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DOE OSTI2025

VA Determinants of Health Data Curation Documentation FY25-Q3

The U.S. Department of Veterans Affairs (VA) places the health and well-being of our nation’s veterans as its top priority. VA is dedicated to offering timely access to high-quality, evidence-based mental health care that meets the needs of veterans and supports their reintegration into society. One of our core missions is to prevent suicide among veterans through innovative approaches and resources. With funding from the VA Office of Mental Health and Suicide Prevention (OMHSP), the Determinants of Health (EDH) project has developed innovative datasets associated with specific health outcomes, a methodology for transforming spatiotemporal data from one spatial reference (e.g., a 1km grid) to another (e.g., US Census Tracts), and capabilities for modeling health outcomes. These datasets represent an enhancement of the Agency for Healthcare Research and Quality (AHRQ), addressing key gaps by introducing finer spatial resolution (Census Tract) and additional geographical covariates into existing data. The curation and standardization of these datasets is a complex task since they often originate from various sources and are measured at different spatial and temporal resolutions. For example, US Census data products typically use census blocks, block groups, or counties, while data like weather data are available on 1km grids. Some economic data may only be available at the zip code level. In this context, ‘standardized’ means that all datasets share the same spatial extent (e.g., US Census Tract and/or County), and ‘curated’ implies a repeatable process with data provenance and the use of appropriate methodologies for covariate conversion. The Determinants of Health datasets draw from multiple sources, resulting in variables with varying degrees of availability, patterns of missing data, and methodological considerations across different sources, geographies, and years.

97 MATHEMATICS AND COMPUTING↗

DOE OSTI2025

VA Community Determinants of Health Data Curation Documentation FY25-Q4

The U.S. Department of Veterans Affairs (VA) places the health and well-being of our nation’s veterans as its top priority. VA is dedicated to offering timely access to high-quality, evidence-based mental health care that meets the needs of veterans and supports their reintegration into society. One of our core missions is to prevent suicide among veterans through innovative approaches and resources. With funding from the VA Office of Mental Health and Suicide Prevention (OMHSP), the Determinants of Health (EDH) project has developed innovative datasets associated with specific health outcomes, a methodology for transforming spatiotemporal data from one spatial reference (e.g., a 1km grid) to another (e.g., US Census Tracts), and capabilities for modeling health outcomes. These datasets represent an enhancement of the Agency for Healthcare Research and Quality (AHRQ), addressing key gaps by introducing finer spatial resolution (Census Tract) and additional geographical covariates into existing data. The curation and standardization of these datasets is a complex task since they often originate from various sources and are measured at different spatial and temporal resolutions. For example, US Census data products typically use census blocks, block groups, or counties, while data like weather data are available on 1km grids. Some economic data may only be available at the zip code level. In this context, standardized’ means that all datasets share the same spatial extent (e.g., US Census Tract and/or County), and ‘curated’ implies a repeatable process with data provenance and the use of appropriate methodologies for covariate conversion. The Determinants of Health datasets draw from multiple sources, resulting in variables with varying degrees of availability, patterns of missing data, and methodological considerations across different sources, geographies, and years.

97 MATHEMATICS AND COMPUTING↗

DOE OSTI2022

VA EDH Data Curation Documentation FY22-Q2, Rev. 2

The health and well-being of the Nation’s men and women who have served in uniform is the highest priority for the U.S. Department of Veterans Affairs (VA). VA is committed to providing timely access to high-quality, recovery-oriented, evidence-based mental health care that anticipates and responds to Veterans’ needs and supports the reintegration of returning Service members into their communities. VA is working to eliminate suicide among all Veterans by developing and implementing innovative suicide prevention approaches and resources. Health outcomes, such as suicide are typically modeled as a function of genetics and environment, where environment refers to factors beyond medical, e.g., air quality, access to transportation and food, homelessness status, etc. Mental health outcomes for each individual are considered to be associated with multiple stressors that fall under a variety of categories socioeconomic, economic, physical environment. Understanding the relationships between these stressors, covariates and health outcomes, requires curated, standardized data that can be input into the VA’s Recovery Engagement and Coordination for Health - Veterans Enhanced Treatment (REACH VET) or other health outcomes model. Environmental Determinants of Health (EDH) as defined by the World Health Organization (WHO) is clean air, stable climate, adequate water, sanitation and hygiene, safe use of chemicals, protection from radiation, healthy and safe workplaces, sound agricultural practices, health-supportive cities and built environments, and a preserved nature are all prerequisites for good health.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2022

VA EDH Data Curation Documentation (FY22-Q3, Rev.2)

59 BASIC BIOLOGICAL SCIENCES↗

DOE OSTI2022

VA EDH Data Curation Documentation FY22-Q4

The health and well-being of the Nation’s men and women who have served in uniform is the highest priority for the U.S. Department of Veterans Affairs (VA). VA is committed to providing timely access to high-quality, recovery-oriented, evidence-based mental health care that anticipates and responds to Veterans’ needs and supports the reintegration of returning Service members into their communities. VA is working to eliminate suicide among all Veterans by developing and implementing innovative suicide prevention approaches and resources. Health outcomes, such as suicide are typically modeled as a function of genetics and environment, where environment refers to factors beyond medical, e.g., air quality, access to transportation and food, homelessness status, etc. Mental health outcomes for each individual are considered to be associated with multiple stressors that fall under a variety of categories socioeconomic, economic, physical environment. Understanding the relationships between these stressors, covariates, and health outcomes, requires curated, standardized data that can be input into the VA’s Recovery Engagement and Coordination for Health - Veterans Enhanced Treatment (REACH VET) or other health outcomes model. Environmental Determinants of Health (EDH) as defined by the World Health Organization (WHO) is clean air, stable climate, adequate water, sanitation and hygiene, safe use of chemicals, protection from radiation, healthy and safe workplaces, sound agricultural practices, health-supportive cities and built environments, and a preserved nature are all prerequisites for good health.

99 GENERAL AND MISCELLANEOUS↗

DOE OSTI2023

VA EDH Data Curation Documentation FY23-Q2

The health and well-being of the Nation’s men and women who have served in uniform is the highest priority for the U.S. Department of Veterans Affairs (VA). VA is committed to providing timely access to high-quality, recovery-oriented, evidence-based mental health care that anticipates and responds to Veterans’ needs and supports the reintegration of returning Service members into their communities. Since its creation, VA has been working to eliminate suicide among all veterans by developing and implementing innovative suicide prevention approaches and resources. Health outcomes, such as suicide are typically modeled as a function of genetics and environment, where environment refers to factors beyond medical, e.g., air quality, access to transportation and food, homelessness status, etc. Mental health outcomes for each individual are considered to be associated with multiple stressors that fall under a variety of categories including socioeconomic, economic, physical environment. Understanding the relationships between these stressors, covariates and health outcomes requires curated, standardized data that can be input into the VA’s Recovery Engagement and Coordination for Health, Veterans Enhanced Treatment (REACH VET) or other health outcomes model. Environmental Determinants of Health (EDH) as defined by the World Health Organization (WHO) is clean air, stable climate, adequate water, sanitation and hygiene, safe use of chemicals, protection from radiation, healthy and safe workplaces, sound agricultural practices, health-supportive cities and built environments, and a preserved nature are all prerequisites for good health.

99 GENERAL AND MISCELLANEOUS↗

DOE OSTI2023

VA EDH Data Curation Documentation FY23-Q3

The health and well-being of the Nation’s men and women who have served in uniform is the highest priority for the U.S. Department of Veterans Affairs (VA). VA is committed to providing timely access to high-quality, recovery-oriented, evidence-based mental health care that anticipates and responds to Veterans’ needs and supports the reintegration of returning Service members into their communities. Since its creation, VA has been working to eliminate suicide among all veterans by developing and implementing innovative suicide prevention approaches and resources. Health outcomes, such as suicide are typically modeled as a function of genetics and environment, where environment refers to factors beyond medical, e.g., air quality, access to transportation and food, homelessness status, etc. Mental health outcomes for each individual are considered to be associated with multiple stressors that fall under a variety of categories including socioeconomic, economic, physical environment. Understanding the relationships between these stressors, covariates and health outcomes requires curated, standardized data that can be input into the VA’s Recovery Engagement and Coordination for Health, Veterans Enhanced Treatment (REACH VET) or other health outcomes model. Environmental Determinants of Health (EDH) as defined by the World Health Organization (WHO) refers to clean air, stable climate, adequate water, sanitation and hygiene, safe use of chemicals, protection from radiation, healthy and safe workplaces, sound agricultural practices, health-supportive cities and built environments, and a preserved nature are all prerequisites for good health.

97 MATHEMATICS AND COMPUTING↗

DOE OSTI2023

VA EDH Data Curation Documentation FY23-Q4

The health and well-being of the Nation’s men and women who have served in uniform is the highest priority for the U.S. Department of Veterans Affairs (VA). VA is committed to providing timely access to high-quality, recovery-oriented, evidence-based mental health care that anticipates and responds to Veterans’ needs and supports the reintegration of returning service members into their communities. Since its creation, the VA has been working to eliminate suicide among all veterans by developing and implementing innovative suicide prevention approaches and resources. Health outcomes, such as suicide, are typically modeled as a function of genetics and environment, where environment refers to factors beyond medical, e.g., air quality, access to transportation and food, homelessness status, etc. Mental health outcomes for each individual are considered to be associated with multiple stressors that fall under a variety of categories, including socioeconomic, economic, and physical environments. Understanding the relationships between these stressors, covariates, and health outcomes requires curated, standardized data that can be input into the VA’s Recovery Engagement and Coordination for Health, Veterans Enhanced Treatment (REACH VET) or other health outcomes model. Environmental Determinants of Health (EDH), as defined by the World Health Organization (WHO), refer to clean air, stable climate, adequate water, sanitation and hygiene, safe use of chemicals, protection from radiation, healthy and safe workplaces, sound agricultural practices, health-supportive cities and built environments, and a preserved nature, which are all prerequisites for good health.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2021

Personal Resiliency Index

A plethora of information exists in literature focusing on different aspects of personal resilience. There are a number of questionnaires available to measure resilience in different aspects of an individual’s life, such as mental health. However, there is a lack of comprehensive information on the subject of personal resilience to natural and man-made disasters. A Personal Resiliency Index identifying four key areas of resilience related to natural and man-made disasters will help fill this gap by providing individuals an idea of where the stand comparatively to their peers on this topics. As an increasing amount of man-made disasters, natural disasters and pandemics occur, we realize that preparation is key.?“Crisis can be experienced at individual, group and mass levels and at local, regional, national or supra-national levels.” 1? Dr. Ron Fisher, the principal investigator has over 20 years’ critical infrastructure protection including developing vulnerability assessment methodology, risk and resiliency analyses and infrastructure interdependencies. Dr. Fisher and his team will research and develop a voluntary survey which evaluates the user’s personal resilience level to natural and man-made disasters. The research team is focusing on 4 main categories:? financial resilience, cyber security, physical and mental health, and emergency preparedness.?The web based application will?provide a resilience score for each of the categories and also a comprehensive personal resiliency score based on the voluntary survey. The application will also provide feedback to the user on actions to take to become more resilient to natural and man-made disasters. Through this effort, we will also be able to identify the areas where participants are excelling as well as opportunities for improvement in terms of resilience. This information will provide insight into areas of further investigation and identify potential areas of support needed for the general public to adopt strategies to become more resilient. 1 Lynott, William. “Surviving a Natural (or Man-Made) Disaster: How to Prepare for and Bounce Back? from a Crisis in Your Business | 2018-02-01 | NOLN.” Home Page, NOLN, 1 Feb. 2018, https://www.noln.net/articles/2683-surviving-a-natural-or-man-made-disaster-how-to-prepare-for-and-bounce-back-from-a-crisis-in-your-business.

99 GENERAL AND MISCELLANEOUS↗

DOE OSTI2024

The lifetime risk and impact of vitiligo across sociodemographic groups: a UK population-based cohort study

Abstract Background Vitiligo is an autoimmune skin disorder characterized by depigmented patches of skin, which can have significant psychological impacts. Objectives To estimate the lifetime incidence of vitiligo, overall, by ethnicity and across other sociodemographic subgroups, and to investigate the impacts of vitiligo on mental health, work and healthcare utilization. Methods Incident cases of vitiligo were identified in the Optimum Patient Care Database of primary care records in the UK between 1 January 2004 and 31 December 2020. The lifetime incidence of vitiligo was estimated at age 80 years using modified time-to-event models with age as the timescale, overall and stratified by ethnicity, sex and deprivation. Depression, anxiety, sleep disturbance, healthcare utilization and work-related outcomes were assessed in the 2 years after vitiligo diagnosis and compared with matched controls without vitiligo. The study protocol for this retrospective observational study was registered with ClinicalTrials.gov (NCT06097494). Results In total, 9460 adults and children were newly diagnosed with vitiligo during the study period. The overall cumulative lifetime incidence was 0.92% at 80 years of age [95% confidence interval (CI) 0.90–0.94]. Cumulative incidence was similar in female (0.94%, 95% CI 0.92–0.97) and male patients (0.89%, 95% CI 0.86–0.92). There were substantial differences in lifetime incidence across ethnic groups, listed by Office for National Statistics criteria [Asian 3.58% (95% CI 3.38–3.78); Black 2.18% (95% CI 1.85–2.50); Mixed/multiple 2.03% (95% CI 1.58–2.47); Other 1.05% (95% CI 0.94–1.17); and White 0.73% (95% CI 0.71–0.76)]. Compared with matched controls, people with vitiligo had an increased risk of depression [adjusted odds ratio (aOR) 1.08, 95% CI 1.01–1.15]; anxiety (aOR 1.19, 95% CI 1.09–1.30); depression or anxiety (aOR 1.10, 95% CI 1.03–1.17); and sleep disturbance [adjusted hazard ratio (aHR) 1.15, 95% CI 1.02–1.31]. People with vitiligo also had a greater number of primary care encounters (adjusted incidence rate ratio 1.29, 95% CI 1.26–1.32) and a greater risk of time off work (aHR 1.15, 95% CI 1.06–1.24). There was little evidence of disparities in vitiligo-related impacts across ethnic subgroups. Conclusions Clinicians should be aware of the markedly increased incidence of vitiligo in people belonging to Asian, Black, Mixed/multiple and Other groups. The negative impact of vitiligo on mental health, work and healthcare utilization highlights the importance of monitoring people with vitiligo to identify those who need additional support.

Eleftheriadou, Viktoria↗

DOE OSTI2020

Explainable Artificial Intelligence Recommendation System by Leveraging the Semantics of Adverse Childhood Experiences: Proof-of-Concept Prototype Development

The study of adverse childhood experiences and their consequences has emerged over the past 20 years. Although the conclusions from these studies are available, the same is not true of the data. Accordingly, it is a complex problem to build a training set and develop machine-learning models from these studies. Classic machine learning and artificial intelligence techniques cannot provide a full scientific understanding of the inner workings of the underlying models. This raises credibility issues due to the lack of transparency and generalizability. Explainable artificial intelligence is an emerging approach for promoting credibility, accountability, and trust in mission-critical areas such as medicine by combining machine-learning approaches with explanatory techniques that explicitly show what the decision criteria are and why (or how) they have been established. Hence, thinking about how machine learning could benefit from knowledge graphs that combine “common sense” knowledge as well as semantic reasoning and causality models is a potential solution to this problem. In this study, we aimed to leverage explainable artificial intelligence, and propose a proof-of-concept prototype for a knowledge-driven evidence-based recommendation system to improve mental health surveillance. We used concepts from an ontology that we have developed to build and train a question-answering agent using the Google DialogFlow engine. In addition to the question-answering agent, the initial prototype includes knowledge graph generation and recommendation components that leverage third-party graph technology. To showcase the framework functionalities, we here present a prototype design and demonstrate the main features through four use case scenarios motivated by an initiative currently implemented at a children’s hospital in Memphis, Tennessee. Ongoing development of the prototype requires implementing an optimization algorithm of the recommendations, incorporating a privacy layer through a personal health library, and conducting a clinical trial to assess both usability and usefulness of the implementation. This semantic-driven explainable artificial intelligence prototype can enhance health care practitioners’ ability to provide explanations for the decisions they make.

adverse childhood experiences↗

DOE OSTI2023

Cultivating a culture of inclusivity in heliophysics

A large number of heliophysicists from across career levels, institution types, and job titles came together to support a poster at Heliophysics 2050 and the position papers for the 2024 Heliophysics decadal survey titled “Cultivating a Culture of Inclusivity in Heliophysics,” “The Importance of Policies: It’s not just a pipeline problem,” and “Mentorship within Heliophysics.” While writing these position papers, the number of people who privately shared disturbing stories and experiences of bullying and harassment was shocking. The number of people who privately expressed how burned out they were was staggering. The number of people who privately spoke about how they considered leaving the field for their and their family’s health was astounding. And for as much good there is in our community, it is still a toxic environment for many. If we fail to do something now, our field will continue to suffer. While acknowledging the ongoing growth that we as individuals must work toward, we call on our colleagues to join us in working on organizational, group, and personal levels toward a truly inclusive culture, for the wellbeing of our colleagues and the success of our field. This work includes policies, processes, and commitments to promote: accountability for bad actors; financial security through removing the constant anxiety about funding; prioritization of mental health and community through removing constant deadlines and constant last-minute requests; a collaborative culture rather than a hyper-competitive one; and a community where people can thrive as whole persons and do not have to give up a healthy or well-rounded life to succeed.

mental health↗

DOE OSTI2021

10 New Insights in Climate Science 2020 - a Horizon Scan

We summarize some of the past year’s most important findings within climate change-related research. New research has improved our understanding of Earth’s sensitivity to carbon dioxide, finds that permafrost thaw could release more carbon emissions than expected and that the uptake of carbon in tropical ecosystems is weakening. Adverse impacts on human society include increasing water shortages and impacts on mental health. Options for solutions emerge from rethinking economic models, rights-based litigation, strengthened governance systems and a new social contract. The disruption caused by COVID-19 could be seized as an opportunity for positive change, directing economic stimulus towards sustainable investments.

29 ENERGY PLANNING, POLICY, AND ECONOMY↗

DOE OSTI2025

CareWELL: Multimodal Region Representation Learning with Spatial Contexts for Urban Health

Rapid urbanization affects living environments by intensifying exposure to air pollution, heat, noise, and urban dynamics, which together contribute to uneven health outcomes across neighborhoods. For instance, cardiovascular, respiratory, and mental health conditions are each influenced by distinct exposures such as air pollution, extreme temperatures, or limited access to green space. These heterogeneous patterns require understanding the characteristics of geographic regions in order to explain why urban health risks vary across urban areas. Recent work in self-supervised region representation learning provides a promising way to model such characteristics from multimodal geospatial data. However, existing methods face two major limitations: (i) they often depend on non-public datasets, limiting reproducibility and applicability, and (ii) their generic pretraining objectives overlook health-relevant determinants, including temporal variability in environmental exposures and inequalities in social conditions. To address these gaps, we propose Context-Aware Region rEpresentation with Weather, Environment, and Location Learning (CareWELL). CareWELL leverages large language models to encode seasonal variability in weather, employs contrastive learning to align geo-coordinate and weather representations, and introduces a context-aware objective that integrates socio-demographic factors while preserving spatial correlations. We evaluate CareWELL by predicting six urban health outcomes in Manhattan, New York City, and demonstrate that CareWELL consistently outperforms state-of-the-art baselines as well as a traditional spatial computing method. These results suggest the importance of context-aware pretraining objectives for learning health-relevant region representations.

Namgung, Min [ORNL]↗

DOE OSTI2023

Physical Education Teachers’ Representations of Their Training to Promote the Inclusion of Students with Disabilities

School inclusion is based on the need to adopt and implement a holistic view of education, training, and human development embodied in the idea of everyone, for everyone. In the context of Physical Education (PE), there are still several constraints to the realization of this universal desideratum. Among these, teacher training and qualification for the inclusion of students with Specific Health Needs (SHNs) stands out. That is, students with physical and mental health problems whose impact is significantly manifested in the learning process. Thus, the objective of this study was to identify the representations of PE teachers about their training to develop inclusive processes with students with SES. Participants in this study were 151 PE teachers from different regions and districts of Portugal (Algarve, Aveiro, Castelo Branco, Lisbon, Porto, and Viseu) who had 23.6 ± 8.1 years of teaching service. Teachers answered an online questionnaire, on the Google Forms platform, with open and closed questions about their education and training to develop inclusive processes in PE. The results indicate two significant dimensions: (1) initial training for teaching inclusive PE and (2) continuous training for inclusion. Regarding initial training, a large majority of the teachers under study, at the end of their initial training, did not have the essential skills to teach PE to students with SES. It was also identified that a large majority reported not having had any contact with students with SES throughout their training process for teaching. It was also recognized that this training was not adjusted to the development of intervention skills with students with SHN. Regarding continuous training, it was identified that attendance at this training increased their skills to teach PE to students with SHN. Workshops/actions/training courses are the main training models adopted. However, it is recognized that the training provided does not respond concretely to their training needs to intervene with students with SHN, since teachers essentially seek to improve intervention in the context of inclusive physical education. We conclude that teacher training for inclusion is not yet fully adjusted to the reality of the inclusive school paradigm. In this sense, in practical terms, the following are suggested: (1) the need for reinforcement in study plans with specific and long-term curricular units; (2) the introduction of real practice components in context; and (3) supervised pedagogical practice in diverse contexts.

Celestino, Tadeu (ORCID:0000000163087981)↗

DOE OSTI2024

Seeking help for perinatal depression and anxiety: a systematic review of systematic reviews from an interdependent perspective

Abstract Background Seeking help for perinatal mood and anxiety disorders is crucial for women’s mental health and babies’ development, yet many women do not seek help for their condition and remain undiagnosed and untreated. This systematic review of systematic reviews aimed at summarizing and synthesizing findings from all systematic reviews on seeking help for PMAD in the context of interdependence theory, highlighting the interdependent relationship between women and healthcare providers and how it may impact women’s seeking-help process. Methods Four electronic databases were searched, and 18 studies published up to 2023 met inclusion criteria for review. Results The capability, opportunity and motivation model of behavior was used as a framework for organizing and presenting the results. Results demonstrate that seeking help for PMAD is a function of the interdependent relationship between perinatal women’s and healthcare providers’ psychological and physical capabilities, social and physical opportunities, and their reflective and automatic motivation. Conclusions Unmet needs in perinatal mental healthcare is an important public health problem. This systematic review of systematic reviews highlights key factors for policymakers, researchers, and practitioners to consider to optimize healthcare systems and interventions in a way that enhances perinatal women’s treatment whenever necessary.

Bina, Rena (ORCID:0000000340729229)↗

DOE OSTI2026

VA Community Determinants of Health Data Curation Documentation FY26-Q3

99 GENERAL AND MISCELLANEOUS↗

DOE OSTI2022

Impact of WELL certification on occupant satisfaction and perceived health, well-being, and productivity: A multi-office pre- versus post-occupancy evaluation

The WELL Building Standard (WELL) is currently one of the most comprehensive building certification programs that aim to enhance the health and well-being of building occupants. However, there is a lack of systematic evaluation of the effectiveness of WELL in achieving its goal. This study investigates the impact of WELL certification on occupant satisfaction with the workplace and occupant perceived health, well-being, and productivity. More than 1300 pre- and post-occupancy survey responses provided by the nearly same cohort of occupants from six companies in North America were quantitatively analyzed. The results showed that transitioning to WELL certified offices from non-WELL certified offices had a positive impact on occupant satisfaction with the workplace and occupant perceived health, well-being, and productivity, with increases in means from pre-to post-occupancy being highly statistically significant. The majority of the studied occupant satisfaction parameters as well as occupant perceived mental health had large effect sizes. While they improved from pre-to post-occupancy, the analysis revealed small effect sizes for occupant perceived physical health and self-assessed productivity. The majority of the effect sizes for the perceived well-being parameters were large and medium. In addition to analyzing the survey responses in aggregate, the responses were examined at the individual company level to confirm the by-company and aggregate findings aligned.

32 ENERGY CONSERVATION, CONSUMPTION, AND UTILIZATI↗