QUERI – Quality Enhancement Research Initiative

The Enhancing Mental and Physical health of Women through Engagement and Retention (EMPOWER)

Los Angeles, CA

View program fact sheet

Women Veterans are the fastest growing segment of VA healthcare users; however, a high rate of their attrition from VA care, along with organizational barriers to care, indicate that organizational changes are needed in order to engage and retain women Veteran VA users. The Enhancing Mental and Physical Health of Women through Engagement and Retention (EMPOWER) QUERI is designed to improve women Veterans’ engagement and retention in evidence-based care that emphasizes local tailoring of care models, multi-level stakeholder engagement, and the systematic evaluation of implementation processes in order to enrich organizational capacity for innovations.

Findings and Expected Impacts:

Tailoring VA’s Diabetes Prevention Program to Women Veterans’ Needs is a quality improvement project conducted in VA Greater Los Angeles women’s health clinics, resulting in a 187% increase in the number of women aware of their pre-diabetes diagnosis.  Women Veterans with prediabetes selected an in-person, peer-led or online gender-specific diabetes prevention program to address their risk behaviors and health conditions. Pre-implementation interviews revealed that women Veterans value having treatment options, and preferred women-only groups; high demand for the program resulted in delivery to triple the number of Veterans originally planned.

The Facilitating Cardiovascular Risk Screening and Risk Reduction in Women Veterans project is implementing a multifaceted, evidence-based CV toolkit in four VA Women’s Health Practice-Based Research Network sites to:

• Increase identification of cardiovascular (CV) risk among women Veterans;
• Enhance patient/provider communication and shared decision-making about CV risk; and
• Provide a supportive, coordinated health-coaching intervention to facilitate women Veterans’ engagement and retention in appropriate health services.

The Implementation of Tailored Collaborative Care for Women Veterans project is evaluating implementation of an evidence-based collaborative care model tailored to enhanced treatment for women Veterans with anxiety, depression, and/or PTSD, thereby improving the effectiveness of organizational primary care-mental health integration (PC-MHI), as well as women Veterans’ engagement and retention in PC-MHI.

Principal Investigators: Alison Hamilton, PhD, MPH (Alison.Hamilton@va.gov); Bevanne Bean-Mayberry, MD, MHS (Bevanne.Bean-Mayberry@va.gov); and Tannaz Moin, MD, MBA, MSHS (Tannaz.Moin@va.gov)

Operations Partner(s): Women’s Health Services, National Center for Disease Prevention and Health Promotion, Women’s Mental Health Services, Primary Care-Mental Health Integration, and the Office of Patient-centered Care and Cultural Transformation.