Leveraging Electronic Health Record Data to Identify Lesbian, Gay, Bisexual, Transgender, and Queer (LGBTQ plus ) Veteran Participants in the Pride in All Who Served Program

Background:Pride in All Who Served (PRIDE) is an intervention in the Veterans Health Administration (VHA) focused on enhancing Lesbian, Gay, Bisexual, Transgender, and Queer (LGBTQ+) veterans' access to affirmative care services, social support, and engagement with VHA. Evaluation of PRIDE to date has focused on self-report data, missing critical opportunities to examine the impact of this program on health outcomes and utilization indicators detectable in the electronic health record (EHR).Objective:This study is the first to: (1) comprehensively identify a sample of LGBTQ+ veterans who attended PRIDE; and (2) describe the sample demographics, health conditions, and health care utilization.Research Design:A retrospective cross-sectional study was conducted using EHR data and staff-reported PRIDE information (eg, site name, facilitator names, dates of delivery). PRIDE-related keywords and chart reviews were used to validate participation and determine the final sample.Subjects:We identified 588 PRIDE participants at 34 VHA sites from 2016 to 2022.Measures:Demographics (eg, age), health conditions (eg, depression), and health care utilization (eg, mental/behavioral health care visits).Results:Nearly half of the PRIDE participants (47%) were women, 75% were transgender and gender diverse, and 37% identified as lesbian or gay. A high proportion of the sample had stress-related health conditions, including depression (63%), hypertension (22%), and posttraumatic stress disorder (48%).Conclusions:PRIDE serves a disproportionate number of women and transgender and gender diverse veterans compared with general VHA users. In the absence of standardized EHR fields, time-intensive methods are required to leverage EHRs to evaluate programs addressing health equity for LGBTQ+ people.