Veterans Affairs Boston Healthcare System, Center for Healthcare Organization and Implementation Research, Boston, MA, USA.
Department of Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA.
J Gen Intern Med. 2024 Apr;39(5):782-789. doi: 10.1007/s11606-023-08530-8. Epub 2023 Nov 27.
Social risk factors, such as food insecurity and financial needs, are associated with increased risk of cardiovascular diseases, health conditions that are highly prevalent in rural populations. A better understanding of rural Veterans' experiences with social risk factors can inform expansion of Veterans Health Administration (VHA) efforts to address social needs.
To examine social risk and need from rural Veterans' lived experiences and develop recommendations for VHA to address social needs.
We conducted semi-structured interviews with participants purposively sampled for racial diversity. The interview guide was informed by Andersen's Behavioral Model of Health Services Use and the Outcomes from Addressing Social Determinants of Health in Systems framework.
Rural Veterans with or at risk of cardiovascular disease who participated in a parent survey and agreed to be recontacted.
Interviews were recorded and transcribed. We analyzed transcripts using directed qualitative content analysis to identify themes.
Interviews (n = 29) took place from March to June 2022. We identified four themes: (1) Social needs can impact access to healthcare, (2) Structural factors can make it difficult to get help for social needs, (3) Some Veterans are reluctant to seek help, and (4) Veterans recommended enhancing resource dissemination and navigation support.
VHA interventions should include active dissemination of information on social needs resources and navigation support to help Veterans access resources. Community-based organizations (e.g., Veteran Service Organizations) could be key partners in the design and implementation of future social need interventions.
社会风险因素,如粮食不安全和财务需求,与心血管疾病风险增加有关,而心血管疾病是农村人口中高发的健康问题。更好地了解农村退伍军人面临的社会风险因素,可以为退伍军人事务部(VHA)扩大努力解决社会需求提供信息。
从农村退伍军人的生活经历中了解社会风险和需求,并为退伍军人事务部提出解决社会需求的建议。
我们对有或有心血管疾病风险的农村退伍军人进行了半结构式访谈,这些退伍军人是根据种族多样性有目的地抽样的。访谈指南的依据是安德生的卫生服务使用行为模型和解决健康系统中社会决定因素的结果框架。
参加了父母调查并同意被重新联系的农村退伍军人,无论是否有心血管疾病。
对访谈进行录音和转录。我们使用定向定性内容分析方法对转录本进行分析,以确定主题。
访谈(n=29)于 2022 年 3 月至 6 月进行。我们确定了四个主题:(1)社会需求会影响获得医疗保健的机会,(2)结构性因素会使寻求社会需求帮助变得困难,(3)一些退伍军人不愿意寻求帮助,(4)退伍军人建议加强资源传播和导航支持。
退伍军人事务部的干预措施应包括积极传播有关社会需求资源和导航支持的信息,以帮助退伍军人获取资源。社区组织(如退伍军人服务组织)可以成为未来社会需求干预措施的设计和实施的关键合作伙伴。