Enhancing Rural Veteran Access to Specialty Pelvic Health Rehabilitation Through Mentorship and a Novel Model of Care...

Pelvic health rehabilitation (PHR) treats pelvic floor disorders that result in pain, incontinence, and sexual dysfunction. Within the Veterans Health Administration (VHA), few clinicians are trained to provide PHR, particularly in rural areas. We developed and implemented 2 programs: a mentorship program to increase the PHR workforce and a virtual Care Navigator program to increase direct PHR access. Our aims were to describe the PHR project and initial program evaluation.

Clinicians across VHA were eligible to apply for the mentorship program, with priority to Physical Therapists (PTs) at rural sites. We selected 2 rural sites to pilot the Care Navigator program. Quantitative evaluation measures included the number of mentees trained and number of Veterans served by mentees (reach), self-reported symptom improvement in the Care Navigator program (effectiveness), and the time from initial referral to Veteran contact with the Care Navigator (efficiency). We tracked these data with project logs, operational dashboard, and patient reported outcome measures. Qualitative data included semi-structured interviews with 7 Veterans who received care navigation.

From October 2020 to September 2025, we trained 38 mentees, who collectively served 22,975 Veterans (9,875 rural). At the 2 Care Navigator sites, we reached 123 Veterans, most of whom reported symptom improvement and high satisfaction, corroborated in qualitative interviews. The average time from referral to contact was 23.5 days.

This comprehensive PHR project bolstered workforce capacity for specialty PHR care without hiring new staff and increased access for rural Veterans. Future work will focus on scaling.