PMID- 37838585 OWN - NLM STAT- MEDLINE DCOM- 20231218 LR - 20231218 IS - 1878-4321 (Electronic) IS - 1049-3867 (Linking) VI - 34 IP - 1 DP - 2024 Jan-Feb TI - Veteran Caretaker Perspectives of the Need for Childcare Assistance During Health Care Appointments. PG - 98-106 LID - S1049-3867(23)00152-4 [pii] LID - 10.1016/j.whi.2023.08.005 [doi] AB - PURPOSE: In 2020, Congress passed legislation to establish the national Veterans Child Care Assistance Program (VCAP) targeting eligible veterans receiving care through the Veterans Health Administration (VA). This needs assessment describes the childcare needs of veteran caretakers of young children and explores the implications of inadequate childcare on health care engagement. METHODS: Survey data were collected from 2,000 VA users with dependent children; data were analyzed using standard descriptive statistics. Qualitative data were collected from 19 veterans through focus groups and analyzed using rapid thematic analysis. FINDINGS: More than 75% of veterans surveyed indicated that they required childcare assistance during health care appointments and 73% reported barriers to finding childcare. Prominent barriers included the high cost of childcare and not having a trusted source of childcare. Nearly 58% of survey respondents reported missed or canceled VA health care appointments due to childcare challenges. Furthermore, 35% of surveyed veterans reported that their children had accompanied them to an appointment in the past year. Among these veterans, 59% brought their children into the exam room. Focus group participants discussed how having children present during their health care appointments hampered communication with health care providers. CONCLUSIONS: Veterans report that lack of childcare keeps them from attending and remaining focused on the provider during their health care visits, which could compromise quality of care. As one of the only health systems in the United States that will offer childcare assistance, VCAP presents an opportunity to improve health care access and quality by reducing missed appointments and suboptimal care. CI - Published by Elsevier Inc. FAU - Shepherd-Banigan, Megan AU - Shepherd-Banigan M AD - Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham Veterans Affairs Health Care System, Durham, North Carolina; Department of Population Health Sciences, Duke University Medical Center, Durham, North Carolina; Duke-Margolis Center for Health Policy, Durham, North Carolina. Electronic address: megan.shepherd-banigan@va.gov. FAU - Cannedy, Shay AU - Cannedy S AD - Center for the Study of Healthcare Innovation, Implementation & Policy (CSHIIP), VA Greater Los Angeles Healthcare System, Los Angeles, California. FAU - Rodriguez, Adriana AU - Rodriguez A AD - Center for the Study of Healthcare Innovation, Implementation & Policy (CSHIIP), VA Greater Los Angeles Healthcare System, Los Angeles, California. FAU - Burns, Madison AU - Burns M AD - Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham Veterans Affairs Health Care System, Durham, North Carolina. FAU - Woolson, Sandra AU - Woolson S AD - Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham Veterans Affairs Health Care System, Durham, North Carolina. FAU - Hamilton, Alison AU - Hamilton A AD - Center for the Study of Healthcare Innovation, Implementation & Policy (CSHIIP), VA Greater Los Angeles Healthcare System, Los Angeles, California; Department of Psychiatry and Biobehavioral Sciences, UCLA David Geffen School of Medicine, Los Angeles, California. FAU - Quiroz, Ismael AU - Quiroz I AD - VA Childcare Assistance Program, Office of Women's Health, VA Central Office, Department of Veterans Affairs, Washington, District of Columbia. FAU - Matthews, Hanh AU - Matthews H AD - VA Childcare Assistance Program, Office of Women's Health, VA Central Office, Department of Veterans Affairs, Washington, District of Columbia. FAU - Garber-Cardwell, Diane AU - Garber-Cardwell D AD - VA Childcare Assistance Program, Office of Women's Health, VA Central Office, Department of Veterans Affairs, Washington, District of Columbia. FAU - Byrd, Kaileigh G AU - Byrd KG AD - Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham Veterans Affairs Health Care System, Durham, North Carolina. FAU - Brown, Adrian AU - Brown A AD - Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham Veterans Affairs Health Care System, Durham, North Carolina. FAU - Goldstein, Karen M AU - Goldstein KM AD - Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham Veterans Affairs Health Care System, Durham, North Carolina; Division of General Internal Medicine, Duke University Medical Center, Durham, North Carolina. LA - eng GR - IK2 HX002591/HX/HSRD VA/United States PT - Journal Article DEP - 20231012 PL - United States TA - Womens Health Issues JT - Women's health issues : official publication of the Jacobs Institute of Women's Health JID - 9101000 SB - IM MH - Humans MH - United States MH - Child MH - Child, Preschool MH - *Veterans MH - Child Care MH - United States Department of Veterans Affairs MH - Health Services Accessibility MH - Needs Assessment EDAT- 2023/10/15 05:46 MHDA- 2023/12/18 06:42 CRDT- 2023/10/14 22:03 PHST- 2023/01/30 00:00 [received] PHST- 2023/08/18 00:00 [revised] PHST- 2023/08/25 00:00 [accepted] PHST- 2023/12/18 06:42 [medline] PHST- 2023/10/15 05:46 [pubmed] PHST- 2023/10/14 22:03 [entrez] AID - S1049-3867(23)00152-4 [pii] AID - 10.1016/j.whi.2023.08.005 [doi] PST - ppublish SO - Womens Health Issues. 2024 Jan-Feb;34(1):98-106. doi: 10.1016/j.whi.2023.08.005. Epub 2023 Oct 12.