Barriers to the use of Veterans Affairs health care services among
                        female veterans who served in Iraq and Afghanistan.

Newins, Amie R.; Wilson, Sarah M.; Hopkins, Tiffany A.; Straits-Tröster, Kristy; Kudler, Harold; Calhoun, Patrick S.

doi:10.1037/ser0000230

Cited by 14 publications

(12 citation statements)

References 23 publications

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“…Although there are a number of evidence-based treatments for PTSD, most Veterans -including women-do not access them (Rosen et al, 2019). Women Veterans report many barriers to accessing care, including concerns about stigma, privacy, and discomfort with using Veterans Affairs (VA) services (Newins et al, 2019). Women living in rural areas may be even more likely to encounter barriers to care (Cully et al, 2010).…”

mentioning

confidence: 99%

A randomized trial of an online, coach-assisted self-management PTSD intervention tailored for women veterans.

Lehavot¹,

Millard²,

Thomas³

et al. 2021

Journal of Consulting and Clinical Psychology

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Objective: Scalable, efficiently delivered treatments are needed to address the needs of women Veterans with PTSD. This randomized clinical trial compared an online, coach-assisted cognitive behavioral intervention tailored for women Veterans with PTSD to phone monitoring only. Method: Women Veterans who met diagnostic criteria for PTSD were randomized to an 8-week web-based intervention, called DElivery of Self TRaining and Education for Stressful Situations (DESTRESS)-Women Veterans version (WV), or to phone monitoring only (N = 102). DESTRESS-WV consisted of online sessions and 15-min weekly phone calls from a study coach. Phone monitoring included 15-min weekly phone calls from a study coach to offer general support. PTSD symptom severity (PTSD Symptom-Checklist-Version 5 [PCL-5]) was evaluated pre and posttreatment, and at 3 and 6 months posttreatment. Results: More participants completed phone monitoring than DESTRESS-WV (96% vs. 76%, p = 0.01), although treatment satisfaction was significantly greater in the DESTRESS-WV condition. We failed to confirm the superiority of DESTRESS-WV in intent-to-treat slope changes in PTSD symptom severity. Both treatments were associated with significant reductions in PTSD symptom severity over time. However, post hoc analyses of treatment completers and of those with baseline PCL ≥ 33 revealed that the DESTRESS-WV group had greater improvement in PTSD symptom severity relative to phone monitoring with significant differences at the 3-month follow-up assessment. Conclusions: Both DESTRESS-WV and phone monitoring resulted in significant improvements in women Veterans' PTSD symptoms. DESTRESS-WV may be an appropriate care model for women Veterans who can engage in the demands of the treatment and have higher baseline symptoms. Future research should explore characteristics of and the methods of reliably identifying women Veterans who are most likely to benefit. Public Health Significance StatementWomen Veterans have a high prevalence of PTSD, unique barriers to care, and underutilize evidencebased PTSD treatments. Findings support further exploration of both DESTRESS-WV and alternative active comparators as low-cost, feasible strategies to enhance access to PTSD care for women Veterans who are otherwise unable to access traditional mental health care.

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mentioning

confidence: 99%

A randomized trial of an online, coach-assisted self-management PTSD intervention tailored for women veterans.

Lehavot¹,

Millard²,

Thomas³

et al. 2021

Journal of Consulting and Clinical Psychology

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“…Recent efforts to expand eligibility to those veterans with other than an honorable discharge may result in improved veteran care (Tsai and Rosenheck, 2018). Future research may also want to examine other possible barriers to eligibility including logistical barriers (Newins et al, 2018) such as paper work, and wait times, which may discourage enrollment of the mentally ill. Additional barriers which could include lack of knowledge about VA services (Washington et al, 2015) and insufficient number of VA providers that may discourage veterans from seeking VA care (Hill et al, 2016). Addressing homelessness may also be critical to reduce veteran suicide and improve veteran physical and mental health.…”

Section: Discussionmentioning

confidence: 99%

Health coverage types and their relationship to mental and physical health in U.S. veterans

Weissman¹,

Russell

Haghighi

et al. 2019

Preventive Medicine Reports

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ObjectiveTo examine sociodemographic characteristics and chronic health conditions in veterans across health coverage types including those without coverage.DesignThe sample included cross-sectional data from veterans aged 18 years and over, collected in the 2016 National Health Interview Survey (n = 3487). Chronic health conditions and sociodemographic variables were examined across eleven health coverage types and combinations of health coverage types, as follows: No coverage, Medicare, Medicaid, Private, TRICARE (formerly known as the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS)), TRICARE and Medicare, Veteran's Administration, Veteran's Administration and Medicare, Veteran's Administration and Private, Veteran's Administration and Private and Medicare.ResultsApproximately 3.9% of veterans did not have coverage. The greatest proportion had private coverage (28.2%), then private coverage plus Medicare (19.6%). Only 5.9% had Veterans Administration coverage solely. Among the veterans not covered, the majority were young, lived alone, had less than a high school education and resided in the South. The most common chronic health conditions among non-covered veterans were obesity and migraine. Regional differences were observed in the types of chronic health conditions. Veterans in the Northeast were less likely to report serious psychological distress. In a logistic regression, younger age (18–44 years), living alone and having less than a high school education were predictive of no coverage, but number of chronic health conditions was not.ConclusionA population of veterans without health coverage may be undeserved and at risk for poor mental and physical health due to non-health related factors.

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“…There is some evidence that mental health service use by men and women veterans is similar but there may be gender differences in treatment receipt 75 . Other barriers to accessing health care may include logistics, stigma and confidentiality 76 . Gender specific services may also be important 77 .…”

Section: Post Service Risk Factorsmentioning

confidence: 99%

Risk factors for mental ill health in UK Army personnel: an overview

Ross¹,

Mackay

Bergman

2021

BMJ Mil Health

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Women in the UK military are more commonly diagnosed with a mental health disorder than men, but the reasons for this difference are not fully understood. This literature review identifies the risk factors for mental ill health in military personnel before serving, during service and as a veteran. The interaction of risk factors is complex and, in some cases, may be synergistic, such as experiencing adverse events in childhood and exposure to combat. Identification of risk factors allows further research to better understand differences between men and women, and the impact of these risk factors on army personnel. In turn this will inform better preventive strategies, which could be targeted at the primary, secondary or tertiary levels.

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Barriers to the use of Veterans Affairs health care services among female veterans who served in Iraq and Afghanistan.

Cited by 14 publications

References 23 publications

A randomized trial of an online, coach-assisted self-management PTSD intervention tailored for women veterans.

A randomized trial of an online, coach-assisted self-management PTSD intervention tailored for women veterans.

Health coverage types and their relationship to mental and physical health in U.S. veterans

Risk factors for mental ill health in UK Army personnel: an overview

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