# Telehealth Treatment of Veterans with Alcohol Misuse at Risk for Cardiovascular Disease

> **NIH VA IK2** · DURHAM VA MEDICAL CENTER · 2021 · —

## Abstract

Background: Cardiovascular disease (CVD) is the most common cause of death in Veterans. CVD-related
deaths are over twice as likely in patients with comorbid alcohol misuse, due in part to alcohol misuse
directly exacerbating several modifiable factors that lead to CVD. No interventions exist targeting both
these comorbidities, and current VA/DoD treatment guidelines for comorbid alcohol misuse in primary care
are ineffective. Because alcohol misuse is often a recurrent problem, and the dominant driver of treatment
recommendations, timely treatment of these Veterans’ CVD risk in conjunction with alcohol misuse
treatment in may be critical for developing clinical traction with CVD risk. Dr. Blalock seeks to refine a
telehealth intervention and acquire necessary training throughout this CDA-2 proposal to begin his career
as an independent VA health services researcher who seeks to improve the effectiveness and reach of
behavioral health treatments for Veterans with comorbid behavioral health problems.
Significance/Impact: 9-32% of the entire Veteran population has comorbid alcohol misuse and modifiable
elevated CVD risk. This high-risk population is entirely preventable, but is undertreated and understudied.
The proposed CDA research would be the first to directly target this high-risk population. This research is
highly relevant to Veteran health, VHA priorities, and HSR&D priorities because the combined intervention
targets and telehealth approaches address critical gaps in treatment timeliness and access.
Specific Aims: Aim 1 –Characterize a national cohort of Veterans with alcohol misuse and modifiable CVD
risk, their alcohol services utilization, and clinical outcomes. Aim 2 – Qualitatively assess barriers to
treatment for Veterans with alcohol misuse and CVD risk across multiple stakeholders. Aim 3 – Use a
successive cohort design to iteratively develop an intervention based on patient feedback. Aim 4 – Test the
acceptability and feasibility of an intervention to reduce alcohol misuse and CVD risk in Veterans.
Innovation: This application is highly innovative in its attempt to address for the first time: 1) perceptions of
barriers to treatment in this population, 2) the utility of a combined intervention for alcohol misuse and CVD
risk, 3) multimorbid patient preferences for timing of treatments for multiple different targets, and 4) the
sustainability of health behavior habits in VA formed by an intervention using “implementation intentions.”
Methodology: Aim 1 will use electronic health records to examine the status of key health criteria and
services utilization among Veterans with alcohol misuse, both with and without comorbid CVD risk. Aim 2
will use qualitative interviews of both Veterans with comorbid alcohol misuse and elevated modifiable CVD
risk, their providers across different settings, and systems-level stakeholders to assess current treatment
barriers. Aim 3 will employ a successive cohort design to iteratively test the proposed...

## Key facts

- **NIH application ID:** 10182749
- **Project number:** 1IK2HX003085-01A2
- **Recipient organization:** DURHAM VA MEDICAL CENTER
- **Principal Investigator:** Daniel V Blalock
- **Activity code:** IK2 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2021
- **Award amount:** —
- **Award type:** 1
- **Project period:** 2021-05-01 → 2026-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10182749

## Citation

> US National Institutes of Health, RePORTER application 10182749, Telehealth Treatment of Veterans with Alcohol Misuse at Risk for Cardiovascular Disease (1IK2HX003085-01A2). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10182749. Licensed CC0.

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