a message to our women veterans women’s health · care, according to a recent va study, and even...

Research to Improve the

Lives of Women Veterans

W O M E N ’ S H E A L T H

D I S C O V E R Y I N N O V A T I O N A D V A N C E M E N T

Joel Kupersmith, M.D.Chief Research and Development OfficerDepartment of Veterans Affairs

A Message to Our Women Veterans

With the fast-growing presence of women in the U.S. Armed Forces, there has beena steep increase in the number of women Veterans seeking Department of VeteransAffairs (VA) health care. Numbering 1.7 million currently, women Veterans makeup 7 percent of the total veteran population—and are expected to account for 10percent of Veterans by the year 2020.

VA is committed to delivering the best-quality care to meet the special healthcare needs of women Veterans, including the more than 250,000 who already useVA health care services. To support provision of this kind of world-class care, theVA has established research in women Veterans’ health as a top priority.

VA’s commitment to women’s health care research is a long-standing one. In theearly 1990s, the agency took steps to significantly increase the participation ofwomen Veterans in VA studies and women's health issues were declared a researchpriority. In 2005, VA research formed a Women’s Health Research Planning Groupto develop an expansive research agenda for women Veterans and to establish VA as a national leader in the investigation of women’s health.

Today, more VA-based women’s health research is being funded than ever before.Research efforts are aimed at better understanding the general health care needsand service utilization of women Veterans; examining the unique experiences of

women Veterans regarding risks, treatment, and healthcare outcomes related to military traumas; assessingVA’s organization of care for women Veterans andthe implications for improving quality of care; anddeveloping innovative ways to meet women Veterans’health needs.

This brochure highlights examples of VA Research’sinnovations and discoveries that are further advancing health care for women Veterans.

VA Research and Development Program:

Focusing on Women Veterans’ Special

Health Care Needs.

2009For questions or additional copies contact:

R&D Communications (12)

103 South Gay Street, Ste. 517

Baltimore, MD 21202

(410) 962-1800 x223

[email protected]

D I S C O V E R Y I N N O V A T I O N A D V A N C E M E N T D I S C O V E R Y I N N O V A T I O N A D V A N C E M E N T D I S C O V E R Y I N N O V A T I O N A D V A N C E M E N T D I S C O V E R Y I N N O V A T I O N A D V A N C E M E N T

Health Care Needs.

For questions or additional copies contact:

Baltimore, MD 21202

(410) 962-1800 x223

[email protected]

Focusing on Women Veterans’

Special Health Care Needs

Research into Care, Quality,and AccessCurrent studies are examining the health careusage of women Veterans and assessing deliveryof care to this population to identify effectiveapproaches, barriers to care, and opportunitiesfor care improvement.

VA Research focusing on women’s health caresatisfaction and the delivery of equitable, high-quality care to women Veterans has yieldedvaluable findings:

• Quality and sensitivity as top-rankedissues—Researchers have found that amongthe health care issues that matter most towomen Veterans are overall quality of care,access to gender-appropriate services, and agender-sensitive environment that respectsprivacy.

• Gynecologic services as key to satisfaction—Availability of routine gynecologic carewithin primary care settings, whichreduces fragmentation of women’s healthcare, has been found to directly influencewhether women choose VA or non-VA care.Integrated gynecologic care—along with access to female providers—earns VA primarycare clinics extremely high satisfaction ratingsamong women Veterans.

• Dedicated women’s clinic as importantfactor—Women Veterans are more satisfiedwith women’s clinics than traditional primarycare clinics, and the availability of such clinicsis cited by many women as a major factor inchoosing VA care.

• Lack of knowledge as barrier to use—Educational campaigns could be useful inimproving women Veterans’ knowledgeabout VA eligibility and available services,research has shown. Many women Veteransnot enrolled in the VA health system areunaware that VA provides women’s healthcare, according to a recent VA study, andeven female Veterans who use VA care arenot fully informed about the types andquality of care available.

• Violence against servicewomen—To identify risk factors for sexual assaultand physical violence against women in themilitary, a VA research team is interviewingabout 500 active-duty women Veterans,all currently or formerly with the Reservesor National Guard. The researchers will alsolook at health care use, health outcomes,and any barriers to VA care.

• Mammography recommendations—An American College of Physicianscommittee chaired by VA and StanfordUniversity researcher Douglas Owens,M.D., recently published a new set of mam-mogram guidelines for women in their 40s.The guidelines, based on a rigorous reviewof the medical literature, call for periodi-cally performing individual assessments ofbreast cancer risk; informing women of thepotential benefits and harms of theprocedure; and incorporating women’spreferences and risk profiles into screeningdecisions.

• Other gender-specific health issues—Additional VA research is examining the cellular mechanisms underlying breast andcervical cancers, the role of hormones instroke and aging, the basic neurobiologicalchanges in women who have gone through severe trauma, and tailored prostheticdesigns for women.

Spotlight on VA ResearchWomen’s gender-specific healthcare needs, including some thatare combat-related, have been animportant part of VA’s research

agenda for more than a decade. Researchin this area is greatly enhanced by VA’spartnerships with other organizations thatshare its strong commitment to promotingwomen’s health and advancing gender equityin health care.

Research into Women’s HealthConditionsResearch priorities cover a broad range of conditions particularly relevant to women Veterans—among them, chronic diseases,cancer, mental health issues, military occupa-tional hazards, and reproductive health.

Important areas of VA research focusing onwomen Veterans’ health conditions include:

• Posttraumatic stress disorder (PTSD)—In the largest randomized clinical trial todate involving women Veterans with PTSD,VA researchers and their colleagues foundthat prolonged-exposure therapy—a typeof cognitive behavioral therapy in whichtherapists help patients recall their traumasunder safe, controlled conditions—was moreeffective in reducing PTSD symptoms thancounseling focused on current problems.Partly as a result of this study, VA launched anationwide effort to train more clinicians inprolonged-exposure therapy.

“It’s important to me, as a VA clinician and researcher, to conduct work that contributesto helping women Veterans access care, and to see research results that constantly improvethe quality of that care.” Donna L. Washington, M.D., M.P.H., VA Greater Los Angeles Healthcare System

“I could not have asked for better. The doctors and allother staff are well-trained,knowledgeable, and mostof all, caring.”One woman Veteran’s experience with VA health care.

Expansive Women-Focused Health ServicesTo respond to the unique needs of women Veterans, VA offers comprehensivehigh-quality primary health care services for women, including Pap smears,mammography, and reproductive health care, as well as mental health servicessuch as substance abuse counseling and treatment of military sexual trauma.

Every VA medical center has a women Veterans program manager; everycommunity-based outpatient clinic has a liaison for women Veterans; and everyregional office has a women Veterans coordinator. In addition to the servicesprovided at each VA medical center, some 50 Women’s Health Centers servewomen Veterans specifically. These centers—whose numbers have increased eight-fold in the past decade in response to increasing need—develop enhanced programsfor women, and some also conduct research in medical and psychosocial issues.

We have created a crucial foundation ofinformation about women’s health conditions,concerns, and experience with care inside andoutside VA that will enable us to improve theirhealth care in the future.

Elizabeth Yano, Ph.D., M.S.P.H., VA HSR&D Center for the

Study of Healthcare Provider Behavior, Sepulveda, CA.

Evolving Research Initiatives In structuring its research agenda, VA continu-ally evaluates the unique health-related needsof women, as well as disparities in care betweenmale and female Veterans. Ongoing researchinitiatives aim to contribute to:• Development of improved therapeuticstrategies for health issues important towomen, such as breast cancer, cardiacconditions, colorectal cancer, and mentalhealth.

• Skills enhancement for primary careproviders who treat women Veterans.

• Improvement of health strategies for familyand reproductive issues.

To ensure that VA stays on the leading edge ofwomen’s health care, the Department conductsand participates in conferences focusing onwomen Veterans’ health issues, including:

“Trauma Spectrum Disorders: The Role of Gender,Race, and Other Socioeconomic Factors”—Thistwo-day conference held in October 2008 washosted by VA, the National Institutes of Health,and the Department of Defense.

Fourth National Summit on Women Veterans’ Issues—This June 2008 event focused on advancing issuesrelating to women Veterans, including militarysexual trauma and readjustment.

Health Care Needs.

For questions or additional copies contact:

Baltimore, MD 21202

(410) 962-1800 x223

[email protected]

a message to our women veterans women’s health · care, according to a recent va study, and even...

Documents