The VA Women's Overall Mental Health Assessment of Needs (WOMAN)
Rachel Kimerling PhD
VA Palo Alto Health Care System, Palo Alto, CA
Palo Alto, CA
Funding Period: April 2012 - March 2014

BACKGROUND/RATIONALE:
Women are among the fastest growing population subgroups of VHA users, but are still an under-represented minority within the health care system. Most research on women Veterans' mental health to date has focused specifically on PTSD and military sexual trauma (MST), and little is known about the prevalence and impact of other symptoms and conditions that may exist among women Veterans and be appropriate targets for gender-specific intervention. Some data suggest that women Veterans' concerns about comfort in the VA environment and the quality of care limit VHA utilization, but little is known about how such concerns may specifically impact access to mental health care nor what strategies for intervention might promote better treatment engagement among these women. Gender-specific data are essential to inform the current efforts to expand mental health resources for women Veterans and assure their access to and engagement with these services. The VA Women's Overall Mental Health Assessment of Needs (WOMAN) study, funded by VA Patient Care Services and upon which this project builds, is designed to assess in detail the mental health needs of women Veteran VHA users.

OBJECTIVE(S):
The goal of this project is to build on the WOMAN study by adding an emphasis on gender-sensitive access to mental health care and explore the role of patient activation and engagement in women Veterans' access to mental health care. Specifically, the objectives of this project are to:
a) Assess potential gender-sensitive dimensions of access to mental health services;
b) Validate indicators of gender-sensitive access by examining the associations of the access dimensions to utilization and quality;
c) Examine the associations of patient activation with mental health care utilization, quality, and gender-sensitive access.

METHODS:
The WOMAN study is a nationwide telephone survey of approximately 4,000 women Veteran VA healthcare users to determine the prevalence of a wide range of mental health symptoms and conditions among women in VHA, and to assess mental health care needs and utilization. The survey will assess patient characteristics (e.g., demographics, family composition), screening questions for presence of possible active mental health issues, and access to mental health/behavioral health services (assessed using items that query perceived need, efforts to obtain, and utilization of such services). Survey responses will be matched to participants' VA electronic medical record data including medical and mental health diagnoses, utilization, and MST screening status.

FINDINGS/RESULTS:
None at this time

IMPACT:
The WOMAN study will be the first population-based study of the mental health and mental health care needs of women VHA users. This project seeks to identify patient-centered, gender sensitive points of intervention to improve women Veterans' access to mental health care. The survey will contain information that is not easily or accurately available by analysis of VHA electronic medical record data, or other existing data sources on women Veterans

PUBLICATIONS:
None at this time.

DRA: Health Systems, Mental, Cognitive and Behavioral Disorders, Military and Environmental Exposures
DRE: Diagnosis
Keywords: Anxiety Disorders, Attitudes/Beliefs, Clinical Diagnosis and Screening, Depression, Family, Patient Preferences, PTSD, Quality of Care, Sexual Trauma/Assault, Social Support
MeSH Terms: none