{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T05:25:29Z","timestamp":1774243529065,"version":"3.50.1"},"reference-count":22,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,1,3]],"date-time":"2025-01-03T00:00:00Z","timestamp":1735862400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,1,3]],"date-time":"2025-01-03T00:00:00Z","timestamp":1735862400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"VA Virtual Care QUERI","award":["1l50HX003202"],"award-info":[{"award-number":["1l50HX003202"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Health Serv Res"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>2022 survey data showed 29% of Veterans utilized Veterans Affairs (VA) paid health care at a non-VA facility, 6% higher than in 2021. Despite an increase in the number of Veterans accessing care in the community via the MISSION Act Community Care Program (CCP), there is limited information on the quality of mental health care delivered to Veterans in these settings. Further, Veterans report barriers to quality care, including poor communication between CCP and VA providers, which can result in negative patient outcomes. We aimed to evaluate the feasibility and acceptability of using electronic screening, eScreening, as part of a process involving remote symptom screening, symptom monitoring, and clinically driven communication from VA to CCP providers, for Veterans accessing mental health treatment in CCP settings.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Veterans (<jats:italic>n<\/jats:italic>\u2009=\u2009150) diagnosed with major depressive disorder, an anxiety disorder, post-traumatic stress disorder, and\/or an adjustment disorder referred to mental health care in CCP between August-November 2021 were eligible to participate. Veterans received an eScreening link to complete an initial web-based assessment and three follow-up assessments spaced 4\u20136\u00a0weeks apart over the course of their treatment. Quantitative assessment data was largely characterized using descriptive statistics and included patient-reported outcome (PRO) measures (PTSD and depression), health-related quality of life\/functioning, community care information (e.g., number of sessions attended), and satisfaction with the eScreening technology. Qualitative interview data was also collected from participating Veterans and CCP providers to better understand experiences with eScreening.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Findings support the feasibility and acceptability of using eScreening to administer and monitor PROs for Veterans accessing mental health treatment in CCP. Of the Veterans who provided eScreening satisfaction ratings (Ns\u2009=\u200945\u201355), 89% had no technical difficulties; 78% felt comfortable entering personal information; and 83% were neutral or positive about ease of use. Focus group interviews revealed strong support from Veterans, who stated the software was easy to use; they felt comfortable completing PRO measures; and they appreciated having their symptoms monitored. Similarly, providers indicated eScreening had a positive impact on communication, collaboration of care, and transparency.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Technologies like eScreening represent a promising tool to support the mental health care Veterans receive when they access CCP.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12913-024-12029-1","type":"journal-article","created":{"date-parts":[[2025,1,3]],"date-time":"2025-01-03T04:18:12Z","timestamp":1735877892000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Mixed method study of feasibility and acceptability of electronic screening for measurement-based symptom monitoring of veterans accessing mental health treatment in VA community care program settings"],"prefix":"10.1186","volume":"25","author":[{"given":"Erin","family":"Almklov","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael W.","family":"Lee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John D.","family":"Gault","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brian H.","family":"Blanco","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brian","family":"Huynh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abigail","family":"Angkaw","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neal","family":"Doran","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Niloofar","family":"Afari","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James O. E.","family":"Pittman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,1,3]]},"reference":[{"key":"12029_CR1","unstructured":"Statement of Miguel Lapuz, M.D. Acting Deputy Under Secretary for Health Veterans Health Administration (Vha) Department of Veterans Affairs (Va) Before The House Committee On Veterans\u2019 Affairs Subcommittee On Health. 2022. Available from: https:\/\/docs.house.gov\/meetings\/VR\/VR03\/20220714\/114988\/HHRG-117-VR03-Wstate-LaPuzM-20220714-U1.pdf."},{"key":"12029_CR2","unstructured":"\u200cCongressional Budget Office. The Veterans Community Care Program: Background and Early Effects. October 2021. Washington, D.C. Available from https:\/\/www.cbo.gov\/publication\/57583."},{"issue":"7\/8","key":"12029_CR3","doi-asserted-by":"publisher","first-page":"e301","DOI":"10.1093\/milmed\/usy429","volume":"184","author":"JM Pyne","year":"2019","unstructured":"Pyne JM, Kelly PA, Fischer EP, Miller CJ, Wright P, Zamora K, et al. Development of a Perceived Access Inventory for Community Care Mental Healthcare Services for Veterans. Military Medicine. 2019;184(7\/8):e301-8. Available from: https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC7521611\/.","journal-title":"Military Medicine."},{"issue":"7","key":"12029_CR4","doi-asserted-by":"publisher","first-page":"557","DOI":"10.1097\/MLR.0000000000000933","volume":"56","author":"KM Mattocks","year":"2018","unstructured":"Mattocks KM, Yano EM, Brown A, Casares J, Bastian L. Examining women veteran\u2019s experiences, perceptions, and challenges with the veterans choice Program. Med Care. 2018;56(7):557\u201360.","journal-title":"Med Care"},{"issue":"S1","key":"12029_CR5","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1007\/s11606-019-04997-6","volume":"34","author":"CL Greenstone","year":"2019","unstructured":"Greenstone CL, Peppiatt J, Cunningham K, Hosenfeld C, Lucatorto M, Rubin M, et al. Standardizing care coordination within the department of veterans Affairs. J Gen Intern Med. 2019;34(S1):4\u20136.","journal-title":"J Gen Intern Med"},{"issue":"5","key":"12029_CR6","doi-asserted-by":"publisher","first-page":"1567","DOI":"10.1007\/s11606-019-05404-w","volume":"35","author":"JT Kullgren","year":"2020","unstructured":"Kullgren JT, Fagerlin A, Kerr EA. Completing the MISSION: a blueprint for helping veterans make the most of new choices. J Gen Intern Med. 2020;35(5):1567\u201370.","journal-title":"J Gen Intern Med"},{"issue":"5","key":"12029_CR7","doi-asserted-by":"publisher","first-page":"945","DOI":"10.1542\/peds.2009-1964","volume":"125","author":"W Gardner","year":"2010","unstructured":"Gardner W, Klima J, Chisolm D, Feehan H, Bridge J, Campo J, Cunningham N, Kelleher K. Screening, triage, and referral of patients who report suicidal thought during a primary care visit. Pediatrics. 2010;125(5):945\u201352.","journal-title":"Pediatrics"},{"issue":"8","key":"12029_CR8","doi-asserted-by":"publisher","first-page":"1165","DOI":"10.1086\/651420","volume":"50","author":"T Lawrence Sarah","year":"2010","unstructured":"Lawrence Sarah T, Willig James H, Crane Heidi M, Ye J, Aban I, Lober W, et al. Routine, self-administered, touch-screen, computer-based suicidal ideation assessment linked to automated response team notification in an HIV primary care setting. 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Mil Medi. 2020;185:519\u201329.","journal-title":"Mil Medi"},{"issue":"3","key":"12029_CR11","doi-asserted-by":"publisher","first-page":"255","DOI":"10.1001\/jama.2016.18764","volume":"317","author":"SM Elnahal","year":"2017","unstructured":"Elnahal SM, Clancy CM, Shulkin DJ. A framework for disseminating clinical best practices in the VA health system. JAMA. 2017;317(3):255.","journal-title":"JAMA."},{"issue":"6","key":"12029_CR12","doi-asserted-by":"publisher","first-page":"874","DOI":"10.1093\/intqhc\/mzx108","volume":"29","author":"J \u00d8vretveit","year":"2017","unstructured":"\u00d8vretveit J, Zubkoff L, Nelson EC, Frampton S, Knudsen JL, Zimlichman E. Using patient-reported outcome measurement to improve patient care. 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Available from: https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC5047000\/.","journal-title":"P.T"}],"container-title":["BMC Health Services Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12913-024-12029-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12913-024-12029-1\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12913-024-12029-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,3]],"date-time":"2025-01-03T07:12:42Z","timestamp":1735888362000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmchealthservres.biomedcentral.com\/articles\/10.1186\/s12913-024-12029-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,3]]},"references-count":22,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["12029"],"URL":"https:\/\/doi.org\/10.1186\/s12913-024-12029-1","relation":{},"ISSN":["1472-6963"],"issn-type":[{"value":"1472-6963","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,3]]},"assertion":[{"value":"9 July 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 November 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 January 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The VA San Diego Institutional Review Board (IRB) waived the ethics approval and informed consent as this project was considered quality improvement in nature and determined by the IRB not to constitute research (reference ID: HRD210087).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not Applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"10"}}