Elisa Borah, PhD and Val Rosen, MD How Does Primary Care Provider Training in Military Cultural Competence Influence Military Veterans’ Quality of Care? Elisa Borah, PhD and Val Rosen, MD

Veterans Choice Program (VCP) Seton Healthcare became a participant in the Veterans Choice Program (VCP) in early 2016. The program was established by The Veterans Access, Choice, and Accountability Act of 2014 (VACCA) to improve veterans’ access to health care by allowing eligible veterans to use approved health care providers outside of the VA.

Background Texas is home to 1.9 million veterans. Recent research has documented the benefits of MCC in effective healthcare for military members. Veterans often present with unique needs. Research indicates the perceived value of MCC but there are many training methods available that are not evaluated, and limited research showing the efficacy of MCC based on patient experiences. ranging from toxic exposures, sustained traumatic event exposures, and the psychosocial impact and corollary conditions related to multiple deployments that can significantly impact the clinical presentation of veteran symptoms.

Study Goal To advance knowledge of how health care providers’ military cultural competence (MCC) influences military veteran patients’ healthcare experiences and perception of health improvement.   Seton primary care providers will receive specialized training to increase their knowledge and awareness of relevant military cultural elements, health risks and concerns essential to treating military-connected patients.

Study Question How do providers’ level of competency, and different training models for military cultural competence, influence veteran patients’ perceptions of their care experience and perception of healthcare outcomes?

Study Objectives Objective 1: Compare the efficacy of two trainings in MCC as measured by changes in providers’ level of military cultural competence and patient’s perception of healthcare. We will compare the delivery of the VA online One training will be the online version developed by the Department of Veteran’s Affairs which stands as the current method of training Seton providers can view as a slide presentation. The in person training will be a one hour training adopted from Tim Keesling (Interim Director of the Texas Veteran’s Mental Health Program.) This will involve an interactive segment with a veteran and will be based on feedback procured from Veteran and military pt’s focus groups.

Objective 2: Assess Seton’s veteran patients’ health care preferences and experiences from providers who received each type of MCC training.

Objective 3: Determine effectiveness and cost efficiency for training for Seton.