United States Veteran Perceptions of the Veterans Health Administration Spinal Cord Injuries and Disorders Annual Evaluation

Veterans Health Administration (VHA) offers Annual Evaluations (AEs) to Veterans with spinal cord injuries and disorders (SCI/D) for preventive services, managing common complications, psychosocial services, and addressing equipment needs. Obtain Veteran perceptions of AE services and examine their association with Veteran characteristics and receipt of AEs. Surveys were sent to <i>n</i> = 8,421 Veterans in the VHA SCI/D Registry electronically (<i>n</i> = 8,121) or through US mail (<i>n</i> = 300), with a 23.64% response rate. After excluding participants with missing data, <i>n</i> = 1,687 Veterans were included in descriptive and logistic regression analyses. Respondents were aged 60.7 years (SD=11.60) on average; most were male (91.2%), white (75.9%), and non-Hispanic (90.5%). 72.4% indicated receiving their most recent SCI/D AE about one year ago, 24.8% more than one year ago, and 3.4% had never had an AE. The most frequently reported reasons for not receiving an AE were COVID-19 related concerns (46.1%), and that AE was not offered (23.4%). Most (73.7%) indicated the AE was “Very Important” for their health and well-being. Veterans living more than 120  min from their VA had lower odds (0.51, 95% CI 0.32–0.80) of reporting recent AEs compared to Veterans who lived within 30  min. Veterans expressed high levels of satisfaction with the AE and found many aspects to be valuable. Additional strategies are needed to address travel barriers and COVID-19 related access challenges to bolster AE receipt. Future research and efforts to leverage technology for reminders may improve AE uptake.

美国退伍军人事务部（Veterans Health Administration, VHA）为脊髓损伤与障碍（spinal cord injuries and disorders, SCI/D）退伍军人提供年度评估（Annual Evaluations, AEs）服务，涵盖预防保健、常见并发症管理、社会心理服务及设备需求适配。本研究旨在调研退伍军人对AE服务的使用感知，并探讨其与退伍军人个体特征及AE服务接受情况的关联。

研究通过电子渠道（n=8121）或美国邮政（n=300）向VHA SCI/D登记系统内的n=8421名退伍军人发放问卷，最终有效回收率为23.64%。剔除存在数据缺失的参与者后，共纳入1687名退伍军人进行描述性分析及逻辑回归分析。

受访对象平均年龄为60.7岁（SD=11.60）；绝大多数为男性（91.2%）、白人（75.9%）及非西班牙裔（90.5%）。72.4%的受访者表示其最近一次SCI/D年度评估距今约1年，24.8%的受访者接受评估的时间超过1年，另有3.4%的受访者从未接受过AE服务。未接受AE服务的最常见原因为新冠疫情相关顾虑（46.1%）及未被提供AE服务（23.4%）。多数（73.7%）受访者认为AE服务对其健康与福祉"极为重要"。

居住距离退伍军人事务部医疗中心超过120分钟车程的退伍军人，报告近期接受过AE服务的比值比为0.51（95%CI 0.32~0.80），显著低于居住时长在30分钟以内的退伍军人。受访退伍军人对AE服务的满意度较高，并认为其多项服务环节具有较高价值。

亟需制定针对性策略以破解出行障碍及新冠疫情相关的服务可及性难题，从而提升AE服务的接受率。未来可探索借助技术手段设置提醒服务，以进一步提高AE服务的参与度。