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CDA 17-018
Improving Health Care for Women Veterans: Addressing Menopause and Mental Health
Carolyn J Gibson PhD MPH
San Francisco VA Medical Center, San Francisco, CA
San Francisco, CA
Funding Period: June 2018 - May 2023

BACKGROUND/RATIONALE:
Women in midlife face increasing health risks related to menopause, a period of biological, hormonal, and social change characterized by often disruptive menopause symptoms. Unaddressed menopause symptoms contribute to significant health care burden, impacting health risk behaviors, chronic health conditions, and mental health concerns. Although little is known about women Veterans' experience of menopause and menopause-related care, almost half of women Veteran VA users are in midlife, with prevalent risk factors for disruptive menopause symptoms and a high rate of medical and mental health comorbidities. This research will answer key questions about depression, anxiety, and PTSD risk in the menopause transition, and clarify the experiences, care needs, and care preferences of midlife women Veterans. These findings will inform the development of resources and interventions for integrated menopause-related care in VA settings, and help providers offer effective, gender-sensitive care during this vulnerable period.

OBJECTIVE(S):
Aim 1: To describe midlife women Veterans' experience of menopause symptoms, and associations between menopause symptom burden and mental health. Aim 2: To examine patient and provider preferences, experiences, and practices seeking and receiving menopause-related care in the VA. Aim 3: To develop a Veteran-focused tool to activate self-management of menopause symptoms in the VA setting.

METHODS:
Aim 1: I will use VA administrative data to examine menopause-related diagnoses, treatments, and comorbidities in a national sample of women Veteran VA users aged 45-64 (n=151,546). A sample (n=200) of women Veterans aged 45-64 enrolled in the San Francisco VA Health Care System will then be recruited to complete structured surveys to thoroughly assess menopause status, menopause symptoms, and current depression, anxiety, and PTSD symptoms, with survey data linked to electronic health records. Associations between self-reported and diagnosed menopause symptoms and treatments, mental health concerns, and medical comorbidities will be examined. Aim 2: I will use semi-structured phone interviews with VA primary care providers and midlife women Veterans recruited from gender-specific and general primary care settings in the national Women's Health Practice-Based Research Network to examine preferences, experiences, and practices in menopause-related care. Aim 3: Findings from Aims 1 and 2 and a participatory research process will inform the development of a VA-tailored, menopause-focused psychoeducation and symptom tracking tool.

FINDINGS/RESULTS:
Not yet available.

IMPACT:
This research will provide novel evaluation of menopause-related symptoms, comorbidities, practices, and needs among midlife women Veterans, and will address gaps in knowledge related to anxiety and PTSD. It will also provide an innovative model for promoting collaborative self-management and increasing access to gender-sensitive, patient-centered care in the VA and other health care settings.

PUBLICATIONS:
None at this time.


DRA: Mental, Cognitive and Behavioral Disorders
DRE: none
Keywords: none
MeSH Terms: none