The role of organizational factors in the provision of comprehensive women's health in the veterans health administration
MetadataShow full item record
Background: Increasing numbers of women veterans (WV) present an organizational challenge to a healthcare system that primarily serves men. WV use reproductive services traditionally not provided by the Veterans Health Administration (VHA). Objective: Examine the association of organizational factors and adoption of comprehensive women’s health (WH) care in the VHA. Study Design: Cross-sectional secondary analysis of the 2007 VHA Survey of Women’s Veterans Health Programs and Practices. Methods: Dependent measures were (a) model of women’s health care: separate women’s health clinic (WHC), designated women’s health provider within primary care (DWHP), both (WHC/DWHP), or neither and (b) availability of five basic WH services: cervical cancer screening and evaluation and management of: vaginitis, menstrual disorders, contraception and menopause. Exposure variables were organizational factors drawn from an adaptation of the Greenhalgh model of diffusion of innovations including structural factors, measures of absorptive capacity and system readiness for innovation. Results: Compared to sites with DWHP or neither, WHC and WHC/DWHP were more likely at facilities with: a gynecology clinic, an academic affiliation, a WH representative on high impact committee, and a greater number of WV. Academic affiliation and high impact committee remained significant in multivariable analysis. All five basic WH services were more likely to be offered at sites with WHC or WHC/DWHP, remaining significant after adjusting for organizational factors. Conclusion: Facilities that adopt WHC are associated with greater absorptive capacity (academic affiliation and WH representation on high-impact committees) and are more likely to deliver basic WH services. Separate WHCs may promote more comprehensive care for WV.
Showing items related by title, author, creator and subject.
Medical social work in a public health setting: a study of the service given by a district public health social work supervisor of the Massachusetts Department of Public Health in sixty-six cases, 1947-1950 Vehslage, Richard Royce (Boston University, 1951)
Public relations and governmental public health services: analysis of the health education programs in three Massachusetts health units Smith, E. Jane (Boston University, 1961)Statement of Problem: Problems of health are of personal and social concern. Yet, unless people are individually involved, health problems fail to arouse their interest. Thus, to protect the general welfare of society, ...
Lessons from the field: how successful community-based coalitions on obesity, choose and prioritize interventions to improve health policy, health behaviors, and health outcomes Turgiss, Jennifer (Boston University, 2013)Background: Community-based coalitions could be mechanisms to foster individual and systems change in their communities in order to reduce the burden of obesity. Coalitions can increase the likelihood of reducing obesity ...