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Patient-centered substance use disorder treatment for women Veterans

Giannitrapani KF, Huynh AK, Schweizer CA, Hamilton AB, Hoggatt KJ. Patient-centered substance use disorder treatment for women Veterans. Journal of Military, Veteran, and Family Health. 2018 Sep 10; 4(1):DOI: 10.3138/jmvfh.2017-0006.

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Introduction: Substance use disorder (SUD) is damaging to women's health and quality of life. Appropriate treatment can mitigate the effects and health consequences of SUD, yet many woman face access barriers to such treatment. This research seeks to bridge gaps in the current understanding of access to gender-aware care for women Veterans with SUD and to identify ideal treatment program elements for this population. Methods: We interviewed interdisciplinary providers in Los Angeles Veterans Health Administration facilities (n = 17; psychiatrists, psychologists, social workers, primary care providers, and nurses) and Veterans (n = 6), identified using purposive snowball sampling, to characterize key components of a non-residential patient-centred SUD treatment program for women Veterans. A semi-structured interview guide elicited current SUD treatment options for women Veterans, barriers to SUD services, and ideal SUD treatment program components. Mutually agreed-on themes were reached using constant comparison. Results: Analyses revealed five key elements of an ideal SUD treatment program for women Veterans: safety (safe and free from harassment in treatment), flexible scheduling (able to accommodate other work and life responsibilities), resourced (no limit to number of visits, staff able to meet needs of comorbidities, on-site child care, etc.), informed providers (providers with access to a comprehensive resource list and aware of easy referral options), and positive (supportive and not punitive). Discussion: The elements identified as necessary for an optimal outpatient SUD treatment program may guide future implementation efforts. SUD programs may not be viable options for women Veterans if they cannot accommodate multidimensional barriers of health care access.

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