Karen E Dyer1, Sharyn J Potter2, Alison B Hamilton3, Tana M Luger4, Alicia A Bergman5, Elizabeth M Yano4, Ruth Klap3. 1. VA HSR&D Center for the Study of Healthcare Innovation, Implementation and Policy (CSHIIP), VA Greater Los Angeles Healthcare System, Los Angeles, California. Electronic address: karen.dyer@va.gov. 2. Department of Sociology, Prevention Innovations Research Center, University of New Hampshire, Durham, New Hampshire. 3. VA HSR&D Center for the Study of Healthcare Innovation, Implementation and Policy (CSHIIP), VA Greater Los Angeles Healthcare System, Los Angeles, California; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California. 4. VA HSR&D Center for the Study of Healthcare Innovation, Implementation and Policy (CSHIIP), VA Greater Los Angeles Healthcare System, Los Angeles, California; Department of Health Policy and Management, Fielding School of Public Health, University of California Los Angeles, Los Angeles, California. 5. VA HSR&D Center for the Study of Healthcare Innovation, Implementation and Policy (CSHIIP), VA Greater Los Angeles Healthcare System, Los Angeles, California.
Abstract
PURPOSE: Stranger harassment at Veterans Health Administration (VA) facilities is prevalent, affecting one in four women veteran VA primary care users. Harassment interferes with health care quality and may result in veterans forgoing or delaying needed care. To better understand this phenomenon, gender-stratified discussion groups were held with men and women veterans. This article examines gender differences in veterans' perceptions and experiences of harassment on VA grounds. METHODS: We conducted a total of 15 discussion groups at four VA medical centers, eight with men (n = 57) and seven with women (n = 38). Transcripts were coded using the constant comparative method and analyzed for overarching themes. RESULTS: Awareness of harassment was not uniformly high among participants. Although women voiced clear understandings and experiences of specific behaviors constituting harassment (e.g., cat-calls, sexual comments), many men expressed confusion about how to differentiate between harassment, "harmless flirting," and general friendliness; they were unsure which behaviors "cross a line." Furthermore, men placed the onus on women for setting boundaries, whereas women indicated it was not their responsibility to "train" men about acceptable behavior. Men and women agreed that VA staff hold primary responsibility for preventing and managing harassment. CONCLUSIONS: Substantive gender differences in understandings of harassment exist among veteran VA users. To minimize harassment, veterans recommend education of men veteran VA users, and staff-oriented trainings. Privacy, safety, dignity, and security are the cornerstones of women veterans' health care, per VA policy. Harassment undermines these standards, impeding women's access to VA care and compromising both their health outcomes and health care experiences. Understanding harassment through a gendered lens is a critical step in designing comprehensive initiatives that respond to diverse viewpoints and experiences. Published by Elsevier Inc.
PURPOSE: Stranger harassment at Veterans Health Administration (VA) facilities is prevalent, affecting one in four women veteran VA primary care users. Harassment interferes with health care quality and may result in veterans forgoing or delaying needed care. To better understand this phenomenon, gender-stratified discussion groups were held with men and women veterans. This article examines gender differences in veterans' perceptions and experiences of harassment on VA grounds. METHODS: We conducted a total of 15 discussion groups at four VA medical centers, eight with men (n = 57) and seven with women (n = 38). Transcripts were coded using the constant comparative method and analyzed for overarching themes. RESULTS: Awareness of harassment was not uniformly high among participants. Although women voiced clear understandings and experiences of specific behaviors constituting harassment (e.g., cat-calls, sexual comments), many men expressed confusion about how to differentiate between harassment, "harmless flirting," and general friendliness; they were unsure which behaviors "cross a line." Furthermore, men placed the onus on women for setting boundaries, whereas women indicated it was not their responsibility to "train" men about acceptable behavior. Men and women agreed that VA staff hold primary responsibility for preventing and managing harassment. CONCLUSIONS: Substantive gender differences in understandings of harassment exist among veteran VA users. To minimize harassment, veterans recommend education of men veteran VA users, and staff-oriented trainings. Privacy, safety, dignity, and security are the cornerstones of women veterans' health care, per VA policy. Harassment undermines these standards, impeding women's access to VA care and compromising both their health outcomes and health care experiences. Understanding harassment through a gendered lens is a critical step in designing comprehensive initiatives that respond to diverse viewpoints and experiences. Published by Elsevier Inc.
Authors: Karissa M Fenwick; Karen E Dyer; Ruth Klap; Kristina Oishi; Jessica L Moreau; Elizabeth M Yano; Bevanne Bean-Mayberry; Anne G Sadler; Alison B Hamilton Journal: J Gen Intern Med Date: 2022-03-09 Impact factor: 6.473
Authors: Karissa M Fenwick; Tana M Luger; Karen E Dyer; Joya G Chrystal; Alison B Hamilton; Elizabeth M Yano; Ruth Klap Journal: J Gen Intern Med Date: 2021-02-25 Impact factor: 6.473
Authors: Jan A Lindsay; Alexandra Caloudas; Julianna Hogan; Anthony H Ecker; Stephanie Day; Giselle Day; Samantha L Connolly; Hilary Touchett; Kendra R Weaver; Amber B Amspoker Journal: J Gen Intern Med Date: 2022-08-30 Impact factor: 6.473