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Henion A, Cheney A, Pugh MJ, Leykum LK, Trivedi RB, Dang S, Kalvesmaki A, Sundstrom K, Rupper R, Bouldin ED. Women Veterans as caregivers: Characteristics and comparisons with women non-veterans using BRFSS. J Women Aging 2024; 36:534-545. [PMID: 39520305 DOI: 10.1080/08952841.2024.2409998] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 09/18/2024] [Accepted: 09/20/2024] [Indexed: 11/16/2024]
Abstract
Veterans frequently need assistance because of injuries and chronic conditions, but also serve as caregivers to family and friends. Our aim was to describe the prevalence of characteristics and experiences of women veterans who serve as caregivers and compare them with non-veteran women. We measured caregiving prevalence caregiving among women veterans (N = 4,179) and women non-veterans (n = 160,307) using population-based data from 48 jurisdictions in the Behavioral Risk Factor Surveillance System from 2021 to 2022. We calculated weighted prevalence estimates and adjusted prevalence ratios [PR] for the association between veteran status and three health outcomes adjusted for age, race and ethnicity, and caregiving activities. Similar proportions (∼23%) of women veterans (n = 1,000) and non-veterans (n = 36,929) were caregivers. Among women caregivers, veterans were more likely than non-veterans to have had a chronic health condition (63 vs. 57%), disability (39 vs. 35%), and current frequent mental distress (27 vs. 22%), although all were quite prevalent in both groups. In adjusted models, the only significant difference was in current frequent mental distress among women veterans compared with non-veteran women caregivers age 18-44 (PR = 1.49, 95%CI: 1.20 - 1.85). Women veterans provide similar care as non-veteran women. However, younger women veteran caregivers more frequently experience mental distress, suggesting the importance of routine assessment of caregiving status to initiate support. This may be a result of military experiences (e.g., combat, trauma) and related comorbidities (e.g., traumatic brain injury, PTSD) that could enhance caregiving burden, making caregiver support, chronic disease self-management programs, and mental health services priorities for women veteran caregivers.
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Affiliation(s)
- Amy Henion
- Informatics, Decision-Enhancement and Analytic Sciences Center, VA Salt Lake City Health Care System, Salt Lake City, Utah, USA
- Division of Epidemiology, Department of Internal Medicine, University of Utah Spencer Fox Eccles School of Medicine, Salt Lake City, Utah, USA
| | - Amanda Cheney
- Informatics, Decision-Enhancement and Analytic Sciences Center, VA Salt Lake City Health Care System, Salt Lake City, Utah, USA
- Division of Epidemiology, Department of Internal Medicine, University of Utah Spencer Fox Eccles School of Medicine, Salt Lake City, Utah, USA
| | - Mary Jo Pugh
- Informatics, Decision-Enhancement and Analytic Sciences Center, VA Salt Lake City Health Care System, Salt Lake City, Utah, USA
- Division of Epidemiology, Department of Internal Medicine, University of Utah Spencer Fox Eccles School of Medicine, Salt Lake City, Utah, USA
- Elizabeth Dole Center of Excellence for Veteran and Caregiver Research, US Department of Veterans Affairs, Washington, DC, USA
| | - Luci K Leykum
- Elizabeth Dole Center of Excellence for Veteran and Caregiver Research, US Department of Veterans Affairs, Washington, DC, USA
- South Texas Veterans Health Care System, San Antonio, Texas, USA
- Harbor Health, Austin, Texas, USA
- Dell Medical School, at the University of Texas at Austin, Austin, Texas, USA
| | - Ranak B Trivedi
- Elizabeth Dole Center of Excellence for Veteran and Caregiver Research, US Department of Veterans Affairs, Washington, DC, USA
- Center for Innovation to Implementation (Ci2i), VA Palo Alto Health Care System, Palo Alto, California, USA
- Division of Public Mental Health and Population Sciences, Dept. of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California, USA
| | - Stuti Dang
- Elizabeth Dole Center of Excellence for Veteran and Caregiver Research, US Department of Veterans Affairs, Washington, DC, USA
- Miami Veterans Affairs Geriatric Research Education and Clinical Center (GRECC), Miami, Florida, USA
- Division of Geriatrics and Palliative Care, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Andrea Kalvesmaki
- Informatics, Decision-Enhancement and Analytic Sciences Center, VA Salt Lake City Health Care System, Salt Lake City, Utah, USA
- Division of Epidemiology, Department of Internal Medicine, University of Utah Spencer Fox Eccles School of Medicine, Salt Lake City, Utah, USA
- Elizabeth Dole Center of Excellence for Veteran and Caregiver Research, US Department of Veterans Affairs, Washington, DC, USA
| | - Kim Sundstrom
- Informatics, Decision-Enhancement and Analytic Sciences Center, VA Salt Lake City Health Care System, Salt Lake City, Utah, USA
- Division of Epidemiology, Department of Internal Medicine, University of Utah Spencer Fox Eccles School of Medicine, Salt Lake City, Utah, USA
| | - Rand Rupper
- Division of Epidemiology, Department of Internal Medicine, University of Utah Spencer Fox Eccles School of Medicine, Salt Lake City, Utah, USA
- Elizabeth Dole Center of Excellence for Veteran and Caregiver Research, US Department of Veterans Affairs, Washington, DC, USA
- Salt Lake City Veterans Affairs Geriatric Research Education and Clinical Center (GRECC), Salt Lake City, Utah, USA
| | - Erin D Bouldin
- Informatics, Decision-Enhancement and Analytic Sciences Center, VA Salt Lake City Health Care System, Salt Lake City, Utah, USA
- Division of Epidemiology, Department of Internal Medicine, University of Utah Spencer Fox Eccles School of Medicine, Salt Lake City, Utah, USA
- Elizabeth Dole Center of Excellence for Veteran and Caregiver Research, US Department of Veterans Affairs, Washington, DC, USA
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Dawson BD, Keller HE, Sawyer LM, Gorman S, Sabangan JA, McPartlin A, Payne S, Brown KJ, Li G, Sullivan DH. Evaluation of a Virtual Tai Chi Program for Older Veterans at Risk of Loneliness or Physical Deconditioning: A Quality Improvement Project. Geriatrics (Basel) 2024; 9:91. [PMID: 39051255 PMCID: PMC11270295 DOI: 10.3390/geriatrics9040091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Revised: 06/17/2024] [Accepted: 07/05/2024] [Indexed: 07/27/2024] Open
Abstract
This Quality Improvement project evaluated the implementation of a virtual Tai Chi program for older Veterans (OVs) at risk of loneliness and/or physical deconditioning. A 12-week Tai Chi course was conducted virtually at three Veterans Affairs sites using VA Video Connect (VVC). Changes in physical function based on the 30-Second Chair Stand (30CST) and loneliness based on the De Jong Gierveld Loneliness Scale (DJGS) were measured, as were the OVs' satisfaction and adherence. Of 109 OVs who enrolled, 74 completed the program with a mean attendance rate of 84%. Completers demonstrated a statistically significant improvement in the 30CST, and those who were moderately or severely lonely at baseline saw a statistically significant improvement in the DJGS. Course evaluations were generally very positive. Results suggest that a virtual Tai Chi program is an effective and very satisfying intervention for OVs at risk of loneliness or physical deconditioning.
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Affiliation(s)
- Bonnie D. Dawson
- Geriatric Research Education and Clinical Center, Central Arkansas Veterans Healthcare System, 2200 Fort Roots Drive, North Little Rock, AR 72114, USA; (H.E.K.); (L.M.S.); (D.H.S.)
| | - Hallie E. Keller
- Geriatric Research Education and Clinical Center, Central Arkansas Veterans Healthcare System, 2200 Fort Roots Drive, North Little Rock, AR 72114, USA; (H.E.K.); (L.M.S.); (D.H.S.)
| | - Linda M. Sawyer
- Geriatric Research Education and Clinical Center, Central Arkansas Veterans Healthcare System, 2200 Fort Roots Drive, North Little Rock, AR 72114, USA; (H.E.K.); (L.M.S.); (D.H.S.)
| | - Shannon Gorman
- VA Palo Alto Health Care System, 3801 Miranda Ave, Palo Alto, CA 94304, USA; (S.G.); (J.A.S.)
| | - Jerome A. Sabangan
- VA Palo Alto Health Care System, 3801 Miranda Ave, Palo Alto, CA 94304, USA; (S.G.); (J.A.S.)
| | - Adam McPartlin
- VA Puget Sound Health Care System, 1660 S. Columbian Way, Seattle, WA 98108, USA; (A.M.); (S.P.); (K.J.B.); (G.L.)
| | - Sarah Payne
- VA Puget Sound Health Care System, 1660 S. Columbian Way, Seattle, WA 98108, USA; (A.M.); (S.P.); (K.J.B.); (G.L.)
| | - Karl J. Brown
- VA Puget Sound Health Care System, 1660 S. Columbian Way, Seattle, WA 98108, USA; (A.M.); (S.P.); (K.J.B.); (G.L.)
| | - Gail Li
- VA Puget Sound Health Care System, 1660 S. Columbian Way, Seattle, WA 98108, USA; (A.M.); (S.P.); (K.J.B.); (G.L.)
| | - Dennis H. Sullivan
- Geriatric Research Education and Clinical Center, Central Arkansas Veterans Healthcare System, 2200 Fort Roots Drive, North Little Rock, AR 72114, USA; (H.E.K.); (L.M.S.); (D.H.S.)
- Donald W. Reynolds Department of Geriatrics, University of Arkansas for Medical Sciences, 4301 W. Markham St., Little Rock, AR 72205, USA
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Shanmugam R, Fulton L, Kruse CS, Beauvais B, Betancourt J, Pacheco G, Pradhan R, Sen K, Ramamonjiarivelo Z, Sharma A. The effect of COVID-19 on cancer incidences in the U.S. Heliyon 2024; 10:e28804. [PMID: 38601551 PMCID: PMC11004761 DOI: 10.1016/j.heliyon.2024.e28804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 03/10/2024] [Accepted: 03/25/2024] [Indexed: 04/12/2024] Open
Abstract
Fundamental data analysis assists in the evaluation of critical questions to discern essential facts and elicit formerly invisible evidence. In this article, we provide clarity into a subtle phenomenon observed in cancer incidences throughout the time of the COVID-19 pandemic. We analyzed the cancer incidence data from the American Cancer Society [1]. We partitioned the data into three groups: the pre-COVID-19 years (2017, 2018), during the COVID-19 years (2019, 2020, 2021), and the post-COVID-19 years (2022, 2023). In a novel manner, we applied principal components analysis (PCA), computed the angles between the cancer incidence vectors, and then added lognormal probability concepts in our analysis. Our analytic results revealed that the cancer incidences shifted within each era (pre, during, and post), with a meaningful change in the cancer incidences occurring in 2020, the peak of the COVID-19 era. We defined, computed, and interpreted the exceedance probability for a cancer type to have 1000 incidences in a future year among the breast, cervical, colorectal, uterine corpus, leukemia, lung & bronchus, melanoma, Hodgkin's lymphoma, prostate, and urinary cancers. We also defined, estimated, and illustrated indices for other cancer diagnoses from the vantage point of breast cancer in pre, during, and post-COVID-19 eras. The angle vectors post the COVID-19 were 72% less than pre-pandemic and 28% less than during the pandemic. The movement of cancer vectors was dynamic between these eras, and movement greatly differed by type of cancer. A trend chart of cervical cancer showed statistical anomalies in the years 2019 and 2021. Based on our findings, a few future research directions are pointed out.
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Affiliation(s)
- Ramalingam Shanmugam
- Texas State University, School of Health Administration, Encino Hall, Room 250A, 601 University Drive, San Marcos, TX, 78666, USA
| | - Larry Fulton
- Boston College, Woods College of Advancing Studies, St. Mary's Hall South, Chestnut Hill, MA, 02467, USA
| | - C. Scott Kruse
- Texas State University, School of Health Administration, Encino Hall, Room 250A, 601 University Drive, San Marcos, TX, 78666, USA
| | - Brad Beauvais
- Texas State University, School of Health Administration, Encino Hall, Room 250A, 601 University Drive, San Marcos, TX, 78666, USA
| | - Jose Betancourt
- Texas State University, School of Health Administration, Encino Hall, Room 250A, 601 University Drive, San Marcos, TX, 78666, USA
| | - Gerardo Pacheco
- Texas State University, School of Health Administration, Encino Hall, Room 250A, 601 University Drive, San Marcos, TX, 78666, USA
| | - Rohit Pradhan
- Texas State University, School of Health Administration, Encino Hall, Room 250A, 601 University Drive, San Marcos, TX, 78666, USA
| | - Keya Sen
- Texas State University, School of Health Administration, Encino Hall, Room 250A, 601 University Drive, San Marcos, TX, 78666, USA
| | - Zo Ramamonjiarivelo
- Texas State University, School of Health Administration, Encino Hall, Room 250A, 601 University Drive, San Marcos, TX, 78666, USA
| | - Arvind Sharma
- Boston College, Woods College of Advancing Studies, St. Mary's Hall South, Chestnut Hill, MA, 02467, USA
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