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Corry NH, Radakrishnan S, Williams CS, Woodall KA, Stander VA. Longitudinal association of health behaviors and health-related quality of life with military spouse readiness. BMC Public Health 2024; 24:1341. [PMID: 38762717 PMCID: PMC11102189 DOI: 10.1186/s12889-024-18786-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 05/07/2024] [Indexed: 05/20/2024] Open
Abstract
BACKGROUND Unhealthy behaviors impose costs on health-related quality of life (HRQOL) reducing productivity and readiness among military members (Hoge et al., JAMA 295:1023-32, 2006; Mansfield et al. 362:101-9, 2010). Among married personnel in particular, patterns of spouse health behaviors may play an interdependent role. As a result, the identification of military spouse health factors related to readiness may inform strategies to screen for and identify those in need of greater support and enhance readiness. This study explored behavioral and HRQOL predictors and potential mediators of military spouse readiness utilizing data from the Millennium Cohort Family Study. METHODS The analytic sample comprised of 3257 spouses of active-duty, non-separated service members who responded to both waves 1 and 2 of the survey. Sample characteristics are described with respect to demographics (e.g., age, sex, race/ethnicity, etc.), readiness measures (i.e., military satisfaction, lost workdays, health care utilization, military-related stress, and satisfaction), health behaviors (i.e., exercise, sleep, smoking, and alcohol use) and HRQOL (Veterans RAND 12-Item Short Form Survey). We conducted multivariate mediation analyses to evaluate the role of mental and physical HRQOL as mediators between the baseline health behaviors and the health readiness outcomes at follow-up, while adjusting for spouse and service member demographics. RESULTS HRQOL had direct effects for all five readiness outcomes examined. Multiple health behaviors (insomnia, smoking, binge drinking, and exercise) were further significantly associated with spouse readiness outcomes, although most effects were mediated through HRQOL, suggesting this may be a useful index of military spouse readiness. Insomnia was the specific health behavior most consistently associated with poorer readiness across outcomes, and effects were only partially mediated by physical and mental HRQOL. CONCLUSIONS The results show spouse health behaviors are directly and indirectly (through HRQOL) associated with readiness indicators. This suggests that assessments of modifiable health behaviors (e.g., insomnia symptoms) and mental and physical HRQOL are important indicators of readiness among military spouses and should be used to inform future programs designed to improve population health.
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Affiliation(s)
- Nida H Corry
- Health Care Evaluation, NORC at the University of Chicago, Chicago, IL, USA
| | - Sharmini Radakrishnan
- Division of Health and Environment, Abt Associates, Rockville, MD, USA.
- , 10 Fawcett St, Cambridge, MA, 02138, USA.
| | | | - Kelly A Woodall
- , Leidos, Reston, VA, USA
- Deployment Health Research Department, Naval Health Research Center, San Diego, CA, USA
| | - Valerie A Stander
- Deployment Health Research Department, Naval Health Research Center, San Diego, CA, USA
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Wang T, Tang H, Li X, Wu L, Li N, Zhang W, Shao Q, Cai M, Shang L. Development and preliminary evaluation of the Comprehensive Health Self-Assessment Questionnaire (CHSAQ) for individuals in the Chinese People Liberation Army. BMC Public Health 2024; 24:610. [PMID: 38408976 PMCID: PMC10895798 DOI: 10.1186/s12889-024-18085-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 02/13/2024] [Indexed: 02/28/2024] Open
Abstract
OBJECTIVE There is currently no widely accepted multidimensional health assessment questionnaire for individuals in the Chinese People Liberation Army (PLA). This study developed a multidimensional health survey questionnaire (Comprehensive Health Self-Assessment Questionnaire, CHSAQ) suitable for personnel in the PLA and conducted a preliminary examination of its reliability, validity, and discriminative ability. METHODS After 183 items from 32 dimensions were selected to form the initial version of the CHSAQ, three groups of soldiers were selected from May 2022 to April 2023 and completed three survey rounds (with 183, 131, and 55 valid items). The items were screened based on classic test theory. After screening, the final questionnaire entries were formed, the structure of the questionnaire was explored through exploratory factor analysis and confirmatory factor analysis, and its reliability, structural validity, and discriminative ability were evaluated. RESULTS The final questionnaire consisted of 8 dimensions and 55 items on job satisfaction, anxiety and depression, daily activities, physical function, the otolaryngology system, the integumentary system, sleep disorders, and the visual system. The total cumulative variance contribution rate was 64.648% according to exploratory factor analysis. According to the confirmatory factor analysis, the normed fit index (NFI) was 0.880, and the comparison fit index (CFI) was 0.893 (close to 0.90). The Cronbach's α coefficient of the total questionnaire was 0.970, the split half reliability coefficient was 0.937, and the retest reliability coefficient was 0.902. The results are presented as different pairwise comparisons. CONCLUSION Our study developed a self-report questionnaire for evaluating the comprehensive health status of personnel in the PLA in accordance with the standard procedure for questionnaire development. Our findings also showed that the CHSAQ for individuals in the PLA has good reliability and structural validity.
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Affiliation(s)
- Tao Wang
- Department of Health Statistics, School of Public Health, the Fourth Military Medical University, 710032, Xi'an, Shaanxi, China
- The Medical Department, Xijing Hospital, the Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Han Tang
- Department of Health Statistics, School of Public Health, the Fourth Military Medical University, 710032, Xi'an, Shaanxi, China
| | - Xinrui Li
- Department of Health Statistics, School of Public Health, the Fourth Military Medical University, 710032, Xi'an, Shaanxi, China
| | - Lin Wu
- Department of Military Medical Psychology, the Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Ning Li
- Department of Psychiatry, Xijing Hospital, the Fourth Military Medical University, 710032, Xi'an, Shaanxi, China
| | - Wei Zhang
- Department of Health Statistics, School of Public Health, the Fourth Military Medical University, 710032, Xi'an, Shaanxi, China
| | - Qiongjie Shao
- Department of Health Statistics, School of Public Health, the Fourth Military Medical University, 710032, Xi'an, Shaanxi, China
- Department of Thoracic Surgery, Tangdu Hospital, the Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Min Cai
- Department of Psychiatry, Xijing Hospital, the Fourth Military Medical University, 710032, Xi'an, Shaanxi, China.
| | - Lei Shang
- Department of Health Statistics, School of Public Health, the Fourth Military Medical University, 710032, Xi'an, Shaanxi, China.
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Olapeju B, Ahmed AE, Chu K, Yoon J, Mancuso JD. Perceived Health Status and Medical Conditions Among US Active-Duty Service Members. Psychol Res Behav Manag 2023; 16:5121-5138. [PMID: 38146390 PMCID: PMC10749538 DOI: 10.2147/prbm.s429341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 11/27/2023] [Indexed: 12/27/2023] Open
Abstract
Purpose This paper investigates the association between self-reported perceived health status and doctor-informed medical conditions among US active duty service members (ADSM). Methods Data are from the 2018 Health-Related Behaviors Survey - a cross-sectional survey weighted to represent the US military (N = 17166). Perceived good health status was defined as having a response choice of "good", "very good", or "excellent" to the question: Would you say your overall physical health is ___? Medical conditions were based on self-reported presence of nine clinical conditions. Analysis included weighted prevalence and log-binomial regression models to explore relationships between ADSM characteristics with perceived good health status as well as concordance between perceived status and medical conditions. Results ADSM rated their health to be excellent (14.6%), very good (37.7%), good (36.2%), fair (9.7%) and poor (1.7%). About 88.5% perceived a good (to excellent) health status. Perceived good health status was negatively associated with the number of medical conditions present (adjusted odds ratio (aOR): ranging from 0.78 to 0.92) as well as several health behaviors (aOR): ranging from 0.86 to 0.98) and other sociodemographic factors. Among all ADSMs, 51% perceived good health in the absence of medical conditions, while 8% perceived poor health status in the presence of medical conditions. Concordance between perceived health status and medical conditions was significantly lower among ADSM who were older (aOR: 0.61; 95% CI: 0.54-0.69), with dependent children (aOR: 0.89; 95% CI: 0.84-0.95), or had been deployed (aOR: 0.89, 95% CI: 0.84-0.95). Conclusion The prevalence of perceived good health status among ADSMs was consistent with those documented in the general US population. The interrelationships between ADSM's perceptions, medical conditions and sociodemographic characteristics may have implications for their health literacy and utilization of health services. Study findings suggest that interventions promoting healthy behaviors, health literacy and treatment-seeking may influence perceived health status and mitigate medical conditions among ADSM, thus improving the US Military readiness, resilience and mission success.
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Affiliation(s)
- Bolanle Olapeju
- Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Anwar E Ahmed
- Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Kasi Chu
- Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Jangho Yoon
- Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - James D Mancuso
- Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
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Comparisons of Baseline Obesity Prevalence and Its Association with Perceived Health and Physical Performance in Military Officers. BIOLOGY 2022; 11:biology11121789. [PMID: 36552298 PMCID: PMC9774890 DOI: 10.3390/biology11121789] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 12/05/2022] [Accepted: 12/06/2022] [Indexed: 12/13/2022]
Abstract
Increasing obesity rates among USA military members vary by age, pay grade, and measurement methods and threaten force fitness and readiness. Limited research has directly measured obesity among officers; those enrolled in graduate school at the Command and General Staff College (CGSC) face additional demands and increased obesity risk. This study compared obesity measurements and performance on the Army Physical Fitness test and self-rated health for a sample of mostly CGSC officers. Participants (n = 136, 75.7% male, 79.6% officers) completed body composition measures; BMI, body fat percentage (BF%), waist circumference (WC), and waist-to-height ratio (WHtR) estimated obesity rates and were compared for discordance. Army Physical Fitness Test pass/fail rates and self-reported perceived health were compared with each obesity classification. Obesity prevalence was 18.5-39.7%, differing by sex and measure. BMI, WC, and WHtR underestimated obesity compared to BF% at least 21% of the time. WHtR had the lowest discordance with BF%. Soldiers categorized as obese were significantly more likely to fail the fitness test and report lower self-rated health than non-obese soldiers. Overall, obesity rates among our primarily officer sample were higher than previous studies, particularly for women. Interventions to address obesity are necessary among military officers to optimize human performance.
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Hruby A, Lieberman HR, Smith TJ. Behavioral correlates of self-reported health status in US active duty military. Prev Med 2020; 131:105930. [PMID: 31765709 DOI: 10.1016/j.ypmed.2019.105930] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 10/10/2019] [Accepted: 11/21/2019] [Indexed: 10/25/2022]
Abstract
Trends and relationships between health behaviors and conditions in US active duty military and Coast Guard personnel are understudied. Self-reported data from the 2011 and 2015 Department of Defense Health Related Behaviors Surveys were analyzed to estimate associations between seven behaviors (reasons for not exercising; moderate, vigorous, and strength training exercise; alcohol intake; sleep; and smoking) and five health conditions (high blood pressure [BP], blood sugar [BG], cholesterol [CH]; overweight/obesity [OW]; or obesity [OB]). In 33,531 respondents, 14.8%, 1.7%, 13.6%, 65.5%, and 12.1% had high BP, BG, CH, OW, or OB, respectively. Respondents in 2015, versus 2011, had higher odds of BP, BG, OW, and OB. Compared to exercising as much as desired, citing a disability or injury, or work commitments as reasons for not exercising associated with higher odds of each condition. Longer sleep associated with lower odds of each condition except BG. Current and former smoking associated with higher odds of BP; former smoking also associated with higher odds of high CH and OW. Three behaviors contributing to the best predictive models of each condition resulted in associations of reasons for not exercising with all conditions; strength training for OW and OB; alcohol intake for BP and BG; sleep for BP and CH; and moderate exercise for BG. Disability and injury and time constraints limiting exercise were consistent markers of self-reported health conditions. Military-specific initiatives to promote strategies for overcoming barriers to exercising, continued emphasis on adequate sleep, and reduction of alcohol intake and smoking are warranted.
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Affiliation(s)
- Adela Hruby
- Military Nutrition Division, US Army Research Institute of Environmental Medicine, Natick, MA 01760, USA; Henry Jackson Foundation for the Advancement of Military Medicine, 6720-A Rockledge Drive, Suite 100, Bethesda, MD 20817, USA; Nutritional Epidemiology Program, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA 02111, USA
| | - Harris R Lieberman
- Military Nutrition Division, US Army Research Institute of Environmental Medicine, Natick, MA 01760, USA
| | - Tracey J Smith
- Military Nutrition Division, US Army Research Institute of Environmental Medicine, Natick, MA 01760, USA.
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Šimenko J, Kovčan B, Pori P, Vodičar J, Vodičar M, Hadžić V. The Relationship Between Army Physical Fitness and Functional Capacities in Infantry Members of the Slovenian Armed Forces. J Strength Cond Res 2019; 35:3506-3512. [PMID: 31800475 DOI: 10.1519/jsc.0000000000003344] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Šimenko, J, Kovčan, B, Pori, P, Vodičar, J, Vodičar, M, and Hadžić, V. The Relationship between army physical fitness and functional capacities in infantry members of the Slovenian Armed Forces. J Strength Cond Res XX(X): 000-000, 2019-The primary purpose of this study was to determine the relationship between traditional army physical fitness test (APFT) and a novel functional testing battery that included counterMovement jump (CMJ) testing, stork balANce test, pUll-ups, single leg hAmstring bridge test, and loaded prone pLank test-MANUAL battery. The secondary purpose was to explore additional baseline fitness aspects traditionally not covered by APFT. This cross-sectional study involved 181 Slovenian Armed Forces (SAF) infantry members (age 31.4 ± 6.1 years) that were tested using both the regular annual APFT and the MANUAL battery (testing was conducted 2 weeks apart). At the significance level of p ≤ 0.05, significant but weak associations between the MANUAL testing battery and APFT battery (0.2 ≦ r < 0.5; p ≤ 0.05) were observed. The MANUAL battery has highlighted possible hamstring (less than 20 repetitions on a single leg bridge test in 26% of SAF infantry members) and posterior shoulder pull-up muscle weakness (mean score 5 ± 4 pull-ups). Functional predictors from the MANUAL explained only 33.6% of the APFT score (R = 0.336). Significant predictors of APFT score were single leg hamstring left (p = 0.048), loaded plank (p = 0.049), number of pull-ups (p < 0.001), CMJ (p = 0.01), and loaded CMJ (p = 0.026). The findings suggest that higher APFT marks are associated with better performance on the MANUAL tests and indicate the problem of hamstring and pull-up muscle weakness. The general recommendation is that the physical condition military programs should include more exercises to strengthen those muscle groups.
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Affiliation(s)
- Jožef Šimenko
- University of Essex, Essex Pathways Department, Colchester, United Kingdom
| | | | - Primož Pori
- Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia
| | - Janez Vodičar
- Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia
| | - Miha Vodičar
- Department of Orthopedic Surgery, University Medical Center Ljubljana, Ljubljana, Slovenia
| | - Vedran Hadžić
- Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia
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Hansen UM, Olesen K, Browne JL, Skinner TC, Willaing I. A call for inclusion of work-related diabetes distress in the spectrum of diabetes management: Results from a cross-sectional survey among working people with type 1 diabetes. Diabetes Res Clin Pract 2018; 140:139-147. [PMID: 29604390 DOI: 10.1016/j.diabres.2018.03.040] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Revised: 02/27/2018] [Accepted: 03/23/2018] [Indexed: 02/06/2023]
Abstract
AIM Diabetes distress captures a range of emotional responses and reactions to life with diabetes and is considered a part of the experience of managing diabetes and its treatment. Given the importance of the social context of work life for people of working age we set out to explore whether work-related diabetes distress is a distinct and important dimension of diabetes-related emotional distress in working people with type 1 diabetes. METHODS A questionnaire with self-reported measures of psychosocial health and well-being at work was completed by 1126 working people with type 1 diabetes from a specialist diabetes clinic in Denmark. Work-related diabetes distress was assessed with two questions about worry and exhaustion related to reconciling work life and diabetes. Diabetes-related emotional distress was assessed with the Problem Areas in Diabetes scale (PAID-5), a short form version of the full PAID scale. We performed inter-item correlation analyses, exploratory factor analysis, and hierarchical multiple regression analyses. RESULTS Inter-item correlations and exploratory factor analysis indicated that work-related diabetes distress was distinct from diabetes-related emotional distress. Further, work-related diabetes distress was found to be a unique contributor to work ability, quality of life, intentional hyperglycaemia at work, and absenteeism, after adjusting for covariates and diabetes-related emotional distress. CONCLUSIONS The findings suggest that work-related diabetes distress captures an aspect of distress so far unaccounted for in workers with type 1 diabetes. Further studies are needed to strengthen the conceptual basis of work-related diabetes distress, explore its clinical usefulness and clarify its risk factors.
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Affiliation(s)
- Ulla M Hansen
- Steno Diabetes Center Copenhagen, Gentofte, Denmark; University of Southern Denmark, National Institute of Public Health, Copenhagen, Denmark.
| | | | - Jessica L Browne
- Deakin University, Geelong, School of Psychology, Victoria, Australia; The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, Victoria, Australia
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