title: Veteran identity and race/ethnicity: influences on VA outpatient care utilization.
abstract: BACKGROUND
  "Veteran identity" is defined as veterans' self-concept that derives from his/her military experience within a sociohistorical context. Veteran identity may vary by race/ethnicity because the sociohistorical context of the military experience varies by race.
  
  
  OBJECTIVE
  To explore veteran identity and how it varies by race/ethnicity, and to identify aspects of veteran identity that significantly influence preferences for, and use of, VA outpatient care.
  
  
  METHODS
  Focus groups were conducted at community sites to explore concepts related to veteran identity, race/ethnicity, military experience, and health services use. The focus groups informed the development of a telephone survey, which was administered to veterans of four racial/ethnic groups in Southern California and Southern Nevada.
  
  
  METHODS
  One hundred seventy-eight veterans participated in the focus groups, and 3,227 veterans completed the telephone survey.
  
  
  METHODS
  Dependent variables include: (1) preference for VA health services, (2) VA-only outpatient use, (3) Any VA outpatient use, and (4) number of outpatient visits within the previous 12 months. Independent variables include veteran identity, sociodemographic, and health-related characteristics.
  
  
  RESULTS
  All veteran identity variables were significantly associated with race/ethnicity. Race/ethnicity, eg, being black or Hispanic, in addition to veteran identity factors, significantly influenced preferences for VA outpatient care. Veteran identity factors, however, had less influence on VA outpatient service utilization than socioeconomic factors.
  
  
  CONCLUSIONS
  Minority veterans who highly identify with their veteran status may prefer the VA to other systems of care. Factors associated with veteran identity may be useful for incorporation into interventions to improve access to VA care.
authors.affiliation: VA Greater Los Angeles Healthcare System, West Los Angeles Healthcare Center, UCLA, California 90073, USA. nharada@ucla.edu
authors.forename: Nancy D
authors.initials: ND
authors.lastname: Harada
authors.forename: JoAnn
authors.initials: J
authors.lastname: Damron-Rodriguez
authors.forename: Valentine M
authors.initials: VM
authors.lastname: Villa
authors.forename: Donna L
authors.initials: DL
authors.lastname: Washington
authors.forename: Shawkat
authors.initials: S
authors.lastname: Dhanani
authors.forename: Herbert
authors.initials: H
authors.lastname: Shon
authors.forename: Manas
authors.initials: M
authors.lastname: Chattopadhyay
authors.forename: Howard
authors.initials: H
authors.lastname: Fishbein
authors.forename: Martin
authors.initials: M
authors.lastname: Lee
authors.forename: Takashi
authors.initials: T
authors.lastname: Makinodan
authors.forename: Ronald
authors.initials: R
authors.lastname: Andersen
mesh_terms: D000328:Adult; D001741:Black or African American / Q000523:psychology; D000368:Aged; D001213:Asian / Q000523:psychology; D002140:California; D005006:Ethnicity / Q000523:psychology*; D017144:Focus Groups; D019538:Health Care Surveys / Q000379:methods; D006297:Health Services Accessibility; D006630:Hispanic or Latino / Q000523:psychology; D006787:Hospitals, Veterans / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009505:Nevada; D010044:Outpatient Clinics, Hospital / Q000706:statistics & numerical data*; D017060:Patient Satisfaction / Q000208:ethnology*; D012933:Social Identification; D012959:Socioeconomic Factors; D013689:Telephone; D014728:Veterans / Q000145:classification / Q000523:psychology* / Q000706:statistics & numerical data; D014857:Warfare; D044465:White People / Q000523:psychology