Developing a rural Veterans Affairs health care research program: Diligence and unique resolutions

LAY SUMMARY Development and growth of a rural Veterans Affairs Medical Center (VAMC) research program is one way to provide best care. This article reports the steps and barriers to building a rural research centre, using examples from western North Carolina. One goal driving the research centre’s creation was to increase under-served communities in the research workforce and among participants enrolled in Veterans Health Administration (VHA) research. The VHA reports health care differences for 4.7 million rural and highly rural Veterans, with rural Veterans using VHA services differently than urban and suburban Veterans. A total of 58% of rural Veterans enroll in the VHA, compared with 37% of urban and suburban Veterans. To achieve optimal Veteran health, all Veteran sub-groups must be adequately represented in clinical research trials, but rural Veterans are currently not equally represented. Research centre development steps included: 1) hiring a program specialist to focus on developmental needs, 2) finding a local program assistant to address the details required to develop a research centre, 3) obtaining a designated regulatory staff member, 4) negotiating staff, space, and focus needs, 5) hiring an experienced researcher to support initial research efforts, and 6) networking with other VAMCs, hospitals, agencies, and universities to create a best-care community.