Rural female veterans’ experiences of VA care and a VA telehealth outreach program

Female U.S. military veterans are the fastest growing segment of Veteran’s Health Affairs (VA) users, comprising 11.3% of veterans in 2023, and this number is projected to grow to 17.2% of veterans by 2043. While improving access to care for female veterans is a VA priority, female veterans still underutilize healthcare services relative to male veterans. Issues related to accessing appropriate female-specific healthcare services are often amplified among those who reside in rural communities. In this qualitative study, we examine perceptions and experiences of VA care among rural female veterans, views of a pilot VA clinician-delivered telehealth outreach program for female veterans aimed at using a tailored approach to bridging gaps in care, and recommendations for VA programming. We conducted this qualitative analysis as part of a larger quality improvement project evaluating a clinician-delivered telehealth outreach program, called the Boost Program, aimed at improving access to and engagement with VA services among rural female veterans. We conducted 30-minute virtual semi-structured interviews and used a rapid qualitative analysis approach developed for health services research settings to analyze and synthesize data. Three primary themes emerged: (1) veterans described how the landscape of female-specific healthcare has expanded at the VA in recent decades, but still has a long way to go; (2) veterans valued the way the Boost Program outreach calls communicate to them that the VA cares about them and their unique needs, both as female veterans and as rural veterans; and (3) the Boost Program outreach call works against the perception that the VA does not offer female-specific healthcare services. Our findings highlighted multiple areas in which services for rural female veterans can be further enriched. Future studies will examine how clinician-delivered outreach impacts utilization of specialty care among rural female veterans as well as how the Boost outreach model can be scaled nationally across the VA.