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GEN 20-057 – HSR&D Study

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GEN 20-057
Toward Gender Aware VA Health Care: Development and Evaluation of an Intervention
Dawne S Vogt PhD BA
VA Boston Healthcare System Jamaica Plain Campus, Jamaica Plain, MA
Boston, MA
Funding Period: October 2002 - September 2005

BACKGROUND/RATIONALE:
While VHA and HSR&D have increasingly focused on the health care provided to women veterans, the need for additional improvements remains. Findings from a previously funded HSR&D project revealed deficits in VHA staff gender awareness, conceptualized as the three interrelated components of gender-role ideology (extent to which a healthcare worker does or does not rely on stereotypes about women to make judgments about aspects of their care), sensitivity (degree to which a healthcare worker is aware of and sympathetic toward the unique needs and requirements of female patients), and knowledge (extent to which a healthcare worker possesses accurate information regarding women veterans and their VHA care).

OBJECTIVE(S):
The primary objective of this project was to develop a computerized education program that would challenge negative stereotypes about female patients, increase empathy toward female patients’ needs, and enhance knowledge regarding women veterans and general aspects of their VHA care. The achievement of this long-term objective involved three immediate objectives. Immediate Objective 1 (Phase 1) was to identify content domains in which enhanced staff gender awareness is needed and develop vignettes that address these content domains. Immediate Objective 2 (Phase 2) was to integrate vignettes into a computerized interactive educational program (CD medium). Immediate Objective 3 (Phase 3) was to implement and scientifically validate the impact of this educational intervention on staff gender awareness.

METHODS:
During Phase I we developed the content for the educational program based on results from our previous gender awareness study, a review of the literature, and input from women’s health experts. During Phase 2, we created a 30-minute computerized interactive CD-based program entitled “Caring for Women Veterans.” The primary design for the quantitative component of the evaluation of this intervention in Phase 3 was experimental, involving a two-group pretest--posttest--follow-up equivalent control group design with an additional other-site comparison group to test for the infusion of effects from the experimental group to the same-site control group. Participants were randomized to complete either the Caring for Women Veterans program (experimental condition) or to complete a program on stress management (control and comparison condition). Analyses of covariance were used to determine if intervention participants have higher gender awareness scores at both post-intervention assessment time points compared with control and comparison group participants, after controlling for pre-intervention scores. Participants also completed a qualitative evaluation of the Caring for Women Veterans program.

FINDINGS/RESULTS:
The Caring for Women Veterans program consists of five interactive modules that incorporate video scenarios and interactive question-and-answer segments targeting identified areas for improvement. Participants who completed the Caring for Women Veterans program showed significantly greater improvement in sensitivity and knowledge relative to the same-site control group participants. In addition, results were maintained for sensitivity over a one-month period. While knowledge was significantly higher at the one-month post-intervention assessment than at the pre-intervention assessment, scores declined slightly from T2 to T3. There was no significant change in gender-role ideology for the intervention group relative to the control group. Preliminary results provide no evidence for infusion: there were no significant differences in improvement in gender awareness between the same-site control group and the other-site comparison group. User satisfaction with the gender awareness program was high; 95% of respondents found the information interesting and informative and 95% would recommend the training to fellow coworkers.

IMPACT:
The Caring for Women Veterans program is a brief, easy-to-administer and effective mechanism that can be used to foster enhanced sensitivity toward and knowledge of women veterans among VHA staff. This educational program can be adapted for web-based administration to new VHA employees as an extension of their personnel training and to existing VHA employees as part of their ongoing education. This mechanism can also be modified for use with other patient populations.

PUBLICATIONS:

Journal Articles

  1. Vogt DS, Barry AA, King LA. Toward gender-aware health care: evaluation of an intervention to enhance care for female patients in the VA setting. Journal of Health Psychology. 2008 Jul 1; 13(5):624-38.
Conference Presentations

  1. Vogt DS, Tanner LR, King DW, Samper RE, La Bash. Short- and long-term effects of a gender awareness intervention among VA healthcare employees. Poster session presented at: VA HSR&D National Meeting; 2005 Feb 17; Baltimore, MD.


DRA: Mental, Cognitive and Behavioral Disorders, Health Systems
DRE: Epidemiology, Technology Development and Assessment
Keywords: Education (provider), Women - or gender differences
MeSH Terms: none

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