Health Services Research & Development

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2017 HSR&D/QUERI National Conference Abstract

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4055 — Complementary and Integrative Health Preferences of Women Veterans: A Women's Health Practice-Based Research Network Veteran Feedback Project

Lead/Presenter: Rachel Golden, COIN - Palo Alto
All Authors: Golden R (HSR&D Center for Innovation to Implementation (Ci2i), VA Palo Alto Health Care System, Menlo Park, CA) Carney D (HSR&D Ci2i) Vega Hernandez M (HSR&D Ci2i) Klap R (The VA Women's Health Research Consortium and HSR&D Center for the Study of Healthcare Innovation, Implementation & Policy, CSHIIP, VA Greater LA Healthcare) Taylor S (HSR&D CSHIIP and HSR&D QUERI’s Complementary and Integrative Health Evaluation Center) Kligler B (Integrative Health Coordinating Center, Office of Patient-Centered Care & Cultural Transformation) Krejci L (Integrative Health Coordinating Center, Office of Patient-Centered Care & Cultural Transformation) Whitehead A (Integrative Health Coordinating Center, Office of Patient-Centered Care & Cultural Transformation) Yano E (HSR&D CSHIIP) Frayne S (HSR&D Ci2i and Stanford University School of Medicine)

Objectives:
Because the VA aspires to be a learning healthcare system where data informs practice and policy, we conducted the first-ever test of the 60-facility Women's Health Practice-Based Research Network's (PBRN's) capacity to collect data rapidly in support of quality improvement (QI). In response to a data request from the Office of Patient Centered Care and Cultural Transformation and Women's Health Services, we assessed women Veterans' (WVs') preferences for complementary and integrative health (CIH) services.

Methods:
This cross-sectional Veteran feedback project (September 2016-March 2017) asked WVs about 5 types of CIH, including prior use of CIH and what delivery approach they would prefer. We also asked WVs their age and where they received primary care (VAMC, CBOC, other). Over a 1-2 week period, clerks/nurses in 24 PBRN sites distributed this anonymous, confidential, 1-page survey to sequential WVs in primary care clinic settings, which WVs then submitted to a lockbox in each clinic. The PBRN Coordinating Center conducted descriptive analyses of findings.

Results:
Among WVs completing surveys (N = 1,129), 49%, 45%, 16%, 57%, and 35% had tried yoga, mindfulness/meditation, tai chi/qigong, therapeutic massage, and acupuncture, respectively, and 53%, 54%, 43%, 76% and 61%, respectively, would participate if offered at the VA. For yoga, mindfulness/meditation, and tai chi/qigong, 31%, 33%, and 28% would participate in televised classes offered at the VA, 46%, 47%, and 41% would participate in televised VA classes at home, and 53%, 48%, and 47% preferred women-only classes. Preferences were similar for WVs receiving primary care at VAMCs versus CBOCs (p > 0.05).

Implications:
Many WVs have used CIH and express high interest in participating in CIH in-person at the VA, in televised classes at the VA, or from home. About half preferred women-only CIH classes. The PBRN was successful in rapidly collecting patient-centered preferences for care from women at 24 sites around the country.

Impacts:
Consistent with learning healthcare system principles, results were transmitted to national partners to inform policy and planning, and to front-line teams at participating sites to inform their local QI efforts; this promising approach can be replicated to elicit patient-centered perspectives for future policy questions.