Organizational Factors Associated with Screening for Military Sexual Trauma
Office of Mental Health Services, Military Sexual Trauma Support Team, Department of Veterans Affairs, Washington, DC, USA. Women s Health Issues
(Impact Factor: 2.33).
11/2011; 22(2):e209-15. DOI: 10.1016/j.whi.2011.09.001
This exploratory study investigated organizational factors associated with receipt of military sexual trauma (MST) screening during an early timeframe of the Veterans Health Administration's (VHA) implementation of the universal MST screening policy.
The sample consisted of all VHA patients eligible for MST screening in fiscal year 2005 at 119 VHA facilities. Analyses were conducted separately by gender and by user status (i.e., new patients to the VHA health care system in FY 2005 and continuing users who had previously used the VHA health care system in the past year). Multivariate generalized estimating equations were used to assess the effects of facility-level characteristics and adjusted for person-level covariates.
Facility-level mandatory universal MST screening policies were associated with increased odds of receiving MST screening among new female patients and both continuing and new male patients: Odds ratio (OR), 2.87 (95% confidence interval [CI], 1.39-5.89) for new female patients; OR, 8.15 (95% CI, 2.93-22.69) for continuing male patients; and OR, 4.48 (95% CI, 1.79-11.20) for new male patients. Facility-level audit and feedback practices was associated with increased odds of receiving MST screening among new patients: OR, 1.91 (95% CI, 1.26-2.91) for females and OR, 1.86 (95% CI, 1.22-2.84) for males. Although the facility-level effect for women's health clinic (WHC) did not emerge as significant, patient-level effects indicated that among these facilities, women who used a WHC had greater odds of being screened for MST compared with women who had not used a WHC: OR, 1.79 (95% CI, 1.18-2.71) for continuing patients and OR, 2.20 (95% CI, 1.59-3.04) for new patients.
This study showed that facility policies that promote universal MST screening, as well as audit and feedback practices at the facility, significantly improved the odds of patients receiving MST screening. Women veterans' utilization of a WHC was associated with higher odds of receiving MST screening. This study provides empirical support for the use of policies and audit and feedback practices which the VHA has used since the implementation of the MST screening directive to encourage compliance with VHA's MST screening policy and is likely associated with the present-day success in MST screening across all VHA facilities.
Available from: Patricia Ann Herlihy
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ABSTRACT: This article examines an age-old problem-sexual assault-through the lens of its occurrence within the military culture. Specific cases as well as U.S. Department of Defense responses to better handle these issues are offered to educate psychiatric-mental health nurses of the potential differences in symptomatology and presentation of military sexual trauma (MST). This appears to be an increasing problem with the predicted cohort of returning veterans appearing both in the U.S. Department of Veterans Affairs system as well as in civilian locations, hospitals, community centers, and especially the workplace. It will be critical to develop training materials and pursue further research to identify this silent syndrome of MST to better meet the needs of our returning veterans.
Available from: publications.amsus.org
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