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2015 HSR&D/QUERI National Conference Abstract

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1029 — Women Veterans' Experiences of Stranger Harassment at VA Medical Centers

Darling JE, VHAGLAHS Center for the Study of Healthcare Implementation, Innovation and Policy; Hamilton AB, VHAGLAHS Center for the Study of Healthcare Implementation, Innovation and Policy; Canelo IA, VHAGLAHS Center for the Study of Healthcare Implementation, Innovation and Policy; Haskell SG, VHA Office of Women's Health Services; Yano EA, VHAGLAHS Center for the Study of Healthcare Implementation, Innovation and Policy;

Objectives:
Stranger harassment has been defined as unwanted verbal or physical behaviors by an individual with no ties to the target of harassment, often in public settings. No studies to date have examined the extent to which women Veterans (WVs) experience stranger harassment when visiting VA medical centers (VAMCs) for care.

Methods:
We conducted computer-assisted telephone interviews from January-March 2015 among WVs with three or more VA primary care and/or women's health visits in the prior 12 months at 12 VAMCs across four VISNs (n = 1205, 45% response rate). The interview included an item asking if they had experienced inappropriate or unwanted comments toward them from male Veterans in the past 12 months. WVs who reported negative interactions were asked for brief verbal descriptions and whether they had mentioned the incident to anyone at VA, such as their VA provider, staff member, or volunteer. Descriptions of interactions were transcribed verbatim and thematically coded.

Results:
Twenty-four percent experienced stranger harassment at their VAMC. Commonly occurring types of harassment included derogatory remarks and slurs; staring; propositions; remarks; catcalls; sexual or personal comments, jokes and innuendos; and comments that women don't belong at VA. Incidents mainly occurred in areas where patients congregate, such as mixed-gender waiting rooms, and in transition zones, such as hallways, elevators and entrance walkways. Forty-four percent mentioned such incidents to their provider and/or someone else at VA.

Implications:
An alarming proportion of women experienced stranger harassment when visiting their VAMCs for care, but often did not report these incidents. Women-only clinics/waiting areas may reduce incidence but these options are not consistently available, and do not address the underlying problem of unwelcome interactions in shared areas such as hallways and elevators.

Impacts:
The VA has defined comprehensive care for WVs to include sensitivity to gender-specific needs in environments that offer safety and dignity. Our assessment of the extent and type of stranger harassment experienced by WVs at VA demonstrates a significant threat to VA's ability to deliver such care. While the VA is focused on increasing access to address waits and delays, ensuring that the environment of care is appropriate is also critical.