# Developing a Shared Decision-Making Support Tool to Promote Evidence-based Treatment for Veterans with Post-concussive Sleep Conditions

> **NIH VA I21** · VA EASTERN COLORADO HEALTH CARE SYSTEM · 2022 · —

## Abstract

Background: Veterans with mild traumatic brain injury (mTBI) are at high risk for sleep conditions (insomnia;
obstructive sleep apnea [OSA]), which disrupt sleep quality and undermine recovery. Identifying and treating
such sleep conditions using the VA/DoD clinical practice guideline (CPG) for the management of insomnia and
OSA (Sleep CPG) can produce wide-ranging benefits for Veterans’ post-concussive recovery.
Significance: The Sleep CPG specifies an evidence-based workflow for management of sleep conditions,
including: 1) screening for sleep problems; 2) assessing for sleep conditions; and, 3) delivering evidence-
based treatments. Further, the Sleep CPG includes a recommendation that Veterans and providers collaborate
to select empirically supported treatments to ensure that care aligns with Veterans’ preferences (i.e., Veteran-
centered care). However, there exists variability in Veterans’ receipt of guideline-concordant care (GCC) for
post-concussive sleep conditions due in part to: 1) lack of access to guideline-recommended practices at the
point-of-care (PoC); and, 2) challenges associated with facilitating Veteran-centered care due to the highly
individualized nature of Veterans’ preferences. Implementation strategies can enable GCC and facilitate
Veterans’ recovery by providing: 1) Veterans and providers with information regarding guideline-recommended
practices at the PoC; and, 2) structured support to facilitate Veteran-centered care. However, such strategies
have yet to be widely developed or implemented. The proposed project will address this gap in rehabilitative
care for those with mTBI and sleep conditions by developing a decision support system. The system will be
comprised of two complementary tools. First, it will include a clinical dashboard that distills patient-level data
into actionable information at the PoC, providing decision support with respect to: 1) screening for sleep
problems; 2) assessments to detect insomnia and/or OSA; and, 3) recommending guideline-concordant
treatment options based on clinical presentation. Second, a decision aid will facilitate collaboration between
providers and Veterans to promote selection of guideline-concordant treatment recommendations that align
with patients’ personal preferences. This will be accomplished by providing Veterans with necessary
information and assisting them with clarifying their priorities for intervention. The proposed system will be the
first to offer decision support across the continuum of GCC, from screening for sleep problems to Veteran-
centered treatment of identified conditions.
Specific Aims and Methodology: In Aim 1, we will use semi-structured interviews with Veterans, providers,
and policymakers to identify barriers and facilitators to evidence-based, Veteran-centered management of
post-concussive sleep conditions. In Aim 2, we will leverage stakeholder input from Aim 1 to develop a
decision support system (i.e., dashboard, decision aid) and training mat...

## Key facts

- **NIH application ID:** 10481936
- **Project number:** 1I21RX004073-01
- **Recipient organization:** VA EASTERN COLORADO HEALTH CARE SYSTEM
- **Principal Investigator:** Adam Kinney
- **Activity code:** I21 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2022
- **Award amount:** —
- **Award type:** 1
- **Project period:** 2022-07-01 → 2024-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10481936

## Citation

> US National Institutes of Health, RePORTER application 10481936, Developing a Shared Decision-Making Support Tool to Promote Evidence-based Treatment for Veterans with Post-concussive Sleep Conditions (1I21RX004073-01). Retrieved via AI Analytics 2026-05-27 from https://api.ai-analytics.org/grant/nih/10481936. Licensed CC0.

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