# Enhancing Mental and Physical Health of Women through Engagement and Retention (EMPOWER) QUERI 2.0

> **NIH VA I50** · VA GREATER LOS ANGELES HEALTHCARE SYSTEM · 2021 · —

## Abstract

Women Veterans are the fastest-growing segment of users in the Veterans Health Administration (VA). Their
numbers are projected to increase by 73%, from 9.3% to 16.4%, between 2015 and 2043. Despite VA
investment in improving care for women Veterans, gender disparities persist in cardiovascular (CV) and
diabetes risk factor control. Also, the rate of perinatal depression among women Veterans is higher than that
among civilian women, which is of particular concern given the association between perinatal depression and
suicidality. Barriers to care for women Veterans include distance to VA care, rurality, competing work and
caregiving responsibilities, comorbid mental health issues, and harassment on VA grounds. Improvements are
still needed to increase women Veterans’ access to and engagement in convenient, safe, evidence-based,
patient-centered care that achieves the VA “lane of effort” of Veterans’ “lifelong health, well-being, and
resilience.” Since its inception in 2015, the Enhancing Mental and Physical health of Women through
Engagement and Retention (EMPOWER) QUERI 1.0 team has focused on implementing gender-tailored care
models for women Veteran patients. In EMPOWER 1.0 studies, women expressed preferences for gender-
specific (women only) care and for virtual care options. Therefore, our EMPOWER 2.0 Impact Goal is to
expand access to virtual, evidence-based, preventive lifestyle and mental health services for women Veterans
with high-priority health conditions in rural and urban-isolation areas. To achieve this impact goal, we propose
a Level 3 QUERI Program with three aims:
1) Using two implementation strategies (Replicating Effective Practices [REP] and Evidence-Based Quality
 Improvement [EBQI]), support implementation and sustainment of three evidence-based practices (EBPs)
 focused on preventive lifestyle and mental health care for women Veterans across 20 VA facilities (10 with
 REP, 10 with EBQI), several of which are rural, low-performing in women’s health care, and/or lead sites
 for high reliability organization.
2) Conduct a mixed methods implementation evaluation using a cluster randomized type 3 hybrid
 implementation-effectiveness trial design. We will compare the effectiveness of REP and EBQI in terms of:
 (a) improved access to and rates of engagement in virtual preventive lifestyle and mental health services
 and improved VA performance metrics for virtual and telehealth care delivery and related clinical outcomes
 for women Veterans; (b) progression along the Stages of Implementation Completion; (c) adaptation,
 sensemaking, and experiences of EBP implementation among multilevel stakeholders; and (d) cost and
 return on investment.
3) Generate implementation “playbooks” for program partners that are scalable and serve as guidance for
 future implementation of a broader array of evidence-based women’s health programs and policies.
We will implement three EBPs: 1) Virtual Diabetes Prevention Program (DPP), an evidence-base...

## Key facts

- **NIH application ID:** 10070430
- **Project number:** 1I50HX003199-01
- **Recipient organization:** VA GREATER LOS ANGELES HEALTHCARE SYSTEM
- **Principal Investigator:** Bevanne Bean-Mayberry
- **Activity code:** I50 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2021
- **Award amount:** —
- **Award type:** 1
- **Project period:** 2020-10-01 → 2025-09-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10070430

## Citation

> US National Institutes of Health, RePORTER application 10070430, Enhancing Mental and Physical Health of Women through Engagement and Retention (EMPOWER) QUERI 2.0 (1I50HX003199-01). Retrieved via AI Analytics 2026-05-28 from https://api.ai-analytics.org/grant/nih/10070430. Licensed CC0.

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