The purpose of the Women Veterans Cohort Study (WVCS) is to identify the unique chronic healthcare risks and needs of women Veterans who served during the Iraq and Afghanistan conflicts (OIF/OEF/OND). During these conflicts the overall representation of women in military service has increased to 20%, and over 50% of women Veterans have enrolled for VHA care compared to 11% in prior eras. Thus, the need to understand the unique healthcare needs of women veterans is essential for future planning. During the 5-years of WVCS Wave 1 we created, a) an electronic database cohort of all VHA enrolled Veterans of OIF/OEF/OND conflicts (N>800,000), and b) a prospective Veteran cohort that has completed surveys annually for 3 years (N>700). We have found so far that compared to men, women Veterans of OEF/OIF/OND are more likely to have musculoskeletal and mental health conditions (depression or adjustment disorders) and are less likely to receive management for cardiovascular risk factors. They also have higher rates of outpatient utilization and costs for pharmacy and outpatient care. Further tracking of these cohorts and complementary data collection is essential if we are to understand the unique disease trajectory and treatment needs of women OIF/OEF/OND veterans, and if we are to inform the structure and delivery of healthcare to women Veterans so as to alter the trajectory of disease and disability, and substantially reduce future healthcare expenditures by VHA. The proposed 4-year WVCS 2 will leverage the two WVCS 1 components of the overall cohort to identify longitudinally, the 1) predictors of, 2) psychiatric and psychosocial moderators of, 3) treatment patterns for, and 4) barriers to care for painful musculoskeletal conditions, mental health conditions, and CVD risk uniquely experienced by women Veterans.
Our aims are to 1) determine the pattern of disease onset and progression among women OEF/OIF/OND Veterans compared to men, 2) determine the unique psychiatric and psychosocial moderators of disease progression for women OIF/OEF/OND Veterans, 3) determine unique care patterns for women OIF/OEF/OND veterans, and 4) determine the barriers to care that arise for women Veterans. The main research methods will include, 1) collection and analysis of existing and newly available VA electronic health record and administrative data, 2) additional surveys to an expanded catchment area (new recruitment from LA and Durham), and 3) performance of focus groups from 4 Women's Health Practice Based Research Network sites (West Haven, LA, Durham and Northhampton VAs) to obtain important qualitative data. Significance. The WVCS Wave 2 will provide critical information that will help the VHA to achieve its goal of providing equitable, high quality, comprehensive healthcare services in a sensitive and safe environment at all VA facilities, so that VHA may continue its role as a national leader in the provision of health care for women Veterans, thereby raising the standard of care for women everywhere.

Public Health Relevance

With a young cohort of returning Veterans, VHA must focus on prevention. Strategies that VHA develops will reduce the burden of chronic disease faced by individual Veterans and by the healthcare system. Understanding the prevalence of disease by gender, and risk factors for developing disabling conditions, is of paramount importance in VHA's ability to create programs that are specific to women and to mitigate disparities in healthcare and health outcomes for women Veterans. Women Veterans have higher risks of musculoskeletal conditions and chronic pain than men, and poorer control of cardiovascular risk factors. Women Veterans are using VHA for mental healthcare yet little is known about women's experiences with these services. This study will provide a better understanding of experiences and needs of women Veterans for preventive services.

Agency
National Institute of Health (NIH)
Institute
Veterans Affairs (VA)
Type
Non-HHS Research Projects (I01)
Project #
1I01HX000915-01A2
Application #
8676379
Study Section
HSR-2 Determinants of Patient Response to Care (HSR2)
Project Start
2014-07-01
Project End
2018-06-30
Budget Start
2014-07-01
Budget End
2015-06-30
Support Year
1
Fiscal Year
2014
Total Cost
Indirect Cost
Name
VA Connecticut Healthcare System
Department
Type
DUNS #
039624291
City
West Haven
State
CT
Country
United States
Zip Code
06516
Han, Ling; Allore, Heather; Goulet, Joseph et al. (2017) Opioid dosing trends over eight years among US Veterans with musculoskeletal disorders after returning from service in support of recent conflicts. Ann Epidemiol 27:563-569.e3
Altalib, H H; Fenton, B T; Sico, J et al. (2017) Increase in migraine diagnoses and guideline-concordant treatment in veterans, 2004-2012. Cephalalgia 37:3-10
Kroll-Desrosiers, Aimee R; Skanderson, Melissa; Bastian, Lori A et al. (2016) Receipt of Prescription Opioids in a National Sample of Pregnant Veterans Receiving Veterans Health Administration Care. Womens Health Issues 26:240-6
Trentalange, Mark; Bielawski, Mark; Murphy, Terrence E et al. (2016) Patient Perception of Enough Time Spent With Provider Is a Mechanism for Improving Women Veterans' Experiences With VA Outpatient Health Care. Eval Health Prof 39:460-474
Wang, Karen H; Goulet, Joseph L; Carroll, Constance M et al. (2016) Estimating healthcare mobility in the Veterans Affairs Healthcare System. BMC Health Serv Res 16:609
Mankowski, Mariann; Tower, Leslie E; Brandt, Cynthia A et al. (2015) Why Women Join the Military: Enlistment Decisions and Postdeployment Experiences of Service Members and Veterans. Soc Work 60:315-23
Driscoll, Mary A; Higgins, Diana M; Seng, Elizabeth K et al. (2015) Trauma, social support, family conflict, and chronic pain in recent service veterans: does gender matter? Pain Med 16:1101-11
Mankowski, Mariann; Haskell, Sally G; Brandt, Cynthia et al. (2015) Social support throughout the deployment cycle for women veterans returning from Iraq and Afghanistan. Soc Work Health Care 54:287-306
Mattocks, Kristin; Kroll-Desrosiers, Aimee; Zephyrin, Laurie et al. (2015) Infertility care among OEF/OIF/OND women Veterans in the Department of Veterans Affairs. Med Care 53:S68-75
Volkman, Julie E; DeRycke, Eric C; Driscoll, Mary A et al. (2015) Smoking Status and Pain Intensity Among OEF/OIF/OND Veterans. Pain Med 16:1690-6

Showing the most recent 10 out of 27 publications