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2019 HSR&D/QUERI National Conference Abstract

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4128 — Increasing Engagement of Women Veterans in Research

Lead/Presenter: Joya Chrystal,  COIN - Los Angeles
All Authors: Chrystal JG (Department of Veterans Affairs, Health Services Research & Development Center for the Study of Healthcare Innovation, Implementation & Policy), Dyer, KE (Department of Veterans Affairs, Health Services Research & Development Center for the Study of Healthcare Innovation, Implementation & Policy), Gammage, CE (Department of Veterans Affairs, Health Services Research & Development Center for the Study of Healthcare Innovation, Implementation & Policy) Tennenbaum, D (Department of Veterans Affairs, Health Services Research & Development Center for the Study of Healthcare Innovation, Implementation & Policy) Klap, RS (Department of Veterans Affairs, Health Services Research & Development Center for the Study of Healthcare Innovation, Implementation & Policy); (Department of Psychiatry and Biobehavioral Sciences, UCLA David Geffen School of Medicine) Carney, DV (Department of Veterans Affairs, Health Services Research & Development Center for Innovation to Implementation) Frayne, SM (Department of Veterans Affairs, Health Services Research & Development Center for Innovation to Implementation); (Division of Primary Care and Population Health, Stanford University School of Medicine) Yano, EM (Department of Veterans Affairs, Health Services Research & Development Center for the Study of Healthcare Innovation, Implementation & Policy); (Department of Health Policy & Management, UCLA Fielding School of Public Health) Hamilton, AB (Department of Veterans Affairs, Health Services Research & Development Center for the Study of Healthcare Innovation, Implementation & Policy); (Department of Psychiatry and Biobehavioral Sciences, UCLA David Geffen School of Medicine)

Objectives:
Consistent with initiatives in health services research nationally, VA Health Services Research and Development has increasingly recognized the value of engaging Veterans in research. In an effort to shift toward a more community-engaged research paradigm in VA women's health research, we sought the input of women Veterans, women's health primary care providers (PCPs), and administrators regarding barriers to and facilitators of women Veterans' engagement in research, and suggestions for improvement.

Methods:
We conducted semi-structured qualitative telephone interviews Women Veterans (N = 31), PCPs (N = 22), and administrators (N = 6) across five VA Women's Health Practice-Based Research Network sites between October 2016-April 2018. Interviews were audio recorded and transcribed. Consensus-based coding was conducted by two expert analysts.

Results:
All participant groups perceived increasing women's engagement in women's health research to be an important priority. Similarities and differences across participant groups emerged. All groups identified the following barriers to women Veterans' engagement: unaware of opportunities, distrust of research, competing priorities, limited time, and fear of exposure. Women Veterans identified the following barriers: confidentiality concerns, referencing the past, and perception of no effect. PCPs and administrators identified additional barriers: environment concerns, mental health distress, and cultural disconnect. All groups identified the following facilitators to women Veterans' engagement: recruitment using the electronic patient portal, warm hand-offs from provider/staff to Veteran, adoption of research registry, and emphasizing study details. Women Veterans identified the following facilitators: word of mouth from other Veterans, social media outlets, and women Veteran-focused events. PCPs and administrators identified additional facilitators: research ambassadors, provide Veterans with research findings, and adopt trauma-informed research methods. Women Veterans expressed altruistic motives most frequently as an engagement determinant, as well as a strong interest in working alongside researchers to help drive women's health research forward.

Implications:
All participant groups expressed support for increasing women Veterans' engagement in women's health research. Lack of awareness of research opportunities was a key barrier to engagement, and distrust in research could be mitigated by better efforts to disseminate research findings.

Impacts:
Knowledge about barriers to engagement and how to improve women Veterans' engagement will inform ongoing efforts to design, conduct, and disseminate community-engaged women's health research in VA.