Women Veterans, interventions for mental health, care-seeking for physical health

Abstract:United States women veterans have high rates of some mental health conditions associated with military service such as post-traumatic stress disorder and physical health conditions such as cardiovascular disease (CVD). To address health needs of this population, this dissertation involved studies guided by a theory of care-seeking behavior (TCSB). This theory includes psychosocial concepts such as affect, beliefs and external conditions in healthcare. First, I described interventions designed to improve women veterans’ mental health given a lack of synthesis about such interventions. I identified factors about women veterans’ careseeking for mental health. Common factors included feelings of shame and discomfort, reflecting affect in TCSB. I identified attributes of gender sensitive care that improved acceptance of interventions such as arranging same gender clinicians. Second, I developed and evaluated survey items about women veterans’ care-seeking for CVD prevention given little research on women veterans’ care-seeking for physical health. I documented content validity with experts and confirmed women veterans’ understanding of most items. Then, I revised selected items for clarity and relevance.Third, using a descriptive design, I administered the valid survey online to a national sample of 245 women veterans. Participants provided narrative and numeric responses. Most participants’ reported reasons for care-seeking as: affordability, accessibility, beliefs of importance, normative influences, and acceptability of services. Most participants’ reported barriers to care-seeking as lack of: affordable and accessible services, respect, and awareness of their risk for CVD. These findings reflected all concepts in TCSB, with one exception. Overall, findings advance understanding of influences on women veterans’ care-seeking for mental and physical health care needs. Across type of responses and studies, concepts in the TCSB were supported. Future researchers can design and evaluate interventions to improve women veterans’ affect, beliefs, norms about preventive care-seeking and awareness of their CVD risk. Interdisciplinary scholars can design and test interventions to improve the affordability, accessibility, and acceptability of services for women veterans who seek care for their mental and physical health care needs. In future research, scholars can apply TCSB to assess and address influences on women’s care-seeking in different contexts and populations.