# Designing a novel post-incident intervention to address patient harassment of staff in VA primary care settings

> **NIH VA I21** · VA GREATER LOS ANGELES HEALTHCARE SYSTEM · 2023 · —

## Abstract

Project Background: Ninety-seven percent of women and 77% of men internal medicine physicians in a
recent Veterans Affairs (VA) healthcare facility survey reported sexual harassment from patients. Staff may
cope with patient-perpetrated harassment by omitting elements of care, rushing clinical tasks, and distancing
from the patient emotionally and physically. Further, patient-perpetrated harassment is associated with
decreased staff well-being and increased burnout and turnover, which are in turn associated with decreased
quality of care, decreased patient satisfaction, and increased risk of medical errors. Secretary McDonough
recently vowed to end all forms of harassment and discrimination at VA, and the new Deborah Sampson Act
requires facilities to implement anti-harassment procedures. However, prior work indicates that VA lacks
systematic, evidence-based interventions for responding to patient harassment of staff that anticipate
harassment, stop the incident, communicate that harassment is unwelcome, facilitate incident reporting, and
support affected staff. The goal of this pilot project is to design a novel intervention to guide immediate post-
incident staff, clinic, and facility responses to patient-perpetrated sexual harassment of staff in primary care.
Significance/Impact: The resulting intervention will address ORD Strategic Priority 4: actively promoting
diversity, equity, and inclusion by communicating that VA does not tolerate harassment based on social identity
characteristics. Additionally, it will contribute to HSR&D priority domain: Primary Care Practice and Complex
Chronic Disease Management by offering support related to patient-perpetrated harassment that can “improve
provider and staff morale,” improve staff-provider interactions, and increase quality of patient care.
Innovation: This pilot project leverages a unique opportunity to respond to unprecedented leadership and
policy support for interventions to address harassment at VA. The resulting intervention will fill a critical gap in
procedures grounded in empirical data for responding to patient-perpetrated harassment and supporting VA
staff, and will complement VA’s ongoing anti-harassment efforts. Our design process will be guided by an
innovative framework that will ensure that the intervention fits with VA priorities and stakeholder needs.
Specific Aims: The Specific Aims are to: 1) identify intervention components based on existing and ideal
practices for responding to patient-perpetrated harassment of staff; and 2) refine the post-incident intervention
through iterative stakeholder feedback.
Methodology: Guided by a Steering Committee of operations partners, VA leadership, and subject matter
experts, we will follow a step-based process of transcreation, i.e., co-designing interventions with stakeholders
to fit with local contexts from the outset. We will focus on primary care settings, which have established rates of
harassment and serve as the main port of entry in...

## Key facts

- **NIH application ID:** 10420831
- **Project number:** 1I21HX003523-01
- **Recipient organization:** VA GREATER LOS ANGELES HEALTHCARE SYSTEM
- **Principal Investigator:** Karissa Fenwick
- **Activity code:** I21 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2023
- **Award amount:** —
- **Award type:** 1
- **Project period:** 2023-01-01 → 2024-09-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10420831

## Citation

> US National Institutes of Health, RePORTER application 10420831, Designing a novel post-incident intervention to address patient harassment of staff in VA primary care settings (1I21HX003523-01). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10420831. Licensed CC0.

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