Charlie Jia

Center of Innovation on Disability & Rehabilitation Research · U.S. Department of Veterans Affairs

Kidney health advocacy organizations and leaders in the nephrology community have repeatedly emphasized the need to increase home dialysis utilization in the United States. Limited awareness and understanding of options for the management of kidney failure among patients living with advanced CKD is a significant barrier to increasing the selection...

Background The Veterans Health Administration (VHA) is one of the largest providers of telehealth in the United States and continues to lead the way in transforming healthcare services. VHA has been implementing its Whole Health (WH) initiative since 2018, a proactive practice empowering patients to take charge of their health and well-being. A key...

Objective: To understand the sociodemographic, geographical, and clinical characteristics of rural veterans utilizing home modification (HM) healthcare services under the Home Improvement Structural Alterations (HISA) program, to compare these characteristics between rural and urban veteran users, to estimate the costs of HMs performed, and to pre...

The purpose of this qualitative study was to explore perspectives of Whole Health (WH) coaches at the Veterans Health Administration (VHA) on meeting the needs of rural Veterans during the COVID-19 pandemic. The evaluation design employed a qualitative description approach, employing focus groups and in-depth interviews with a convenience sample of...

It has been widely demonstrated that patient education and empowerment, especially involving shared treatment decisions, improve patient outcomes in chronic medical conditions, including chronic kidney disease requiring kidney replacement therapies. Accordingly, regulatory agencies in the US and worldwide recommend shared decision-making for finali...

Purpose: To evaluate the long-term effect of vibration therapy with holistic and local intervention in treating muscle fatigue in elite athletes during their intensive training season. Methods: Study participants included five male athletes from a provincial Greco-Roman wrestling team who were qualified for the finals of China's national games....

Background Informed dialysis selection and greater home dialysis use are the two long-desired, underachieved targets of advanced chronic kidney disease (CKD) care in the US healthcare system. Observational institutional studies have shown that comprehensive pre-kidney failure, conventionally referred to as end stage kidney disease education (CPE) c...

This study comprises a systematic national examination of how Centers for Independent Living can and do support Veteran consumers, especially those living in rural communities. This research provides contextualized understanding of rural Veteran needs for community-based services and resources available through Centers for Independent Living. A sur...

Background Informed dialysis selection and greater home dialysis use are the two long-desired, underachieved targets of advanced chronic kidney disease care in the US healthcare system. Observational institutional studies have shown that comprehensive pre-end stage kidney disease (ESKD) disease education (CPE) can improve both these outcomes. Howev...

Inaccessible home environments that create barriers to the enjoyment and the approachability of the living space impact some U.S. Veterans. Injuries acquired while serving in the military or developed through the aging process complicate matters for Veterans with disabilities. Home modifications (HM) afforded by the Home Improvements and Structural...

Introduction: Vibration therapy has been widely used and published in alleviating muscle fatigue. However, reports on applying vibration therapy based on the holisitic theory of traditional Chinese medicine (TCM) remains limited. This study is to evaluate the immediate effect of vibration therapy on exercise-induced muscle fatigue. Methods: For...

Background Kidney Disease Education (KDE) has been shown to improve informed dialysis selection and home dialysis use, two long-held but underachieved goals of US nephrology community. In 2010, the Center for Medicare and Medicaid Services launched a policy of KDE reimbursements for all Medicare beneficiaries with advanced chronic kidney disease. H...

Purpose: Telerehabilitation (TR) is increasingly being used to meet the rehabilitation needs of individuals living in rural areas. Nevertheless, reports on TR implementation for rural patients remain limited. As part of a broader evaluation, this study investigated barriers and facilitators to the implementation of a national TR program to meet th...

Inaccessible living environments are problematic for some US Veterans, due to injuries sustained in service or attributed to aging, but can be addressed through home modification (HM) afforded by the Home Improvements and Structural Alterations (HISA) program. The retrospective national assessment of HISA, considering a 50% expected increase in Vet...

Background: Suicide is the 10th leading cause of death in the US, primarily from drug overdose. In 2017, 67.8% of drug overdoses were with prescription opioids. The rate of opioid use disorder among patients in the Veterans Health Administration (VHA) is 7 times higher than that of non-VHA enrollees. This study compares the incidence of overdose an...

Inaccessible home environments can negatively affect the health-related quality of life of individuals with disabilities, increase the number of home accidents, diminish activities of daily living, and increase avoidable institutionalization. Appropriate home modification (HM) can change the home environment by making it more accessible. Accessible...

Introduction: Effective post-acute multidisciplinary rehabilitation therapy improves stroke survivors' functional recovery and daily living activities. The US Department of Veterans Affairs (VA) places veterans needing post-acute institutional care in private community nursing homes (CNHs). These placements are made under the same rules and regula...

The number of US veterans with disabilities has increased in recent years as service members have returned home with extensive injuries and veterans from previous wars acquire functional limitations as a consequence of aging with chronic diseases. Veterans with severe disabilities need assistance and support to maintain independence at home and to...

Veterans Affairs (VA) community living centers (CLCs) and VA-contracted community nursing homes (CNHs) are two major sources of institutional post-acute care for Veterans with stroke. However, our understanding about these Veterans’ functional performances in these two types of facilities is limited. In this study, we evaluate and compare Activitie...

Effective rehabilitation care improves stroke survivors’ functional recovery. In addition to its 133 Community Living Centers, the Department of Veterans Affairs (VA) also places Veteran enrollees needing post-acute institutional care in Community Nursing Homes (CNHs) under a per diem contractual program. These CNHs provide post-acute care for many...

Effective post-stroke rehabilitation care can speed patient recovery and minimize patient functional disabilities. Veterans Affairs (VA) community living centers (CLCs) and VA-contracted community nursing homes (CNHs) are two major sources of institutional long-term care for Veterans with stroke receiving care under VA auspices. This study compares...

Background: Effective poststroke rehabilitation care can speed patient recovery and minimize patient functional disabilities. Veterans affairs (VA) community living centers (CLCs) and VA-contracted community nursing homes (CNHs) are the 2 major sources of institutional long-term care for Veterans with stroke receiving care under VA auspices. Obje...

This study examined functional outcomes, health-related quality of life (HRQoL), and satisfaction in a group of Veterans who received physical therapy via an in-home video telerehabilitation program, the Rural Veterans TeleRehabilitation Initiative (RVTRI). A retrospective, pre–post study design was used. Measures obtained from 26 Veterans who rece...

Hypogonadism is prevalent in older men and testosterone replacement therapy (TRT) for older hypogonadal men is a promising therapy. However, a number of important clinical concerns over TRT safety remain unsolved due to a lack of large-scale randomized clinical trials directly comparing the health risks of untreated hypogonadism vs long-term use of...

PurposeDifferences in stroke care quality for patients in rural and urban locations have been suggested, but whether differences exist across Veteran Administration Medical Centers (VAMCs) is unknown. This study examines whether rural-urban disparities exist in inpatient quality among veterans with acute ischemic stroke. Methods In this retrospecti...

Potential cardiovascular (CV) risks of testosterone replacement therapy (TRT) are currently a topic of intense interest. However, no studies have addressed CV risk as a function of the route of administration of TRT. Two meta-analyses were conducted, one of CV adverse events (AEs) in 35 randomized controlled trials (RCTs) of TRT lasting 12 weeks or...

The Department of Veterans Affairs (VA) manages the largest healthcare system under a single management structure in the United States. Providing access to high quality healthcare to the VA's nearly 9 million enrollees is a mission priority for the Veterans Health Administration (VHA), the arm of the VA that oversees all medical facilities and oper...

This study examined whether age disparities existed across postdischarge quality indicators (QIs) for veterans with ischemic stroke who received care at Department of Veterans Affairs medical centers (VAMCs). This retrospective cohort included a national sample of 3,196 veterans who were diagnosed with ischemic stroke and received acute and postdis...

Background: Stroke mortality has been found to be much higher among residents in the stroke belt region than in the rest of United States, but it is not known whether differences exist in the quality of stroke care provided in Department of Veterans Affairs medical centers in states inside and outside this region. Objective: We compared mortalit...

To assess the association between Veterans affairs (VA) stroke patients' poststroke rehabilitation utilization and their residential settings by using 2 common rural-urban taxonomies. This retrospective study included all VA stroke inpatients in 2001 and 2002. Rehabilitation utilization referred to rehabilitation therapy received 12-months poststro...

Background This is the first study of age disparities in ischemic stroke care quality and post-stroke outcomes across the Department of Veterans Affairs (VA) system. Methods This was a retrospective study of a national sample of US veterans admitted to VA medical centers for ischemic stroke between 10/1/06 and 9/30/07. The following 14 inpatient st...

Studies generally do not examine patients' prestroke depression diagnoses and treatments. To examine the association of depression diagnosis and prestroke and/or poststroke selective serotonin reuptake inhibitor (SSRI) treatment with poststroke mortality. We conducted a retrospective study of the medical records of a cohort of veterans with a strok...

Background: Some studies have found that older individuals are not as likely as their younger counterparts to be treated with some guideline-based stroke therapies. We examined whether age-related differences in inpatient quality of care exist among US veterans with ischemic stroke. Methods: This was a retrospective study of a national sample of...

To examine the association between dispensing of a selective serotonin reuptake inhibitor (SSRI) antidepressant medication and inpatient and outpatient service use in a cohort of veterans with confirmed acute stroke. Retrospective study.Setting: Southeastern U. S. Veterans Health Administration (VHA) network, from October 1, 2000, to September 30,...

We assessed the effects of a care coordination home-telehealth (CCHT) programme on health service utilization. The subjects (n = 387 for each group) were US veterans diagnosed with diabetes and followed for 48 months. The service utilization measures were numbers of all-cause inpatient stays and outpatient visits during the follow-up period. We use...

To 1) describe the prevalence of before the stroke depression (BSD) and poststroke depression (PSD) and 2) serotonin selective reuptake inhibitor (SSRI) treatment patterns. Naturalistic, retrospective cohort design. Veterans Healthcare System. Seven hundred ninety veterans with confirmed stroke during fiscal year 2001. Diagnosis of depression and d...

Post-stroke depression (PSD) is common among stroke survivors and is associated with increased morbidity and mortality. Little is understood about racial/ethnic differences in PSD detection. This study assessed the racial/ethnic disparities in PSD detection in a national cohort of Department of Veterans Affairs (VA) acute stroke patients. The study...

We assessed a home monitoring/care coordination programme for veterans with diabetes. Patients enrolled in the programme (n = 387) were followed for four years and compared with a retrospective control group (n = 387). Each patient in the intervention group used a messaging device in the home that was connected by a conventional telephone line. Car...

In this study, we assessed the longitudinal effect of a Department of Veterans Affairs (VA) patient-centered Care Coordination Home Telehealth (CCHT) program on preventable hospitalization use by veterans with diabetes mellitus (DM) at four VA medical centers. We used a matched treatment-control design (n = 387 for both groups). All patients were f...

Post-stroke depression (PSD) is prevalent, often undiagnosed, and undertreated. The accuracy of detecting patients with post-stroke depression in administrative databases has not been examined.The objective was to validate a case-finding algorithm for post-stroke depression (PSD) among veteran stroke survivors. We conducted a retrospective cohort s...

This study compared patterns of poststroke depression (PSD) detection among veterans with acute stroke in eight U.S. geographic regions. Department of Veterans Affairs (VA) medical and pharmacy data as well as Medicare data were used. International Classification of Diseases-9th Revision depression codes and antidepressant medication dispensing wer...

This study compares the characteristics of state veterans' nursing homes and community nursing homes with VA per-diem residentes between 1999 - 2002. A structure, process, and outcome model was used to examine whether there was any difference in the multi-dimensional quality measures among the three types of community nursing homes (for profit, not...

This study compared the characteristics of community nursing homes where veterans received their care with those of facilities that did not treat veterans from 1999 to 2002 using the Centers for Medicare and Medicaid Services (CMS) Online Survey Certification and Reporting system data merged with the CMS Minimum Data Set. A structure, process, and...

This is the third study in a line of research which is designed to increase scientific understanding of the predictors of health-related quality of life (HRQOL) among men with HIV infection using data collected in large, prospective cohort study. Building on two prior investigations, this study examined the time-dependent relationships of psychosoc...

Many Veteran Health Administration (VHA) enrollees receive health services outside the VHA system. However, limited information is available about poststroke utilization and mortality by veterans who used multiple sources of health care. This study assessed the likelihood of 12-month poststroke rehospitalization and mortality of veterans who used V...

Medicare claims data are available to Department of Veterans Affairs (VA) researchers to identify veterans with acute stroke. Our study sought to (1) ascertain whether additional acute stroke cases are identified with Medicare data and (2) assess the use of VA and Medicare inpatient automated data for assigning the stroke date. The study population...

Poststroke depression (PSD) is common among stroke survivors, and it is associated with worse functional outcomes and increased poststroke mortality. Limited information is available about its impact on healthcare use. This study assessed the impact of PSD on healthcare use by veterans with acute stroke. In this retrospective, observational nationa...

Misclassification of race and ethnicity in administrative data may produce misleading results if it is overlooked or ignored. In this study, we examined the racial/ethnic classifications of 1,084 veterans with stroke in Florida who received inpatient and outpatient services within the Department of Veterans Affairs (VA) healthcare system and who we...

Stroke is the third leading cause of death in the United States, following only heart disease and cancer. Approximately 500,000 strokes occur each year in the United States. Patients suffering from poststroke depression have higher rates of morbidity and mortality, slower physical recovery, and lower functional status than stroke patients without d...

In a prospective cohort study between February 2001 and January 2004, baseline and 12-month follow-up data were collected on 226 and 197 men with HIV infection at three infectious disease clinics in a southern state, respectively. While many studies have provided important information on the correlates of health-related quality of life (HRQOL) duri...

Evidence for ethnic disparities in stroke incidence, severity, and mortality has continued to mount in recent years. However, the picture for disparities in acute management and rehabilitation remains more ambiguous. The objective of this report is to summarize current evidence from stroke epidemiology and studies focusing on disparities in stroke...

In a prospective cohort study, baseline data were collected on 226 males with HIV infection attending three infectious disease clinics in a southern state. As a result of advances in HIV treatment, understanding the association between psychosocial factors and health-related quality of life has become an important area of study. The purpose of this...

Patients with irritable bowel syndrome (IBS) have reduced pain thresholds for rectal distension. In addition, the prevalence of sexual/physical abuse in referred IBS patients is high and is associated with greater pain reporting, poorer health status, and poorer outcome. This lead to a hypothesis that abuse history may sensitise patients to report...

Little is know about the relationship of abuse history and other risk factors with being overweight and obese among gastrointestinal patients. The purpose of this study was to assess the relative risk of abuse history on being overweight and obese among 239 female gastrointestinal patients. Forty-one percent of the patients were found to be overwei...

Studies of antidepressants and psychological treatments in functional bowel disorders (FBD) are methodologically limited. The aim of this study was to assess the clinical efficacy and safety of cognitive-behavioral therapy (CBT) against education (EDU) and desipramine (DES) against placebo (PLA) in female patients with moderate to severe FBD (irrit...

Anxiety, discomfort, and high levels of concern can affect patient attitude toward endoscopic procedures as well as compliance and adherence to current recommendations for the examination. This study evaluated how patients perceive flexible sigmoidoscopy. A prospective study was conducted at two sites of 764 patients presenting for GI endoscopy (fl...

For patients with painful functional bowel disorders (FBD), physicians frequently make diagnostic and treatment decisions based on the severity of the pain reported; patients with severe painful complaints may receive extensive diagnostic tests and treatments. Therefore, it would be important to determine what clinical factors contribute to the jud...

There has been growing interest in the investigation of health-related quality of life (HRQOL) among patients with gastrointestinal (GI) disorders. We recently reported on the development and preliminary validation of the IBS-QOL, a specific quality-of-life measure for irritable bowel syndrome (IBS). The aim of this study was to determine the longi...

Thesis (Ph. D.)--University of North Carolina at Chapel Hill, 1997. Includes bibliographical references (leaves 248-254). Microfiche. s