Association for Public Policy Analysis & Management

Background: The growing group of women veterans commonly experience military sexual trauma (MST) and interpersonal violence (IPV). Yet, while MST screening is closely monitored at the facility-level little is known about individual primary care provider (PCP) behavior in regards to screening women veterans who use the Veterans Health Administration (VHA) healthcare system for MST and IPV. Objectives: To understand how PCP experiences and beliefs regarding women’s healthcare influence PCP-reported interpersonal violence screening. Research Design and Participants: We sent a cross-sectional online survey administered from September 2014 through April 2015 (supplemented by a mailed survey between April and May, 2015) to 281 PCPs in 12 VHA medical centers. Measures and Analysis: PCP-reported screening frequency for MST and IPV, experience with women veterans, self-efficacy beliefs, gender-sensitivity, and perceived discomfort regarding women veteran healthcare. We used multivariable ordered logistic regression analysis to identify correlates of screening, weighted for non-response and adjusted for clustering. Results: Ninety-four PCPs (34%) completed the survey. More experience with women veterans (having a higher proportion of women patients in the panel, p<.05 and being a designated women’s health provider, p<.001) and stronger self-efficacy beliefs about screening women for interpersonal violence (p<.001) were associated with reporting screening for interpersonal violence more frequently. Conclusions: VHA initiatives to enhance PCP experiences and strengthen self-efficacy beliefs about comprehensive women’s healthcare may increase screening of women veterans for interpersonal violence.