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Monday, June 22, 2020

Women are the fastest-growing subpopulation of veterans, according to the Department of Veterans Affairs. And female veterans deserve and require qualified and available health care services as they transition from the military into the civilian sector.

But in the past, female veterans reported dissatisfaction in navigating and receiving female-specific care within VA health facilities due to the limited number of VA health care providers for women.

In response, the VA’s Veterans Health Administration (VHA) created a mini-residency program on women’s health geared toward VHA clinicians who are caring for more female veterans. Since beginning in 2008, over 7,500 clinicians have attended mini-residency programs to integrate women’s health care into their practice with the intent to expand health care services for female patients.

Additionally, VHA developed musculoskeletal training for clinicians caring for female veterans because women’s pain often presents differently to medical providers than male veterans’, which can complicate medical diagnosis and treatment regimens.

Reaching Out

VHA’s initiatives to attract and retain female veterans as patients at VA health care centers include adding comprehensive primary care, gynecologic care, maternity benefits, infertility and adoption reimbursement services, mental health services and military sexual trauma counseling. Furthermore, in 2013, the VA developed a Women Veterans Call Center hotline to provide information about VA services and resources for female veterans.

More women are choosing the VA for health care than ever, with women accounting for over 30% of the increase in veterans served over the past five years. The number of women veterans using VA health care services has tripled since 2000, growing from about 160,000 to over 500,000 in April 2019.

Still, of the approximately 20,000 women who transitioned from the military in 2018, only about 40% of them enrolled in the VHA, and only 22% used the VHA for medical services.

To educate transitioning female Air Force members while increasing their enrollment rates in the VHA, the Air Force’s Women’s Initiative Team partnered with the VHA in 2017 to create and implement a health information session exclusively for those women. Under the auspices of the Joint VA/DoD Health Executive Committee, which included the Transition Assistance Program senior steering group and VHA’s Women Health Services, the team collaborated to establish the Women’s Health Transition Training pilot program. The goal of the pilot program was to provide transitioning military women with an understanding of the female health services offered within VHA facilities and of other VA services available, such as shelter, home loan and behavioral health.

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A Department of Veterans Affairs health care provider consults with a patient in a new space at the VA’s Ambulatory Care Center in Charleston, South Carolina. The space was created for privacy for the center’s growing population of female veterans.
(Credit: Department of Veterans Affairs)

Focus on Well-Being

The Women’s Health Transition Training pilot program’s primary purpose is to educate women about VHA health care after leaving military service, show them how to enroll, and encourage them to embrace ownership of their self-care. The pilot program offers information to women with a focus on health and well-being.

The one-day program questions transitioning women regarding their health-seeking behaviors post-service and educates them regarding the health services available to them within the VA so they can make informed decisions regarding their health. The program consists of five phases:

  • Phase 1: Shifting from active duty to veteran status.
  • Phase 2: Understanding the VHA health system.
  • Phase 3: Discussing women’s health services available within the VHA.
  • Phase 4: Learning how to enroll in the VHA.
  • Phase 5: Using the Transition Assistance Program.

Measuring program success includes VA enrollment rates for women pilot participants; the time to enrollment from separation; VA health services utilization; changes in knowledge about, preparedness for and perceptions of the Women’s Health Transition Training presentation; and satisfaction with the VA health system. The overwhelming success of the 18-month pilot program assisted in moving it from a pilot to a permanent program in fiscal 2020. It is available to female service members in all branches of the military.

All in a Day’s Training

During Women’s Health Transition Training, the day focuses on and promotes information and education regarding access to care within the VHA system. Each participant receives an 88-page Women’s Health Transition Training booklet, which provides in-depth information on topics discussed during the presentation. Additionally, the female veteran instructors discuss real and perceived struggles of transitioning to civilian life.

Training starts with participants answering a questionnaire about their understanding of what the VHA offers women, their perceptions of VA medical care and their preparedness to start enrollment in the VHA. Past results revealed that 82% of participants wanted to learn more about health care options within the VHA. Pre- and post-session surveys showed knowledge about VHA services increased by 97%. Additionally, 60% of the women commented on how the women-only environment was perceived as a “safe place” to ask female-specific questions, to include questions about behavioral health.

The participant satisfaction rate hovers around 98%, and 97% of participants said they found the training resources useful and felt positive about getting their questions about VHA care answered. Although the statistics reveal a 125% increase in awareness regarding women’s health services available within the VHA and a 98.5% preparedness for enrolling in the VHA, the real question remains whether this knowledge will be used to create actionable outcomes (i.e., VHA enrollment and VHA service utilization).

Expanded Delivery Options

Due to the success of the Women’s Health Transition Training pilot program, Congress requested all military branches offer the Women’s Health Transition Training course to transitioning women starting in fiscal 2020. With expansion of the training, the plan is to increase the ways in which the information is delivered to meet the needs of transitioning women. Due to the COVID-19 pandemic, the course is delivered virtually in a variety of time slots to ensure women have the opportunity to attend. In-person sessions should resume later this year, and the virtual sessions will continue.

In fiscal 2021, ownership of the Women’s Health Transition Training program will transfer from the VHA to the Veterans Benefits Administration’s Office of Transition and Economic Development, which will maintain collaboration with the VHA’s Office of Women’s Health Services and the Air Force’s Women’s Initiative Team to ensure the program stays on course as designed. This transfer also will ensure that the program meets the fiscal 2020 National Defense Authorization Act for Transition Assistance Program changes, receives appropriate funding necessary to remain successful, and acts as a foundation to build upon for other veteran subpopulations.

Each year, 200,000 Americans transition from the military, and every one of those military members has a story to tell that shapes them as the veterans they are today. The transition can be difficult for some. Culture and community support play a large role in how a veteran will transition as well as in their sense of belonging. The VA continues to make significant changes to meet the needs of today’s female veterans, which hopefully will shape tomorrow’s veterans as strong, agile and healthy.

To learn more or to register for Women’s Health Transition Training, visit www.va.gov/womenvet/whtt/index.asp or search [email protected].