title: Creating a roadmap for delivering gender-sensitive comprehensive care for women Veterans: results of a national expert panel.
abstract: BACKGROUND
  Women Veterans are a significant minority of users of the VA healthcare system, limiting provider and staff experience meeting their needs in environments historically designed for men. The VA is nonetheless committed to ensuring that women Veterans have access to comprehensive care in environments sensitive to their needs.
  
  
  OBJECTIVE
  We sought to determine what aspects of care need to be tailored to the needs of women Veterans in order for the VA to deliver gender-sensitive comprehensive care.
  
  
  METHODS
  Modified Delphi expert panel process.
  
  
  METHODS
  Eleven clinicians and social scientists with expertise in women's health, primary care, and mental health.
  
  
  METHODS
  Importance of tailoring over 100 discrete aspects of care derived from the Institute of Medicine's definition of comprehensive care and literature-based domains of sex-sensitive care on a 5-point scale.
  
  
  RESULTS
  Panelists rated over half of the aspects of care as very-to-extremely important (median score 4+) to tailor to the needs of women Veterans. The panel arrived at 14 priority recommendations that broadly encompassed the importance of (1) the design/delivery of services sensitive to trauma histories, (2) adapting to women's preferences and information needs, and (3) sex awareness and cultural transformation in every facet of VA operations.
  
  
  CONCLUSIONS
  We used expert panel methods to arrive at consensus on top priority recommendations for improving delivery of sex-sensitive comprehensive care in VA settings. Accomplishment of their breadth will require national, regional, and local strategic action and multilevel stakeholder engagement, and will support VA's national efforts at improving customer service for all Veterans.
authors.affiliation: *Department of Primary and Community Care, Gender and Women's Health Unit, Radboud University Medical Center, Nijmegen, The Netherlands †VA HSR&D Center for the Study of Healthcare Innovation, Implementation and Policy, VA Greater Los Angeles, Sepulveda ‡Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, CA.
authors.forename: Miriam
authors.initials: M
authors.lastname: deKleijn
authors.forename: Antoine L M
authors.initials: AL
authors.lastname: Lagro-Janssen
authors.forename: Ismelda
authors.initials: I
authors.lastname: Canelo
authors.forename: Elizabeth M
authors.initials: EM
authors.lastname: Yano
mesh_terms: D003191:Comprehensive Health Care / Q000458:organization & administration*; D003697:Delphi Technique; D005260:Female; D006801:Humans; D016134:Organizational Policy; D014481:United States; D014493:United States Department of Veterans Affairs; D058014:Veterans Health; D016387:Women's Health