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Mental Health Screening Results Associated with Women Veterans’ Ratings of Provider Communication, Trust and Care Quality

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posted on 2018-11-07, 00:00 authored by Catherine Chanfreau-Coffinier, Howard S. Gordon, Amanda Schweizer, Bevanne A. Bean-Mayberry, Jill E. Darling, Ismelda Canelo, Elizabeth M. Yano
BACKGROUND: Identifying factors influencing patient experience and communication with their providers is crucial for tailoring comprehensive primary care for women veterans within the Veterans Health Administration. In particular, the impact of mental health (MH) conditions that are highly prevalent among women veterans is unknown. METHODS: From January to March 2015, we conducted a cross-sectional survey of women veterans with three or more primary care and/or women's health visits in the prior year at 12 Veterans Health Administration sites. Patient measures included ratings of provider communication, trust in provider, and care quality; demographics, health status, health care use; and brief screeners for symptoms of depression, anxiety, and posttraumatic stress disorder. We used multivariate models to analyze associations of patient ratings and characteristics. RESULTS: Among the 1,395 participants, overall communication ratings were high, but significant variations were observed among women screening positive for MH conditions. In multivariate models, high communication ratings were less likely among women screening positive for multiple MH conditions compared with patients screening negative (odds ratio, 0.43; p < .001). High trust in their provider and high care ratings were significantly less likely among women with positive MH screens. Controlling for communication, the effect of MH on trust and care ratings became less significant, whereas the effect of communication remained highly significant. CONCLUSIONS: Women veterans screening positive for MH conditions were less likely to give high ratings for provider communication, trust, and care quality. Given the high prevalence of MH comorbidity among women veterans, it is important to raise provider awareness about these differences, and to enhance communication with patients with MH symptoms in primary care.


This work was supported by the Department of Veterans Affairs, Veterans Health Administration (VHA), Health Services Research and Development Service (HSR&D) through the Women Veterans Healthcare CREATE Initiative on Implementation of Women’s Health Patient Aligned Care Teams (Project #CRE 12-026), a cluster randomized trial registered in #NCT02039856; with secondary funding from the Women’s Health Research Network (Project #SDR 10-012). Dr. Yano’s effort was funded by a VA HSR&D Senior Research Career Scientist Award (Project #RCS 05-195). Drs. Chanfreau-Coffinier and Schweizer were supported by the VA Office of Academic Affiliations through the Advanced Fellowship Programs in HSR&D and in Women’s Health, respectively.



Chanfreau-Coffinier, C., Gordon, H. S., Schweizer, C. A., Bean-Mayberry, B. A., Darling, J. E., Canelo, I., & Yano, E. M. (2018). Mental Health Screening Results Associated with Women Veterans' Ratings of Provider Communication, Trust, and Care Quality. Womens Health Issues, 28(5), 430-438. doi:10.1016/j.whi.2018.05.00




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