Evidence map›Paper›PMID 41385255›Full record

ArticleMedical care2026

Conceptualizing the Core Components of Exposure-Informed Care: A Delphi Quality Improvement Study.

Rachel L Boska, Laura M Lesnewich, Katharine J Bloeser, Mikayla B McAdams, Andrea R Kossoudji, Shannon M Nugent, Stephen C Hunt, Lisa M McAndrew

Abstract read
In one paragraph

Article in Medical care, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Rachel L BoskaWar Related Illness and Injury Study Center (WRIISC), Veterans Affairs New Jersey Health Care System, East Orange, NJ.ORCID 0000-0001-9280-8100
Laura M LesnewichWar Related Illness and Injury Study Center (WRIISC), Veterans Affairs New Jersey Health Care System, East Orange, NJ.
Katharine J BloeserWar Related Illness and Injury Study Center (WRIISC), Veterans Affairs New Jersey Health Care System, East Orange, NJ.
Mikayla B McAdamsWar Related Illness and Injury Study Center (WRIISC), Veterans Affairs New Jersey Health Care System, East Orange, NJ.
Andrea R KossoudjiWar Related Illness and Injury Study Center (WRIISC), Veterans Affairs New Jersey Health Care System, East Orange, NJ.
Shannon M NugentCenter to Improve Veteran Involvement in Care (CIVIC), VA Portland Healthcare System, Portland, OR.
Stephen C HuntDepartment of Veterans Affairs, Office of Primary Care, NW, Washington DC.
Lisa M McAndrewWar Related Illness and Injury Study Center (WRIISC), Veterans Affairs New Jersey Health Care System, East Orange, NJ.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEnvironmental exposures are common, may impact health, and may cause concerns. There have been calls to improve clinical care for exposure concerns through an "informed care" approach, which designs care in consideration of the patient's experiences with the concern. Understanding Veterans' experiences and concerns about military environmental exposures through an "informed care" approach may help with care; however, there is a need to better define the core components of this model of care.

objectivesThe current project aimed to define the core components of "exposure-informed care" using a modified Delphi quality improvement study. RESEARCH

designDelphi methodology utilizes expert opinion in a series of rounds and is appropriate to use when there is incomplete knowledge, uncertainty, or lack of evidence on a specific topic.

resultsExperts in military environmental exposures (n=35) provided their feedback on the definition of "exposure-informed care." After 4 rounds of rating, 20 statements were agreed upon as core components of exposure-informed care. Accepted statements about the core components of exposure-informed care were coded into a 6-part framework: (1) use concordant communication, (2) build trust, (3) provide resources and support, (4) assess and document, (5) take professional responsibility, and (6) integrate into care.

conclusionsThe 6-part exposure-informed care framework represents experts' definition of the core components of "exposure-informed care." Future implementation of exposure-informed care and the impact of each theme are discussed.

Indexed as

Environmental ExposureQuality ImprovementVeteransCommunicationDelphi TechniqueHumansMilitary PersonnelDelphiexposure-informed caremilitary environmental exposures

Identifiers

PMID41385255
PMCPMC12704662

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.