# Optimizing Function and Independence

> **NIH VA I50** · DURHAM VA MEDICAL CENTER · 2021 · —

## Abstract

Background: The overall impact goal of the Optimizing Function and Independence QUERI program (“Function
QUERI”) is to improve VA care by implementing and evaluating evidence-based clinical programs (EBPs) to
maximize function and independence in vulnerable Veterans. Since its inception in 2016, Function QUERI has
supported implementation of three EBPs to optimize function and independence: group physical therapy for knee
osteoarthritis (Group PT), supervised walking for hospitalized older adults (STRIDE) and caregiver skills training
(Caregivers FIRST). These EBPs have demonstrated positive effects for both Veterans and their families.
Building on successful partnerships with national and VISN partners and incorporating lessons learned, in the
next 4 program years (October 2021-September 2025), Function QUERI will advance each EBP to the next
phase of implementation at additional sites. Group PT was evaluated as a quality improvement program (QI) at
one VA medical center (VAMC), and we will now implement and evaluate this program at 16 sites. STRIDE and
Caregivers FIRST have each been implemented in 8 VAMCs in ongoing clinical trials and have now been
endorsed by VA program offices for national dissemination; thus, we have the unique opportunity and capability
to develop and test prototype approaches for taking EBPs to national scale in VA.
Methods: Adopting new EBPs requires buy-in and cooperation among many different service lines, and a ‘one-
size’ fits all approach to getting programs implemented is rarely effective. Therefore, as Function QUERI meets
our primary goal of spreading EBPs to optimize Veteran function and independence we will also conduct rigorous
evaluations to understand how evidence-based implementation strategies can best support the adoption of
complex interventions and maximize their sustainability. First, Function QUERI will advance understanding and
application of implementation strategies that promote adaptability of clinical programs to fit local environments
and build skills among implementation teams. Second, across EBPs, we will monitor sites’ implementation
progress and test the impact of adding higher intensity implementation strategies at sites with low adoption of
the EBP. In this way, Function QUERI will fill a critical knowledge gap of how to optimize use of implementation
strategies on a national scale.
We will accomplish Function QUERI’s overall goals through the following specific aims:
1) Implement 3 EBPs that have been recognized by VA leaders as high priority programs to fill quality gaps for
 Veterans at risk for functional decline or disability and their family caregivers;
2) Assess EBP impact on quality metrics and conduct business case analysis to inform sustainment;
3) Advance application of implementation strategies by testing implementation intensification approaches across
EBPs;
4) Partner with VA leaders to conduct rapid, high-quality implementation and evaluation projects to inform
 decisions o...

## Key facts

- **NIH application ID:** 10070421
- **Project number:** 1I50HX003200-01
- **Recipient organization:** DURHAM VA MEDICAL CENTER
- **Principal Investigator:** Kelli D. Allen
- **Activity code:** I50 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2021
- **Award amount:** —
- **Award type:** 1
- **Project period:** 2021-10-01 → 2025-09-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10070421

## Citation

> US National Institutes of Health, RePORTER application 10070421, Optimizing Function and Independence (1I50HX003200-01). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10070421. Licensed CC0.

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