background and Objectives Nutrition education programs implemented in congregate dining service (CDS) settings have the potential to improve healthy eating behaviors among older adult populations. However, little is understood about the types of nutrition education programs that are implemented at CDS sites and the factors that impede or promote implementation efforts. The purpose of this scoping review was to examine the characteristics of CDS nutrition education programs, barriers and supports to program implementation, and opportunities to enhance implementation of programming. Research Design and Methods We adopted a scoping review methodology to assess the relevant literature published between January 2000 and 2020 by accessing CINAHL, SocINDEX, MEDLINE, AgeLine, and Academic Search Complete. Results We identified 18 studies that met our inclusion criteria. The majority of nutrition education programs were led by trained facilitators, included the use of interactive activities, and also incorporated written or video materials. Programs that were adapted to the needs of older participants were perceived as supports to implementation whereas participants' needs and resources (e.g. lack of resources and lower health literacy) were occasionally found to limit the effective implementation of programming. Discussion and Implications As the older adult population continues to access CDS sites to address their health and nutritional needs, purposeful efforts are needed to examine the specific approaches that can support nutrition education program implementation. Future opportunities lie in assessing strategies that are effective for mitigating barriers to implementing nutrition education programming in the CDS setting. [ABSTRACT FROM AUTHOR]

Nutritional and body weight recommendations for cardiovascular diseases are well established, yet there are no equivalent guidelines for peripheral arterial disease (PAD). This cross-sectional study measured the prevalence of cardiovascular-related nutritional and body composition risk factors in sixty PAD patients and their association with PAD severity. A diet that exceeds daily recommended intake of fat and that falls short of recommended intakes of fiber, folate, and vitamin D was associated with increased leg pain and walking difficulty. Increased body fat and waist circumference were associated with diminished walking ability and poorer psychosocial quality of life. Future prospective investigations are merited to inform both PAD clinical care and disease management guidelines. [ABSTRACT FROM AUTHOR]

Peripheral arterial disease (PAD) is a group of syndromes characterized by chronic and progressive atherosclerosis with a high burden of physical disability and cardiovascular morbidity and mortality. Recruiting patients for clinical research is therefore challenging. In this article, we describe and evaluate our methods for recruiting participants for a cross-sectional feasibility study of PAD, nutritional status, and body composition. We used convenience and purposive sampling approaches to identify potential participants. Between May 2012 and April 2013, 1,446 patients were identified, and 165 patients (11.4%) responded to recruitment requests. The final enrollment was 64 participants (64/1,446; 4.4%), and four subjects (6.3%) subsequently withdrew from the study. Recruiting PAD patients presents a variety of challenges, due largely to the burdens of living with coexistent illnesses, and patients' reluctance or inability to travel for research. In this article, we delineate suggestions for improving the efficacy of recruitment methods in future PAD studies. [ABSTRACT FROM AUTHOR]