# Understanding Racial/Ethnic Disparities in Uterine Fibroid Outcomes among Women Veterans: A mixed-methods study

> **NIH VA I01** · VA PUGET SOUND HEALTHCARE SYSTEM · 2022 · —

## Abstract

Background: Uterine fibroids (UF) are a common and costly gynecologic condition that disproportionately affect Black
women with regard to incidence, severity, treatment, and outcomes. UF result in debilitating symptoms including pelvic
pressure and pain, problems with reproduction, heavy menstrual bleeding, and severe anemia, and are the leading
cause of hysterectomy among women Veterans in VA. Although VA is a model healthcare system regarding health
equity in many areas, recent data suggest that substantial Black/White disparities in UF treatment and outcomes exist
within VA. As one-third of women Veterans using VA health care are Black and this proportion is increasing,
understanding the underlying drivers of these disparities within VA is of critical importance. Limited research has
examined these mechanisms either outside or within VA. Building a comprehensive understanding of UF disparities
and potential opportunities to address them will require examining the role of race and racism in women Veterans’
pathways to diagnosis and treatment of UF and their UF treatment patterns and experiences.
Objectives: Our objective is to investigate the mechanisms underlying Black/White disparities in UF-related outcomes
among women Veterans receiving VA care. Guided by the Public Health Critical Race Praxis, which asserts that race
is a social construct and that ubiquitous patterns and structures of contemporary racism shape racial disparities in
health, we propose: (1) To examine Black/White differences in treatment patterns for women Veterans with UF and
identify modifiable determinants; (2) To examine Black/White differences in clinical and post-surgical outcomes among
women Veterans receiving treatment for UF in VA and identify modifiable determinants; and (3) To understand and
contextualize differences identified in Aims 1 and 2 using qualitative exploration of Black women Veterans’
experiences with UF symptoms, care seeking behaviors, and treatment and how they differ from those of White
women Veterans.
Methods: We will use a mixed methods approach to address our study objectives. All three aims, will draw from a
single cohort of Black and White women Veteran users of VA healthcare with newly diagnosed symptomatic UF
between Fiscal Year 2010 (FY10) and FY12, identified through the Corporate Data Warehouse (CDW). Aims 1 and 2
are retrospective cohort analyses. We will examine administrative data and chart-abstracted medical record data
through FY18 to compare Black/White differences in treatment and outcomes. Aim 1 will compare time from diagnosis
to initial treatment and surgical treatments; type of initial treatment (medical, non-definitive procedure, hysterectomy);
and mode of surgery (minimally invasive vs abdominal). Aim 2 will examine Black/White differences in clinical
(emergency room visits, hospitalization for anemia, blood transfusion) and surgical outcomes (surgical complications,
30-day readmission) for UF. Aim 3 is a qualitative study w...

## Key facts

- **NIH application ID:** 10114141
- **Project number:** 5I01HX003061-02
- **Recipient organization:** VA PUGET SOUND HEALTHCARE SYSTEM
- **Principal Investigator:** Lisa Susanne Callegari
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2022
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2020-02-01 → 2024-01-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10114141

## Citation

> US National Institutes of Health, RePORTER application 10114141, Understanding Racial/Ethnic Disparities in Uterine Fibroid Outcomes among Women Veterans: A mixed-methods study (5I01HX003061-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10114141. Licensed CC0.

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