Rates and Predictors of Follow-Up Care and Treatment Initiation Among Women Veterans After a Positive Alcohol Screen

Abstract

Background:

Gender-related disparities in access to alcohol-related care exist in the Department of Veterans Affairs’ (VA) health care system. Understanding differences in the use of alcohol-related care in the context of potentially important covariates (e.g., race, ethnicity, younger age, and military sexual trauma [MST]) is critical to support the health and well-being of women Veterans. This study examined differences in the use of alcohol preventive care among women Veterans.

Methods:

From VA administrative data (2010-2016), we drew a sample of women Veterans (n = 280) who screened positive for at-risk drinking in inpatient/outpatient settings. We conducted a chart review to abstract variables from the medical record. Then, we employed logistic regression to predict receipt of any follow-up (brief intervention and/or referral to treatment) and initiation of treatment, as with covariates of race, ethnicity, age, and clinical characteristics such as MST.

Results:

Seventy-four percent (n = 207) of the sample received any follow-up. Of those referred to treatment (n = 115), 73% (n = 84) initiated treatment. Hispanic women were 71% less likely to receive follow-up care than non-Hispanic women. Women Veterans 21 to 24 years were less likely to initiate treatment than those 25 to 29 years. While women Veterans who endorsed MST were more likely to receive follow-up care than others, they were no more likely to initiate treatment.

Conclusions:

Given the rapid growth of the women Veteran population, their access to alcohol-related care is vital. Without culturally competent, clinically and developmentally appropriate alcohol prevention messaging for Hispanic and younger women Veterans with trauma, differences in access to care and disparities in outcomes will persist.