A Supplemental Women’s Health Questionnaire for Women Veterans With Military Environmental Exposures: Project Development and Implementation

Abstract BackgroundThe number of women in the armed forces has steadily increased across all branches, even as the overall size of the military remains stable. The population of women veterans is also expanding. The existing literature has extensively reported the impact of mi...

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Main Authors: Leah N Eizadi, Mehret T Assefa, Jordan M Nechvatal, G Marina Veltkamp, Abou Ibrahim-Biangoro, Maheen M Adamson, Jennifer S Jennings
Format: Article
Language:English
Published: JMIR Publications 2025-07-01
Series:JMIR Formative Research
Online Access:https://formative.jmir.org/2025/1/e73223
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author Leah N Eizadi
Mehret T Assefa
Jordan M Nechvatal
G Marina Veltkamp
Abou Ibrahim-Biangoro
Maheen M Adamson
Jennifer S Jennings
author_facet Leah N Eizadi
Mehret T Assefa
Jordan M Nechvatal
G Marina Veltkamp
Abou Ibrahim-Biangoro
Maheen M Adamson
Jennifer S Jennings
author_sort Leah N Eizadi
collection DOAJ
description Abstract BackgroundThe number of women in the armed forces has steadily increased across all branches, even as the overall size of the military remains stable. The population of women veterans is also expanding. The existing literature has extensively reported the impact of military environmental exposures (MEEs) on adverse physical and mental health outcomes in service members and veterans; however, most of these studies focus on the experiences of men. In response to the growing need to address women-specific health care concerns, particularly for women with MEEs, the Women’s Operational Military Exposure Network Center of Excellence (WOMEN CoE) developed and implemented the Women’s Health Addendum (WHA). ObjectiveThe primary objective of this project is to (1) describe the development and implementation of a comprehensive health questionnaire for women veterans, (2) systematically describe and characterize the health conditions of women seeking care for MEE-related health concerns, and (3) use findings to inform clinic policies and develop targeted programs. MethodsThe WHA was introduced to assess the prevalence of health conditions that are female-specific, or disproportionately impact women; examine the relationship between these health conditions and MEEs; and use findings to improve care. The WHA was developed through an iterative process, incorporating literature review, veteran and clinician feedback, and clinical expertise. It consists of 81 questions across 7 categories related to health conditions across the lifespan and was implemented in 2 phases. Phase 1 was administered to women at the California War Related Illness and Injury Study Center (WRIISC), and phase 2 included women at the New Jersey and Washington, DC, WRIISC sites. Descriptive findings are presented here. ResultsA total of 63 women participated in the program evaluation from October 2022 to April 2024. In phase 1, 39% (29/75) of the women who were invited agreed to participate. In phase 2, 34 (10%) of the 325 invited veterans responded. Several women’s health conditions were reported, with approximately 97% (61/63) of women reporting at least one health condition and 87% (55/63) reporting 3 or more. Among respondents, the most prevalent conditions included sexual dysfunction (23/33, 70%), urinary incontinence (33/56, 59%), pelvic floor dysfunction (33/63, 52%), and pregnancy loss (20/45, 44%). Overall, more than 40% (3/7) of the most frequent conditions were related to urinary health and pelvic floor dysfunction. ConclusionsFindings highlight the need for services related to women’s health, especially for this cohort with MEE concerns seen at a tertiary care center. Initial findings emphasize concerns that women have about fertility and MEE experienced during deployments. Next steps include administering the WHA to women at sister WRIISC sites in real time and establishing a wider distribution network for the WHA. Future efforts to further evaluate the relationship between MEE and women’s health concerns are underway.
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spelling doaj-art-e98e564fbc954dbc830e052500bf06942025-08-20T03:39:18ZengJMIR PublicationsJMIR Formative Research2561-326X2025-07-019e73223e7322310.2196/73223A Supplemental Women’s Health Questionnaire for Women Veterans With Military Environmental Exposures: Project Development and ImplementationLeah N Eizadihttp://orcid.org/0009-0001-3030-713XMehret T Assefahttp://orcid.org/0009-0009-8600-4822Jordan M Nechvatalhttp://orcid.org/0009-0008-5863-9698G Marina Veltkamphttp://orcid.org/0000-0001-9379-6850Abou Ibrahim-Biangorohttp://orcid.org/0009-0002-9718-2746Maheen M Adamsonhttp://orcid.org/0000-0002-1534-4063Jennifer S Jenningshttp://orcid.org/0009-0008-2025-6413 Abstract BackgroundThe number of women in the armed forces has steadily increased across all branches, even as the overall size of the military remains stable. The population of women veterans is also expanding. The existing literature has extensively reported the impact of military environmental exposures (MEEs) on adverse physical and mental health outcomes in service members and veterans; however, most of these studies focus on the experiences of men. In response to the growing need to address women-specific health care concerns, particularly for women with MEEs, the Women’s Operational Military Exposure Network Center of Excellence (WOMEN CoE) developed and implemented the Women’s Health Addendum (WHA). ObjectiveThe primary objective of this project is to (1) describe the development and implementation of a comprehensive health questionnaire for women veterans, (2) systematically describe and characterize the health conditions of women seeking care for MEE-related health concerns, and (3) use findings to inform clinic policies and develop targeted programs. MethodsThe WHA was introduced to assess the prevalence of health conditions that are female-specific, or disproportionately impact women; examine the relationship between these health conditions and MEEs; and use findings to improve care. The WHA was developed through an iterative process, incorporating literature review, veteran and clinician feedback, and clinical expertise. It consists of 81 questions across 7 categories related to health conditions across the lifespan and was implemented in 2 phases. Phase 1 was administered to women at the California War Related Illness and Injury Study Center (WRIISC), and phase 2 included women at the New Jersey and Washington, DC, WRIISC sites. Descriptive findings are presented here. ResultsA total of 63 women participated in the program evaluation from October 2022 to April 2024. In phase 1, 39% (29/75) of the women who were invited agreed to participate. In phase 2, 34 (10%) of the 325 invited veterans responded. Several women’s health conditions were reported, with approximately 97% (61/63) of women reporting at least one health condition and 87% (55/63) reporting 3 or more. Among respondents, the most prevalent conditions included sexual dysfunction (23/33, 70%), urinary incontinence (33/56, 59%), pelvic floor dysfunction (33/63, 52%), and pregnancy loss (20/45, 44%). Overall, more than 40% (3/7) of the most frequent conditions were related to urinary health and pelvic floor dysfunction. ConclusionsFindings highlight the need for services related to women’s health, especially for this cohort with MEE concerns seen at a tertiary care center. Initial findings emphasize concerns that women have about fertility and MEE experienced during deployments. Next steps include administering the WHA to women at sister WRIISC sites in real time and establishing a wider distribution network for the WHA. Future efforts to further evaluate the relationship between MEE and women’s health concerns are underway.https://formative.jmir.org/2025/1/e73223
spellingShingle Leah N Eizadi
Mehret T Assefa
Jordan M Nechvatal
G Marina Veltkamp
Abou Ibrahim-Biangoro
Maheen M Adamson
Jennifer S Jennings
A Supplemental Women’s Health Questionnaire for Women Veterans With Military Environmental Exposures: Project Development and Implementation
JMIR Formative Research
title A Supplemental Women’s Health Questionnaire for Women Veterans With Military Environmental Exposures: Project Development and Implementation
title_full A Supplemental Women’s Health Questionnaire for Women Veterans With Military Environmental Exposures: Project Development and Implementation
title_fullStr A Supplemental Women’s Health Questionnaire for Women Veterans With Military Environmental Exposures: Project Development and Implementation
title_full_unstemmed A Supplemental Women’s Health Questionnaire for Women Veterans With Military Environmental Exposures: Project Development and Implementation
title_short A Supplemental Women’s Health Questionnaire for Women Veterans With Military Environmental Exposures: Project Development and Implementation
title_sort supplemental women s health questionnaire for women veterans with military environmental exposures project development and implementation
url https://formative.jmir.org/2025/1/e73223
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