{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T18:06:10Z","timestamp":1787162770785,"version":"build-2736575974"},"reference-count":6,"publisher":"Oxford University Press (OUP)","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"Abstract<\/jats:title>\n \n Introduction<\/jats:title>\n Pelvic floor dysfunction detrimentally impacts function. Pelvic Health Rehabilitation (PHR) is a first-line, non-invasive treatment. However, access to PHR services is deficient due to lack of trained rehabilitation providers, limited public awareness of its value, and knowledge gaps among potential referral sources. The purpose of this project was to (1) use geospatial mapping to identify areas of need for PHR services in the Veterans Health Administration (VHA) and (2) apply the results to create a feedback loop to guide VHA strategic planning.<\/jats:p>\n <\/jats:sec>\n \n Materials and Methods<\/jats:title>\n Veteran data were extracted from clinical and administrative data sources, where pelvic health-related diagnostic codes were queried to reflect Veterans who could potentially benefit from PHR services. Data were summarized by the 96 VHA market geographic areas based on the Veteran\u2019s home residence. The number of VHA PHR providers was extracted from a national directory based on provider self-report. Data were imported into a Geographic Information System (GIS) software application to visualize maps.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n A total of 2,746,003 Veterans had a diagnosis that would potentially benefit from PHR services. The highest need areas also were those with the least access to in-house VHA PHR services, with the VHA employing 117 Pelvic Health Physical Therapists nationally.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Geospatial mapping and analyses allows for visualization of gaps in PHR access across the VHA system. This information is being utilized by clinical and operational partners to develop a multi-modal approach to building PHR workforce capacity with the goal of increasing timely Veteran access to PHR services.<\/jats:p>\n <\/jats:sec>","DOI":"10.1093\/milmed\/usag335","type":"journal-article","created":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T11:55:03Z","timestamp":1783684503000},"source":"Crossref","is-referenced-by-count":1,"title":["Utilizing Geospatial Mapping to Identify High-Need Areas for Pelvic Health Rehabilitation and Inform Strategic Health System Planning"],"prefix":"10.1093","author":[{"given":"Jordan","family":"Mamkhezri","sequence":"first","affiliation":[{"name":"Veterans Health Administration, El Paso VA Healthcare System , El Paso, TX 79930,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-4804-5987","authenticated-orcid":false,"given":"Justin K","family":"Ahern","sequence":"additional","affiliation":[{"name":"Veterans Health Administration, Executive Office of Strategic Planning, Strategic and Geospatial Analysis,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-9048-0594","authenticated-orcid":false,"given":"Mark","family":"Havran","sequence":"additional","affiliation":[{"name":"Veterans Health Administration, Office of Rehabilitation & Prosthetics Services , Des Moines, IA 50310,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Khaldy","sequence":"additional","affiliation":[{"name":"Veterans Hospital Administration, Department of Physical Therapy, VA Southern Nevada, Health Care System, Southwest Clinic , Las Vegas, NV 89113,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melanie","family":"Pomasko","sequence":"additional","affiliation":[{"name":"Veterans Hospital Administration, Department of Physical Therapy, James A. Haley Veterans\u2019 Hospital , Tampa, FL 33612,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6401-1230","authenticated-orcid":false,"given":"Allison M","family":"Gustavson","sequence":"additional","affiliation":[{"name":"Veterans Affairs Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System , Minneapolis, MN 55417,","place":["United States"]},{"name":"Veterans Affairs Rehabilitation Research and Development Center for Rehabilitation & Engineering Center for Optimizing Veteran Engagement & Reintegration, Minneapolis Veterans Affairs Health Care System , Minneapolis, MN 55417,","place":["United States"]},{"name":"Department of Medicine, University of Minnesota , Minneapolis, MN 55455,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,7,22]]},"reference":[{"key":"2026072218470274100_usag335-B1","doi-asserted-by":"publisher","first-page":"2789","DOI":"10.3390\/ijerph19052789","article-title":"Pelvic floor muscle training for urinary incontinence with or without biofeedback or electrostimulation in women: a systematic review","volume":"19","author":"Alouini","year":"2022","journal-title":"Int J Environ Res Public Health"},{"key":"2026072218470274100_usag335-B2","doi-asserted-by":"publisher","first-page":"574","DOI":"10.1097\/SPV.0000000000001215","article-title":"Barriers and promotors to health service utilization for pelvic floor disorders in the United States: systematic review and meta-analysis of qualitative and quantitative studies","volume":"28","author":"Mou","year":"2022","journal-title":"Urogynecology (Phila)"},{"key":"2026072218470274100_usag335-B3","first-page":"23","article-title":"The association between distances traveled for care and treatment choices for pelvic floor disorders in a rural southwestern population","volume":"7","author":"Dunivan","year":"2014","journal-title":"J Health Dispar Res Pract"},{"key":"2026072218470274100_usag335-B4","doi-asserted-by":"publisher","first-page":"2563","DOI":"10.1007\/s11606-025-09645-w","article-title":"A qualitative assessment of pelvic floor physical therapy experiences for women veterans in VHA care","volume":"40","author":"Mog","year":"2025","journal-title":"J Gen Intern Med"},{"key":"2026072218470274100_usag335-B5","doi-asserted-by":"publisher","first-page":"174","DOI":"10.3138\/ptc-2023-0114","article-title":"Geographic accessibility to pelvic health physiotherapy services across Ontario: a geographic information system analysis","volume":"77","author":"Charette","year":"2025","journal-title":"Physiotherapy Canada"},{"key":"2026072218470274100_usag335-B6","doi-asserted-by":"publisher","first-page":"335","DOI":"10.3138\/ptc.2015-70","article-title":"Examining the supply of and demand for physiotherapy in Saskatchewan: the relationship between where physiotherapists work and population health need","volume":"68","author":"McFadden","year":"2016","journal-title":"Physiotherapy Canada"}],"container-title":["Military Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/milmed\/advance-article-pdf\/doi\/10.1093\/milmed\/usag335\/69819596\/usag335.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/milmed\/advance-article-pdf\/doi\/10.1093\/milmed\/usag335\/69819596\/usag335.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T22:47:06Z","timestamp":1784760426000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/milmed\/advance-article\/doi\/10.1093\/milmed\/usag335\/8740153"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,22]]},"references-count":6,"URL":"https:\/\/doi.org\/10.1093\/milmed\/usag335","relation":{},"ISSN":["0026-4075","1930-613X"],"issn-type":[{"value":"0026-4075","type":"print"},{"value":"1930-613X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,22]]},"article-number":"usag335"}}