Experiences and Knowledge of US Department of Veterans Affairs Clinical Services, Research, and Education: Results From a National Survey of Veterans.
Journal
Journal of public health management and practice : JPHMP
ISSN: 1550-5022
Titre abrégé: J Public Health Manag Pract
Pays: United States
ID NLM: 9505213
Informations de publication
Date de publication:
Historique:
pubmed:
9
10
2019
medline:
16
10
2021
entrez:
9
10
2019
Statut:
ppublish
Résumé
This study examined (1) sociodemographic, health, and psychosocial characteristics associated with using the Department of Veterans Affairs (VA) health care system as a primary health care provider; (2) veterans' experience and knowledge of VA clinical services, research, and education; and (3) veteran characteristics associated with VA experience and knowledge. A nationally representative survey was conducted in 2018; eligibility criteria for participation were adults aged 18 years or older, currently living in the United States, and having served on active duty in the US military. The survey was conducted online using large national survey panels. A sample of 1002 veterans across 49 states participated. The survey assessed experience and knowledge of majority of VA clinical services, research, and education. One-quarter of the total sample reported that the VA was their primary health care provider. Among veterans who had ever used VA health care, the majority (68%) reported overall high satisfaction with VA health care but also agreed with "privatizing parts of the VA" (70%). The majority (51%-73%) of veterans reported knowledge of major VA clinical services, with the exception of comprehensive management for chronic pain (24%) and treatment of opioid use disorders (31%). One-quarter to one-half also reported knowledge of several VA research and education centers. Less than 10% of veterans reported having ever used a VA mobile app. The US veterans generally reported positive experiences and good knowledge of VA services and resources. Greater awareness of available VA services for chronic pain and opioid use disorders, as well as VA mobile apps, may help promote more comprehensive care in this population.
Identifiants
pubmed: 31592984
pii: 00124784-202103000-00012
doi: 10.1097/PHH.0000000000001053
doi:
Types de publication
Journal Article
Research Support, U.S. Gov't, Non-P.H.S.
Langues
eng
Pagination
173-185Informations de copyright
Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.
Déclaration de conflit d'intérêts
None of the authors report any conflicts of interest with this work.
Références
Tsai J, Rosenheck RA. US Veterans' use of VA mental health services and disability compensation increased from 2001 to 2010. Health Aff (Millwood). 2016;35(6):966–973.
US Department of Veterans Affairs. Department of Veterans Affairs, FY 2018-2024 Strategic Plan. Washington, DC: US Department of Veterans Affairs; 2018.
US Department of Veterans Affairs. Medical and Dental Education Program. Washington, DC: US Department of Veterans Affairs. https://www.va.gov/OAA/GME_default.asp . Published 2018. Accessed April 14, 2019.
Nutbeam D. Health literacy as a public health goal: a challenge for contemporary health education and communication strategies into the 21st century. Health Promot Int. 2000;15(3):259–267.
Ratzan SC. Health literacy: communication for the public good. Health Promot Int. 2001;16(2):207–214.
Bernhardt JM. Communication at the core of effective public health. Am J Public Health. 2004;94(12):2051–2053.
Westat, Department of Veterans Affairs. National Survey of Veterans, Active Duty Service Members, Demobilized National Guard and Reserve Members, Family Members, and Surviving Spouses. Rockville, MD: Westat and Department of Veterans Affairs; 2010.
Huang G, Muz B, Kim S, Gasper J. 2017 Survey of Veteran Enrollees' Health and Use of Health Care. Rockville, MD: Westat; 2018.
US Department of Veterans Affairs. Key Indicators for Veterans Signals VHA Outpatient Survey. Washington, DC: US Department of Veterans Affairs. https://www.data.va.gov/story/key-indicators-veterans-signals-vha-outpatient-survey . Published 2018. Accessed April 5, 2019.
Riffkin R. Americans With Government Health Plans Most Satisfied. Washington, DC: Gallup, Inc. https://news.gallup.com/poll/186527/americans-government-health-plans-satisfied.aspx . Published 2015. Accessed April 9, 2019.
National Center for Veterans Analysis and Statistics. Veteran population. US Department of Veterans Affairs. Fiscal Year 2016 Population Tables Web site. https://www.va.gov/vetdata/Veteran_Population.asp . Published 2018. Updated November 12, 2018. Accessed January 9, 2019.
Kroenke K, Spitzer RL, Williams JB, Löwe B. An ultra-brief screening scale for anxiety and depression: the PHQ-4. Psychosomatics. 2009;50(6):613–621.
Kroenke K, Spitzer RL, Williams JBW, Monahan PO, Löwe B. Anxiety disorders in primary care: prevalence, impairment, comorbidity, and detection. Ann Intern Med. 2007;146(5):317–325.
Prins A, Bovin MJ, Smolenski DJ, et al. The primary care PTSD screen for DSM-5 (PC-PTSD-5): development and evaluation within a veteran primary care sample. J Gen Intern Med. 2016;31(10):1206–1211.
Bush K, Kivlahan DR, McDonnell MB, Fihn SD, Bradley KA. The AUDIT alcohol consumption questions (AUDIT-C): an effective brief screening test for problem drinking. Ambulatory Care Quality Improvement Project (ACQUIP). Alcohol Use Disorders Identification Test. Arch Intern Med. 1998;158(16):1789–1795.
Kleiman SE, Bovin MJ, Black SK, et al. Psychometric properties of a brief measure of posttraumatic stress disorder-related impairment: the Brief Inventory of Psychosocial Functioning [published online ahead of print October 8, 2018]. Psychol Serv. doi:10.1037/ser0000306.
Sherbourne CD, Stewart AL. The MOS social support survey. Soc Sci Med. 1991;32(6):705–714.
Amstadter AB, Begle AM, Cisler JM, Hernandez MA, Muzzy W, Acierno R. Prevalence and correlates of poor self-rated health in the United States: the national elder mistreatment study. Am J Geriatr Psychiatry. 2010;18(7):615–623.
Britt TW, Greene-Shortridge TM, Brink S, et al. Perceived stigma and barriers to care for psychological treatment: Implications for reactions to stressors in different contexts. J Soc Clin Psychol. 2008;27(4):317–335.
Pietrzak RH, Johnson DC, Goldstein MB, Malley JC, Southwick SM. Perceived stigma and barriers to mental health care utilization among OEF-OIF veterans. Psychiatr Serv. 2009;60(8):1118–1122.
US Department of Veterans Affairs. Vet Center Program. US Department of Veterans Affairs. https://www.vetcenter.va.gov/ . Published 2018. Updated December 4, 2018. Accessed December 9, 2018.
O'Connell MJ, Rosenheck RA. Supported housing: twenty-five years of the Housing and Urban Development-Veterans Affairs Supported Housing (HUD-VASH) Program. In: Tsai J, ed. Homelessness Among U.S. Veterans: A Critical Perspective. New York, NY: Oxford University Press; 2019:77–107.
US Department of Veterans Affairs. Grant and Per Diem Program. Washington, DC: US Department of Veterans Affairs. https://www.va.gov/homeless/gpd.asp . Published 2019. Accessed March 29, 2019.
Kerns RD, Philip EJ, Lee AW, Rosenberger PH. Implementation of the veterans health administration national pain management strategy. Transl Behav Med. 2011;1(4):635–643.
US Department of Veterans Affairs. Opioid Use disorder: A VA Clinician's Guide to Identification and Management of Opioid Use Disorder (2016). Washington, DC: US Department of Veterans Affairs; 2016.
Libby DJ, Pilver CE, Desai R. Complementary and alternative medicine in VA specialized PTSD treatment programs. Psychiatr Serv. 2012;63(11):1134–1136.
US Department of Veterans Affairs. PTSD: National Center for PTSD. Washington, DC: US Department of Veterans Affairs. https://www.ptsd.va.gov/professional/consult/index.asp . Published 2019. Accessed March 3, 2019.
US Department of Veterans Affairs. Veterans Choice Program (VCP). Washington, DC: US Department of Veterans Affairs. https://www.va.gov/COMMUNITYCARE/programs/veterans/VCP/index.asp . Published 2019. Accessed March 29, 2019.
US Department of Veterans Affairs. Coaching Into Care. Washington, DC: US Department of Veterans Affairs. https://www.mirecc.va.gov/coaching/ . Published 2019. Accessed March 20, 2019.
Tragedy Assistance Program for Survivors. TAPS. Arlington, VA: Tragedy Assistance Program for Survivors, Inc. https://www.taps.org/ . Published 2019. Accessed March 25, 2019.
US Department of Veterans Affairs. PTSD: National Center for PTSD. Washington, DC: U.S. Department of Veterans Affairs. https://www.ptsd.va.gov/ . Published 2019. Accessed March 1, 2019.
US Department of Veterans Affairs. National Center on Homelessness among Veterans. Washington, DC: US Department of Veterans Affairs. https://www.va.gov/HOMELESS/nchav/index.asp . Published 2019. Accessed March 27, 2019.
US Department of Veterans Affairs. VISN 2 Center of Excellence for Suicide Prevention. Washington, DC: US Department of Veterans Affairs. https://www.mirecc.va.gov/suicideprevention/ . Published 2018. Updated May 15, 2018. Accessed December 14, 2018.
US Department of Veterans Affairs. MIRECC/CoE. Washington, DC: US Department of Veterans Affairs. https://www.mirecc.va.gov/ . Published 2018. Accessed March 2, 2019.
Kuhn E, Greene C, Hoffman J, et al. Preliminary evaluation of PTSD Coach, a smartphone app for post-traumatic stress symptoms. Mil Med. 2014;179(1):12–18.
US Department of Veterans Affairs. Virtual Hope Box Smartphone App to Prevent Suicide. Washington, DC: US Department of Veterans Affairs. https://www.research.va.gov/research_in_action/Virtual-Hope-Box-smartphone-app-to-prevent-suicide.cfm . Published 2018. Updated June 25, 2018. Accessed December 15, 2018.
US Department of Veterans Affairs. ACT Coach. Washington, DC: US Department of Veterans Affairs. https://mobile.va.gov/app/act-coach . Published 2017. Accessed March 1, 2019.
Kuhn E, Weiss BJ, Taylor KL, et al. CBT-I coach: a description and clinician perceptions of a mobile app for cognitive behavioral therapy for insomnia. J Clin Sleep Med. 2016;12(04):597–606.
Enggasser JL, Hermos JA, Rubin A, et al. Drinking goal choice and outcomes in a web-based alcohol intervention: results from VetChange. Addict Behav. 2015;42:63–68.
Wilson NJ, Kizer KW. The VA health care system: an unrecognized national safety net. Health Aff (Millwood). 1997;16(4):200–204.
Hoge CW, Auchterlonie JL, Milliken CS. Mental health problems, use of mental health services, and attrition from military service after returning from deployment to Iraq or Afghanistan. JAMA. 2006;295(9):1023–1032.
Tsai J, Shen J, Southwick SM, Greenberg S, Pluta A, Pietrzak RH. Public attitudes and literacy about posttraumatic stress disorder in U.S. adults. J Anxiety Disord. 2018;55:63–69.
McCarthy JF, Blow FC, Valenstein M, et al. Veterans Affairs Health System and mental health treatment retention among patients with serious mental illness: evaluating accessibility and availability barriers. Health Serv Res. 2007;42(3, pt 1):1042–1060.
Marmar CR. Mental health impact of Afghanistan and Iraq deployment: meeting the challenge of a new generation of veterans. Depress Anxiety. 2009;26(6):493–497.
Blais RK, Tsai J, Southwick SM, Pietrzak RH. Barriers and facilitators of mental healthcare utilization in older U.S. veterans: results from the National Health and Resilience in Veterans Study. Psychiatr Serv. 2015;66(5):500–506.
Lake C, Ulibarri J, Carpenter R. Results From a Recent Survey Among Veterans. Washington, DC: Lake Research Partners and Chesapeake Beach Consulting. https://vetvoicefoundation.org/press/VVF-Polling-Memo-151109-Veteransv2.pdf . Published 2015. Accessed April 14, 2019.
US Department of Veterans Affairs. VA MISSION Act. Washington, DC: US Department of Veterans Affairs. https://www.va.gov/oei/missionAct/ . Published 2019. Updated March 21, 2019. Accessed April 14, 2019.
Washington DL, Bean-Mayberry B, Hamilton AB, Cordasco KM, Yano EM. Women Veterans' healthcare delivery preferences and use by military service era: findings from the National Survey of Women Veterans. J Gen Intern Med. 2013;28(2):571–576.
Tsai J, Mota N, Pietrzak RH. U.S. female veterans who do and do not rely on VA healthcare: needs and barriers to mental health treatment. Psychiatr Serv. 2015;66(11):1200–1206.
Kaye AD, Baluch A, Scott JT. Pain management in the elderly population: a review. Ochsner J. 2010;10(3):179–187.
Cheatle MD. Prescription opioid misuse, abuse, morbidity, and mortality: balancing effective pain management and safety. Pain Med. 2015;16(suppl 1):S3–S8.
Nuckols TK, Anderson L, Popescu I, et al. Opioid prescribing: a systematic review and critical appraisal of guidelines for chronic pain. Ann Intern Med. 2014;160(1):38–47.
Gellad WF, Good CB, Shulkin DJ. Addressing the opioid epidemic in the United States: lessons from the Department of Veterans Affairs. JAMA Intern Med. 2017;177(5):611–612.
US Department of Veterans Affairs. Choose VA. Washington, DC: US Department of Veterans Affairs. https://www.choose.va.gov/ . Published 2018. Accessed November 9, 2018.
Tsai J, Rosenheck RA. Use of the internet and an online personal health record system by US veterans: comparison of Veterans Affairs mental health service users and other veterans nationally. J Am Med Inform Assoc. 2012;19(6):1089–1094.
McInnes DK, Gifford AL, Kazis L, Wagner TH. Disparities in health-related internet use by US veterans: results from a national survey. Inform Prim Care. 2010;18(1):59–68.