“I Wasn’t Presented with Options”: Perspectives of Black Veterans Receiving Care for Uterine Fibroids in the Veterans Health Administration

Details

• Personal Author:
  Bossick AS ; Callegari LS ; Carey C ; Christy A ; Doll KM ; Katon JG ; Owens S ; Silvestrini M ; Washington DL
• Description:
  Introduction: Black women with uterine fibroids experience greater symptom severity and worse treatment outcomes compared with their White counterparts. Black veterans who use Veterans Health Administration (VA) health care experience similar disparities. This study investigated the experiences of Black veterans receiving care for uterine fibroids at VA. Methods: We identified Black veterans aged 18 to 54 years with newly diagnosed symptomatic uterine fibroids between the fiscal years 2010 and 2012 using VA medical record data, and we recruited participants for interviews in 2021. We used purposive sampling by the last recorded fibroid treatment in the data (categorized as hysterectomy, other uterine sparing treatments, and medication only/no treatment) to ensure diversity of treatment experiences. In-depth semi structured interviews were conducted to gather rich narratives of veterans' uterine fibroid care experiences. Transcribed interviews were analyzed using content analysis. Results: Twenty Black veterans completed interviews. Key themes that emerged included the amplified impact of severe fibroid symptoms in male-dominated military culture; the presence of multilevel barriers, from individual to health care system factors, that delayed access to high-quality treatment; insufficient treatments offered; experiences of interpersonal racism and provider bias; and the impact of fertility loss related to fibroids on mental health and intimate relationships. Veterans with positive experiences stressed the importance of finding a trustworthy provider and self-advocacy. Conclusions: System-level interventions, such as race-conscious and person-centered care training, are needed to improve care experiences and outcomes of Black veterans with fibroids. [Description provided by NIOSH]
• Subjects:
  Healthcare Disparities Minority Health Occupational Health Race Factors Safety Urogenital Diseases Urogenital System Women
• Keywords:
  Health Care Health Disparities Military Personnel Minority Health Racial Factors Reproductive System Disorders Uterus
• ISSN:
  1049-3867
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  California ; District of Columbia ; Michigan ; OSHA Region 10 ; OSHA Region 3 ; OSHA Region 5 ; OSHA Region 9 ; Washington
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  33
• Issue:
  6
• NIOSHTIC Number:
  nn:20068784
• Citation:
  Womens Health Issues 2023 Nov-Dec; 33(6):652-660
• Contact Point Address:
  Lisa Callegari, MD, MPH, Health Services Research and Development (HSR&D) Center of Innovation for Veteran-Centered & Value-Driven Care, U.S. Department of Veterans Affairs, VA Puget Sound Healthcare System, 1660 S Columbian Way, S-152, Seattle, WA 98108
• Email:
  Lisa.Callegari@va.gov
• Federal Fiscal Year:
  2024
• Performing Organization:
  University of Washington
• Peer Reviewed:
  True
• Start Date:
  20050701
• Source Full Name:
  Women's Health Issues
• End Date:
  20250630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:b8a52c8402714ac01907bdea5350e54aedcc6d6129819226019aec038c41d5a1270b4881655b57d932ec45053c3be07d5fb99d6b4f359bbabb8306d4e494cdf4
• Download URL:
  https://stacks.cdc.gov/view/cdc/207365/cdc_207365_DS1.pdf
• File Type:
  [PDF - 388.00 KB ]