@article{ref1,
title="Factors associated with military sexual trauma (MST) disclosure during VA screening among women veterans",
journal="Journal of general internal medicine",
year="2023",
author="Hargrave, Anita S. and Danan, Elisheva R. and Than, Claire T. and Gibson, Carolyn J. and Yano, Elizabeth M.",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="BACKGROUND: Capturing military sexual trauma (MST) exposure is critical for Veterans' health equity. For many, it improves access to VA services and allows for appropriate care. <br><br>OBJECTIVE: Identify factors associated with nondisclosure of MST in VA screening among women. <br><br>DESIGN: Cross-sectional telephone survey linked with VA electronic health record (EHR) data. PARTICIPANTS: Women Veterans using primary care or women's health services at 12 VA facilities in nine states. MAIN MEASURES: Survey self-reported MST (sexual assault and/or harassment during military service), socio-demographics and experiences with VA care, as well as EHR MST results. Responses were categorized as &quot;no MST&quot; (no survey or EHR MST), &quot;MST captured by EHR and survey,&quot; and &quot;MST not captured by EHR&quot; (survey MST but no EHR MST). We used stepped multivariable logistic regression to examine &quot;MST not captured by EHR&quot; as a function of socio-demographics, patient experiences, and screening method (survey vs. EHR). KEY RESULTS: Among 1287 women (mean age 50, SD 15), 35% were positive for MST by EHR and 61% were positive by survey. Approximately 38% had &quot;no MST,&quot; 34% &quot;MST captured by EHR and survey,&quot; and 26% &quot;MST not captured by EHR&quot;. In fully adjusted models, odds of &quot;MST not captured by EHR&quot; were higher among Black and Latina women compared to white women (Black: OR = 1.6, 1.2-2.2; Latina: OR = 1.9, 1.0-3.6). Women who endorsed only sexual harassment in the survey (vs. sexual harassment and sexual assault) had fivefold higher odds of &quot;MST not captured by EHR&quot; (OR = 4.9, 3.2-7.3). Women who were screened for MST in the EHR more than once had lower odds of not being captured (OR = 0.3, 0.2-0.4). <br><br>CONCLUSIONS: VA screening for MST may disproportionately under capture patients from historically minoritized ethnic/racial groups, creating inequitable access to resources. Efforts to mitigate screening disparities could include re-screening and reinforcing that MST includes sexual harassment.<p /> <p>Language: en</p>",
language="en",
issn="0884-8734",
doi="10.1007/s11606-023-08257-6",
url="http://dx.doi.org/10.1007/s11606-023-08257-6"
}