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CDA 12-273 – HSR&D Study

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CDA 12-273
Gender & Access to VA Mental Health Care: The Example of Military Sexual Trauma
Jessica A. Turchik PhD
VA Palo Alto Health Care System, Palo Alto, CA
Palo Alto, CA
Funding Period: October 2013 - July 2015

BACKGROUND/RATIONALE:
Each year, VHA provides care to a Veteran population where approximately 20% of women and 1% of men have reported m sexual trauma (MST), a VA-defined term that refers to unwanted and threatening sexual harassment or sexual assault that occurred during military service. Veterans who report MST have greater rates of a wide range of mental health diagnoses and physical health diagnoses compared to those without MST, even after controlling for a number of demographic and military service-related variables. Currently only one study has examined MST MH care (Turchik et al., 2012), and more research is needed in this area to determine whether Veterans have adequate access to it. Given the current status of the literature, much is still unknown regarding access to MST MH care, although data suggests Veterans may be underutilizing these services.

OBJECTIVE(S):
The main objectives of this study are to quantify the gender disparity in access to MST care (Phase 1), to examine factors related to access to MST MH care (Phase 2), and to pilot an intervention designed to reduce the gender disparity and promote access to care (Phase 3).

METHODS:
The current study will use an innovative and efficient combination of VA administrative data and national survey data to measure access to care to determine the most important modifiable points of interventions with Veterans. Phase 1 of the research will include the analysis of Veteran administrative data to quantify use and intensity of MST MH care in a one year period. During phase 2, 5,000 Veterans who had positive screens with MST will be contacted by mail to complete a survey regarding use of VA services, perceived barriers and facilitators to receiving VA care for MST related services, and satisfaction with VA services. In phase 3, approximately 240 Veterans who have screened positive for MST in VA electronic record in the past 48 months will be enrolled in a cognitive-behavioral based telephone intervention designed to increase access to mental health care for Veterans who have experienced MST.

FINDINGS/RESULTS:
Not yet available.

IMPACT:
It is hoped that the findings from this study will lead to improvements in care for Veterans with MST and increase in awareness of VA services and service utilization among study participants.

PUBLICATIONS:

Journal Articles

  1. Tiet QQ, Leyva YE, Blau K, Turchik JA, Rosen CS. Military sexual assault, gender, and PTSD treatment outcomes of U.S. Veterans. Journal of traumatic stress. 2015 Apr 1; 28(2):92-101.
  2. Turchik JA, Hassija CM. Female Sexual Victimization Among College Students: Assault Severity, Health Risk Behaviors, and Sexual Functioning. Journal of interpersonal violence. 2014 Sep 1; 29(13):2439-2457.
  3. Turchik JA, Walsh K, Marcus D. Confirmatory validation of the factor structure and reliability of the Sexual Risk Survey in a large multi-university sample of U.S. students. International journal of sexual health : official journal of the World Association for Sexual Health. 2014 Aug 14; doi: 10.1080/19317611.2014.944295.
  4. Turchik JA, Rafie S, Rosen CS, Kimerling R. Preferences for gender-targeted health information: a study of male veterans who have experienced military sexual trauma. American Journal of Men's Health. 2014 May 1; 8(3):240-8.
  5. Turchik JA, Bucossi M, Kimerling R. Perceived barriers to care and gender preferences among veteran women who experienced military sexual trauma: A qualitative analysis. Military Behavioral Health. 2014 Apr 1; 2(2):180-188.
  6. Bell ME, Turchik JA, Karpenko JA. Impact of gender on reactions to military sexual assault and harassment. Health & Social Work. 2014 Feb 1; 39(1):25-33.
  7. Dardis CM, Dixon KJ, Edwards KM, Turchik JA. An Examination of the Factors Related to Dating Violence Perpetration Among Young Men and Women and Associated Theoretical Explanations: A Review of the Literature. Trauma, violence & abuse. 2014 Jan 10; doi: 10.1177/1524838013517559 .
  8. Turchik JA, McLean C, Rafie S, Hoyt T, Rosen CS, Kimerling R. Perceived barriers to care and provider gender preferences among veteran men who have experienced military sexual trauma: a qualitative analysis. Psychological Services. 2013 May 1; 10(2):213-22.
Book Chapters

  1. Edwards KE, Turchik JA, Dardis C, Reynolds N, Gidycz CA. Rape Myths. In: Stombler M, Baunach DM, Simonds W, Windsor EJ, Burgess EO, editors. Sex Matters: The Sexuality and Society Reader. 4 ed. New York, NY: W. W. Norton & Company; 2014. Chapter 52. 597-607 p.
Conference Presentations

  1. DuBois R, McBain S, Garneau-Fournier J, Turchik JA. Gender-targeted military sexual trauma healthcare information: An analysis among male Veterans. Poster session presented at: American Psychological Association Annual Convention; 2014 Aug 9; Washington, DC.
  2. Garneau-Fournier J, DuBois R, McBain S, Turchik JA. Predictors of sexual dysfunction in female college students. Poster session presented at: American Psychological Association Annual Convention; 2014 Aug 8; Washington, DC.
  3. McBain S, DuBois R, Garneau-Fournier J, Turchik JA. Veterans’ perceptions of how the VA can increase access to military sexual trauma related care. Poster session presented at: American Psychological Association Annual Convention; 2014 Aug 7; Washington, DC.
  4. Karpenko JA, Greene L, Pavao JR, Rodriguez A, Turchik JA, Makin-Byrd K, Kimerling R. Lesbian and Bisexual Women Veterans in VA: Mental Health Status and VA Mental Health Care Utilization. Presented at: VA HSR&D Enhancing Partnerships for Research and Care of Women Veterans Conference; 2014 Aug 1; Arlington, VA.
  5. Pavao JR, Makin-Byrd K, Turchik JA, Karpenko JA, Greene L, Saweikis M, Rodriguez A, Kimerling R. Prevalence of Intimate Partner Violence and Association with Mental Health Symptoms and Life Stressors among Women Veterans. Presented at: VA HSR&D Enhancing Partnerships for Research and Care of Women Veterans Conference; 2014 Jul 31; Arlington, VA.
  6. Bucossi M, DuBois R, Garneau-Fournier J, Hebenstreit C, Kimerling R, Koo KH, Kulkarni M, Madden E, Maguen S, McBain S, Oliva EM, Timko C, Trafton JA, Turchik JA. Service Utilization and Barriers to Care Among Female Veterans - Symposium. Presented at: Association for Psychological Science Annual Convention; 2014 May 25; San Francisco, CA.
  7. Hebenstreit C, Kimerling R, Turchik JA. The Importance of Women-Specific Services among Veteran Women Receiving VA Health Care. Poster session presented at: Association for Psychological Science Annual Convention; 2014 May 25; San Francisco, CA.
  8. McBain S, DuBois R, Garneau-Fournier J, Bucossi M, Kimerling R, Turchik JA. Perceived barriers to care and gender preferences among Veteran women who have experience military sexual trauma: A qualitative analysis. Paper presented at: Association for Psychological Science Annual Convention; 2014 May 22; San Francisco, CA.
  9. Karpenko JA, Greene L, Pavao JR, Rodriguez A, Turchik JA, Makin-Byrd K, Kimerling R. Lesbian and Bisexual Women Veterans in VA: Mental Health Status and VA Mental Health Care Utilization. Presented at: VA Ci2i / NCPTSD / HERC Annual Research Assistant Conference; 2014 May 21; Menlo Park, CA.
  10. Turchik JA, Rafie S, Makin-Byrd K, Rosen CS, Kimerling R. Male Veterans who have experienced military sexual trauma: Perceived barriers, provider gender preferences, and informational preferences. Presented at: International Society for Traumatic Stress Studies Annual Symposium; 2013 Nov 7; Philadelphia, PA.
  11. Turchik JA, Rosen CS, Timko C, Whooley M, Kimerling R. Military Sexual Trauma-Related VA Outpatient Mental Health Care: Which Veterans Utilize this Free Care? Presented at: International Society for Traumatic Stress Studies Annual Symposium; 2013 Nov 7; Philadelphia, PA.


DRA: Health Systems, Military and Environmental Exposures, Mental, Cognitive and Behavioral Disorders
DRE: Technology Development and Assessment, Treatment - Efficacy/Effectiveness Clinical Trial
Keywords: none
MeSH Terms: none

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