Importance Although interest is high in addressing suicide mortality after the transition from military to civilian life, little is known about the risk factors associated with this transition. To support the ongoing suicide surveillance work of the US Department of Veterans Affairs (VA) Office of Mental Health and Suicide Prevention, examining these factors is important for targeting suicide prevention efforts. Objective To examine the prevalence, patterns, and associated characteristics of suicide mortality among US service members after separation from military active status. Design, Setting, and Participants This retrospective population-based cohort study obtained demographic and military service data from the VA/Department of Defense Identity Repository. Individuals who served on active duty in the US Army, Navy, Air Force, Marine Corps, or Coast Guard after September 11, 2001, and who separated from active status between January 1, 2010, and December 31, 2017, were included in the cohort. Data analyses were conducted from September 9, 2019, to April 1, 2020. Main Outcomes and Measures Suicide mortality within 6 years after separation from military service. Results A total of 1 868 970 service members (1 572 523 men [84.1%]; mean [SD] age at separation, 30.9 [9.9] years) separated from the military during the study period. Through the end of the study period (December 31, 2017), 3030 suicides (2860 men and 170 women) were identified as having occurred within 6 years of separation from the military. Statistically significant differences in suicide risk were found by demographic and military service characteristics. Suicide rates after separation were time dependent, generally peaking 6 to 12 months after separation and declining only modestly over the study period. Male service members had a statistically significantly higher hazard of suicide than their female counterparts (hazard ratio [HR], 3.13; 95% CI, 2.68-3.69). Younger individuals (aged 17-19 years; HR, 4.46 [95% CI, 3.71-5.36]) had suicide hazard rates that were approximately 4.5 times higher than those who transitioned at an older age (
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1 Association of suicide risk with transition to civilian life among US Military service members
Association of suicide risk with transition to civilian life among US Military service members
APA Citation:
Ravindran, C., Morley, S. W., Stephens, B. M., Stanley, I. H., & Reger, M. A. (2020). Association of suicide risk with transition to civilian life among US military service members. JAMA Network Open, 3(9), e2016261. https://doi.org/10.1001/jamanetworkopen.2020.16261
Focus:
Mental health
Veterans
Branch of Service:
Multiple branches
Army
Navy
Air Force
Marine Corps
Coast Guard
Military Affiliation:
Veteran
Population:
Adulthood (18 yrs & older)
Young adulthood (18 - 29 yrs)
Thirties (30 - 39 yrs)
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Ravindran, Chandru; Morley, Sybil W.; Stephens, Brady M.; Stanley, Ian H.; Reger, Mark A.
2020
2 Implementing a nicotine-free policy in the United States military
Implementing a nicotine-free policy in the United States military
APA Citation:
Lang, A. E., & Yakhkind, A. (2022). Implementing a nicotine-free policy in the United States military. Chest, 161(3), 845–852. https://doi.org/10.1016/j.chest.2021.09.020
Focus:
Substance use
Programming
Branch of Service:
Army
Military Affiliation:
Active Duty
Population:
Adulthood (18 yrs & older)
Young adulthood (18 - 29 yrs)
Thirties (30 - 39 yrs)
Middle age (40 - 64 yrs)
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Lang, Adam Edward; Yakhkind, Aleksandra
2021
In December 2019, the command of a US Army Advanced Individual Training battalion on Fort Eustis, Virginia, was briefed on the results of tobacco and nicotine use surveys distributed to trainee soldiers and subsequently decided to ban tobacco and nicotine products in this population. The policy implementation process was thoroughly planned in a joint effort between battalion leadership and the installation military health facility. Data were collected throughout the process that evaluated nicotine product use among trainee soldiers, instructors, and leaders. Preferences on assistance with quitting and views on policy implementation processes also were collected. Comprehensive and multimodal resources and therapy to assist with treatment of dependence of tobacco and nicotine were offered. Although more data are needed on outcomes of this type of intervention, addressing tobacco and nicotine use in the military is long overdue, and our intervention offers a reproducible model to do so. It incorporates education, behavioral resources, and medication therapy with the aim to improve long-term quit rates and to improve the health of soldiers throughout and after their careers.
Evaluation of safe firearm storage messaging in a sample of firearm-owning US military service members
APA Citation:
Anestis, M. D., Cryan, C. J., Capron, D. W., & Bryan, A. O. (2022). Evaluation of safe firearm storage messaging in a sample of firearm-owning US military service members. JAMA Network Open, 5(10), Article e2235984. https://doi.org/10.1001/jamanetworkopen.2022.35984
Focus:
Other
Branch of Service:
Multiple branches
Military Affiliation:
Active Duty
Veteran
Population:
Adulthood (18 yrs & older)
Young adulthood (18 - 29 yrs)
Thirties (30 - 39 yrs)
Middle age (40 - 64 yrs)
Aged (65 yrs & older)
Very old (85 yrs & older)
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Anestis, Michael D.; Bryan, Craig J.; Capron, Daniel W.; Bryan, AnnaBelle O.
2022
Nearly two-thirds of military suicides involve firearms, and safe firearm storage is rare.To examine whether US military service members endorse greater openness to safe firearm storage depending on the content of the visual message they are randomly assigned to view.This comparative effectiveness study used a 3 × 2 × 2 factorial design to randomize US military service members to view 1 of 12 visual messages on safe firearm storage. Willingness to use safe firearm storage practices was assessed immediately before and after exposure to the message. Participants were recruited using the KnowledgePanel Calibration approach. Inclusion criteria included current membership in the US military and current firearm ownership. The KnowledgePanel sample was fielded from December 3 to 27, 2021, with a 76% completion rate and 45 individuals determined to be qualified (28% qualification rate). The opt-in sample was fielded December 7, 2021, through January 4, 2022, with 699 individuals (3%) qualified and 674 included in the final data set.Messages shared the same image and text on safe firearm storage but varied in messenger occupation (eg, primary care physician, security forces, or combat controller), the presence of text validating the perspective of firearm owners, and the presence of text validating the drive for home protection.Outcomes included changes in willingness to use 4 at-home (unloaded, separate from ammunition, in a locked location, and with a locking device) and 3 away-from-home (with family or friend, at a firearm retailer, or at a law enforcement agency) firearm storage practices. All analyses, including sample descriptives, are based on weighted data.Of the 719 individuals in the data set, 367 (median [range] age, 33.64 [18-86] years; 80.4% male; 71.4% White) who endorsed not currently storing firearms using the methods assessed were included in analyses. In a multivariate analysis of variance, a significant interaction was found among time, messenger profession, gun-friendly text, and home protection text across all outcomes (Wilks’
Animal-assisted interventions and post-traumatic stress disorder of military workers and veterans: A systematic review
APA Citation:
Chirico, F., Capitanelli, I., Nowrouzi-Kia, B., Howe, A., Batra, K., Sharma, M., Szarpak, Ł., Pruc, M., Nucera, G., Ferrari, G., Cortese, C., Gianino, M., & Acquadro Maran, D. (2022). Animal-assisted interventions and post-traumatic stress disorder of military workers and veterans: A systematic review. Journal of Health and Social Sciences, 7, 152–180. https://doi.org/10.19204/2022/NMLS4
Focus:
Trauma
Mental health
Veterans
Branch of Service:
Multiple branches
Military Affiliation:
Veteran
Active Duty
Population:
Adulthood (18 yrs & older)
Young adulthood (18 - 29 yrs)
Thirties (30 - 39 yrs)
Middle age (40 - 64 yrs)
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Chirico, Francesco; Capitanelli, Ilaria; Nowrouzi-Kia, Behdin; Howe, Aaron; Batra, Kavita; Sharma, Manoj; Szarpak, Łukasz; Pruc, Michał; Nucera, Gabriella; Ferrari, Giuseppe; Cortese, Claudio; Gianino, Mariola; Acquadro Maran, Daniela
2022
Introduction: Animal-Assisted Interventions (AAIs) have been increasingly used in the workplace to mitigate the effect of work-related stress and improve psychological well-being among employees. Military workers returning home from combat and veterans face a high burden of post-traumatic stress disorders (PTSD). This systematic review aimed to investigate the potential benefits of AAIs on military workers and veterans affected by PTSD. Methods: A systematic review was conducted across Scopus, PubMed Central/Medline, Web of Science, and Google Scholar in December 2021 and June 2022 using predefined search criteria. All types of studies published in the English language were included except editorials, commentaries, and narrative reviews. Studied published from January 2001 to December 2021 were included. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 reporting guidelines for this systematic review. The assessment of study quality was carried out with a 16-item Quality Assessment Tool for Studies with Diverse Designs (QATSDD) Results: Overall, 25 studies were finally included in this systematic review. Most of the AAIs were canine-assisted programs (n=12) and therapeutic horseback riding or equine-assisted psychotherapy (n=11). There was only one intervention study utilizing a pinnipeds-based program (n=1), while one study was based on several types of animals (n=1). Out of 25 studies focusing on the effects of AAIs on PTSD in the military (n=3) and veterans (n=21), the majority of them (n=18) observed significantly lower PTSD symptomatology following AAIs. Three studies observed no statistically significant difference in PTSD symptomatology. Discussion: Our findings indicated that implementing AAI programs among military workers and veterans may improve their psychological well-being and reduce the severity of PTSD symptoms. Policymakers and occupational health services should consider adopting AAIs during military service and after military discharge to support the mental health of military workers.
Variation in call volume to the Veterans Crisis Line by women and men veterans prior to and following onset of the COVID-19 pandemic
APA Citation:
Dichter, M. E., Chhatre, S., Hoffmire, C., Bellamy, S., Montgomery, A. E., & McCoy, I. (2022). Variation in call volume to the Veterans Crisis Line by women and men veterans prior to and following onset of the COVID-19 pandemic. Journal of Psychiatric Research, 151, 561–563. https://doi.org/10.1016/j.jpsychires.2022.05.037
Focus:
Veterans
Programming
Branch of Service:
Multiple branches
Military Affiliation:
Veteran
Population:
Adulthood (18 yrs & older)
Young adulthood (18 - 29 yrs)
Thirties (30 - 39 yrs)
Middle age (40 - 64 yrs)
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Dichter, Melissa E.; Chhatre, Sumedha; Hoffmire, Claire; Bellamy, Scarlett; Montgomery, Ann Elizabeth; McCoy, Ian
2022
Objectives To identify trends in volume of calls to the Veterans Crisis Line (VCL) around the onset of the COVID-19 pandemic. Methods Analysis of call frequency from VCL administrative records for all veteran contacts calling on their own behalf with gender identified from January 1, 2018 through December 31, 2020. Interrupted time series analysis used to identify potential impact of COVID-19 pandemic on call volume by women and men veteran contacts. Results Call volume to VCL from veterans increased over time, for both women and men veterans, with no significant change in call volume by women contacts following the onset of the COVID-19 pandemic and a decrease in calls by men contacts associated with COVID-19 onset. Call volume varied by month with patterns similar in years prior to and following COVID-19 onset. Conclusions The onset of the COVID-19 pandemic in 2020 was not associated with a spike in calls by veterans to VCL. The pandemic may have led to an increase in calls by some as well as a decrease in calls by others, leveling out the overall volume trends.
Patient perspectives on recovery and information needs after surgery: A qualitative study of veterans
APA Citation:
Sasnal, M., Langston, A. H., Morris, A. M., Harris, A. H. S., & Arya, S. (2022). Patient perspectives on recovery and information needs after surgery: A qualitative study of veterans. Journal of Surgical Research, 279, 765–773. https://doi.org/10.1016/j.jss.2022.06.050
Focus:
Veterans
Physical health
Branch of Service:
Multiple branches
Military Affiliation:
Veteran
Population:
Adulthood (18 yrs & older)
Aged (65 yrs & older)
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Research
Sasnal, Marzena; Langston, Ashley H.; Morris, Arden M.; Harris, Alex H. S.; Arya, Shipra
2022
Introduction Little is known about patients' postoperative emotional and social functioning and preferences for recovery settings. This qualitative study explores patients’ perspectives on factors influencing postoperative recovery, including the proportion of time recovering at home (home time) and unmet information needs. Methods Semistructured interviews were conducted between September and December 2020 with veteran patients aged 65 y or older who underwent surgery at a single hospital. A purposeful sampling strategy was used to identify patients with a broad representation of major operations and various amounts of home time. One-hour interviews were audio-recorded, transcribed verbatim, and anonymized for analysis. A rigorous team-based in-depth thematic analysis was performed. Validation techniques to enhance the quality and credibility of the study included triangulation, independent coding, and search for disconfirming evidence. Results Twelve patients were interviewed (11 [91.7%] males; mean (standard deviation) age, 72.3 [4.8] y). Five factors that influenced the recovery process emerged: (1) professional support services, (2) informal caregiver support, (3) environment for recovery, (4) individual traits, and (5) physical and functional impairments. The analysis also elucidated four unmet information needs regarding recovery: (1) personalized and detailed information, (2) anticipated recovery time, (3) possible complications, and (4) comprehensive information about discharge location options. Conclusions The study demonstrated that patients recovering from surgery require wide-ranging levels of support to meet their unique needs and preferences. Patients value easy-to-understand and personalized information about recovery from providers. These findings may be helpful to develop strategies that better support patients in their postoperative recovery and post–acute care transition pathways.
7 Advance care directive preferences in women veterans: A snapshot
Advance care directive preferences in women veterans: A snapshot
APA Citation:
West, S. K., Peek, B., Al-Achi, A., & LeCompte, D. (2022). Advance care directive preferences in women veterans: A snapshot. OMEGA - Journal of Death and Dying. Advance online publication. https://doi.org/10.1177/00302228221130115
Focus:
Veterans
Physical health
Branch of Service:
Multiple branches
Military Affiliation:
Veteran
Population:
Adulthood (18 yrs & older)
Middle age (40 - 64 yrs)
Aged (65 yrs & older)
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West, Sharon K.; Peek, Brian; Al-Achi, Antoine; LeCompte, Doreen
2022
Prior research characterizes mainly male veteran preferences at end of life using the Veterans Administration Advance Directive (VA AD), there has been no specific studies focusing on women veteran?s preferences concerning whether the AD is to be strictly (S) followed or to serve as a general guide (G). The purpose of this study was to describe women veteran preferences for life-sustaining treatments (LSTs) in various illness situations to assist providers in discussing end-of-life decisions. Additionally, we compared previously published LST preferences of male veterans with the study?s sample. Using a descriptive retrospective approach, data was collected from 484 women veterans ADs between January 2010 and December 2019. Findings revealed that women tended to trend in the same direction as men, preferring to have advance directives serve as general guidance over being strictly followed. Unconscious/Coma/Vegetative was the only factor that was statistically significant for affecting the choice of following the AD.
Burnout, surface acting, and suicidal ideation among military personnel: Results of a longitudinal cohort study
APA Citation:
Bryan, C. J., Bryan, A. O., Baker, J. C., Ammendola, E., & Szeto, E. (2022). Burnout, surface acting, and suicidal ideation among military personnel: Results of a longitudinal cohort study. Journal of Social and Clinical Psychology, 41(6), 593–610. https://doi.org/10.1521/jscp.2022.41.6.593
Focus:
Mental health
Other
Branch of Service:
Multiple branches
Military Affiliation:
Active Duty
Population:
Adulthood (18 yrs & older)
Young adulthood (18 - 29 yrs)
Thirties (30 - 39 yrs)
Middle age (40 - 64 yrs)
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Bryan, Craig J.; Bryan, Annabelle O.; Baker, Justin C.; Ammendola, Ennio; Szeto, Edwin
2022
Introduction: Chronic life stressors are positively correlated with suicidal ideation and suicidal behaviors among military personnel. Surface acting, a strategy that involves hiding or faking one's emotional state to match organizational expectations dictating when and how to express emotions, contributes to burnout and increased emotional distress. Because surface acting involves a form of emotional suppression, frequent use of surface acting may also contribute to suicidal ideation. Methods: One thousand seven-hundred fifty-four military personnel stationed at a U.S. military installation completed a self-report survey repeatedly administered 6 times from January 2020 to December 2021. Survey items assessed suicidal ideation, surface acting, burnout, and depression. Results: Burnout and surface acting were significantly correlated with severity of suicidal ideation. When depression was added as a covariate, surface acting but not burnout remained a statistically significant correlate of suicidal ideation. Discussion: Surface acting, a job-specific form of emotional suppression, may increase suicide risk among military personnel. Creating opportunities for military personnel to appropriately express their emotional states could mitigate suicide risk in this population.
9 Newborn medication refusal and childhood under-immunization in military beneficiaries
Newborn medication refusal and childhood under-immunization in military beneficiaries
APA Citation:
Vereen, R. J., Aden, J. K., & Drumm, C. (2022). Newborn medication refusal and childhood under-immunization in military beneficiaries. Pediatrics, 149(1), 976.
Focus:
Children
Physical health
Branch of Service:
Multiple branches
Military Affiliation:
Active Duty
Population:
Childhood (birth - 12 yrs)
Neonatal (birth - 1 mo)
Infancy (2 - 23 mo)
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Vereen, Rasheda J.; Aden, James K.; Drumm, Caitlin
2022
Background: The American Academy of Pediatrics recommends birth doses of vitamin K, erythromycin ointment and the hepatitis B vaccine to decrease the prevalence of hemorrhagic disease of the newborn, ophthalmia neonatorum and hepatitis B. Global disease reduction goals target a birth hepatitis B vaccination rate of 85%. Per the 2017-2019 National Immunization Survey, 76.3% of newborns received the birth hepatitis B vaccine but individual centers reported rates as low as 30%. Relationship between birth medication administration and childhood immunization compliance is understudied. One prior study does show increased risk of childhood non-immunization following vitamin K refusal only. The purpose of this study was to evaluate rates of newborn medication administration and risk factors for refusal in military beneficiaries and to determine the relationship between newborn medication refusal and under-immunization by 15 months. Methods: A retrospective chart review was completed for all newborns admitted to the Brooke Army Medical Center nursery from January 1, 2016 to December 31, 2019. The electronic medical record was queried for birth medication administration, maternal age, active duty status, rank, and birth order. Childhood immunization records were queried for all patients who continued care at our facility. Results: Seven thousand one hundred and thirty-nine infants met inclusion criteria; within this cohort, 99.3% received vitamin K, 98.8% received erythromycin and 93.8% received the hepatitis B vaccine. Refusal of erythromycin and hepatitis B vaccine was associated with older maternal age and higher birth order (Table 1). Childhood immunization records were available for 607 infants; within this cohort, 100% received vitamin K, 99% received erythromycin and 95.5% received the hepatitis B vaccine. Of the 607 infants, 7.2% (n=44) were under-immunized by 15 months with no infants being non-immunized. Refusal of only the hepatitis B vaccine at birth was associated with a higher risk being under-immunized (RR = 2.7, CI 1.18-6.42). Conclusion: Compliance with birth medication recommendations is high in the military beneficiary population and the administration of the hepatitis B vaccine is well above the national average. Refusal was associated with older maternal age and higher birth order. High adherence in our population may be due to mandatory vaccination policy for active duty service members. Newborn providers should be aware that birth hepatitis B vaccine refusal is associated with under-immunization status at 15 months.
10 Outcomes for newborns born to adolescents and young women in the Military Health System
Outcomes for newborns born to adolescents and young women in the Military Health System
APA Citation:
Vereen, R. J., Ahmed, S., Aden, J. K., Dillon, C., & Shapiro, J. (2022). Outcomes for newborns born to adolescents and young women in the Military Health System. Pediatrics, 149(1), 978.
Focus:
Children
Youth
Physical health
Parents
Branch of Service:
Multiple branches
Military Affiliation:
Active Duty
Population:
Childhood (birth - 12 yrs)
Adulthood (18 yrs & older)
Young adulthood (18 - 29 yrs)
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Vereen, Rasheda J.; Ahmed, Saira; Aden, James K.; Dillon, Christopher; Shapiro, Jonathan
2022
Background: Infants born to adolescent mothers represent 15.3 per 1,000 births in the United States.1 Newborns born to young mothers are at risk are for prematurity, low birth weight and for being small for gestation age.2,3 Under the Patient Protection and Affordable Care Act (2010), eligible dependents could remain on their parent’s health care plan until age 26 which expanded maternity care and access for military dependents. Few studies have been performed examining neonatal outcomes in infants born to adolescent and young adult military beneficiaries. The purpose of this study was to examine neonatal outcomes of infants born to adolescent and young adult women in the military health system and compare these to national outcomes. We hypothesize that given these adolescents and young adults have access to low to no cost health care, neonatal outcomes may be improved. Methods: We performed a retrospective chart review for all singleton deliveries born at our facility to women 26 and younger between October 2015 and December 2020. To be eligible for care at our facility, mothers must be active duty, an active-duty spouse, or a child of an active-duty service member. The electronic medical record was queried for maternal age, documentation of chorioamnionitis, gestational age, documentation of prematurity (<37 weeks), birthweight percentile (small for gestational age, average for gestation age, large for gestation age), NICU admission, neonatal death, hypoglycemia, respiratory distress or failure, sepsis work-up or screen , cardiac malformation, hypothermia, or a CPS referral. Results: There were 2107 newborns that met our eligibility criteria. 331 newborns were born to a military dependent daughter while 1776 were born to active-duty mothers and spouses. There was no significant difference in gestational age at birth, incidence of prematurity, birthweight percentile, occurrence of a NICU admission, neonatal death, hypoglycemia, respiratory distress or failure, sepsis screen, congenital cardiac disease or hypothermia based on maternal age (Table 1). A maternal diagnosis of chorioamnionitis, sepsis work-up and a CPS referral was associated with maternal age (Table 1). In comparison to published national outcomes and data, there was a significant smaller occurrence of preterm births, SGA and LGA births but a higher occurrence of NICU admissions (Table 2) . Conclusion: Newborns born to adolescent and young adult military beneficiaries have improved neonatal outcomes in comparison to national published data. These results may correlate to improved maternal access to a comprehensive free health care system.
Racial disparities in prescription of antidepressants among U.S. veterans referred to behavioral health care
APA Citation:
Remmert, J. E., Guzman, G., Mavandadi, S., & Oslin, D. (2022). Racial disparities in prescription of antidepressants among U.S. veterans referred to behavioral health care. Psychiatric Services, 73(9), 984-990. https://doi.org/10.1176/appi.ps.202100237
Focus:
Veterans
Substance use
Mental health
Branch of Service:
Multiple branches
Military Affiliation:
Veteran
Population:
Adulthood (18 yrs & older)
Thirties (30 - 39 yrs)
Middle age (40 - 64 yrs)
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Remmert, Jocelyn E.; Guzman, Gabriella; Mavandadi, Shahrzad; Oslin, Dave
2022
Objective: Antidepressants are often prescribed in primary care to treat veterans who have depression. An evaluation of current racial disparities in integrated primary care is warranted. This study examined the association between race and prescription of antidepressants among veterans in primary care. Methods: Veterans in primary care (Black, N=4,120; White, N=4,372) who were referred from primary care to a collaborative care program completed an assessment of demographic characteristics and clinical symptoms, including of current antidepressant prescription before the referral, verified by chart review. Patient data were collected from January 1, 2015, to December 22, 2020. Logistic regression analyses were conducted to examine the relationships between patient race and both depression symptoms and antidepressant prescription. Analyses were also stratified by severity of depression symptoms to understand the results in the context of clinical guidelines. Results: White patients were almost two times (odds ratio=1.96, 95% confidence interval [CI]=1.75–2.19, p<0.001) more likely than Black patients to receive an antidepressant prescription, after the analysis was controlled for depression symptoms, demographic characteristics, and other clinical symptoms. Among patients with severe depression, for whom prescription of antidepressants is clinically indicated, White patients were 1.87 times more likely than Black patients to receive an antidepressant prescription (95% CI=1.40–2.50, p<0.001). Conclusions: The findings reveal racial disparities in antidepressant prescription for veterans in primary care. Regular clinical review of antidepressant prescription is recommended to identify disparities in individual clinics. Future research should aim to identify drivers of racial disparities and provide recommendations for health care systems, providers, and patients.
Exploring the cumulative trauma and abusive parenting behaviors among United States military-affiliated mothers
APA Citation:
Ponteen, E. M. (2022). Exploring the cumulative trauma and abusive parenting behaviors among United States military-affiliated mothers [Ph.D., Fordham University]. https://www.proquest.com/docview/2678669010/abstract/CBCEDABE0B3E4453PQ/1
Focus:
Trauma
Parents
Children
Child maltreatment
Branch of Service:
Air Force
Military Affiliation:
Active Duty
Population:
Adolescence (13 - 17 yrs)
Young adulthood (18 - 29 yrs)
Thirties (30 - 39 yrs)
Middle age (40 - 64 yrs)
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Other
Ponteen, Erica Melissa
2022
Child maltreatment has been reported to be associated with a multitude of adverse lifetime outcomes, including those who become parents. Few studies have showed that child maltreatment has an abusive impact on parenting behaviors. This study used a secondary data analysis of a subsample of only military-affiliated mothers substantiated of exhibiting abusive parenting behaviors from the Air Force Family Advocacy System of Records (FASOR) database located at Air Force base worldwide, beginning on January 1, 2008 through December 31, 2018. This study examined the association between cumulative trauma experienced by military-affiliated mothers, their mental health concerns, and exhibited abusive parenting behaviors (physical abuse, emotional abuse, or neglect). Parental variables, parental risk factors, and case characteristics associated with cumulative trauma, abusive parenting behaviors, and potential social factors included maternal age, mental health concerns, emotional support, military status, and race. Military affiliated mothers with a cumulative trauma had higher likelihood to exhibit abusive parenting behaviors. There were no interactions between in cumulative trauma across all abusive parenting behaviors by most of the hypothesized military-affiliated mothers’ risk factors (e.g., maternal age, mental health concerns, emotional support). Active-duty military-affiliated mothers with cumulative trauma were shown to have a significantly lesser likelihood of exhibiting physical abuse, emotional abuse, and neglect towards their children compared to civilian military-affiliated mothers. These research findings contribute to social work literature showing that cumulative trauma is associated with the relationship of mothers’ parenting behaviors. Social work professionals can use results from this study to raise awareness and social work knowledge regarding the parenting behaviors among military-affiliated mothers.
Household preparedness and perceptions of workforce preparedness during pandemics: A health care employee survey at the US Department of Veterans Affairs
APA Citation:
Der-Martirosian, C., Balut, M. D., & Dobalian, A. (2022). Household preparedness and perceptions of workforce preparedness during pandemics: A health care employee survey at the US Department of Veterans Affairs. Disaster Medicine and Public Health Preparedness, 16, 1953-1958. https://doi.org/10.1017/dmp.2021.198
Focus:
Other
Branch of Service:
Multiple branches
Military Affiliation:
Veteran
Population:
Adulthood (18 yrs & older)
Young adulthood (18 - 29 yrs)
Thirties (30 - 39 yrs)
Middle age (40 - 64 yrs)
Aged (65 yrs & older)
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Der-Martirosian, Claudia; Balut, Michelle D.; Dobalian, Aram
2022
Objective:To examine the effects of household preparedness on perceptions of workplace preparedness during a pandemic among all employees at the US Department of Veterans Affairs (VA) medical facilities.Methods:The VA Preparedness Survey (October–December 2018, Los Angeles, CA) used a stratified simple random, web-based survey. Multivariate statistical analyses examined the effect of household preparedness on perceptions of workforce preparedness during a pandemic: institutional readiness; desire for additional training; and understanding their role and its importance.Results:VA employees totaling 4026 participated. For a pandemic, 55% were confident in their VA medical facility’s ability to respond, 63% would like additional training, 49% understood their role during a response, and 68% reported their role as important. Only 23% reported being “well prepared” at home during major disasters. After controlling for study-relevant factors, household preparedness was positively associated with perceptions of workforce preparedness during a pandemic.Conclusions:Efforts to increase household preparedness for health care employees could bolster workforce preparedness during pandemics. Organizations should consider robust policies and strategies, such as flexible work arrangements, in order to mitigate factors that may serve as barriers to household preparedness.
14 Trends in cardiovascular risk factors among women veterans
Trends in cardiovascular risk factors among women veterans
APA Citation:
Ebrahimi, R., Leng, M., & Shroyer, A. L. (2022). Trends in cardiovascular risk factors among women veterans. Circulation, 146(Suppl_1), A11245–A11245. https://doi.org/10.1161/circ.146.suppl_1.11245
Focus:
Veterans
Physical health
Branch of Service:
Multiple branches
Military Affiliation:
Veteran
Population:
Adulthood (18 yrs & older)
Young adulthood (18 - 29 yrs)
Thirties (30 - 39 yrs)
Middle age (40 - 64 yrs)
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Research
Ebrahimi, Ramin; Leng, Mei; Shroyer, Annie L.
2022
Introduction: Women Veterans (WV) have been identified as a high-risk population for developing ischemic heart disease (IHD). Trends for prevalence of IHD risk factors for WV over the past two decades is unknown. The goal of this study was to evaluate these trends. Methods: Veterans Affairs (VA) electronic health records were used to identify WV aged ≥18 years who visited any VAs nationwide from 1/1/2001-12/31/2017. Risk factors studied included diabetes, hypertension, hyperlipidemia, smoking, and obesity. Prevalence of each risk factor was calculated based on the number of patients alive, and of those, the number of patients with the specific risk factor on December 31st of each year. Diagnosis of each risk factor was based on the International Classification of Disease versions 9 and 10 codes. Results: Table 1 reveals the prevalence of each risk factor from 2001-2017. During this period the prevalence of these risk factors increased by, 28% for hypertension, 67% for diabetes, 71% for obesity, 140% for hyperlipidemia and 178% for smoking. Alarmingly, in 2017, the prevalence of obesity in WV was >43%. Conclusions: The prevalence of each of these cardiovascular risk factors significantly increased from 2001-2017 in WV. Research towards prevention of these risk factors is warranted in this high-risk population. Download figure
15 Rates and predictors of returns to homelessness among veterans, 2018-2022
Rates and predictors of returns to homelessness among veterans, 2018-2022
APA Citation:
Tsai, J., & Byrne, T. H. (2024). Rates and predictors of returns to homelessness among veterans, 2018-2022. American Journal of Preventive Medicine, 66(4), 590-597. https://doi.org/10.1016/j.amepre.2023.11.013
Focus:
Veterans
Substance use
Mental health
Branch of Service:
Multiple branches
Military Affiliation:
Veteran
Population:
Adulthood (18 yrs & older)
Young adulthood (18 - 29 yrs)
Thirties (30 - 39 yrs)
Middle age (40 - 64 yrs)
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Research
Tsai, Jack; Byrne, Thomas H.
2024
Introduction The progress made by the U.S. Department of Veterans Affairs (VA) towards ending veteran homelessness requires attention be paid to preventing returns to homelessness. Methods Using national VA data on 293,820 exits from a VA homeless program to a permanent housing destination between January 2018 thru December 2022, rates and predictors of returns to homelessness among veterans were examined. Analyses were conducted June-August 2023. A return to homelessness was operationally defined as a return encounter with a VA homeless program. Results 5.8% of successful exits to permanent housing resulted in a return to homelessness within 6 months, 10.2% return within 12 months, and 16.7% return within 24 months. In the total sample, veterans who were male (hazard ratio [HR]= 1.47), widowed (HR= 1.29), had diagnoses of drug use disorder (HR= 1.40) or psychotic disorder (HR= 1.20), and had used more inpatient or urgent care services in the year prior (HR= 1.05-1.15) were at significantly greater risk of returning to homelessness. Many of these predictors remained significant in subgroup analyses of female veterans, veterans aged 65 or older, and veterans in the Housing and Urban Development-Veterans Affairs Supportive Housing (HUD-VASH) program. Conclusions Most homeless veterans served by VA who exit to permanent housing do not return to homelessness within 2 years. The most critical period seems to be the first year, when 1 in 10 veterans return to homelessness. Knowledge of these risk factors may be important in planning secondary and tertiary prevention efforts for homelessness.
Evaluation of the recovery engagement and coordination for health – veterans enhanced treatment suicide risk modeling clinical program in the Veterans Health Administration
APA Citation:
McCarthy, J.F., Cooper, S.A., Dent, K.R., Eagan, A.E., Matarazzo, B.B., Hannemann, C.M., Reger, M.A., Landes, S.J., Trafton, J.A., Schoenbaum, M., & Katz, I.R. (2021). Evaluation of the recovery engagement and coordination for health-veterans enhanced treatment suicide risk modeling clinical program in the Veterans Health Administration. JAMA Network Open, 4(10), e2129900. https://doi.org/10.1001/jamanetworkopen.2021.29900
Focus:
Veterans
Mental health
Branch of Service:
Multiple branches
Military Affiliation:
Veteran
Population:
Young adulthood (18 - 29 yrs)
Adulthood (18 yrs & older)
Thirties (30 - 39 yrs)
Middle age (40 - 64 yrs)
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Research
McCarthy, John F.; Cooper, Samantha A.; Dent, Kallisse R.; Eagan, Aaron E.; Matarazzo, Bridget B.; Hannemann, Claire M.; Reger, Mark A.; Landes, Sara J.; Trafton, Jodie A.; Schoenbaum, Michael; Katz, Ira R.
2021
The Veterans Health Administration (VHA) implemented a national clinical program using a suicide risk prediction algorithm, Recovery Engagement and Coordination for Health–Veterans Enhanced Treatment (REACH VET), in which clinicians facilitate care enhancements for individuals identified in local top 0.1% suicide risk tiers. Evaluation studies are needed.To determine associations with treatment engagement, health care utilization, suicide attempts, safety plan documentation, and 6-month mortality.This cohort study used triple differences analyses comparing 6-month changes in outcomes after vs before program entry for individuals entering the REACH VET program (March 2017-December 2018) vs a similarly identified top 0.1% suicide risk tier cohort from prior to program initiation (March 2014-December 2015), adjusting for trends across subthreshold cohorts. Subcohort analyses (including individuals from March 2017-June 2018) evaluated difference-in-differences for cause-specific mortality using death certificate data. The subthreshold cohorts included individuals in the top 0.3% to 0.1% suicide risk tier, below the threshold for REACH VET eligibility, from the concurrent REACH VET period and from the pre–REACH VET period. Data were analyzed from December 2019 through September 2021.REACH VET–designated clinicians treatment reevaluation and outreach for care enhancements, including safety planning, increased monitoring, and interventions to enhance coping.Process outcomes included VHA scheduled, completed, and missed appointments; mental health visits; and safety plan documentation and documentation within 6 months for individuals without plans within the prior 2 years. Clinical outcomes included mental health admissions, emergency department visits, nonfatal suicide attempts, and all-cause, suicide, and nonsuicide external-cause mortality.A total of 173 313 individuals (mean [SD] age, 51.0 [14.7] years; 161 264 [93.1%] men and 12 049 [7.0%] women) were included in analyses, including 40 816 individuals eligible for REACH VET care and 36 604 individuals from the pre–REACH VET period in the top 0.1% of suicide risk. The REACH VET intervention was associated with significant increases in completed outpatient appointments (adjusted triple difference [ATD], 0.31; 95% CI, 0.06 to 0.55) and proportion of individuals with new safety plans (ATD, 0.08; 95% CI, 0.06 to 0.10) and reductions in mental health admissions (ATD, −0.08; 95% CI, −0.10 to −0.05), emergency department visits (ADT, −0.03; 95% CI, −0.06 to −0.01), and suicide attempts (ADT, −0.05; 95% CI, −0.06 to −0.03). Subcohort analyses did not identify differences in suicide or all-cause mortality (eg, age-and-sex-adjusted difference-in-difference for suicide mortality, 0.0007; 95% CI, −0.0006 to 0.0019).These findings suggest that REACH VET implementation was associated with greater treatment engagement and new safety plan documentation and fewer mental health admissions, emergency department visits, and suicide attempts. Clinical programs using risk modeling may be effective tools to support care enhancements and risk reduction.
A mixed methods study of the effects of gender integration on perceptions of women in U.S. Army combat units
APA Citation:
Miller, C. J. (2022) A mixed methods study of the effects of gender integration on perceptions of women in U.S. Army combat units [Doctoral dissertation, University of Maryland].
Focus:
Programming
Parents
Mental health
Branch of Service:
Army
Military Affiliation:
Active Duty
Population:
Adulthood (18 yrs & older)
Young adulthood (18 - 29 yrs)
Thirties (30 - 39 yrs)
Middle age (40 - 64 yrs)
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Other
Miller, Catherine J.
2022
In 2013, the Ground Combat Exclusion Policy (GCEP) for the United States military was eliminated, and in December 2015 Secretary of Defense Ash Carter opened all ground combat military specialties and positions to women without exceptions. Using primary survey data that I collected in 2021 from the 33 active-duty Army brigade combat teams (BCTs), this dissertation explores the effects of exposure to serving with women on male opinions about gender integration in the combat arms, perceptions of women’s capabilities (physical fitness and mental toughness), and predicted effects of gender integration on unit cohesion and unit performance in the formerly all-male Infantry and Armor branches of the Army. This mixed methods study explores the following question: To what extent does exposure to serving with female soldiers and officers in combat units help explain differences in male support for gender integration, and perceptions about its effects? Since the policy change is fairly new, a natural experiment in military assignments provided an opportunity to learn about how exposure impacts male soldier opinions in formerly all-male units. Women have been assigned in clusters to some Army Infantry and Armor units but not others due to their small numbers. At the time of the survey, there was still significant variation in exposure to serving with women in Infantry and Armor units, so exposure is examined as a treatment variable to determine if male opinions differ by unit level of exposure. The women in these newly integrated units, as well as the men and women in the associated combat support units that have been gender integrated for decades, are also included in the analysis for comparison. The findings demonstrate that the presence of women within a formerly all-male Infantry or Armor platoon or squad, and exposure to a female leader, predict that a male respondent is significantly more likely to support gender integration in the combat arms, perceive that female soldiers in their units are physically fit and mentally tough enough to be effective in their military jobs, and is less likely to worry about gender integration effects on unit cohesion and performance.
Social learning and career navigation in the U.S. military: The personal experiences, observations and socializations of servicewomen
APA Citation:
Erwin, S. K. (2022). Social learning and career navigation in the U.S. military: The personal experiences, observations and socializations of servicewomen. Industrial and Commercial Training, 54(4), 613-622. https://doi.org/10.1108/ICT-01-2022-0005
Focus:
Other
Branch of Service:
Multiple branches
Military Affiliation:
Active Duty
Population:
Young adulthood (18 - 29 yrs)
Adulthood (18 yrs & older)
Thirties (30 - 39 yrs)
Middle age (40 - 64 yrs)
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Research & Summary
Erwin, Stephanie K.
2022
Purpose This paper aims to explore the interactions of social learning and career navigation and their associated implications for women in military service. Design/methodology/approach Social learning theory (Bandura, 1977) exposes and aids in understanding the ability of an organization’s members to reconcile their personal experiences, socialization and observations. Drawn from a larger qualitative study of gender in the US military, this study highlights the US military’s rigorous socialization practices and the reliance on communal memory and social learning including matters pertaining to gender including career navigation. Findings Military servicewomen use these processes to learn military culture, acceptable behaviors, institutional norms and organizational realities for career navigation reflective of gender. Originality/value This article presents a novel exploration of gender in the military as it pertains to social learning and career progression.
Comparing predictors of intention for physical activity participation between normal and overweight military spouses
APA Citation:
Speed, S., Branscum, P., & Gresla, A. (2022). Comparing predictors of intention for physical activity participation between normal and overweight military spouses. Americal Journal of Health Education, 53(4), 248-255. https://doi.org/10.1080/19325037.2022.2071363
Focus:
Physical health
Branch of Service:
Navy
Army
Marine Corps
Coast Guard
Air Force
Multiple branches
Military Affiliation:
Active Duty
Population:
Young adulthood (18 - 29 yrs)
Adulthood (18 yrs & older)
Thirties (30 - 39 yrs)
Middle age (40 - 64 yrs)
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Research & Summary
Speed, Shannon; Branscum, Paul; Gresla, Alice
2022
Background The Department of Defense (DOD) annually spends billions in medical care for military beneficiaries. Overweight and obesity are top concerns for dependents. Only 44% of military spouses (86% female, ages 25 to 34) meet Healthy People 2020 weight/BMI goals. Physical activity (PA) is an important modifiable behavior for preventing and treating obesity. The Theory of Planned Behavior (TPB) is a behavior change model that has been used in predicting PA behaviors.Purpose The purpose was to evaluate theory-based determinants of aerobic and muscle-strengthening PA among female military spouses.Methods Participants were recruited via social media to complete a modified version of an online survey measuring TPB constructs for aerobic and muscle strengthening PA.Results Regression models showed TPB constructs predicted significant variance of intentions to engage in PA (44.9% to 52.1%) for normal weight and obese/overweight military spouses.Discussion Results indicate interventions should differ by normal weight and overweight/obese due to differences in predictors of PA.Translation to Health Education Practice Future research should test these findings in experimental studies evaluating the effectiveness of intervention to create PA adherence based on weight status of military spouses and at multiple levels of the ecological to understand how the environment influences.
20 Families of origin: The experience of parents of single military members
Families of origin: The experience of parents of single military members
APA Citation:
Williams, L., Goubanova, E., & Morrow, R. (2022). Families of origin: The experience of parents of single military members. Military Behavioral Health, 10(2), 112-123. https://doi.org/10.1080/21635781.2022.2067922
Focus:
Parents
Branch of Service:
International Military
Military Affiliation:
Active Duty
Population:
Adulthood (18 yrs & older)
Middle age (40 - 64 yrs)
Aged (65 yrs & older)
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Research & Summary
Williams, Lisa; Goubanova, Elena; Morrow, LCol Robert
2022
Enlisting in the military is a career choice that impacts the entire family unit. Many research studies have examined the effect of military life on spouses and children of military members; however little research to date has examined the experience of parents of adult children, especially for those of single Canadian Armed Forces (CAF) members. Given that many military members are often younger and not yet in stable romantic relationships, parents are often a primary source of emotional and instrumental support. Building on military family research, the current study was conducted to gain a greater understanding of parents’ experiences upon the enlistment of their adult children and adjustment to their military career. Parents of single CAF members’ experiences were examined through a series of semi-structured interviews and focus groups in seven major Canadian cities. The study group consisted of 55 participants with a mean age of 56 years. Thematic analysis was employed to identify common themes across interviews and focus groups. Results suggest that parents often experience fear and worry over their children’s wellbeing, loss of control, and uncertainty. They strive to maintain connection to their adult children and provide emotional, instrumental, and financial support. Over time, many parents are able to develop increased resilience and adjustment to their children’s careers, in part due to the development of military connections, informal and formal support, and adaptive coping methods. The findings are discussed in relation to improving parental resilience and how the CAF may best support them.
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Showing monthly topics for: December 2022
SOCIAL SUPPORT DURING THE HOLIDAYS
Posted by Hale, Caroline; Hawkins, Haley
