Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Jan 12:3:1237701.
doi: 10.3389/frhs.2023.1237701. eCollection 2023.

Evaluating an Enterprise-Wide Initiative to enhance healthcare coordination for rural women Veterans using the RE-AIM framework

Mark R Relyea  1   2 , Rebecca L Kinney  3   4 , Eric C DeRycke  1 , Sally Haskell  1   5 , Kristin M Mattocks  3   4 , Lori A Bastian  1   5
Affiliations

Evaluating an Enterprise-Wide Initiative to enhance healthcare coordination for rural women Veterans using the RE-AIM framework

Mark R Relyea et al. Front Health Serv. .

Abstract

Introduction: The Veterans Health Administration (VA) Office of Rural Health (ORH) and Office of Women's Health Services (OWH) in FY21 launched a three-year Enterprise-Wide Initiative (EWI) to expand access to preventive care for rural, women Veterans. Through this program, women's health care coordinators (WHCC) were funded to coordinate mammography, cervical cancer screening and maternity care for women Veterans at selected VA facilities. We conducted a mixed-methods evaluation using the RE-AIM framework to assess the program implementation.

Materials and methods: We collected quantitative data from the 14 program facilities on reach (i.e., Veterans served by the program), effectiveness (e.g., cancer screening compliance, communication), adoption, and maintenance of women's health care coordinators (WHCC) in FY2022. Implementation of the program was examined through semi-structured interviews with the facility WHCC funding initiator (e.g., the point of contact at facility who initiated the request for WHCC funding), WHCCs, and providers.

Results: Reach. The number of women Veterans and rural women Veterans served by the WHCC program grew (by 50% and 117% respectively). The program demonstrated effectiveness as screening rates increased for cervical and breast cancer screening (+0.9% and +.01%, respectively). Also, maternity care coordination phone encounters with Veterans grew 36%. Adoption: All facilities implemented care coordinators by quarter two of FY22. Implementation. Qualitative findings revealed facilitators and barriers to successful program implementation and care coordination. Maintenance: The EWI facilitated the recruitment and retention of WHCCs at respective VA facilities over time.

Implications: In rural areas, WHCCs can play a critical role in increasing Reach and effectiveness. The EWI demonstrated to be a successful care coordination model that can be feasibly Adopted, Implemented, and Maintained at rural VA facilities.

Keywords: Rural Health coordination; Veterans Affairs; care coordination; maternity care; preventive screening; rural women; women Veterans; women’s health coordination.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Map of 14 facilities that participated in the women Veteran care coordination program from FY21–FY22.
Figure 2
Figure 2
Reach of women Veteran care coordination program at 14 VA facilities from FY21–FY22. Encounters = the number of face-to-face patient encounters, patient phone calls, mammograms or paps scheduled, patients being tracked or followed, or any combination of those items. Served = the number of unique Veterans directly touched or impacted by the ORH funded program. Numbers reflect half year totals at each timepoint; FY21Q2 = from October 1, 2020 through March 31, 2021, FY21Q4 = April 1, 2021 through September 30, 2021, FY22Q2 = numbers from October 1, 2021 through March 31, 2022, FY22Q4 = April 1, 2022/through September 30, 2022.
Figure 3
Figure 3
Breast and cervical cancer screening rates FY20–22 at 14 VA grantee facilities vs. national VA comparison.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Veterans Health Administration. Providing Health Care for Veterans. Available at: https://www.va.gov/health/
    1. National Center for Veterans Analysis and Statistics. Veteran Population: Demographic Characterstics. Washington, DC: U.S. Department of Veterans Affairs; (2021).
    1. Mattocks KM, Yano EM, Brown A, Casares J, Bastian L. Examining women Veteran's experiences, perceptions, and challenges with the veterans choice program. Med Care. (2018) 56(7):557–60. 10.1097/MLR.0000000000000933 - DOI - PubMed
    1. Mattocks KM, Baldor R, Bean-Mayberry B, Cucciare M, Gerber MR, Goldstein KM, et al. Factors impacting perceived access to early prenatal care among pregnant veterans enrolled in the department of veterans affairs. Women’s Health Issues. (2019) 29(1):56–63. 10.1016/j.whi.2018.10.001 - DOI - PubMed
    1. Miller C, Gurewich D, Garvin L, Pugatch M, Koppelman E, Pendergast J, et al. Veterans affairs and rural community providers’ perspectives on interorganizational care coordination: a qualitative analysis. J Rural Health. (2021) 37(2):417–25. 10.1111/jrh.12453 - DOI - PubMed

Grants and funding

This project was supported by VHA Office of Rural Health GPAA-RHLHRH52

LinkOut - more resources