Local Leaders' Perspectives on Women Veterans’ Health Care: What Would Ideal Look Like?

Abstract

Background: The Veterans Health Administration (VHA) faces challenges in providing comprehensive, gender-sensitive care for women. National policies have led to important advancements, but local leadership also plays a vital role in implementing changes and operationalizing national priorities. In this paper, we explore notions of ideal women Veterans’ health care articulated by women’s health leaders at local VHA facilities and regional networks, with the goal of identifying elements that could inform practice and policy. Methods: We conducted semi-structured interviews with 86 local and regional women’s health leaders at 12 VHA medical centers across four regions. At the conclusion of interviews about women’s primary care, participants were asked to imagine “ideal care” for women Veterans. Interviews were transcribed and coded using a hybrid inductive/deductive approach. Main findings: In describing ideal care, participants commonly touched on: whether women Veterans should have separate primary care services from men; the need for childcare, expanded reproductive health services, resources and staffing; geographic accessibility; the value of input from women Veterans; physical appearance of facilities; fostering active interest in women’s health across providers and staff; and the relative priority of women’s health at the VHA. Principal conclusions: Policy and practice changes to care for women Veterans must be mindful of key stakeholders’ vision for that care. Specific features of that vision include: clinic construction that anticipates a growing patient population; providing childcare and expanded reproductive health services; ensuring adequate support staff; expanding mechanisms to incorporate women Veterans’ input; and fostering a culture oriented towards women’s health at the organizational level.

Ethnoracial status, intersectionality with gender, and psychotherapy utilization, retention, and outcomes.

“…Beyond the financial impact of ethnoracial differences in employment, hourly positions with work schedules that change biweekly are barriers to establishing a regular schedule for treatment (Henly & Lambert 2014; Lambert et al, 2012). This coupled with the lack of adequate childcare represent additional barriers to securing time for psychotherapy that is particularly relevant for women (Brunner et al, 2019; Henly & Lambert, 2014). Finally, lack of knowledge about where to receive care may explain the increased reliance on primary care physicians and emergency rooms for psychiatric needs by Black and Latinx clients (Lê Cook et al, 2014).…”

Mind the gap: Sex, gender, and intersectionality in military-to-civilian transitions

“…The research literature emphasizes the need to develop specifically tailored programs and care that can meet the needs of women Veterans, MST survivors, and other vulnerable subpopulations of Veterans, such as LGBT+, Black, Indigenous, and People of Colour. [87][88][89][90][91] The U.S. Department of Veterans Affairs (VA) and its Veterans Health Administration (VHA) have made great strides toward identifying and addressing the needs of women Veterans and, to a lesser extent, the needs of LGBT+ and racialized Veterans through a number of initiatives: dedicated research, 92 designated personnel (e.g., women Veteran coordinators, 93 MST coordinators, 94 and LGBT coordinators 95 ), sex-specific programming and service delivery models, 96 and the use of technology for outreach. 97 The United States stands out for its government-driven and -supported research agenda that covers a wide range of types of research, from biomedical, demographic, and statistical to qualitative, particularly when it comes to women Veterans' health.…”

The training needs for gender-sensitive care in a pediatric rehabilitation hospital: a qualitative study

“…Although research in the area of gender-sensitive care is growing, most studies focus on the need for gendersensitive care or exploratory research with specific adult populations (e.g., mental health, veterans' health care, reproductive health), and focus mostly on women's healthcare [48][49][50][51][52]. Of the limited research that has explored the challenges amongst providers practicing gendersensitive care within pediatric rehabilitation they found gender differences within their clinical practice were often based on stereotypes [20].…”