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2011 HSR&D National Meeting Abstract

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2011 National Meeting

3078 — Operation Enduring Freedom and Operation Iraqi Freedom (OEF/OIF) Service Members’ and Veterans’ Decisions to Access the VA

Reisinger HS (CRIISP, Iowa City VAMC)

Objectives:
To characterize reasons returning service members OEF/OIF access the VA or not, and to examine the role family members and VA outreach programs play in service members’ decisions. Previous studies have found veterans with lower income, no private health insurance, lower health status, and service-connected disabilities are more likely to access VA; however, few have analyzed the factors that contribute to OEF/OIF veterans’ decisions.

Methods:
The study employs an ethnographic approach to formative evaluation. Observations were conducted at four family outreach events, in four different communities, targeting family members of currently deployed National Guard and Army and Navy Reserve units. Twelve dyads (service and family member) are participating in the study, which includes a series of in-depth interviews. Data are content analyzed for top-level codes and more detailed coding is completed through subcoding and matrix analyses. Data collection and analysis are ongoing.

Results:
Identified barriers for OEF/OIF veterans accessing care include: lack of understanding of benefits, being too overwhelmed to approach VA as an institution and bureaucracy, and negative perceptions of the VA (e.g., quality, generational, stigma). Factors that facilitate service members’ access to the VA include: leadership and peer encouragement, increased familiarity with the VA due to multiple deployments, and family, particularly spouses. Both family members and service members have personal networks that they consult as need arises. They are more likely to access services based on recommendations of these personal networks rather than outside sources.

Implications:
Although historically important access barriers persist for OEF/OIF veterans, other barriers are unique to OEF/OIF service era. Family members act as important facilitators to service members’ access, but VA outreach encounters barriers to reaching out to families. On-going feedback and evaluation is an important process in program implementation and improvement. An ethnographic approach to formative evaluation may be particularly useful when evidence-based practice is not defined and local programs must both adhere to national mandates as well as respond to local needs.

Impacts:
Understanding the factors that influence OEF/OIF veterans’ decision to use the VA is an important step in tailoring outreach to increase access to VA services.


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