An Evidence Map of the Women Veterans’ Health Research Literature (2008–2015)

Elisheva R. Danan, Erin E. Krebs, Kristine Ensrud, Eva Koeller, Roderick MacDonald, Tina Velasquez, Nancy Greer, Timothy J. Wilt

Research output: Contribution to journalReview article

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Abstract

Background: Women comprise a growing proportion of Veterans seeking care at Veterans Affairs (VA) healthcare facilities. VA initiatives have accelerated changes in services for female Veterans, yet the corresponding literature has not been systematically reviewed since 2008. In 2015, VA Women’s Health Services and the VA Women’s Health Research Network requested an updated literature review to facilitate policy and research planning. Methods: The Minneapolis VA Evidence-based Synthesis Program performed a systematic search of research related to female Veterans’ health published from 2008 through 2015. We extracted study characteristics including healthcare topic, design, sample size and proportion female, research setting, and funding source. We created an evidence map by organizing and presenting results within and across healthcare topics, and describing patterns, strengths, and gaps. Results: We identified 2276 abstracts and assessed each for relevance. We excluded 1092 abstracts and reviewed 1184 full-text articles; 750 were excluded. Of 440 included articles, 208 (47%) were related to mental health, particularly post-traumatic stress disorder (71 articles), military sexual trauma (37 articles), and substance abuse (20 articles). The number of articles addressing VA priority topic areas increased over time, including reproductive health, healthcare organization and delivery, access and utilization, and post-deployment health. Three or fewer articles addressed each of the common chronic diseases: diabetes, hypertension, depression, or anxiety. Nearly 400 articles (90%) used an observational design. Eight articles (2%) described randomized trials. Conclusions: Our evidence map summarizes patterns, progress, and growth in the female Veterans’ health and healthcare literature. Observational studies in mental health make up the majority of research. A focus on primary care delivery over clinical topics in primary care and a lack of sex-specific results for studies that include men and women have contributed to research gaps in addressing common chronic diseases. Interventional research using randomized trials is needed.

LanguageEnglish (US)
Pages1359-1376
Number of pages18
JournalJournal of general internal medicine
Volume32
Issue number12
DOIs
StatePublished - Dec 1 2017

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Veterans Health
Women's Health
Veterans
Research
Delivery of Health Care
Primary Health Care
Mental Health
Women's Health Services
Chronic Disease
Reproductive Health
Post-Traumatic Stress Disorders
Sample Size
Substance-Related Disorders
Observational Studies
Anxiety
Organizations
Depression
Hypertension
Health
Wounds and Injuries

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An Evidence Map of the Women Veterans’ Health Research Literature (2008–2015). / Danan, Elisheva R.; Krebs, Erin E.; Ensrud, Kristine; Koeller, Eva; MacDonald, Roderick; Velasquez, Tina; Greer, Nancy; Wilt, Timothy J.

In: Journal of general internal medicine, Vol. 32, No. 12, 01.12.2017, p. 1359-1376.

Research output: Contribution to journalReview article

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abstract = "Background: Women comprise a growing proportion of Veterans seeking care at Veterans Affairs (VA) healthcare facilities. VA initiatives have accelerated changes in services for female Veterans, yet the corresponding literature has not been systematically reviewed since 2008. In 2015, VA Women’s Health Services and the VA Women’s Health Research Network requested an updated literature review to facilitate policy and research planning. Methods: The Minneapolis VA Evidence-based Synthesis Program performed a systematic search of research related to female Veterans’ health published from 2008 through 2015. We extracted study characteristics including healthcare topic, design, sample size and proportion female, research setting, and funding source. We created an evidence map by organizing and presenting results within and across healthcare topics, and describing patterns, strengths, and gaps. Results: We identified 2276 abstracts and assessed each for relevance. We excluded 1092 abstracts and reviewed 1184 full-text articles; 750 were excluded. Of 440 included articles, 208 (47{\%}) were related to mental health, particularly post-traumatic stress disorder (71 articles), military sexual trauma (37 articles), and substance abuse (20 articles). The number of articles addressing VA priority topic areas increased over time, including reproductive health, healthcare organization and delivery, access and utilization, and post-deployment health. Three or fewer articles addressed each of the common chronic diseases: diabetes, hypertension, depression, or anxiety. Nearly 400 articles (90{\%}) used an observational design. Eight articles (2{\%}) described randomized trials. Conclusions: Our evidence map summarizes patterns, progress, and growth in the female Veterans’ health and healthcare literature. Observational studies in mental health make up the majority of research. A focus on primary care delivery over clinical topics in primary care and a lack of sex-specific results for studies that include men and women have contributed to research gaps in addressing common chronic diseases. Interventional research using randomized trials is needed.",
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