{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,25]],"date-time":"2026-10-25T08:36:31Z","timestamp":1792917391954,"version":"4.5.0"},"reference-count":71,"publisher":"SAGE Publications","issue":"12","license":[{"start":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:00:00Z","timestamp":1787011200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Office of Rural Health","award":["NOMAD PROJ-04277"],"award-info":[{"award-number":["NOMAD PROJ-04277"]}],"id":[{"id":"https:\/\/ror.org\/03ydjzz16","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Women's Health"],"published-print":{"date-parts":[[2026,12,1]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Screening mammography contributes to reduced breast cancer mortality and is an essential preventive service. In the Department of Veterans Affairs (VA), women are the fastest-growing group enrolling in health care, yet factors that influence their screening use remain understudied. Our aim was to characterize screening mammography use among women veterans in VA primary care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We conducted a retrospective cohort study using VA administrative data, including 374,132 women veterans aged 42\u201374 who were eligible for breast cancer screening and using VA primary care. The study period was July 1, 2022, to September 30, 2024. Multivariable logistic regression models estimated associations between veteran characteristics and biennial screening mammography completion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The screening mammography completion rate was 70%. Completion was associated with a recent women\u2019s health visit (odds ratio [OR] = 1.75; 95% confidence interval [CI]: 1.72, 1.78), any service-connected disability (OR = 1.58; 95% CI: 1.55, 1.61), and Black race (OR = 1.40; 95% CI: 1.38, 1.42). Lower completion was associated with substance-related disorder (OR = 0.67; 95% CI: 0.64, 0.69), alcohol-related disorder (OR = 0.87; 95% CI: 0.84, 0.90), and Pacific region residence (OR = 0.76; 95% CI: 0.74, 0.78). Women aged 54\u201362 had the highest screening odds; those aged 42\u201353 had the lowest across predictors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Efforts to optimize screening should target regional barriers, developing interventions for specific groups, and increasing the availability of specialized women\u2019s health training for VA.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15409996261479558","type":"journal-article","created":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T04:55:09Z","timestamp":1787115309000},"page":"1131-1141","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Factors Associated with Screening Mammography Utilization Among Women Veterans in VA Primary Care"],"prefix":"10.1177","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7681-4719","authenticated-orcid":false,"given":"Elizabeth","family":"Hulen","sequence":"first","affiliation":[{"name":"Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, Oregon, USA."},{"name":"VHA Office of Rural Health Veterans Rural Health Resource Center-Portland, Portland, Oregon, USA."},{"name":"Division of General Internal Medicine and Geriatrics, Department of Medicine, Oregon Health &amp; Science University, Portland, Oregon, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara A.","family":"Vlajic","sequence":"additional","affiliation":[{"name":"Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, Oregon, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Shull","sequence":"additional","affiliation":[{"name":"Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, Oregon, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth R.","family":"Hooker","sequence":"additional","affiliation":[{"name":"Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, Oregon, USA."},{"name":"VHA Office of Rural Health Veterans Rural Health Resource Center-Portland, Portland, Oregon, USA."},{"name":"OHSU-PSU School of Public Health, Portland, Oregon, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leah L.","family":"Zullig","sequence":"additional","affiliation":[{"name":"Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Health Care System, Durham, North Carolina, USA."},{"name":"Department of Population Health Sciences, Duke University, Durham, North Carolina, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jenny","family":"Krause Cohen","sequence":"additional","affiliation":[{"name":"San Francisco VA Health Care System, San Francisco, California, USA."},{"name":"Department of Medicine and Department of Clinical Informatics and Digital Transformation, University of California, San Francisco, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2857-1668","authenticated-orcid":false,"given":"Sarah S.","family":"Ono","sequence":"additional","affiliation":[{"name":"Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, Oregon, USA."},{"name":"VHA Office of Rural Health Veterans Rural Health Resource Center-Portland, Portland, Oregon, USA."},{"name":"Department of Psychiatry, Oregon Health &amp; Science University, Portland, Oregon, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel T.","family":"Edwards","sequence":"additional","affiliation":[{"name":"Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, Oregon, USA."},{"name":"Division of General Internal Medicine and Geriatrics, Department of Medicine, Oregon Health &amp; Science University, Portland, Oregon, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,8,18]]},"reference":[{"key":"e_1_3_2_2_1","unstructured":"1.Common Cancer Sites\u2014Cancer Stat Facts. Surveillance Epidemiology and End Results (SEER) Program National Cancer Institute: Bethesda MD; n.d. Available from: https:\/\/seer.cancer.gov\/statfacts\/html\/common.html [Last accessed: August8 2025]."},{"key":"e_1_3_2_3_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21871"},{"key":"e_1_3_2_4_1","unstructured":"3.American Cancer Society. About Breast Cancer. American Cancer Society: Atlanta GA; 2025. Available from: https:\/\/www.cancer.org\/content\/dam\/CRC\/PDF\/Public\/8577.00.pdf [Last accessed: August8 2025]."},{"key":"e_1_3_2_5_1","doi-asserted-by":"publisher","DOI":"10.7326\/M15-0969"},{"key":"e_1_3_2_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2023.25881"},{"key":"e_1_3_2_7_1","unstructured":"6.National Cancer Institute. Mammograms\u2014NCI. National Cancer Institute (NCI): Bethesda MD; 2023. Available from: https:\/\/www.cancer.gov\/types\/breast\/mammograms-fact-sheet [Last accessed: August8 2025]."},{"key":"e_1_3_2_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2023.25844"},{"key":"e_1_3_2_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacr.2021.04.021"},{"key":"e_1_3_2_10_1","unstructured":"9.American Cancer Society Inc. 2022. American Cancer Society. Breast Cancer Facts & Figures 2022\u20132024. American Cancer Society Inc: Atlanta GA; 2022. Available from: https:\/\/www.cancer.org\/content\/dam\/cancer-org\/research\/cancer-facts-and-statistics\/breast-cancer-facts-and-figures\/2022-2024-breast-cancer-fact-figures-acs.pdf"},{"key":"e_1_3_2_11_1","doi-asserted-by":"publisher","DOI":"10.1038\/bjc.2013.177"},{"key":"e_1_3_2_12_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2015.13183"},{"key":"e_1_3_2_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13058-024-01841-6"},{"key":"e_1_3_2_14_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2024.52821"},{"key":"e_1_3_2_15_1","unstructured":"14.U.S. Department of Veterans Affairs Women\u2019s Health Services. Sourcebook_Vol_3_FINAL07-22-14. U.S. Department of Veterans Affairs Women\u2019s Health Services: Washington DC; 2014. Available from: https:\/\/www.womenshealth.va.gov\/WOMENSHEALTH\/docs\/Sourcebook_Vol_3_FINAL07-22-14.pdf [Last accessed: August29 2024]."},{"key":"e_1_3_2_16_1","volume-title":"Health Care Services for Women Veterans","author":"Department of Veterans Affairs Veterans Health Administration","year":"2023","unstructured":"15.Department of Veterans Affairs Veterans Health Administration. Health Care Services for Women Veterans. Department of Veterans Affairs, Veterans Health Administration: Washington, DC; 2023."},{"key":"e_1_3_2_17_1","doi-asserted-by":"publisher","DOI":"10.1093\/milmed\/usae345"},{"key":"e_1_3_2_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajim.20201"},{"key":"e_1_3_2_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.34978"},{"key":"e_1_3_2_20_1","doi-asserted-by":"publisher","DOI":"10.1158\/1055-9965.EPI-09-0041"},{"key":"e_1_3_2_21_1","doi-asserted-by":"publisher","DOI":"10.1177\/17455057251399013"},{"key":"e_1_3_2_22_1","unstructured":"21.VA National Oncology Program. Learn About Cancer Screening. VA National Oncology Program: Washington DC; n.d. Available from: https:\/\/www.cancer.va.gov\/learn-about-cancer-screening.html [Last accessed: September26 2025]."},{"key":"e_1_3_2_23_1","unstructured":"22.Petersen H. New Breast Cancer Screening Recommendations. VA News: Washington DC; 2025. Available from: https:\/\/news.va.gov\/138863\/new-breast-cancer-screening-recommendations\/ [Last accessed: September26 2025]."},{"key":"e_1_3_2_24_1","doi-asserted-by":"publisher","DOI":"10.1093\/milmed\/usae252"},{"key":"e_1_3_2_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ypmed.2023.107545"},{"key":"e_1_3_2_26_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm7315e1"},{"key":"e_1_3_2_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ypmed.2015.09.011"},{"key":"e_1_3_2_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ypmed.2021.106741"},{"key":"e_1_3_2_29_1","doi-asserted-by":"publisher","DOI":"10.1089\/jwh.1998.7.239"},{"key":"e_1_3_2_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.whi.2011.04.027"},{"key":"e_1_3_2_31_1","doi-asserted-by":"publisher","DOI":"10.3390\/medicines10010001"},{"key":"e_1_3_2_32_1","doi-asserted-by":"publisher","DOI":"10.1093\/milmed\/usac036"},{"key":"e_1_3_2_33_1","doi-asserted-by":"publisher","DOI":"10.1093\/milmed\/usaf252"},{"key":"e_1_3_2_34_1","unstructured":"33.U.S. Department of Veterans Affairs. About our VA community care network and covered services. U.S. Department of Veterans Affairs: Washington DC USA; 2023. Available from: https:\/\/www.va.gov\/resources\/about-our-va-community-care-network-and-covered-services\/ [Last accessed: February20 2026]."},{"key":"e_1_3_2_35_1","unstructured":"34.Economic Research Service. Rural-Urban Commuting Area Codes Economic Research Service: United States; 2025. Available from: https:\/\/www.ers.usda.gov\/data-products\/rural-urban-commuting-area-codes [Last accessed: November24 2025]."},{"key":"e_1_3_2_36_1","unstructured":"35.Healthcare Cost and Utilization Project (HCUP). Clinical Classifications Software Refined (CCSR). Healthcare Cost and Utilization Project (HCUP): Rockville MD; 2025. Available from: https:\/\/hcup-us.ahrq.gov\/toolssoftware\/ccsr\/ccs_refined.jsp [Last accessed: March24 2026]."},{"key":"e_1_3_2_37_1","doi-asserted-by":"publisher","DOI":"10.1513\/AnnalsATS.201808-564PS"},{"key":"e_1_3_2_38_1","doi-asserted-by":"publisher","DOI":"10.7602\/jmis.2023.26.3.97"},{"key":"e_1_3_2_39_1","doi-asserted-by":"publisher","DOI":"10.21105\/joss.00772"},{"key":"e_1_3_2_40_1","unstructured":"39.R Core Team. R: A language and environment for statistical computing. R Core Team: Vienna Austria; 2021. Available from: https:\/\/www.R-project.org\/"},{"key":"e_1_3_2_41_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.34632"},{"key":"e_1_3_2_42_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacr.2016.07.034"},{"key":"e_1_3_2_43_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2024.1354717"},{"key":"e_1_3_2_44_1","doi-asserted-by":"publisher","DOI":"10.1089\/jwh.2013.4668"},{"key":"e_1_3_2_45_1","doi-asserted-by":"publisher","DOI":"10.1080\/08870446.2013.766734"},{"key":"e_1_3_2_46_1","doi-asserted-by":"publisher","DOI":"10.1089\/jwh.2010.2195"},{"key":"e_1_3_2_47_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ypmed.2019.03.023"},{"key":"e_1_3_2_48_1","doi-asserted-by":"publisher","DOI":"10.1080\/10410236.2019.1687129"},{"key":"e_1_3_2_49_1","doi-asserted-by":"publisher","DOI":"10.1089\/jwh.2021.0232"},{"key":"e_1_3_2_50_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinimag.2025.110561"},{"key":"e_1_3_2_51_1","doi-asserted-by":"publisher","DOI":"10.1093\/jbi\/wbac072"},{"key":"e_1_3_2_52_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2011.04.025"},{"key":"e_1_3_2_53_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-020-05922-y"},{"key":"e_1_3_2_54_1","doi-asserted-by":"publisher","DOI":"10.1089\/jwh.2011.2751"},{"key":"e_1_3_2_55_1","doi-asserted-by":"publisher","DOI":"10.1089\/jwh.2017.6402"},{"key":"e_1_3_2_56_1","doi-asserted-by":"publisher","DOI":"10.1177\/0886260518812797"},{"key":"e_1_3_2_57_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(23)00438-2"},{"key":"e_1_3_2_58_1","doi-asserted-by":"publisher","DOI":"10.1093\/fampra\/cmaf018"},{"key":"e_1_3_2_59_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2010-000046"},{"key":"e_1_3_2_60_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.josat.2023.209251"},{"key":"e_1_3_2_61_1","doi-asserted-by":"publisher","DOI":"10.1177\/10732748231187836"},{"issue":"2","key":"e_1_3_2_62_1","first-page":"2730","article-title":"Effect of rurality on screening for breast cancer: A systematic review and meta-analysis comparing mammography","volume":"14","author":"Leung J","year":"2014","unstructured":"61.Leung J, , McKenzie S, , Martin J, et al. Effect of rurality on screening for breast cancer: A systematic review and meta-analysis comparing mammography. Rural Remote Health 2014;14(2):2730.","journal-title":"Rural Remote Health"},{"key":"e_1_3_2_63_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10552-019-01217-8"},{"key":"e_1_3_2_64_1","unstructured":"63.Influence of health insurance coverage on breast cervical and colorectal cancer screening in rural primary care settings\u2014Carney\u20142012. Cancer: Hoboken NJ; 2012. Available from: https:\/\/acsjournals.onlinelibrary.wiley.com\/doi\/10.1002\/cncr.27635 [Last accessed: September30 2025]."},{"key":"e_1_3_2_65_1","unstructured":"64.VHA Mammography Suites. Radiology: United States; 2025. Available from: https:\/\/vaww.va.gov\/RADIOLOGY\/Mammography\/VHA_Mammography_Suites.asp [Last accessed: September30 2025]."},{"key":"e_1_3_2_66_1","doi-asserted-by":"publisher","DOI":"10.1111\/jrh.12609"},{"key":"e_1_3_2_67_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.whi.2022.11.004"},{"key":"e_1_3_2_68_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-025-09451-4"},{"key":"e_1_3_2_69_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.whi.2014.07.005"},{"key":"e_1_3_2_70_1","doi-asserted-by":"publisher","DOI":"10.1002\/lrh2.10334"},{"key":"e_1_3_2_71_1","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0000000000000323"},{"key":"e_1_3_2_72_1","doi-asserted-by":"publisher","DOI":"10.1089\/jwh.2021.0033"}],"container-title":["Journal of Women's Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15409996261479558","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/15409996261479558","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15409996261479558","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,25]],"date-time":"2026-10-25T07:58:11Z","timestamp":1792915091000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/15409996261479558"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,18]]},"references-count":71,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2026,12,1]]}},"alternative-id":["10.1177\/15409996261479558"],"URL":"https:\/\/doi.org\/10.1177\/15409996261479558","relation":{},"ISSN":["1540-9996","1931-843X"],"issn-type":[{"value":"1540-9996","type":"print"},{"value":"1931-843X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,18]]}}}