{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T02:14:06Z","timestamp":1769912046752,"version":"3.49.0"},"reference-count":27,"publisher":"Oxford University Press (OUP)","issue":"9-10","license":[{"start":{"date-parts":[[2024,5,9]],"date-time":"2024-05-09T00:00:00Z","timestamp":1715212800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"Veteran Affair\u2019s Airborne Hazards and Open Burn Pit Center of Excellence"},{"name":"Veteran Affair\u2019s Airborne Hazards and Open Burn Pit Center of Excellence"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,8,30]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>The Veterans Health Administration (VHA) established the Airborne Hazards and Open Burn Pit Registry (AHOBPR) in 2014 to address exposure concerns for veterans who have served in military operations in Southwest Asia and Afghanistan. By 2021, over 236,086 veterans completed the online questionnaire and 60% requested an AHOBPR examination. Of those requesting an exam, only 12% had an exam recorded in their medical record. This article summarizes barriers and facilitators to delivering AHOBPR exams and shares lessons learned from facilities who have successfully implemented burn pit exams for veterans.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Materials and Methods<\/jats:title>\n                  <jats:p>We (I.C.C and J.H.) constructed a key performance measure of AHOBPR examination (the ratio of examinations performed in facility over examinations assigned to a facility) to identify top performing facilities and then used stratified purposeful sampling among high-performing sites to recruit a diverse set of facilities for participation. We (P.V.C. and A.A.) recruited and interviewed key personnel at these facilities about their process of administering burn pit exams. Rapid qualitative methods were used to analyze interviews.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The ratio of exams performed to exams assigned ranged from 0.00 to 14.50 for the 129 facilities with available information. Twelve interviews were conducted with a total of 19 participants from 10 different facilities. We identified 3 barriers: Unclear responsibility, limited incentives and competing duties for personnel involved, and constrained resources. Facilitators included the presence of an internal facilitator, additional staff support, and coordination across a facility\u2019s departments to provide care.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Gaps across many VHA facilities to provide AHOBPR exams may be understood as stemming from organizational issues related to clear delegation of responsibility and staffing issues. VHA facilities that wish to increase AHOBPR exams for veterans may need additional administrative and medical staff.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/milmed\/usae175","type":"journal-article","created":{"date-parts":[[2024,5,9]],"date-time":"2024-05-09T06:29:04Z","timestamp":1715236144000},"page":"e2153-e2162","source":"Crossref","is-referenced-by-count":2,"title":["Barriers and Facilitators to Administering Burn Pit Registry Exams in VHA Facilities"],"prefix":"10.1093","volume":"189","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8030-8141","authenticated-orcid":false,"given":"Patricia V","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Medicine, Baylor College of Medicine , Houston, TX 77030, USA"},{"name":"Center for Innovations in Quality, Effectiveness and Safety (IQuESt), Michael E Debakey VA Medical Center , Houston, TX 77030, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Israel C","family":"Christie","sequence":"additional","affiliation":[{"name":"Department of Medicine, Baylor College of Medicine , Houston, TX 77030, USA"},{"name":"Center for Innovations in Quality, Effectiveness and Safety (IQuESt), Michael E Debakey VA Medical Center , Houston, TX 77030, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kyler M","family":"Godwin","sequence":"additional","affiliation":[{"name":"Department of Medicine, Baylor College of Medicine , Houston, TX 77030, USA"},{"name":"Center for Innovations in Quality, Effectiveness and Safety (IQuESt), Michael E Debakey VA Medical Center , Houston, TX 77030, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jaehwan","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Medicine, Baylor College of Medicine , Houston, TX 77030, USA"},{"name":"Center for Innovations in Quality, Effectiveness and Safety (IQuESt), Michael E Debakey VA Medical Center , Houston, TX 77030, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nisha","family":"Jani","sequence":"additional","affiliation":[{"name":"War Related Illness and Injury Study Center (WRIISC), VA New Jersey Healthcare System , East Orange, NJ 07018, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anays","family":"Sotolongo","sequence":"additional","affiliation":[{"name":"War Related Illness and Injury Study Center (WRIISC), VA New Jersey Healthcare System , East Orange, NJ 07018, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Asma","family":"Ali","sequence":"additional","affiliation":[{"name":"Center for Innovations in Quality, Effectiveness and Safety (IQuESt), Michael E Debakey VA Medical Center , Houston, TX 77030, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Drew A","family":"Helmer","sequence":"additional","affiliation":[{"name":"Center for Innovations in Quality, Effectiveness and Safety (IQuESt), Michael E Debakey VA Medical Center , Houston, TX 77030, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2024,5,9]]},"reference":[{"issue":"8","key":"2024083012554280500_R1","doi-asserted-by":"publisher","first-page":"e1","DOI":"10.1513\/AnnalsATS.201904-344WS","article-title":"Respiratory health after military service in Southwest Asia and Afghanistan. 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