RAND Corporation, Santa Monica, California; VA HSR&D Center for the Study of Healthcare Innovation, Implementation and Policy, VA Greater Los Angeles Healthcare System, Sepulveda, California.
RAND Corporation, Santa Monica, California; Pardee RAND Graduate School, Santa Monica, California.
Womens Health Issues. 2017 Sep-Oct;27(5):586-591. doi: 10.1016/j.whi.2017.06.003. Epub 2017 Jul 25.
Military sexual trauma (MST) and/or intimate partner violence (IPV) are common experiences in the growing group of women veterans using the Veterans Health Administration health care system. And even though MST screening is closely monitored at the facility level, little is known about individual primary care provider (PCP) behavior with regard to screening women for MST and IPV.
To understand how PCP experiences and beliefs regarding women's health care influence PCP-reported screening for MST and IPV.
We administered a cross-sectional online survey from September 2014 through April 2015 (supplemented by a mailed survey between April and May 2015) to 281 PCPs in 12 Veterans Health Administration medical centers.
Surveys measured PCP-reported screening frequency for MST and IPV, experience with women veterans, self-efficacy, gender-sensitive beliefs, and perceived barriers to providing comprehensive care for women. We used multivariable ordered logistic regression analysis to identify correlates of screening, weighted for nonresponse and adjusted for clustering.
Ninety-four PCPs (34%) completed the survey. Being a designated women's health provider (p < .05) and stronger self-efficacy beliefs about screening women for MST (p < .001) were associated with reporting more frequent screening for MST. Being a designated women's health provider (p < .01), seeing women patients at least once per week (p < .001), and self-efficacy beliefs about screening women for IPV (p < .001) were associated with reporting more frequent screening for IPV.
Veterans Health Administration initiatives to enhance PCP opportunities to screen women veterans for trauma and to strengthen self-efficacy beliefs about comprehensive women's health care may increase screening of women veterans for MST and IPV.
军事性创伤（MST）和/或亲密伴侣暴力（IPV）在越来越多的使用退伍军人健康管理局医疗保健系统的女性退伍军人中较为常见。尽管设施层面密切监测 MST 筛查，但对于初级保健提供者（PCP）筛查女性 MST 和 IPV 的个人行为知之甚少。
了解 PCP 对女性保健的经验和信念如何影响 PCP 报告的 MST 和 IPV 筛查。
我们于 2014 年 9 月至 2015 年 4 月（2015 年 4 月至 5 月补充邮寄调查）向 12 个退伍军人健康管理局医疗中心的 281 名 PCP 发放了横断面在线调查。
调查衡量了 PCP 报告的 MST 和 IPV 筛查频率、女性退伍军人的经验、自我效能、性别敏感信念以及为女性提供全面护理的感知障碍。我们使用多变量有序逻辑回归分析确定筛查的相关性，对非响应进行加权调整，并对聚类进行调整。
94 名 PCP（34%）完成了调查。被指定为女性健康提供者（p<0.05）和对筛查女性 MST 的自我效能信念更强（p<0.001）与报告更频繁的 MST 筛查相关。被指定为女性健康提供者（p<0.01）、每周至少看一次女性患者（p<0.001）和筛查女性 IPV 的自我效能信念（p<0.001）与报告更频繁的 IPV 筛查相关。
退伍军人健康管理局增强 PCP 为女性退伍军人筛查创伤的机会并增强全面女性保健自我效能信念的举措可能会增加女性退伍军人 MST 和 IPV 的筛查。
