The Boost Team: transforming outreach for female veterans in rural communities
IntroductionPrior studies show that rurality and sex act synergistically resulting in poor health outcomes for rural female Veterans in large part due to challenges utilizing timely and convenient health care services. We conducted a mixed-methods quality improvement evaluation of a novel outreach p...
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| Format: | Article |
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Frontiers Media S.A.
2025-07-01
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| Series: | Frontiers in Health Services |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/frhs.2025.1617105/full |
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| author | Jenny Krause Cohen Jenny Krause Cohen Kara Zamora-Rogoski Caitlin McLean Mariam Jacob Tara Stacker Caroline Dancu Caroline Dancu Jennifer Childers |
| author_facet | Jenny Krause Cohen Jenny Krause Cohen Kara Zamora-Rogoski Caitlin McLean Mariam Jacob Tara Stacker Caroline Dancu Caroline Dancu Jennifer Childers |
| author_sort | Jenny Krause Cohen |
| collection | DOAJ |
| description | IntroductionPrior studies show that rurality and sex act synergistically resulting in poor health outcomes for rural female Veterans in large part due to challenges utilizing timely and convenient health care services. We conducted a mixed-methods quality improvement evaluation of a novel outreach program within the Veterans Health Administration (VHA) that provides clinician-driven outreach to women Veterans served by rural VHA clinics. Our goal was to understand the impact the program has on rural female Veterans' access to and engagement in VHA care as well as the impact the program has on health system leaders and rural VHA clinic staff.Materials and methodsIn 2022, we developed a clinician-driven outreach program known as The Boost Team. The Boost nurse practitioner (NP) “cold called” female Veterans within a regional VA health care system and provided real-time clinical care and linkage to VHA services. Outreach calls were completed with 543 Veterans and metrics on call attempts and services rendered were tracked. Of Veterans who received the outreach, 58 completed a telephone survey using the Patient Empowerment Engagement Activation Survey (PEEAS), and 21 completed a semi-structured interview. Interviews focused on experiences with the NP, Boost's impact on access to and experience of VHA care, and suggestions for program improvement. Health system leaders (HSLs; n = 11) and rural VHA clinic staff (n = 5) completed interviews focused on barriers and facilitators to wider implementation of the Boost Program.FindingsThe most common needs addressed during outreach calls included new referrals to specialty care, completion of outstanding health care maintenance (e.g., age-appropriate cancer screening), coordination with primary and specialty care, assistance with medication management, and reviewing diagnostics (e.g., labs, imaging). PEEAS data demonstrated strong agreement across all categories (median = 5 or “strongly agree”). Veterans, HSLs, and clinic staff reported that Boost outreach increased trust in VHA among Veterans and provided necessary support for under-staffed clinics.ConclusionsClinician-driven outreach is a powerful tool to improve access to and engagement in care for rural female Veterans and provides necessary support to rural VHA clinics. Future efforts include expanding geographic range of Boost and better characterizing populations of veterans that most benefit from clinician-driven outreach. |
| format | Article |
| id | doaj-art-315204ddfecd4545a648a5a8cee0804c |
| institution | DOAJ |
| issn | 2813-0146 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Health Services |
| spelling | doaj-art-315204ddfecd4545a648a5a8cee0804c2025-08-20T02:45:56ZengFrontiers Media S.A.Frontiers in Health Services2813-01462025-07-01510.3389/frhs.2025.16171051617105The Boost Team: transforming outreach for female veterans in rural communitiesJenny Krause Cohen0Jenny Krause Cohen1Kara Zamora-Rogoski2Caitlin McLean3Mariam Jacob4Tara Stacker5Caroline Dancu6Caroline Dancu7Jennifer Childers8United States Department of Veterans Affairs, San Francisco VA Health Care System, Veterans Health Administration, San Francisco, CA, United StatesDepartment of Medicine and Department of Clinical Informatics and Digital Transformation, University of California, San Francisco, CA, United StatesUnited States Department of Veterans Affairs, San Francisco VA Health Care System, Veterans Health Administration, San Francisco, CA, United StatesUnited States Department of Veterans Affairs, VA Central Western Massachusetts Healthcare System, Veterans Health Administration, Leeds, AL, United StatesUnited States Department of Veterans Affairs, San Francisco VA Health Care System, Veterans Health Administration, San Francisco, CA, United StatesUnited States Department of Veterans Affairs, San Francisco VA Health Care System, Veterans Health Administration, San Francisco, CA, United StatesUnited States Department of Veterans Affairs, San Francisco VA Health Care System, Veterans Health Administration, San Francisco, CA, United StatesDepartment of Medicine and Department of Clinical Informatics and Digital Transformation, University of California, San Francisco, CA, United StatesVeterans Integrated Service Network 21, Pleasanton, CA, United StatesIntroductionPrior studies show that rurality and sex act synergistically resulting in poor health outcomes for rural female Veterans in large part due to challenges utilizing timely and convenient health care services. We conducted a mixed-methods quality improvement evaluation of a novel outreach program within the Veterans Health Administration (VHA) that provides clinician-driven outreach to women Veterans served by rural VHA clinics. Our goal was to understand the impact the program has on rural female Veterans' access to and engagement in VHA care as well as the impact the program has on health system leaders and rural VHA clinic staff.Materials and methodsIn 2022, we developed a clinician-driven outreach program known as The Boost Team. The Boost nurse practitioner (NP) “cold called” female Veterans within a regional VA health care system and provided real-time clinical care and linkage to VHA services. Outreach calls were completed with 543 Veterans and metrics on call attempts and services rendered were tracked. Of Veterans who received the outreach, 58 completed a telephone survey using the Patient Empowerment Engagement Activation Survey (PEEAS), and 21 completed a semi-structured interview. Interviews focused on experiences with the NP, Boost's impact on access to and experience of VHA care, and suggestions for program improvement. Health system leaders (HSLs; n = 11) and rural VHA clinic staff (n = 5) completed interviews focused on barriers and facilitators to wider implementation of the Boost Program.FindingsThe most common needs addressed during outreach calls included new referrals to specialty care, completion of outstanding health care maintenance (e.g., age-appropriate cancer screening), coordination with primary and specialty care, assistance with medication management, and reviewing diagnostics (e.g., labs, imaging). PEEAS data demonstrated strong agreement across all categories (median = 5 or “strongly agree”). Veterans, HSLs, and clinic staff reported that Boost outreach increased trust in VHA among Veterans and provided necessary support for under-staffed clinics.ConclusionsClinician-driven outreach is a powerful tool to improve access to and engagement in care for rural female Veterans and provides necessary support to rural VHA clinics. Future efforts include expanding geographic range of Boost and better characterizing populations of veterans that most benefit from clinician-driven outreach.https://www.frontiersin.org/articles/10.3389/frhs.2025.1617105/fullmixed methodsrural veteranswomen veteransoutreachprimary care redesign |
| spellingShingle | Jenny Krause Cohen Jenny Krause Cohen Kara Zamora-Rogoski Caitlin McLean Mariam Jacob Tara Stacker Caroline Dancu Caroline Dancu Jennifer Childers The Boost Team: transforming outreach for female veterans in rural communities Frontiers in Health Services mixed methods rural veterans women veterans outreach primary care redesign |
| title | The Boost Team: transforming outreach for female veterans in rural communities |
| title_full | The Boost Team: transforming outreach for female veterans in rural communities |
| title_fullStr | The Boost Team: transforming outreach for female veterans in rural communities |
| title_full_unstemmed | The Boost Team: transforming outreach for female veterans in rural communities |
| title_short | The Boost Team: transforming outreach for female veterans in rural communities |
| title_sort | boost team transforming outreach for female veterans in rural communities |
| topic | mixed methods rural veterans women veterans outreach primary care redesign |
| url | https://www.frontiersin.org/articles/10.3389/frhs.2025.1617105/full |
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