LEADING THE NATION IN WOMEN’S HEALTH: THE IMPORTANT ROLE OF RESEARCH

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LEADING THE NATION IN WOMENS HEALTH THE
IMPORTANT ROLE OF RESEARCH

• Patty Hayes, Ph.D.
• Chief Consultant
• Women Veterans Health Strategic Health Care Group
• Department of Veterans Affairs
• VA Womens Health Services Research Conference
• Arlington, VA ? July 2010

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Overarching Goal

• Enhance the language, practice, and culture of
  VA to be more inclusive of women Veterans

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Strategic Vision

• Understanding and treating the effects of
  military service on womens lives
• All effects- of course awareness of negative
  effects and vulnerabilities, but also of
  strengths and resilience, etc.
• Provide an active communication between
  Researchers and Program/policy Offices to inform
  the provision of care,
• and to provide the most useful research
• Time is short and the stakes are high We must be
  able to be informed about what to do, and measure
  how well we do it.

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Population of Women Veterans
Source data supplied 7/9/10 by the Office of the
Actuary, Office of Policy and Planning,
Department of Veterans Affairs
128,397 separated female OEF/OIF Veterans since
2002
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There are enough women Veterans to study

• Women have often been excluded from VA research
  designs because there were not enough women
  veterans to form a statistical group
• Many VA studies are still reported only for men,
  even when women have been sampled
• Challenge is to
• Provide accessible population data to allow for
  appropriate study design
• Support collaboration across sites

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Women Veterans and the VA
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The population of women Veterans is rapidly
expanding

• Prior to 2005, only 11 of eligible women
  Veterans used VHA health services (compared to
  22 of male Veterans)
• Today, 16 women Veterans use VHA- but still
  relatively fewer than male Veterans who are at
  23 market penetration
• However, 48 of OEF/OIF women have enrolled in
  VHA services
• There are many women Veterans in the pipeline
  and women are accessing VA at an expanding rate

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Women Active Duty Personnel by Branch (2008)
History Vietnam Era, 3 Gulf War I,11 female
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Utility of Research on women Veterans-the
convergence

• Understanding the population and the
  sub-populations of Women Veterans
• Informing program planning, development and
  implementation efforts, including
• Models of provision of health care
• Clinical quality, behavior change implementation
• Rural vs. urban, ethnicity and race factors,
  aging women, young women
• Designing educational tools for staff, providers
  and Veteransand measuring effectiveness

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Key priorities for women Veterans care

• Improve access to VA care
• Improve care culture surrounding women Vets
• Improve woman Veteran centered care
• Improve coordination across providers
• Across womens clinics, primary and specialty
  care
• Reproductive health services
• Within VA and with community providers

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A key example Redesigning Primary Care Delivery

• Comprehensive Primary Care for Women Veterans
  Complete primary care from one designated Womens
  Health Primary Care Provider at one site (CBOCs
  included)
• Care for acute and chronic illness
• Gender-specific primary care
• Preventive services
• Mental Health services
• Coordination of care

Note Womens clinics offering only
gender-specific care (Pap clinic or gynecology
care alone) do not meet the new definition for
comprehensive primary care
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Hayes Assessment of WH Field Status

• Aging Infrastructure of womens research, with
  considerable geographic dispersion
• Senior researchers and research-clinicians are
  over-committed for own research survival and
  mentoring
• Little or No protected time for mentoring
  (succession plan)
• The Womens Health Fellows and other junior
  researchers may not have critical alignment with
  mentoring researchers who have direct womens
  health expertise
• Data sources are complex and protected, as well
  as frequently Dirty or not designed with
  gender factors
• Opportunities for start up support may be limited

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Infusion of resources

• Research Practice Based Research Network
  underway
• Research Collaborative Research and Initiatives
• Research Opportunities for mentoring
• Program/Data Partnerships for example Womens
  Health Evaluation Initiative ( WHEI)
• Has allowed for data identification and
  reconciliation across other data sets such as
  VSSC, ARC,etc , and data definitions
• Direct Program support for communications, cross
  pollination of ideas and projects
• Research Agenda setting conference-HSRD
  Womens Healththe way forward

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