Understanding Racial Inequities in Fibroid Care for Veterans (U-RISE)
Principal Investigators
Jodie Katon, PhD, MS, Lisa Callegari, MD, MPH
Funding Source
VA Health Services Research & Development
Background
Due to disparities in uterine fibroid (UF) incidence, severity, treatment, and outcomes in Black women compared to white women, we are conducting a mixed methods study to understand the mechanisms underlying this Black/white difference in uterine fibroid outcomes among women Veterans who receive VA care.
Design/Overview
The project includes
- a retrospective cohort study of women Veterans with symptomatic UF to examine racial differences in treatment patterns and surgical outcomes.
- a series of qualitative interviews with a purposively selected sample of Black and white Veterans to further elucidate mechanisms underlying Black/white differences in care and outcomes.
Status
Data collection an analysis ongoing
Impact Statement
This study is the first of its kind to examine treatment pathways for uterine fibroids among Black and White veterans.
Hysterectomy in the Veterans Health Administration
Principal Investigators
Lisa Callegari, MD, MPH, Jodie Katon, PhD, MS, Kristen Gray, PhD, MS
Funding Source
VA Health Services Research and Development, VA Office of Health Equity
Background
Identifying predictors or deterrents of minimally invasive hysterectomy techniques may help highlight factors which can be modified to improve uptake of these techniques, where appropriate.
Design/Overview
Cross sectional chart abstraction of over 1,000 hysterectomies provided by VA and stakeholder interviews with VA providers.
Status
Primary data collection and analysis complete.
Impact Statement
Principal findings suggest health disparities in clinical and surgical outcomes between Black and White Veterans.
Associated Publications
- Katon JG, Gray KE, Callegari LS, Gardella C, Gibson CJ, Ma E, Zephyrin LC. Trends in hysterectomy rates among women Veterans in the US Department of Veterans Affairs. American Journal of Obstetrics Gynecology. 2017 October;217:428.e1-11.
- Callegari L, Katon JG, Gray KE, Doll K, Pauk S, Lynch KE, Uchendu US, Zephyrin L, Gardella C. Associations between race/ethnicity, uterine fibroids, and minimally invasive hysterectomy in the VA healthcare system. Women’s Health Issues. 2019 January-February; 29(1): 48-55.
- Gray KE, Ma EW, Callegari LS, Magnusson SL, Tartaglione EV, Christy AY, Katon JG. Understanding Variation in Availability and Provision of Minimally Invasive Hysterectomy: A Qualitative Study of Department of Veterans Affairs Gynecologists. Women’s Health Issues. September 2019.
- Katon JG, Bossick AS, Doll KM, Fortney J, Gray KE, Hebert P, Lynch KE, Ma EW, Washington DL, Zephyrin L, Callegari LS. Contributors to Racial Disparities in Minimally Invasive Hysterectomy in the US Department of Veterans Affairs. Medical Care. 2019 December 15:57(12):930-6.