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. 2024 Aug 14;14(8):814.
doi: 10.3390/brainsci14080814.

Examining the Utility of Veterans Health Administration (VHA) Traumatic Brain Injury Screening among Women Veterans: Recommendations for Expansion to Include Interpersonal Violence

Michelle M Pebole  1   2 , Katherine M Iverson  3   4 , Caitlin M Bolduc  1 , Julie M Joyce  1 , Caroline A Sablone  1 , Catherine B Fortier  1   2
Affiliations

Examining the Utility of Veterans Health Administration (VHA) Traumatic Brain Injury Screening among Women Veterans: Recommendations for Expansion to Include Interpersonal Violence

Michelle M Pebole et al. Brain Sci. .

Abstract

Women veterans (WVs) are more likely than men veterans to experience traumatic brain injury (TBI) from causes unrelated to deployment. Yet, current Veterans Health Administration (VHA) TBI screening focuses on deployment. This study examines the utility of the VHA TBI screening tool for WVs. Using the Boston Assessment for TBI-Lifetime (BAT-L) as the gold standard, sensitivity and specificity of the VHA screen were identified for deployment and non-deployment injuries. Injuries missed by the screen were thematically described. Sensitivity and specificity were compared by context (research, clinical). Ninety WVs were included; fifty-three (60.9%) met TBI criteria per the BAT-L. For TBIs occurring during deployment, sensitivity was higher in research (89.1%) compared to clinics (61.7%); specificity was lower in research (60.7%) compared to clinics (93.0%). The BAT-L identified 27 non-deployment TBIs not captured by the VHA screen, most frequently from physical assault or sports. The VHA screen does not include non-deployment events; thus, non-deployment sensitivity and specificity could not be calculated. For lifetime TBIs (deployment + non-deployment etiologies), sensitivity was higher in research (73.5%) compared to clinics (48.9%). Specificity was lower in research (60.0%) compared to clinics (100.0%). Findings can inform improvements to TBI screening among WVs, including expansion for interpersonal violence.

Keywords: brain injury; interpersonal violence; partner violence; screening; women veterans.

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Conflict of interest statement

The authors declare no conflicts of interest.

References

    1. Office of Data Governance and Analytics . Women Veterans Report: The Past, Present, and Future of Women Veterans. U.S. Department of Veterans Affairs, National Center for Veterans Analysis and Statistics; Washington, DC, USA: 2017. [(accessed on 1 July 2024)]. Available online: https://www.va.gov/vetdata/docs/SpecialReports/Women_Veterans_2015_Final....
    1. Frayne S., Haskell S., Hayes P., Saechao F. Longitudinal Trends in Sociodemographics, Utilization, Health Profile, and Geographic Distribution. Volume 4 Women’s Health Services, Veterans Health Administration, Department of Veterans Affairs; Washington, DC, USA: 2018.
    1. Department of Veterans Affairs, National Center for Veterans Analysis and Statistics Veteran Population. Population Tables. [(accessed on 1 July 2024)];2017 Available online: https://www.va.gov/vetdata/veteran_population.asp.
    1. Dichter M.E., True G. “This Is the Story of Why My Military Career Ended before It Should Have” Premature Separation from Military Service Among US Women Veterans. Affilia. 2015;30:187–199. doi: 10.1177/0886109914555219. - DOI
    1. Rattray N.A., Natividad D., Spontak K., Kukla M., Do A.-N.L., Danson L., Frankel R.M., True G. Learning from women veterans who navigate invisible injuries, caregiving, and reintegration challenges. BMC Women’s Health. 2023;23:665. doi: 10.1186/s12905-023-02815-0. - DOI - PMC - PubMed

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