SRFP022: Characterizing Veteran Engagement in Whole Health Services: A Program Evaluation

Luke Mitzel, PhD; Kyle Possemato; Allyson Coffey; Cheryl Seifert; Abigail Ramon; Harminder Grewal, MD, MBBS, DGO

Abstract

Context: The Veterans Health Administration (VA) is transitioning to a Whole Health system of care designed to provide holistic, person-centered care focused on what matters most to each Veteran. A major step in this transition is to integrate Whole Health into primary care and mental health services. Objective: To explore who and for what diagnoses Veterans are using Whole Health services, including high utilizers of services. Study Design: Program evaluation of Veterans using Whole Health services. Includes electronic medical record and self-report data. Setting: This program evaluation was conducted at a VA Medical Center and two associated community-based outpatient clinics, including primary care settings. The evaluation started concurrent with the implementation of new Whole Health services. Population Studied: 174 Veterans participated. Data were collected from December 2018 through March 2020. Participation in the evaluation usually started during Whole Health individual coaching sessions or program orientation groups. The mean age of the sample was 56 years, with the majority of the sample identifying as White/Caucasian (84%) and not Hispanic/Latino (93%). Main and Secondary Outcome Measures: Primary outcomes of interest included International Classification of Diseases – 10th revision (ICD-10) diagnostic categorizations and Whole Health service utilization rates. High utilizers (i.e., Veterans who attended eight or more Whole Health services across the evaluation period) were compared to the remaining 70% of the sample on individual versus group service utilization; the same comparison was made for women and men Veterans. Results: High utilizers were more likely than the rest of the sample to engage in group-based Whole Health services. High utilizers were also more likely to be retired and not working compared to the rest of the sample. Women Veterans constituted 25% of the total sample and of high utilizers. Women were more likely than men Veterans to engage in individual only Whole Health services. Conclusions: Understanding who and for what reasons patients are seeking Whole Health services may benefit healthcare systems seeking to increase accessibility to and utilization of proactive, holistic services. For example, future efforts may enhance the development and availability of group programming specifically for women Veterans.
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Jack Westfall
jwestfall@aafp.org 11/21/2021

Great poster and abstract. Thanks for sharing at NAPCRG

Gillian Bartlett
gillian.bartlett@health.missouri.edu 11/21/2021

Great project and such an important area - love the holistic approach and focus on women veterans.

William R. Phillips
wphllps@uw.edu 11/21/2021

Very important research question on this innovative program. High utilizers utilize things highly, including groups. It will be important to know how your findings can be applied to the great variety of PC settings outside of the VA system. Thanks for sharing your work here at NAPCRG. - Bill Phillips

Diane Harper
harperdi@med.umich.edu 11/22/2021

We have not seen very much about Veterans at NAPCRG - thank you for presenting this information!

Luke Mitzel
luke.mitzel@va.gov 11/23/2021

Thanks for the comments everyone! Hopefully Whole Health continues to provide holistic and accessible spaces for person-centered and community-building care across healthcare organizations.

Andy Pasternak
avpiv711@sbcglobal.net 11/26/2021

As you move forward, I think it would be also interesting to look at the role of private docs in the health care of vets. I have a lot of patients who use both systems and coordination is often difficult at VA systems don't interact a lot in communities.

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