Introduction Stress experienced during pregnancy is associated with adverse birth outcomes including preterm delivery (PTD) and low birth weight (LBW). Pregnant spouses and partners of deployed military personnel can experience heightened stress due to several factors associated with the military lifestyle. This systematic review aims to ascertain whether deployment at the time of delivery increases the risk of PTD and/or LBW in babies born to pregnant spouses or partners of deployed service persons. Methods A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses method by searching EMBASE, Medline, PubMed and Global Health databases from inception to March 2021. Keyword searches were used to identify primary research, English language journal articles, that included any military branch and reported a measure of PTD and/or LBW of babies born to spouses/partners of deployed service persons. Risk of bias was assessed with validated tools appropriate for study type and a narrative synthesis was performed. Results Three cohort or cross-sectional studies fulfilled the eligibility criteria. All three studies were conducted in the US military, were published between 2005 and 2016 and included a cumulative total of 11 028 participants. Evidence suggests that spousal deployment may be a risk factor for PTD, although strength of evidence is weak. No association between spousal deployment and LBW was found. Conclusion Pregnant spouses and partners of deployed military personnel may be at increased risk of PTD. The strength of evidence is limited by a paucity of rigorous research in this area. No studies were identified that included service women in the UK Armed Forces. Further research is required to understand the perinatal needs of pregnant spouses/partners of deployed service persons and to understand if there are unmet clinical or social needs in this population.
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Effect of spousal military deployment during pregnancy on neonatal birth outcomes: A systematic review
APA Citation:
Morris, K. (2023). Effect of spousal military deployment during pregnancy on neonatal birth outcomes: A systematic review. BMJ Military Health. Advance online publication. https://doi.org/10.1136/military-2023-002454
Focus:
Deployment
Parents
Other
Branch of Service:
Multiple branches
Military Affiliation:
Active Duty
Population:
Adulthood (18 yrs & older)
Young adulthood (18 - 29 yrs)
Thirties (30 - 39 yrs)
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Research
Morris, Kirsten
2023
2 Alcohol use patterns during and after the COVID-19 pandemic among veterans in the United States
Alcohol use patterns during and after the COVID-19 pandemic among veterans in the United States
APA Citation:
Wong, R. J., Yang, Z., Ostacher, M., Zhang, W., Satre, D., Monto, A., Khalili, M., Singal, A. K., & Cheung, R. (2024). Alcohol use patterns during and after the COVID-19 pandemic among veterans in the United States. The American Journal of Medicine, 137(3), 236-239.e2. https://doi.org/10.1016/j.amjmed.2023.11.013
Focus:
Veterans
Substance use
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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Research
Wong, Robert J.; Yang, Zeyuan; Ostacher, Michael; Zhang, Wei; Satre, Derek; Monto, Alexander; Khalili, Mandana; Singal, Ashwani K.; Cheung, Ramsey
2024
Background Veterans may be especially susceptible to increased alcohol consumption following the COVID-19 pandemic. We aim to evaluate trends in alcohol use among U.S. Veterans before, during, and following the onset of the COVID-19 pandemic. Methods All U.S. Veterans utilizing Veterans Affairs healthcare facilities in the U.S. from March 1, 2018 to February 28, 2023 with ≥1 AUDIT-C score were categorized into 1) No alcohol use (AUDIT-C = 0), 2) Low-risk alcohol use (AUDIT-C 1-2 for women, 1-3 for men), and 3) High-risk alcohol use (AUDIT-C ≥ 3 for women, ≥ 4 for men). Trends in the proportion of Veterans reporting high-risk alcohol use, stratified by sex, age, race/ethnicity, and urbanicity were evaluated. Results Among a cohort of 2.15 to 2.60 million Veterans, 15.5% reported high-risk alcohol use during March 2018-February 2019, which declined to 14.6% during the first year of the pandemic, increased to 15.2% in the second year, and then decreased to 14.9% from March 2022-February 2023. Among non-Hispanic whites, African Americans, Asians, and Hispanics, the proportion of women reporting high-risk alcohol use surpassed that of men during the onset of the pandemic and beyond. The greatest proportion of high-risk alcohol use was observed among young Veterans aged 18-39 years (17-27%), which was consistent across all race/ethnic groups. Conclusions High-risk alcohol use among U.S. Veterans has increased since the COVID-19 pandemic onset, and in the third year following pandemic onset, 15% of Veterans overall and over 20% of young Veterans aged 18-39 years reported high -risk alcohol use.
3 Veterans Affairs’ Whole Health System of Care for transitioning service members and veterans
Veterans Affairs’ Whole Health System of Care for transitioning service members and veterans
APA Citation:
Gantt, C. J., Donovan, N., & Khung, M. (2023). Veterans Affairs’ Whole Health System of Care for transitioning service members and veterans. Military Medicine, 188(Supplement 5), 28–32. https://doi.org/10.1093/milmed/usad047
Focus:
Veterans
Programming
Physical health
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
Gantt, Cynthia J.; Donovan, Nancy; Khung, Maureen
2023
The Department of Veterans Affairs (VA) has launched an organization-wide transformation to a Whole Health System of Care that will ideally begin at the time of transition from active duty through the end of a Veteran’s life. A brief history and overview of the Whole Health approach are provided along with selected evaluation results and planned initial actions as a result of the Total Force Fitness–Whole Health Summit held in March 2022. More work is required to strengthen the natural linkages between the Department of Defense’s Total Force Fitness and Veterans Affairs’ Whole Health approach to care. The Total Force Fitness–Whole Health collaboration is a model of whole-person care for the nation.
4 Incidence of suicidal ideation and suicide attempt based on time in a deployed environment
Incidence of suicidal ideation and suicide attempt based on time in a deployed environment
APA Citation:
Hall, A., Qureshi, I., Meyer, E. G., Currier, G. W., Castaneda, R., & Cardin, S. (2023). Incidence of suicidal ideation and suicide attempt based on time in a deployed environment. Military Medicine, 188(Supplement_6), 41-44. https://doi.org/10.1093/milmed/usac403
Focus:
Mental health
Deployment
Branch of Service:
Army
Military Affiliation:
Active Duty
Population:
Adulthood (18 yrs & older)
Young adulthood (18 - 29 yrs)
Share the article
Research
Hall, Andrew; Qureshi, Iram; Meyer, Eric G.; Currier, Glenn W.; Castaneda, Rebecca; Cardin, Sylvain
2023
Knowing when suicidal ideation (SI) or suicide attempt (SA) is most likely to occur in a deployed environment would aid in focusing prevention efforts. This study aims to determine when evacuation for SA and SI is most likely to occur based on the absolute and relative number of months in a deployed setting.This is a case–control study of active-duty military personnel evacuated from the U.S. Central Command area of responsibility for SI or an SA between April 1, 2020, and March 30, 2021. The arrival month and expected departure month were identified for all the included evacuees. The month of evacuation and proportion of completed deployment were compared. Secondary outcomes of mental health diagnosis or need for a waiver was also examined.A total of 138 personnel evacuated for SI or attempted suicide during the 12-month study period were included in the analysis. Evacuations occurring during month 3 of deployment were significantly higher (P < .0001) than those during other months. The 30% and 50% completion point of deployment had statistically higher frequencies of evacuations for SI/SA (<.0001). A secondary analysis revealed that 25.4% of the individuals had a documented preexisting behavioral health condition before deployment (P < .0001).Specific points along a deployment timeline were significant predictors for being evacuated for SI and SA.
5 Virtual behavioral health for Army soldiers: Soldier perspectives and patterns of treatment
Virtual behavioral health for Army soldiers: Soldier perspectives and patterns of treatment
APA Citation:
Hepner, K. A., Breslau, J., Sousa, J. L., Roth, C. P., Ruder, T., González, I., Montemayor, C. K., & Griffin, B. A. (2023). Virtual behavioral health for Army soldiers: Soldier perspectives and patterns of treatment (Article RR-A2241-1). RAND Corporation. https://www.rand.org/pubs/research_reports/RRA2241-1.html
Focus:
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)
Share the article
Research and Technical Reports
Hepner, Kimberly A.; Breslau, Joshua; Sousa, Jessica L.; Roth, Carol P.; Ruder, Teague; González, Isabelle; Montemayor, Cheryl K.; Griffin, Beth Ann
2023
Delivery of high-quality behavioral health (BH) care is essential to the readiness of the U.S. armed forces and their families. Virtual behavioral health (VBH) care expanded during the COVID-19 pandemic and could support BH care delivery in the future. The authors examined trends in the use of VBH care for U.S. Army soldiers and their spouses from prior to the pandemic through March 2022 and surveyed soldiers about their perceptions of VBH care.
6 Characteristics of men offenders who self-reported veteran status
Characteristics of men offenders who self-reported veteran status
APA Citation:
Farrell MacDonald, S., & Cram, S. (2020). Characteristics of men offenders who self-reported veteran status. Correctional Service Canada. http://www.fimt-rc.org/article/20210126-characteristics-of-men-offenders-who-self-reported-veteran-status
Focus:
Other
Branch of Service:
International Military
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 and Technical Reports
Farrell MacDonald, Shanna; Cram, Sarah
2020
The Correctional Service of Canada (CSC) has a partnership with Veterans Affairs Canada (VAC) to support veterans involved with the federal correctional system. Previous research indicates that veterans are older than non-veterans and have unique needs with respect to personal/emotional issues and antisocial attitudes, with a third having a history of sexual offending. This study was undertaken to update our knowledge of the characteristics of federal veteran offenders. What we did Offenders assessed by the CSC’s Computerized Mental Health Intake Screening System (CoMHISS) between August 2014 and March 2018 were included in this study. Men offenders who self-reported former service in the Canadian Forces were identified as veterans (N = 374) while all other men offenders were categorized as nonveterans (N = 14,471). Additional information from CSC’s Offender Management System (OMS) was extracted.
Marital quality and loneliness among aging Vietnam-era combat veterans: The moderating role of PTSD symptom severity
APA Citation:
Marini, C. M., Yorgason, J. B., Pless Kaiser, A., & Erickson, L. D. (2023). Marital quality and loneliness among aging Vietnam-era combat veterans: The moderating role of PTSD symptom severity. Clinical Gerontologist. Advance online publication. https://doi.org/10.1080/07317115.2023.2274052
Focus:
Veterans
Mental health
Couples
Branch of Service:
Multiple branches
Military Affiliation:
Veteran
Population:
Adulthood (18 yrs & older)
Middle age (40 - 64 yrs)
Aged (65 yrs & older)
Share the article
Research & Summary
Marini, Christina M.; Yorgason, Jeremy B.; Pless Kaiser, Anica; Erickson, Lance D.
2023
Objectives We examined links between marital quality and loneliness among aging veterans and explored whether veterans’ PTSD symptom severity moderated these associations. Methods Data came from 269 Vietnam-Era combat veterans who had a spouse/partner (M age = 60.50). Utilizing two waves of data spanning six years, we estimated multiple regression models that included positive and negative marital quality, PTSD symptom severity, and loneliness in 2010 as predictors of loneliness in 2016. Results Facets of positive (but not negative) marital quality were associated with veterans’ loneliness. Companionship – spousal affection and understanding – was associated with lower subsequent loneliness among veterans with low/moderate – but not high – PTSD symptom severity. Conversely, sociability – the degree to which one’s marriage promotes socializing with others – was associated with lower subsequent loneliness regardless of PTSD symptom severity. Conclusions Companionship and sociability were each associated with veterans’ subsequent loneliness. Whereas benefits of companionship were attenuated at higher levels of PTSD symptom severity, benefits of sociability were not.
Grit but not help-seeking was associated with food insecurity among low income, at-risk rural veterans
APA Citation:
Qin, Y., Sneddon, D. A., MacDermid Wadsworth, S., Topp, D., Sterrett, R. A., Newton, J. R., & Eicher-Miller, H. A. (2023). Grit but not help-seeking was associated with food insecurity among low income, at-risk rural veterans. International Journal of Environmental Research and Public Health, 20(3), Article 2500. https://doi.org/10.3390/ijerph20032500
Focus:
Veterans
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)
Share the article
Research
Qin, Yue; Sneddon, Douglas A.; MacDermid Wadsworth, Shelley; Topp, Dave; Sterrett, Rena A.; Newton, Jake R.; Eicher-Miller, Heather A.
2023
Rural veterans have poorer health, use healthcare services less often than their urban counterparts, and have more prevalent food insecurity than average U.S. households. Food insecurity and resource use may be influenced by modifiable psychological attributes such as grit and help-seeking behaviors, which may be improved through interventions. Grit and help-seeking have not been previously evaluated among rural veterans. Thus, this cross-sectional study evaluated the hypothesis that grit and help-seeking were associated with food insecurity and the use of resources. Food security, resource use, grit, and help-seeking behavior were assessed among rural veterans (≥18 years) from five food pantries in southern Illinois counties (n = 177) from March 2021 to November 2021. Adjusted multiple regression was used to estimate the relationship between the odds of food insecurity and the use of resources with grit and help-seeking scores. Higher grit scores were significantly associated with lower odds of food insecurity (OR = 0.5, p = 0.009). No other associations were detected. The results provided evidence to inform the content of future educational interventions to improve food insecurity and address health disparities among rural veterans by addressing grit. The enhancement of psychological traits such as grit is related to food security and has the potential to benefit other aspects of well-being.
Variation in initial and continued use of primary, mental health, and specialty video care among veterans
APA Citation:
Ferguson, J. M., Wray, C. M., Jacobs, J., Greene, L., Wagner, T. H., Odden, M. C., Freese, J., Van Campen, J., Asch, S. M., Heyworth, L., & Zulman, D. M. (2023). Variation in initial and continued use of primary, mental health, and specialty video care among veterans. Health Services Research, 58(2), 402-414. https://doi.org/10.1111/1475-6773.14098
Focus:
Mental health
Veterans
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)
Aged (65 yrs & older)
Share the article
Research
Ferguson, Jacqueline M.; Wray, Charlie M.; Jacobs, Josephine; Greene, Liberty; Wagner, Todd H.; Odden, Michelle C.; Freese, Jeremy; Van Campen, James; Asch, Steven M.; Heyworth, Leonie; Zulman, Donna M.
2023
Objective To identify which Veteran populations are routinely accessing video-based care. Data Sources and Study Setting National, secondary administrative data from electronic health records at the Veterans Health Administration (VHA), 2019-2021 Study Design This retrospective cohort analysis identified patient characteristics associated with the odds of using any video care; and then, among those with a previous video visit, the annual rate of video care utilization. Video care use was reported overall and stratified into care type (e.g., primary, mental health, and specialty video care) between March 10, 2020 and February 28, 2021. Data Collection Veterans active in VA health care (>1 outpatient visit between March 11, 2019 and March 10, 2020) were included in this study. Principal Findings Among 5,389,129 Veterans in this evaluation, approximately 27.4% of Veterans had at least one video visit. We found differences in video care utilization by type of video care: 14.7% of Veterans had at least one primary care video visit, 10.6% a mental health video visit, and 5.9% a specialty care video visit. Veterans with a history of housing instability had a higher overall rate of video care driven by their higher usage of video for mental health care compared with Veterans in stable housing. American Indian/Alaska Native Veterans had reduced odds of video visits, yet similar rates of video care when compared to White Veterans. Low-income Veterans had lower odds of using primary video care yet slightly elevated rates of primary video care among those with at least one video visit when compared to Veterans enrolled at VA without special considerations. Conclusions Variation in video care utilization patterns by type of care identified Veteran populations that might require greater resources and support to initiate and sustain video care use. Our data support service specific outreach to homeless and American Indian/Alaska Native Veterans.
10 Women veterans’ attitudes toward family involvement in PTSD treatment: A mixed-methods examination
Women veterans’ attitudes toward family involvement in PTSD treatment: A mixed-methods examination
APA Citation:
Reuman, L., & Thompson-Hollands, J. (2023). Women veterans’ attitudes toward family involvement in PTSD treatment: A mixed-methods examination. Psychological Services, 20(4), 770-779. https://doi.org/10.1037/ser0000707
Focus:
Veterans
Mental health
Trauma
Branch of Service:
Multiple branches
Military Affiliation:
Veteran
Population:
Adulthood (18 yrs & older)
Thirties (30 - 39 yrs)
Middle age (40 - 64 yrs)
Share the article
Research & Summary
Reuman, Lillian; Thompson-Hollands, Johanna
2023
Family member (FM) involvement in treatment for posttraumatic stress disorder (PTSD) has the potential to enhance veterans’ sense of support and connection and reduce treatment dropout. Little is known, however, about women veterans’ preferences, concerns, and goals regarding FM involvement in PTSD treatment. The study employed a mixed-methods approach consisting of surveys (n = 143) and interviews (n = 10) with women veterans seeking treatment for PTSD in a Veterans Affairs medical center. Married and partnered women veterans, and women veterans who identified as gay/lesbian, were more likely to be open to FM involvement. Results revealed a range of preferences and goals regarding FM involvement. Women veterans expressed a preference for joint sessions at the midpoint or near the end of treatment. Veterans’ goals for FM involvement included enhancing the relationship with their FM and providing the FM with a basic understanding of PTSD. Conclusions, limitations, and future directions are discussed.
11 Exploring veteran cultural competency in Canadian health care services
Exploring veteran cultural competency in Canadian health care services
APA Citation:
Tam-Seto, L., Williams, A., & Cramm, H. (2023). Exploring veteran cultural competency in Canadian health care services. Journal of Military, Veteran and Family Health, 9(4), 100–110. https://doi.org/10.3138/jmvfh-2022-0073
Focus:
Veterans
Other
Branch of Service:
International Military
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 & Summary
Tam-Seto, Linna; Williams, Ashley; Cramm, Heidi
2023
On leaving the military, Canadian Armed Forces Veterans begin receiving health care services in the civilian community. Health care providers may not understand the military culture from which Veterans come, and how military service can affect health and well-being. The purpose of this study was to identify what civilian health care providers need to know and do to provide culturally competent care to Canadian Veterans. Veterans and health care providers (family physicians and an occupational therapist) were interviewed, and specific knowledge, skills, and abilities were identified as important when establishing a quality health care relationship. This information can be used to develop resources for health care providers when beginning work with Veterans and their families, as well as for Veterans themselves as they transition to receiving care in civilian systems.
Adverse childhood experiences and positive childhood experiences among United States military children
APA Citation:
Crouch, E., Andersen, T. S., & Smith, H. P. (2023). Adverse childhood experiences and positive childhood experiences among United States military children. Military Medicine, usad416. https://doi.org/10.1093/milmed/usad416
Focus:
Children
Trauma
Branch of Service:
Multiple branches
Military Affiliation:
Active Duty
Population:
Adolescence (13 - 17 yrs)
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Research & Summary
Crouch, Elizabeth; Andersen, Tia S.; Smith, Hayden P.
2023
Many facets of military life are contributors to child health including frequent mobility, family separation, and increased risk to parental physical and mental health, as well as strong social networks and military support systems; yet, there has not been an examination of adverse childhood experiences (ACEs) and positive childhood experiences (PCEs) among military children.This study used the 2020–2021 National Survey of Children’s Health, limited to children aged 6 to 17 years of age, to examine the association between a child who has ever had a caregiver on active duty and their exposure to ACEs and PCEs (n = 54,256 children). Bivariate analyses used Pearson’s chi-squared tests and were weighted to be nationally representative. Multivariable regression models were used to examine the association between military status and selected ACEs.There were no statistically significant differences in PCEs between military and civilian children. Compared to children with a civilian caregiver, children who had a caregiver who had ever served on active duty had a higher odds of experiencing domestic violence (adjusted Odds Ratio (aOR), 1.61; 95% CI 1.23–2.11), mental health issues or depression in the household (aOR 1.28; 95% CI 1.07–1.52), and substance use (aOR 1.28; 95% CI 1.06–1.55).This study complements and extends previous research that has taken a deficit approach and focused exclusively on the hardships faced by children in military families. The findings from this study may be instructive for child welfare advocates and policymakers as they intervene in communities with programming that promotes PCEs among children and adolescents.
Considering the psychological experience of amputation and rehabilitation for military veterans: A systematic review and metasynthesis of qualitative research
APA Citation:
Murray, C. D., Havlin, H., & Molyneaux, V. (2024). Considering the psychological experience of amputation and rehabilitation for military veterans: A systematic review and metasynthesis of qualitative research. Disability and Rehabilitation, 46(6), 1053-1072. https://doi.org/10.1080/09638288.2023.2182915
Focus:
Physical health
Veterans
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
Murray, Craig D.; Havlin, Heather; Molyneaux, Victoria
2024
Purpose Research highlights the differences and unique experiences of military veterans experiencing amputation compared to civilians. This review aimed to synthesise qualitative research exploring the experience of amputation and rehabilitation among existing or previous members of the military.Methods A systematic search of six databases (PsycINFO, AMED, MEDLINE, CINAHL, Web of Science and Scopus) was undertaken in March 2022. The results of 17 papers reporting 12 studies published between 2009 and 2022 were synthesised using a meta-ethnographic approach to generate new interpretations reflecting the experiences of members of the military who have experienced limb loss.Results Three themes were developed from the data: (1) Making the physical and psychological transition to life after amputation; (2) The role of the military culture in rehabilitation; and (3) The impact of relationships and the gaze of others during rehabilitation and beyond.Conclusions Military veterans with limb loss experience difficulties in navigating civilian healthcare systems and gaining appropriate support away from the military. Rehabilitation professionals, with psychological training or mentoring, involved in the care of military veterans following amputation could offer psychological support during the transition to civilian life and targeted therapies to veterans experiencing high levels of pain, and facilitate peer support programmes.
14 How does the American public interact with chaplains? Evidence from a national survey
How does the American public interact with chaplains? Evidence from a national survey
APA Citation:
Lawton, A., Cadge, W., & Hamar Martinez, J. (2024). How does the American public interact with chaplains? Evidence from a national survey. Journal of Health Care Chaplaincy, 30(2), 137-151. https://doi.org/10.1080/08854726.2023.2239109
Focus:
Other
Branch of Service:
Multiple branches
Military Affiliation:
Active Duty
Veteran
Population:
Adulthood (18 yrs & older)
Thirties (30 - 39 yrs)
Middle age (40 - 64 yrs)
Share the article
Research
Lawton, Amy; Cadge, Wendy; Hamar Martinez, Jessica
2024
How does the American public understand the term chaplain? What fraction interact with chaplains and in what settings? What is the content of those interactions and do care recipients find them valuable? We answer these questions with data from a nationally representative survey (N = 1096) conducted in March 2022 and interviews with a subset (N = 50) of survey recipients who interacted with chaplains. We find that people in the United States do not have a consistent understanding of the term chaplain. Based on our definition, at least 18% of Americans have interacted with a chaplain. Among those who interacted with a chaplain as defined in the survey, the majority did so through healthcare organizations. Care recipients include people who were ill and their visitors/caregivers. The most common types of support received were prayer, listening and comfort. Overall, survey respondents found chaplains to be moderately or very valuable.
‘Whether it’s your weapon or not, it’s your home’: US military spouse perspectives on personal firearm storage
APA Citation:
Betz, M. E., Meza, K., Friedman, K., Moceri-Brooks, J., Johnson, M. L., Simonetti, J., Baker, J. C., Bryan, C. J., & Anestis, M. D. (2023). “Whether it’s your weapon or not, it’s your home”: US military spouse perspectives on personal firearm storage. BMJ Military Health. Advance online publication. https://doi.org/10.1136/military-2023-002591
Focus:
Couples
Other
Branch of Service:
Multiple branches
Military Affiliation:
Veteran
Guard
Reserve
Active Duty
Population:
Adulthood (18 yrs & older)
Young adulthood (18 - 29 yrs)
Thirties (30 - 39 yrs)
Middle age (40 - 64 yrs)
Share the article
Research & Summary
Betz, Marian E.; Meza, K.; Friedman, K.; Moceri-Brooks, J.; Johnson, M. L.; Simonetti, J.; Baker, J. C.; Bryan, C. J.; Anestis, M. D.
2023
Introduction In the USA, an estimated 45% of veterans personally own firearms. Firearm access increases the risk of suicide, so suicide prevention efforts in the US Department of Defense (DoD) focus on lethal means safety, including reducing firearm access. Spouse input may enhance effective messaging and intervention delivery of lethal means safety. This study used qualitative methods to explore the perspectives of military spouses or partners on personal firearm storage, including at-home decisions, on-base storage and existing messaging from the DoD. Materials and methods Qualitative data were obtained using 1:1 interviews and focus groups with spouses/partners of US military service members (active duty, Reserve, National Guard, recently separated from the military) and representatives from military support organisations. Sessions focused on personal firearm storage (at home or on military installations) and military messaging around secure firearm storage and firearm suicide prevention. Data were analysed using a team-based, mixed deductive–inductive approach. Results Across 56 participants (August 2022–March 2023), the themes were variability in current home firearm storage and spousal participation in decision-making; uncertainty about firearm storage protocols on military installations; mixed awareness of secure firearm storage messaging from the military; and uncertainty about procedures or protocols for removing firearm access for an at-risk person. Conclusion US military spouses are important messengers for firearm safety and suicide prevention, but they are currently underutilised. Tailored prevention campaigns should consider spousal dynamics and incorporate education about installation procedures.
16 Association of place with adolescent obesity
Association of place with adolescent obesity
APA Citation:
Datar, A., Nicosia, N., Mahler, A., Prados, M. J., & Ghosh-Dastidar, M. (2023). Association of place with adolescent obesity. JAMA Pediatrics, 177(8), 847-855. https://doi.org/10.1001/jamapediatrics.2023.1329
Focus:
Children
Physical health
Youth
Branch of Service:
Multiple branches
Military Affiliation:
Active Duty
Population:
Childhood (birth - 12 yrs)
Adolescence (13 - 17 yrs)
Share the article
Research
Datar, Ashlesha; Nicosia, Nancy; Mahler, Amy; Prados, Maria J.; Ghosh-Dastidar, Madhumita
2023
Despite strong evidence linking place and obesity risk, the extent to which this link is causal or reflects sorting into places is unclear.To examine the association of place with adolescents’ obesity and explore potential causal pathways, such as shared environments and social contagion.This natural experiment study used the periodic reassignment of US military servicemembers to installations as a source of exogenous variation in exposure to difference places to estimate the association between place and obesity risk. The study analyzed data from the Military Teenagers Environments, Exercise, and Nutrition Study, a cohort of adolescents in military families recruited from 2013 through 2014 from 12 large military installations in the US and followed up until 2018. Individual fixed-effects models were estimated that examined whether adolescents' exposure to increasingly obesogenic places over time was associated with increases in body mass index (BMI) and probability of overweight or obesity. These data were analyzed from October 15, 2021, through March 10, 2023.Adult obesity rate in military parent’s assigned installation county was used as a summary measure of all place-specific obesogenic influences.Outcomes were BMI, overweight or obesity (BMI in the 85th percentile or higher), and obesity (BMI in the 95th percentile or higher). Time at installation residence and off installation residence were moderators capturing the degree of exposure to the county. County-level measures of food access, physical activity opportunities, and socioeconomic characteristics captured shared environments.A cohort of 970 adolescents had a baseline mean age of 13.7 years and 512 were male (52.8%). A 5 percentage point–increase over time in the county obesity rate was associated with a 0.19 increase in adolescents’ BMI (95% CI, 0.02-0.37) and a 0.02-unit increase in their probability of obesity (95% CI, 0-0.04). Shared environments did not explain these associations. These associations were stronger for adolescents with time at installation of 2 years or longer vs less than 2 years for BMI (0.359 vs. 0.046; P value for difference in association = .02) and for probability of overweight or obesity (0.058 vs. 0.007; P value for difference association = .02), and for adolescents who lived off installation vs on installation for BMI (0.414 vs. -0.025; P value for association = .01) and for probability of obesity (0.033 vs. -0.007; P value for association = .02).In this study, the link between place and adolescents' obesity risk is not explained by selection or shared environments. The study findings suggest social contagion as a potential causal pathway.
Design of the CHARGE study: A randomized control trial evaluating a novel treatment for veterans with binge eating disorder and overweight and obesity
APA Citation:
Boutelle, K. N., Afari, N., Obayashi, S., Eichen, D. M., Strong, D. R., & Peterson, C. B. (2023). Design of the CHARGE study: A randomized control trial evaluating a novel treatment for veterans with binge eating disorder and overweight and obesity. Contemporary Clinical Trials, 130, Article 107234. https://doi.org/10.1016/j.cct.2023.107234
Focus:
Physical health
Programming
Veterans
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
Boutelle, Kerri N.; Afari, Niloofar; Obayashi, Saori; Eichen, Dawn M.; Strong, David R.; Peterson, Carol B.
2023
A large number of Veterans experience binge eating and overweight or obesity, which are associated with significant health and psychological consequences. The gold-standard program for the treatment of binge eating, Cognitive Behavioral Therapy (CBT), results in decreases in binge eating frequency but does not result in significant weight loss. We developed the Regulation of Cues (ROC) program to reduce overeating and binge eating through improvement in sensitivity to appetitive cues and decreased responsivity to external cues, an approach that has never been tested among Veterans. In this study, we combined ROC with energy restriction recommendations from behavioral weight loss (ROC+). This study is a 2-arm randomized controlled trial designed to evaluate the feasibility and acceptability of ROC+, and to compare the efficacy of ROC+ and CBT on reduction of binge eating, weight, and energy intake over 5-months of treatment and 6-month follow-up. Study recruitment completed in March 2022. One hundred and twenty-nine Veterans were randomized (mean age = 47.10 (sd = 11.3) years; 41% female, mean BMI = 34.8 (sd = 4.7); 33% Hispanic) and assessments were conducted at baseline, during treatment and at post-treatment. The final 6-month follow-ups will be completed in April 2023. Targeting novel mechanisms including sensitivity to internal cures and responsivity to external cues is critically important to improve binge eating and weight-loss programs among Veterans.
Motives for using electronic nicotine delivery systems (ENDS) as a cessation tool are associated with tobacco abstinence at 1-year follow-up: A prospective investigation among young adults in the United States Air Force
APA Citation:
Aycock, C. A., Wang, X.-Q., Williams, J. B., Fahey, M. C., Talcott, G. W., Klesges, R. C., & Little, M. A. (2023). Motives for using electronic nicotine delivery systems (ends) as a cessation tool are associated with tobacco abstinence at 1-year follow-up: A prospective investigation among young adults in the united states air force. Preventive Medicine Reports, 35, Article 102399. https://doi.org/10.1016/j.pmedr.2023.102399
Focus:
Substance use
Programming
Branch of Service:
Air Force
Military Affiliation:
Active Duty
Population:
Adulthood (18 yrs & older)
Young adulthood (18 - 29 yrs)
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Aycock, Chase A.; Wang, Xin-Qun; Williams, Juinell B.; Fahey, Margaret C.; Talcott, G. Wayne; Klesges, Robert C.; Little, Melissa A.
2023
Introduction Smokers use electronic nicotine delivery systems (ENDS), including e-cigarettes, as a harm reduction strategy even though the Food and Drug Administration (FDA) has not approved them for tobacco cessation. The limited literature about ENDS use for cigarette cessation is concerning for the U.S. military, which is largely comprised of young adults at increased risk for tobacco use. Thus, the current study aims to evaluate use of ENDS products as a cessation tool in relation to point-prevalence tobacco abstinence at one-year follow-up in a cohort of 8,901 U.S. Air Force personnel attending entry-level job training from March 2016 to April 2019. Methods A propensity-score adjusted multinomial logistic regression model was used to assess the association between the baseline motives for ENDS use (i.e., for cigarette cessation versus alternative reasons) and tobacco use at the one-year follow-up (cigarette use, non-cigarette tobacco product use, and tobacco abstinence) among those reporting history of cigarette use at baseline. Results Smokers reporting ENDS use for cigarette cessation were more likely to be abstinent at one-year follow-up (Odds Ratio[OR] = 1.62, 95% CI: 1.06–2.49, P =.03) as well as quit using non-cigarette tobacco products (OR = 2.11, 95% CI: 1.65–2.70, P <.001) than those reporting ENDS use for alternative reasons. Conclusions Current tobacco users are recommended to use FDA-approved products for smoking cessation, such as nicotine replacement therapy. However, given the high prevalence of cigarette use among military populations, ENDS may provide a useful alternative harm reduction strategy for this high-risk population.
The use of hotels/motels to address homelessness among veterans during the COVID-19 pandemic: Lessons from the supportive services for veteran families program
APA Citation:
Montgomery, A. E., Zickmund, S., Byrne, T. H., Galyean, P., Suo, Y., Pettey, W., Velasquez, T., Gelberg, L., Kertesz, S. G., Tsai, J., & Nelson, R. E. (2023). The use of hotels/motels to address homelessness among veterans during the COVID-19 pandemic: Lessons from the supportive services for veteran families program. Journal of Social Distress and Homelessness. Advance online publication. https://doi.org/10.1080/10530789.2023.2187522
Focus:
Veterans
Programming
Other
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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Montgomery, Ann Elizabeth; Zickmund, Susan; Byrne, Thomas H.; Galyean, Patrick; Suo, Ying; Pettey, Warren; Velasquez, Tania; Gelberg, Lillian; Kertesz, Stefan G.; Tsai, Jack; Nelson, Richard E.
2023
The objective of this exploratory mixed methods study is to assess the use of hotels/motels among Veterans experiencing housing instability during the COVID-19 pandemic to inform policy and programmatic responses to homelessness during such emergencies. We analyzed qualitative interviews conducted with national-level homeless services leadership and Supportive Services for Veteran Families (SSVF) program providers during October 2020–May 2021 and quantitative data for Veterans who enrolled in SSVF during March–August 2020. A multivariable two-part regression model identified factors associated with receiving hotel/motel-specific financial assistance and associated costs. Qualitative interviews indicated that the use of hotels/motels during COVID-19 offered protection from a contagious disease and a novel mechanism to accommodate high-need Veterans who may have previously been unsheltered or resistant to services. Quantitative analyses found that Veteran households’ stays in hotels/motels increased sharply following the onset of the COVID-19 pandemic; this assistance tended to flow to a more vulnerable group (i.e. older, no income, and extensive histories of homelessness). COVID-19 and homelessness are ongoing public health concerns; strategies such as the use of hotels/motels to reduce homelessness and ensure safe options for isolation and quarantine are needed to prevent poor health outcomes for a vulnerable population.
Written exposure therapy vs prolonged exposure therapy in the treatment of posttraumatic stress disorder: A randomized clinical trial
APA Citation:
Sloan, D. M., Marx, B. P., Acierno, R., Messina, M., Muzzy, W., Gallagher, M. W., Litwack, S., & Sloan, C. (2023). Written exposure therapy vs prolonged exposure therapy in the treatment of posttraumatic stress disorder: A randomized clinical trial. JAMA Psychiatry, 80(11), 1093-1100. https://doi.org/10.1001/jamapsychiatry.2023.2810
Focus:
Veterans
Mental health
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)
Share the article
Research
Sloan, Denise M.; Marx, Brian P.; Acierno, Ron; Messina, Michael; Muzzy, Wendy; Gallagher, Matthew W.; Litwack, Scott; Sloan, Colleen
2023
Evidence-based treatments for posttraumatic stress disorder (PTSD) exist, but all require 8 to 15 sessions and thus are less likely to be completed than brief treatments. Written exposure therapy (WET) is a brief and efficacious treatment that has not been directly compared with prolonged exposure therapy (PE), a more time-intensive, exposure-based treatment.To determine whether WET is noninferior to PE in treating PTSD among veterans.A randomized noninferiority clinical trial was conducted between September 9, 2019, and April 30, 2022. Participants were 178 veterans with PTSD presenting to 1 of 3 Veterans Affairs medical centers. Inclusion criteria consisted of a primary diagnosis of PTSD and stable medication. Exclusion criteria included current psychotherapy for PTSD, high suicide risk, active psychosis, unstable bipolar disorder, and severe cognitive impairment. Independent evaluations were conducted at baseline and 10, 20, and 30 weeks after the first treatment session. Data were analyzed from January 1 to March 31, 2023.Participants assigned to WET (n = 88) received five to seven 45- to 60-minute sessions. Participants assigned to PE (n = 90) received eight to fifteen 90-minute sessions. The WET sessions included 30 minutes of writing-based imaginal exposure conducted in session, whereas PE sessions included 40 minutes of in-session imaginal exposure and between-session in vivo exposures.The primary outcome was change in PTSD symptom severity measured with the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) from baseline to the 20-week assessment; noninferiority was defined as a less than 10-point difference between the 2 treatment groups. Difference in treatment dropout was also examined.Of the 178 participants, 134 (75.3%) were men, and the mean (SD) age was 44.97 (13.66) years. In terms of race, 37 participants (20.8%) were Black, 112 (62.9%) were White, 11 (6.2%) were more than 1 race, and 18 (10.1%) were of other race (including American Indian or Alaska Native, Asian, and Native Hawaiian or Other Pacific Islander [some participants did not specify their race when selecting the category “other”]); in terms of ethnicity, 19 participants (10.7%) were Hispanic. Changes in PTSD symptom severity from baseline to all subsequent assessments among individuals randomized to WET were noninferior relative to individuals randomized to PE. The largest difference between treatments was observed at 10 weeks and was in favor of WET (mean difference, 2.42 [95% CI, 0.35-1.46] points). Participants were significantly less likely to drop out of WET compared with PE (11 [12.5%] vs 32 [35.6%];
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