Danielle E. Rose PhD, MPH , Melissa M. Farmer PhD , Sabine M. Oishi PhD, MSPH , Ruth S. Klap PhD , Bevanne A. Bean-Mayberry MD, MHS , Ismelda Canelo MPA , Donna L. Washington MD, MPH , Elizabeth M. Yano PhD, MPH
{"title":"欢迎环境是否会影响女性退伍军人的初级保健体验?","authors":"Danielle E. Rose PhD, MPH , Melissa M. Farmer PhD , Sabine M. Oishi PhD, MSPH , Ruth S. Klap PhD , Bevanne A. Bean-Mayberry MD, MHS , Ismelda Canelo MPA , Donna L. Washington MD, MPH , Elizabeth M. Yano PhD, MPH","doi":"10.1016/j.whi.2024.07.002","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>A welcoming environment may influence patient care experiences, and it may be particularly relevant for underrepresented groups, such as women veterans at Veterans Health Administration (VA) facilities where they represent only 8–10% of patients. Challenges to ensuring a welcoming environment for women veterans may include unwelcome comments from male veterans and staff or volunteers and feeling unsafe inside or outside VA facilities. We assessed associations between reports of gender-related environment of care problems and patient-reported outcomes.</p></div><div><h3>Procedures</h3><p>We merged national patient-reported outcomes from women veterans (<em>n</em> = 4,961) using Consumer Assessment of Health Plans & Systems Patient Centered Medical Home (CAHPS-PCMH) survey composite measures with Women Veteran Program Managers' reports of gender-related environment of care problems (<em>n</em> = 127, 2016–2017) at VA facilities. We performed multilevel bivariate logistic regressions to assess associations between Women Veteran Program Managers' reports of large/extreme problems and likelihood of women veterans’ optimal ratings of primary care experiences (access, coordination, comprehensiveness, provider communication, and overall rating of primary care provider). We adjusted for patient-, site-, and area-level characteristics, and clustering of patients within VA facilities, and we applied design weights to address nonresponse bias in the patient data. Response rates were 40% for women veterans and 90% for Women Veteran Program Managers.</p></div><div><h3>Main Findings</h3><p>Few (<15%) Women Veteran Program Managers reported large/extreme environment of care problems. Women veterans obtaining care at those sites were less likely to rate provider communication and comprehensiveness (psychosocial health assessed) as optimal.</p></div><div><h3>Principal Conclusions</h3><p>Ensuring a welcoming environment may improve women veterans' primary care experiences.</p></div>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":"34 5","pages":"Pages 540-548"},"PeriodicalIF":2.8000,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Does a Welcoming Environment Influence Women Veterans’ Primary Care Experiences?\",\"authors\":\"Danielle E. Rose PhD, MPH , Melissa M. Farmer PhD , Sabine M. Oishi PhD, MSPH , Ruth S. Klap PhD , Bevanne A. Bean-Mayberry MD, MHS , Ismelda Canelo MPA , Donna L. Washington MD, MPH , Elizabeth M. Yano PhD, MPH\",\"doi\":\"10.1016/j.whi.2024.07.002\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>A welcoming environment may influence patient care experiences, and it may be particularly relevant for underrepresented groups, such as women veterans at Veterans Health Administration (VA) facilities where they represent only 8–10% of patients. Challenges to ensuring a welcoming environment for women veterans may include unwelcome comments from male veterans and staff or volunteers and feeling unsafe inside or outside VA facilities. We assessed associations between reports of gender-related environment of care problems and patient-reported outcomes.</p></div><div><h3>Procedures</h3><p>We merged national patient-reported outcomes from women veterans (<em>n</em> = 4,961) using Consumer Assessment of Health Plans & Systems Patient Centered Medical Home (CAHPS-PCMH) survey composite measures with Women Veteran Program Managers' reports of gender-related environment of care problems (<em>n</em> = 127, 2016–2017) at VA facilities. We performed multilevel bivariate logistic regressions to assess associations between Women Veteran Program Managers' reports of large/extreme problems and likelihood of women veterans’ optimal ratings of primary care experiences (access, coordination, comprehensiveness, provider communication, and overall rating of primary care provider). We adjusted for patient-, site-, and area-level characteristics, and clustering of patients within VA facilities, and we applied design weights to address nonresponse bias in the patient data. Response rates were 40% for women veterans and 90% for Women Veteran Program Managers.</p></div><div><h3>Main Findings</h3><p>Few (<15%) Women Veteran Program Managers reported large/extreme environment of care problems. Women veterans obtaining care at those sites were less likely to rate provider communication and comprehensiveness (psychosocial health assessed) as optimal.</p></div><div><h3>Principal Conclusions</h3><p>Ensuring a welcoming environment may improve women veterans' primary care experiences.</p></div>\",\"PeriodicalId\":48039,\"journal\":{\"name\":\"Womens Health Issues\",\"volume\":\"34 5\",\"pages\":\"Pages 540-548\"},\"PeriodicalIF\":2.8000,\"publicationDate\":\"2024-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Womens Health Issues\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S104938672400063X\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Womens Health Issues","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S104938672400063X","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}
Does a Welcoming Environment Influence Women Veterans’ Primary Care Experiences?
Background
A welcoming environment may influence patient care experiences, and it may be particularly relevant for underrepresented groups, such as women veterans at Veterans Health Administration (VA) facilities where they represent only 8–10% of patients. Challenges to ensuring a welcoming environment for women veterans may include unwelcome comments from male veterans and staff or volunteers and feeling unsafe inside or outside VA facilities. We assessed associations between reports of gender-related environment of care problems and patient-reported outcomes.
Procedures
We merged national patient-reported outcomes from women veterans (n = 4,961) using Consumer Assessment of Health Plans & Systems Patient Centered Medical Home (CAHPS-PCMH) survey composite measures with Women Veteran Program Managers' reports of gender-related environment of care problems (n = 127, 2016–2017) at VA facilities. We performed multilevel bivariate logistic regressions to assess associations between Women Veteran Program Managers' reports of large/extreme problems and likelihood of women veterans’ optimal ratings of primary care experiences (access, coordination, comprehensiveness, provider communication, and overall rating of primary care provider). We adjusted for patient-, site-, and area-level characteristics, and clustering of patients within VA facilities, and we applied design weights to address nonresponse bias in the patient data. Response rates were 40% for women veterans and 90% for Women Veteran Program Managers.
Main Findings
Few (<15%) Women Veteran Program Managers reported large/extreme environment of care problems. Women veterans obtaining care at those sites were less likely to rate provider communication and comprehensiveness (psychosocial health assessed) as optimal.
Principal Conclusions
Ensuring a welcoming environment may improve women veterans' primary care experiences.
期刊介绍:
Women"s Health Issues (WHI) is a peer-reviewed, bimonthly, multidisciplinary journal that publishes research and review manuscripts related to women"s health care and policy. As the official journal of the Jacobs Institute of Women"s Health, it is dedicated to improving the health and health care of all women throughout the lifespan and in diverse communities. The journal seeks to inform health services researchers, health care and public health professionals, social scientists, policymakers, and others concerned with women"s health.