Rural Native Veterans' Perceptions of Care in the Context of Navigator Program Development

Area of Science:

• Health Services Research
• Indigenous Health
• Veterans Affairs

Background:

• American Indian and Alaska Natives (AI/AN) serve in the military at high rates.
• AI/AN Veterans experience healthcare disparities exacerbated by access and navigation barriers within the Veterans Health Administration (VHA).
• The VHA is developing a patient navigation program for rural Native Veterans to address these challenges.

Purpose of the Study:

• To understand barriers to VHA care from the perspective of rural Native Veterans.
• To inform the development of a VHA patient navigation program tailored to rural Native Veterans.

Main Methods:

• Semi-structured interviews were conducted with 34 participants.
• Participants included 22 Veterans, 6 family members, and 6 Veteran advocates.
• Participants were drawn from 9 tribal communities across the United States.

Main Results:

• Key barriers identified include perceived care scarcity, long travel distances and costs, and bureaucratic issues (poor customer service, scheduling delays).
• Many Veterans preferred Indian Health Service (IHS)/tribal health care due to proximity, simplicity, and quality.
• Participants recommended navigation program features such as enrollment and scheduling assistance, paperwork support, cost reimbursement, and care coordination.

Conclusions:

• Rural Native Veterans require clear benefits to overcome VHA access obstacles.
• A patient navigation program should incorporate specific recommendations to improve VHA utilization.
• Addressing identified barriers is crucial for enhancing healthcare access and coordination for Native Veterans.