Abstract
Purpose
Managers and leaders have a critical role to play in sexual and gender-based harassment
prevention within organizations. Although the Veterans Health Administration has committed
to eliminating harassment through national directives and training programs, it is
unclear how aware local-level managers and leaders are about public harassment at
their facilities and how they perceive sexual and gender-based harassment. We examined
middle managers' and leaders’ views about whether harassment is perceived as a problem
locally, and what policies and procedures (if any) are in place to address public
harassment.
Methods
We conducted 69 semistructured telephone interviews with middle managers and facility
leaders before implementation of an evidence-based quality improvement project designed
to improve delivery of comprehensive women's health care. Transcripts were coded using
the constant comparative method and analyzed for overarching themes.
Results
Perceptions of the prevalence of sexual and gender-based public harassment varied
among middle managers and leaders. A little more than one-half of respondents were
unaware of facility-level policies and procedures to address public harassment between
patients. To decrease patient-to-patient harassment, both groups generally supported
the creation of separate clinical spaces for women. However, middle managers also
stated that education was needed to change patient harassing behavior, which they
tied to male military culture.
Conclusions
Aligning divergent perspectives of what constitutes sexual and gender-based harassment
and how to address it is a necessary step towards tackling harassment at the local
level. Managers and leaders should continue to assess environments of care and share
findings widely among employees and leadership to improve awareness and inform a unified
response.
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Biography
Shay Cannedy, PhD, is a Cultural Anthropologist and Research Health Scientist at the VA HSR&D Center for the Study of Healthcare Innovation, Implementation and Policy.
Biography
Karen E. Dyer, PhD, MPH, is a Medical Anthropologist and Research Health Scientist at the VA HSR&D Center for the Study of Healthcare Innovation, Implementation & Policy (CSHIIP).
Biography
Anneka Oishi, BA, is a Research Assistant at VA HSR&D Center for the Study of Healthcare Innovation, Implementation & Policy (CSHIIP).
Biography
Karissa M. Fenwick, PhD, MSW, LCSW, is a Research Health Scientist at the Center for the Study of Healthcare Innovation, Implementation & Policy (CSHIIP) in the VA Greater Los Angeles Healthcare System.
Biography
Tanya T. Olmos-Ochoa, PhD, MPH, is an Investigator at the Center for the Study of Healthcare Innovation, Implementation, and Policy at VA Greater Los Angeles. Her work focuses on improving the organization and delivery of care to address health care disparities and better support the health care workforce.
Biography
Tana M. Luger, PhD, MPH, is the Director of Research and Analytics for Covenant Health Network, a non-profit group of post-acute health care providers. Her work focuses on the application of patient-facing and clinical informatics to optimize health care quality and population health.
Biography
Theodore K. Gideonse, PhD, MFA, is an Assistant Professor in the Department of Health, Society, and Behavior and Director of the Undergraduate Program for University of California, Irvine's Program in Public Health.
Biography
Ann M. Cheney, PhD, is an Associate Professor in the Department of Social Science Population and Public Health. Her work focuses on structural inequality in vulnerable populations, including immigrant, veteran, and rural populations.
Biography
Ismelda Canelo, MPA, is a Health Science Specialist, VA HSR&D Center for the Study of Healthcare Innovation, Implementation and Policy. She has 20 years of experience managing VA primary care and women's health organizational and implementation research.
Biography
Elizabeth M. Yano, PhD, MSPH, is Director of the VA HSR&D Center for the Study of Healthcare Innovation, Implementation & Policy (CSHIIP) and Director of the Women's Health Research Network Consortium, and Adjunct Professor in Public Health and Medicine at UCLA.
Biography
Alison B. Hamilton, PhD, MPH, is a VA Research Career Scientist and Chief Officer of Implementation & Policy, VA HSR&D Center for the Study of Healthcare Innovation, Implementation & Policy (CSHIIP), and Professor-in-Residence in the Department of Psychiatry and Biobehavioral Sciences, UCLA David Geffen School of Medicine.
Article info
Publication history
Published online: March 09, 2022
Accepted:
January 27,
2022
Received in revised form:
January 10,
2022
Received:
September 2,
2021
Footnotes
Funding Statement: Funded by the VA Women’s Health Services/Quality Enhancement Research Initiative (WHS/QUERI) Partnered Evaluation Initiative (Project # PEC 16-352) and VA Women's Health Services through an annual Memorandum of Understanding. This evaluation is registered with ClinicalTrials.gov (NCT03238414). Dr. Yano's effort is covered by a VA HSR&D Senior Research Career Scientist award (RCS #05-195). Dr. Hamilton's effort is covered by a VA HSR&D Research Career Scientist award (RCS #21-135). Methods for this study leveraged a previous cluster randomized trial of an EBQI approach to tailoring PACT to the needs of women Veterans (CRE 12-026).
Identification
Copyright
Published by Elsevier Inc. on behalf of Jacobs Institute of Women's Health, George Washington University.
