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2012 HSR&D/QUERI National Conference Abstract

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2012 National Meeting

1121 — Unmet Needs of OEF/OIF/OND Veterans and Their Families Living in the U.S. Virgin Islands

Uphold CR, NF/SG VHS RORC REAP, GRECC; Midolo JP, QUERI Program; Freytes IM, NF/SG VHS RORC REAP; del Valle L, VA Caribbean HCS; Wing KLKnauff L, and Findley K, NF/SG VHS;

Objectives:
Our objective was to describe and address the healthcare needs of OEF/OIF/OND Veterans and their family members living in the U.S. Virgin Islands (USVI). Although USVI soldiers have suffered from the aftermath of all the previous wars, to date, there is no research on this neglected population.

Methods:
We used community-based participatory research methods and collected data from multiple sources in the USVI: a) document review (government, VA, census), b) literature and Internet searches, c) semi-structured telephone interviews with VA employees, US Army administrators, and local community leaders, and d) focus groups with VA and non-VA providers (n = 9) and OEF/OIF/OND Veterans who were receiving and not receiving VA healthcare (total n = 9).

Results:
The number of OEF/OIF/OND Veterans in the USVI is around 580 and most Veterans are Reservists or National Guardsmen. On the island are two operational community-based outpatient clinics and two Vet Centers that are currently closed. The most frequently identified problems were mental illness, violence, and substance abuse. A recurring theme was that many USVI Veterans do not seek VA services because of the stigmatization of mental health problems and a “culture of privacy” on the island. There was a widespread belief that VA services on the island are inadequate. Language is an important barrier as most USVI Veterans speak English but must travel to Puerto Rico to receive their healthcare, which is provided by Spanish-speaking professionals. Other identified issues were the lack of English-language VA health information and limited support for the families of returning USVI Veterans. To address these issues, we developed printed (compiled into a guidebook) and web-based health information for both Veterans and their families. To increase the cultural relevance of our information, we used USVI graphics and photos. We created 29 consumer-oriented, post-deployment factsheets; a comprehensive list of resources in the USVI; and a collection of self-help tools.

Implications:
Stigmatization of mental health services, a “culture of privacy,” discontent of care provided by Spanish-speaking providers, and lack of English-language health information and services for family members were identified as barriers to obtaining needed healthcare.

Impacts:
To address these unmet needs, we developed culturally-relevant printed and web-based health information for both USVI Veterans and their families.


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