Communities Serve: A Systematic Review of Need Assessments on U.S. Veteran and Military-Connected Populations

Slyke, Ryan D. Van; Armstrong, Nicholas J.

doi:10.1177/0095327x19845030

Cited by 14 publications

(5 citation statements)

References 41 publications

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“…37,38 Over 45,000 military-focused non-profit organizations outside the VA also provide support to this population, often with limited coordination across organizations that provide complementary services. 31 Responding to the multitude of services available to Veterans and military families, 7,[39][40][41] the AmericaServes Program was established to build, sustain, and evaluate regional, coordinated networks of public and private organizations supporting US military Veterans. 42,43 Designed to integrate services across systems and improve service navigation, 29 regional AmericaServes Coordination Centers facilitate a hub and spoke model of health and social service delivery with participating organizations serving the same region.…”

Section: Introductionmentioning

confidence: 99%

Participation of Veterans Affairs Medical Centers in veteran‐centric community‐based service navigation networks: A mixed methods study

Hausmann,

Goodrich,

Rodriguez

et al. 2024

Health Services Research

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ObjectiveTo understand the determinants and benefits of cross‐sector partnerships between Veterans Affairs Medical Centers (VAMCs) and geographically affiliated AmericaServes Network coordination centers that address Veteran health‐related social needs.Data Sources and SettingSemi‐structured interviews were conducted with AmericaServes and VAMC staff across seven regional networks. We matched administrative data to calculate the percentage of AmericaServes referrals that were successfully resolved (i.e., requested support was provided) in each network overall and stratified by whether clients were also VAMC patients.Study DesignConvergent parallel mixed‐methods study guided by Himmelman's Developmental Continuum of Change Strategies (DCCS) for interorganizational collaboration.Data CollectionFourteen AmericaServes staff and 17 VAMC staff across seven networks were recruited using snowball sampling and interviewed between October 2021 and April 2022. Rapid qualitative analysis methods were used to characterize the extent and determinants of VAMC participation in networks.Principal FindingsOn the DCCS continuum of participation, three networks were classified as networking, two as coordinating, one as cooperating, and one as collaborating. Barriers to moving from networking to collaborating included bureaucratic resistance to change, VAMC leadership buy‐in, and not having VAMCs staff use the shared technology platform. Facilitators included ongoing communication, a shared mission of serving Veterans, and having designated points‐of‐contact between organizations. The percentage of referrals that were successfully resolved was lowest in networks engaged in networking (65.3%) and highest in cooperating (85.6%) and collaborating (83.1%) networks. For coordinating, cooperating, and collaborating networks, successfully resolved referrals were more likely among Veterans who were also VAMC patients than among Veterans served only by AmericaServes.ConclusionsVAMCs participate in AmericaServes Networks at varying levels. When partnerships are more advanced, successful resolution of referrals is more likely, especially among Veterans who are dually served by both organizations. Although challenges to establishing partnerships exist, this study highlights effective strategies to overcome them.

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Section: Introductionmentioning

confidence: 99%

Participation of Veterans Affairs Medical Centers in veteran‐centric community‐based service navigation networks: A mixed methods study

Hausmann,

Goodrich,

Rodriguez

et al. 2024

Health Services Research

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“…1 As the largest single health care provider in the country, the Veterans Health Administration (VHA) offers veterans broad-ranging services encompassing physical, behavioral, and social health domains. However, little is known about LGBTQ+ veterans' utilization of health care generally or VHA and military health plans specifically, 2 particularly compared to non-LGBTQ+ veterans. LGBTQ+ veterans have experienced a long history of discrimination in military service and in VHA, 3,4 which may contribute to discomfort in seeking care at VHA.…”

Section: Introductionmentioning

confidence: 99%

Primary sources of health care among LGBTQ+ veterans: Findings from the Behavioral Risk Factor Surveillance System

Hahn

Burkitt

Kauth

et al. 2022

Health Services Research

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Objective This study examined the primary source of health care between veterans with lesbian, gay, bisexual, queer and similar identities (LGBTQ+) and non‐LGBTQ+ veterans. Data Sources and Study Setting Veterans (N = 20,497) from 17 states who completed the CDC's Behavioral Risk Factor Surveillance System from 2016 to 2020, including the Sexual Orientation and Gender Identity and Health Care Access modules. Study Design We used survey‐weighted multiple logistic regression to estimate average marginal effects of the prevalence of utilization of Veteran's Health Administration (VHA)/military health care reported between LGBTQ+ and non‐LGBTQ+ veterans. Prevalence estimates were adjusted for age group, sex, race and ethnicity, marital status, educational attainment, employment status, survey year, and US state. Data Collection Methods Study data were gathered via computer‐assisted telephone interviews with probability‐based samples of adults aged 18 and over. Data are publicly available. Principal Findings Overall, there was not a statistically significant difference in estimated adjusted prevalence of primary use of VHA/military health care between LGBTQ+ and non‐LGBTQ+ veterans (20% vs. 23%, respectively, p = 0.13). When examined by age group, LGBTQ+ veterans aged 34 and younger were significantly less likely to report primary use of VHA/military health care compared to non‐LGBTQ+ veterans (25% vs. 44%, respectively; p = 0.009). Similarly, in sex‐stratified analyses, fewer female LGBTQ+ veterans than female non‐LGBTQ+ veterans reported VHA/military health care as their primary source of care (13% vs. 29%, respectively, p = 0.003). Implications and limitations to these findings are discussed. Conclusions Female and younger LGBTQ+ veterans appear far less likely to use VHA/military for health care compared to their cisgender, heterosexual peers; however, because of small sample sizes, estimates may be imprecise. Future research should corroborate these findings and identify potential reasons for these disparities.

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“…A recent systematic review of Veteran needs assessments found a scarcity of reports addressing rural Veterans (Van Slyke & Armstrong, 2020). Further research is required to understand the needs of this population, including how to address obstacles that prevent rural Veterans experiencing housing instability from engaging in services.…”

Section: Introductionmentioning

confidence: 99%

Providers' reflections on infrastructure and improvements to promote access to care for Veterans experiencing housing instability in rural areas of the United States: A qualitative study

Cusack

Montgomery

Harris

et al. 2022

Health Social Care Comm

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Veterans in rural areas of the United States face barriers to accessing healthcare and other services, which are intensified for those experiencing housing instability. Recent legislative acts have the potential to address obstacles faced by rural patients in the U.S. This study explores how infrastructure—including features related to the physical and digital environment—impacts the ability of rural Veterans experiencing housing instability to access healthcare and related services from the perspective of homeless service providers within the Veterans Health Administration (VHA). We conducted semi‐structured telephone interviews (n = 22) with providers in high/low performing and/or resourced communities across the U.S. in May and June 2021 and analysed transcripts using template analysis. Themes described by providers highlight how infrastructure limitations in rural areas can exacerbate health disparities for Veterans experiencing housing instability, the impact of COVID‐19 on service access, and recommendations to enhance service delivery. Providers suggested that VHA reconfigure where and how staff work, identify additional resources for transportation and/or alternative transportation models, and increase Veterans' access to technology and broadband Internet. Federal infrastructure investments should address challenges faced by Veterans experiencing housing instability in rural areas and the concerns of providers connecting them with care.

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Communities Serve: A Systematic Review of Need Assessments on U.S. Veteran and Military-Connected Populations

Cited by 14 publications

References 41 publications

Participation of Veterans Affairs Medical Centers in veteran‐centric community‐based service navigation networks: A mixed methods study

Participation of Veterans Affairs Medical Centers in veteran‐centric community‐based service navigation networks: A mixed methods study

Primary sources of health care among LGBTQ+ veterans: Findings from the Behavioral Risk Factor Surveillance System

Providers' reflections on infrastructure and improvements to promote access to care for Veterans experiencing housing instability in rural areas of the United States: A qualitative study

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