Engaging African American Veterans with Health Care Access Challenges in a Community Partnered Care Coordination Initiative: A Qualitative Needs Assessment.

Background: Little has been written about engaging potentially eligible members of a health care system who are not accessing the care to which they are entitled. Knowing more about the experiences of African American Veterans who regularly experience health care access challenges may be an important step toward equitable, coordinated Veterans Health Administration (VHA) care. This article explores the experiences of African American Veterans who are at risk of experiencing poor care coordination. Design: We partnered with a community organization to recruit and engage Veterans in three exploratory engagement workshops between October 2015 and February 2016. Participants and Setting: Veterans living in South Los Angeles, California. Main Outcome Measures: Veterans were asked to describe their experiences with community care and the VHA, a division of the US Department of Veterans Affairs (VA). Field notes taken during the workshops were analyzed by community and academic partners using grounded theory methodology to identify emergent themes. Results: 12 Veterans and 3 family members of Veterans participated in one or more engagement workshops. Their trust in the VA was generally low. Positive themes included: Veterans have knowledge to share and want to help other Veterans; and connecting to VA services can result in positive experiences. Negative themes included: functional barriers to accessing VA health care services; insensitive VA health care environment; lack of trust in the VA health care system; and Veteran status as disadvantageous for accessing non-VA community services. Conclusions: Veterans living in underserved areas who have had difficulty accessing VA care have unique perspectives on VA services. Partnering with trusted local community organizations to engage Veterans in their home communities is a promising strategy to inform efforts to improve care access and coordination for vulnerable Veterans.