Primary Care Providers with More Experience and Stronger Self-Efficacy Beliefs Regarding Women Veterans Screen More Frequently for Interpersonal Violence

Published in: Women's Health Issues [Epub July 2017]. doi: 10.1016/j.whi.2017.06.003

Posted on RAND.org on September 06, 2017

by Lisa S. Meredith, Gulrez Shah Azhar, Adeyemi Okunogbe, Ismelda A. Canelo, Jill Darling, Amy Street, Elizabeth Yano

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Research Question

  1. What factors influence more frequent screening of military sexual trauma (MST) and intimate partner violence (IPV) among women veterans by primary care providers (PCPs) at the Veterans Health Administration (VHA)?

Background

Military sexual trauma (MST) and/or intimate partner violence (IPV) are common experiences in the growing group of women veterans using the Veterans Health Administration health care system. And even though MST screening is closely monitored at the facility level, little is known about individual primary care provider (PCP) behavior with regard to screening women for MST and IPV.

Objectives

To understand how PCP experiences and beliefs regarding women's health care influence PCP-reported screening for MST and IPV.

Research Design and Participants

We administered a cross-sectional online survey from September 2014 through April 2015 (supplemented by a mailed survey between April and May 2015) to 281 PCPs in 12 Veterans Health Administration medical centers.

Measures and Analysis

Surveys measured PCP-reported screening frequency for MST and IPV, experience with women veterans, self-efficacy, gender-sensitive beliefs, and perceived barriers to providing comprehensive care for women. We used multivariable ordered logistic regression analysis to identify correlates of screening, weighted for nonresponse and adjusted for clustering.

Results

Ninety-four PCPs (34%) completed the survey. Being a designated women's health provider (p < .05) and stronger self-efficacy beliefs about screening women for MST (p < .001) were associated with reporting more frequent screening for MST. Being a designated women's health provider (p < .01), seeing women patients at least once per week (p < .001), and self-efficacy beliefs about screening women for IPV (p < .001) were associated with reporting more frequent screening for IPV.

Conclusions

Veterans Health Administration initiatives to enhance PCP opportunities to screen women veterans for trauma and to strengthen self-efficacy beliefs about comprehensive women's health care may increase screening of women veterans for MST and IPV.

Key Findings

  • Reported screening rates for MST (67 percent) and IPV (59.5 percent) were high in comparison to the general population (12 percent or less), although universal MST screening has been mandated within the VHA since 2000.
  • For MSR, more frequent screening was associated with being a designated women’s health provider and holding strong self-efficacy beliefs about screening women for MST.
  • For IPV, more frequent screening was associated with being a designated women’s health provider, seeing women patients at least once per week, and holding strong self-efficacy beliefs about screening women for IPV.
  • VHA initiatives to enhance PCP opportunities to screen women veterans for trauma and to strengthen self-efficacy beliefs about comprehensive women’s healthcare may have increased screening of women veterans for MST and IPV.

Research conducted by

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