Factors Affecting Women's Disclosure of Alcohol Misuse in Primary Care: A Qualitative Study with U.S. Military Veterans

• Published in: Women's health issues Vol. 26; no. 2; pp. 232 - 239
• Main Authors: Cucciare, Michael A., PhD, Lewis, Eleanor T., PhD, Hoggatt, Katherine J., PhD, MPH, Bean-Mayberry, Bevanne, MD, MHS, Timko, Christine, PhD, Durazo, Eva M., MPH, Jamison, Andrea L., PhD, Frayne, Susan M., MD, MPH
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.03.2016
• Subjects: Adult; Alcohol Drinking; Alcoholism - epidemiology; Alcoholism - psychology; Attitude of Health Personnel; Disclosure; Female; Health Care Surveys; Hospitals, Veterans - utilization; Humans; Middle Aged; Military Personnel; Obstetrics and Gynecology; Primary Health Care; Qualitative Research; United States - epidemiology; United States Department of Veterans Affairs; Veterans - psychology; Veterans - statistics & numerical data; Women's Health
• ISSN: 1049-3867; 1878-4321
• DOI: 10.1016/j.whi.2015.07.010

Abstract Background One in five women veterans screens positive for alcohol misuse. Women may be less likely than men to disclose alcohol use to a primary care provider (PCP), resulting in women being less likely to receive effective interventions. We sought to qualitatively examine factors that may affect women veterans' willingness to disclose alcohol use to a PCP. Methods Between October 2012 and May 2013, in-depth interviews were conducted with 30 women veterans at two Department of Veterans Affairs (VA) medical facilities. Qualitative data analyses identified common themes representing factors that influence women's decision to disclose alcohol use to a PCP. Findings Nine themes were endorsed by women veterans as influencing their willingness to disclose alcohol use to their PCP. Themes included provider behaviors perceived as encouraging or discouraging disclosure of alcohol misuse, perceived positive relationship with provider, negative emotions such as concerns about being judged or labeled an “alcoholic,” health concerns about drinking, non–health-related concerns about drinking, self-appraisal of drinking behavior, social support, and clinic factors. Conclusions Our findings demonstrate the importance of social relationships, comfort with one's provider, and education on the potential harms (especially health related) associated with alcohol in encouraging disclosure of alcohol use in women veterans. Our results also support VA national health care efforts, including the provision of brief alcohol counseling and the use of primary care clinics specializing in the care of women veterans.