Enhancing representation of special populations: An approach to the inclusion of women veterans in VA clinical trials.

The under-recruitment of historically marginalized populations into clinical trials thwarts equitable inclusion of individuals who could benefit from healthcare innovations and limits the generalizability of results. For decades, the Veterans Health Administration (VA) has conducted large clinical trials that impact clinical guidelines for veterans and civilians alike. Within the VA, women are a numeric minority, and recruitment of this population into trials is challenged by gender-specific care structures, distinct demographic characteristics, and mistreatment such as higher rates of military sexual trauma and harassment on VA grounds.

Organizational Climate Related to Patient-Perpetrated Sexual Harassment: VA Primary Care Provider Perceptions.

Background: Patient-perpetrated sexual harassment toward health care providers is common and adversely affects provider well-being, workforce outcomes, and patient care. Organizational climate for sexual harassment-shared perceptions about an organization's practices, policies, and procedures-is one of the strongest predictors of harassment prevalence. We conducted a pilot survey assessing provider perceptions of the Veterans Health Administration (VA)'s climate related to patient-perpetrated sexual harassment.

Increasing Engagement of Women Veterans in Health Research.

Background: Meaningful engagement of patients in health research has the potential to increase research impact and foster patient trust in healthcare. For the past decade, the Veterans Health Administration (VA) has invested in increasing Veteran engagement in research.

Objective: We sought the perspectives of women Veterans, VA women's health primary care providers (WH-PCPs), and administrators on barriers to and facilitators of health research engagement among women Veterans, the fastest growing subgroup of VA users.

Women Veterans' Experiences of Harassment and Perceptions of Veterans Affairs Health Care Settings During a National Anti-Harassment Campaign.

Purpose: In 2017, Veterans Health Administration (VA) launched a social marketing and training campaign to address harassment of women veterans at VA health care facilities. We assessed women veterans' experiences of harassment, reported perpetrators of harassment, and perceptions of VA in 2017 (before campaign launch) and 2018 (1 year after campaign implementation).

Methods: We administered surveys to women veterans attending primary care appointments (2017, n = 1,300; 2018, n = 1,711).

Mobilizing embedded research and operations partnerships to address harassment of women Veterans at VA medical facilities.

Key insights: A: Addressing a complex problem like harassment in VA medical facilities requires committed, engaged collaboration at multiple levels of the organization. B: Timely feedback of initial research findings to operations partners enabled rapid and more responsive development of new programs and policies. C: Our research-clinical partnership has enabled us to pursue targeted change from the outset, while incorporating real-time findings from embedded researchers working to develop a comprehensive understanding of the problem.

Women Veterans' Perspectives on How to Make Veterans Affairs Healthcare Settings More Welcoming to Women.

Purpose: Women veterans are a rapidly increasing subset of the Veterans Affairs (VA) patient population but remain a numerical minority. Men veteran-dominated health care settings pose unique considerations for providing care to women veterans in a comfortable and welcoming environment. We analyzed patient suggestions on how to make the VA more welcoming to women.

Practice-based research networks add value to evidence-based quality improvement.

Background: Evidence-Based Quality Improvement (EBQI) is a systematic, multilevel approach to implementing research evidence into clinical settings. Little is known about EBQI effectiveness in the context of Practice-Based Research Networks (PBRNs), which are themselves designed to foster practice-based change. We evaluated EBQI implementation in a PBRN setting to determine the extent to which the PBRN infrastructure added value.

Effectiveness of an Evidence-Based Quality Improvement Approach to Cultural Competence Training: The Veterans Affairs' "Caring for Women Veterans" Program.

Introduction: Although providing culturally sensitive health care is vitally important, there is little consensus regarding the most effective strategy for implementing cultural competence trainings in the health care setting. Evidence-based quality improvement (EBQI), which involves adapting evidence-based practices to meet local needs, may improve uptake and effectiveness of a variety of health care innovations. Yet, to our knowledge, EBQI has not yet been applied to cultural competence training.

Binge Eating among Women Veterans in Primary Care: Comorbidities and Treatment Priorities.

Background: Little is known about the clinical profile and treatment priorities of women with binge eating disorder (BED), a diagnosis new to the fifth edition of Diagnostic and Statistical Manual of Mental Disorders. We identified comorbidities and patients' treatment priorities, because these may inform implementation of clinical services.

Methods: Data were collected from women veteran primary care patients.

Lessons from Initiating the First Veterans Health Administration (VA) Women's Health Practice-based Research Network (WH-PBRN) Study.

Background: The Veterans Health Administration (VA) Women's Health Practice-Based Research Network (WH-PBRN) was created to foster innovations for the health care of women veterans. The inaugural study by the WH-PBRN was designed to identify women veterans' own priorities and preferences for mental health services and to inform refinements to WH-PBRN operational procedures. Addressing the latter, this article reports lessons learned from the inaugural study.

Patient-centered mental health care for female veterans.

Objective: Mental health services for women vary widely across the Veterans Health Administration (VHA) system, without consensus on the need for, or organization of, specialized services for women. Understanding women's needs and priorities is essential to guide the implementation of patient-centered behavioral health services.

Methods: In a cross-sectional, multisite survey of female veterans using primary care, potential stakeholders were identified for VHA mental health services by assessing perceived or observed need for mental health services.

Seeking Safety treatment for male veterans with a substance use disorder and post-traumatic stress disorder symptomatology.

Aims: To determine whether substituting Seeking Safety (SS), a manualized therapy for comorbid substance use disorders (SUD) and post-traumatic stress disorder (PTSD) for part of treatment-as-usual (TAU) improves substance use outcomes.

Design: Randomized controlled effectiveness trial.

Settings: Out-patient Veterans Administration Health Care System SUD clinic.

Validating nursing competencies using a fair format.

Across the healthcare system, staff development specialists and nurse leaders have been challenged with the development, implementation, and evaluation of processes by which clinical nursing staff demonstrate competence in an efficient and effective manner. The purpose of this article is to describe one approach used in an acute care setting. Staff development specialists and nurse leaders played key roles in assessing, developing, and evaluating a nursing competency validation fair.

Building bridges...and strengthening nursing.

In light of current nursing employment trends, nurses and employment specialists in one rural northern Iowa healthcare organization are collaborating to retain and recruit nurses. The purpose of this article is to describe how these individuals worked toward a comprehensive, cohesive approach to the development, implementation, and evaluation of learning opportunities that support these efforts. Staff development educators played key roles in developing program purposes, descriptions, curriculum, and outcome measures.

Screening for domestic violence.

Nurses have a unique opportunity to develop, implement, and evaluate the outcomes of routine assessments and interventions.