Center for Access & Delivery Research and Evaluation-CADRE

CADRE strives to expand access to high-quality care for rural Veterans by developing, implementing, and testing innovative telehealth strategies; and to ensure that the care delivered is safe and free of preventable antibiotic resistant infections. CADRE is an energetic and upbeat organization with 18 core investigators, 29 affiliate or associate investigators, 3 Career Development Awardees,  5 VA Quality Scholars, over 50 research personnel, and over 40 funded projects.

CADRE’s mission is twofold: (1) to improve access to high quality care for rural Veterans through innovative applications of telehealth in specialty care, community care, and dual use; and (2) to develop and evaluate interventions targeting the multidrug-resistant organism crisis. 

1)  Improve access to high quality care for rural Veterans through innovative applications of telehealth in specialty care, community care, and dual use.

2)  Develop and evaluate interventions targeting the multidrug-resistant organism (MDRO) crisis.

3) Expand our efforts in developing innovative health services research in women’s health, epidemic opioid use, substance abuse disorders, and cardiovascular outcomes.

4) Continue the Center’s success in supporting mentored career-development.

5) Promote Veteran engagement with recognition that Veterans are experts on Veteran experience. 

Primary Research Focus Areas

1) Improve Access to High Quality Care for Rural Veterans
This focus area addresses an HSR&D research emphasis in health care access and equity and brings together priorities to provide greater choice for Veterans, focus resources more efficiently, and improve timeliness of services. It also builds upon CADRE investigators’ strengths and leverages established partnerships: Office of Rural Health (ORH) and Office of Connected Care (OCC).

2) Develop and Evaluate Interventions Targeting MDRO Crisis

Antimicrobial resistance (AMR) is one of today’s most urgent public health problems. VHA has been a leader in MDRO prevention highlighted by the 2007 methicillin-resistant Staphylococcus aureus (MRSA) Directive. CADRE is working to prevent transmission of antibiotic resistant bacteria in acute-care settings, improve antimicrobial stewardship, prevent MDRO outside acute care settings, and target the microbiome to prevent MDRO colonization and infection.

Other Areas of Research

1) Innovative and Collaborative Approaches in Women’s Health

VA faces significant changes in its delivery of healthcare as it becomes a major service provider for women. Two priority female Veteran populations have evolved: those sexually victimized in the military and those exposed to combat. CADRE investigators have developed a collaborative research program to address these difficult and under-researched areas, to identify gaps in care, and develop innovative approaches.

2) Targeting Epidemic Opioid Use and Substance Use Disorders

An emerging area of emphasis in CADRE is ensuring the safe and effective use of opioid pain medications. Programs like the Opioid Safety Initiative and the Stratification Tool for Opioid Risk Mitigation have focused on minimizing potential harms among existing long-term opioid users. As a complement to these efforts, CADRE research has focused on the initiation of new long-term opioid use. An additional area of ongoing focus is tobacco cessation.

3) Growing Cardiovascular Outcomes Research

An emerging area of research interest at CADRE targets Veterans with cardiovascular disease (CVD). Evidence suggests Veterans may be at higher risk for CVD than the general population. The overarching goal of CADRE’s CVD focus is to improve CVD treatment and outcomes through research that characterizes and influences the distribution of CVD-related services within and across VA.

This website is intended for health service researchers and other stakeholders.