1
|
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.
Collapse
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
| |
Collapse
|
2
|
Nieforth LO, Leighton SC, Schwichtenberg AJ, MacDermid Wadsworth S, O’Haire ME. A Preliminary Analysis of Psychiatric Service Dog Placements and Sleep Patterns of Partners of Veterans With PTSD. ANTHROZOOS 2023; 37:125-136. [PMID: 38707260 PMCID: PMC11067924 DOI: 10.1080/08927936.2023.2268979] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2024]
Abstract
Partners of veterans diagnosed with posttraumatic stress disorder (PTSD) are at risk of a variety of challenges, and it is unknown whether psychiatric service dogs are disruptive to their sleep or provide similar benefits that are seen in the limited literature on veterans. As part of a larger clinical trial examining the efficacy of psychiatric service dogs for veterans with PTSD and their families, this study focused on sleep patterns of veterans' partners (n = 88), incorporating both subjective (clinically validated self-report surveys) and objective sleep measures (actigraphy). Linear regression was used to analyze differences in relation to group (intervention versus control) at follow up, controlling for baseline score. Results revealed no significant differences between groups for both the subjective surveys (p = 0.15; p = 0.75) and the objective actigraphy measures (p = 0.06-0.98). This suggests that psychiatric service dogs are not disruptive, nor do they provide any benefits to partner sleep. Partners had sleep patterns on par with national norms at baseline and remained at such levels at follow up. Ultimately, using both subjective and objective measures, we found no impact of psychiatric service dogs on the sleep of veterans' partners.
Collapse
Affiliation(s)
- Leanne O. Nieforth
- College of Veterinary Medicine, University of Arizona, Oro Valley, Arizona, USA. Now at Center for the Human-Animal Bond, Purdue University College of Veterinary Medicine, USA
- Center for the Human-Animal Bond, College of Veterinary Medicine, Purdue University, West Lafayette, Indiana, USA
| | - Sarah C. Leighton
- College of Veterinary Medicine, University of Arizona, Oro Valley, Arizona, USA. Now at Center for the Human-Animal Bond, Purdue University College of Veterinary Medicine, USA
| | - A. J. Schwichtenberg
- Human Development and Family Studies, Purdue University, West Lafayette, Indiana, USA
| | | | - Marguerite E. O’Haire
- College of Veterinary Medicine, University of Arizona, Oro Valley, Arizona, USA. Now at Center for the Human-Animal Bond, Purdue University College of Veterinary Medicine, USA
| |
Collapse
|
3
|
Joneydi R, Sparks AC, Kolenikov S, Jacobson IG, Knobloch LK, Williams CS, Pflieger JC, Corry NH, Stander VA. Partner Effects: Analyzing Service Member and Spouse Drinking Over Time. Am J Prev Med 2023; 65:627-639. [PMID: 37059344 DOI: 10.1016/j.amepre.2023.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 04/07/2023] [Accepted: 04/09/2023] [Indexed: 04/16/2023]
Abstract
INTRODUCTION Excessive alcohol use is a significant problem in the military. Although there is a growing emphasis on family-centered alcohol prevention approaches, little is known about the interplay between partners' drinking behaviors. This study examines how service members and their spouses influence each other's drinking behavior over time and explores the complex individual, interpersonal, and organizational factors that may contribute to alcohol use. METHODS A sample of 3,200 couples from the Millennium Cohort Family Study was surveyed at baseline (2011-2013) and follow-up (2014-2016). The research team estimated how much partners' drinking behaviors influenced one another from baseline to follow-up using a longitudinal structural equation modeling approach. Data analyses were conducted in 2021 and 2022. RESULTS Drinking patterns converged between spouses from baseline to follow-up. Participants' own baseline drinking had a small but significant effect on changes in their partners' drinking from baseline to follow-up. Results from a Monte Carlo simulation showed that the longitudinal model could reliably estimate this partner effect in the presence of several potential sources of bias, including partner selection. The model also identified several common risk and protective factors for drinking shared by both service members and their spouses. CONCLUSIONS Findings suggest that changing the drinking habits of one spouse could lead to a change in the drinking habits of the other, which supports family-centered alcohol prevention approaches in the military. Dual-military couples especially may benefit from targeted interventions because they face a higher risk of unhealthy alcohol consumption.
Collapse
Affiliation(s)
| | | | | | - Isabel G Jacobson
- Leidos, San Diego, California; Naval Health Research Center, San Diego, California
| | - Leanne K Knobloch
- Department of Communication, College of Liberal Arts & Sciences, University of Illinois, Urbana, Illinois
| | | | | | - Nida H Corry
- NORC at the University of Chicago, Chicago, Illinois
| | | |
Collapse
|
4
|
Monk JK, Ruhlmann L, Goff BSN, Ogan M, Miller MB. Translating Discovery Science. Fostering relationships: Service provider perspectives on community building among veteran families. FAMILY RELATIONS 2023; 72:1351-1367. [PMID: 37583766 PMCID: PMC10424772 DOI: 10.1111/fare.12724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Accepted: 04/25/2022] [Indexed: 08/17/2023]
Abstract
Objective We sought to identify the social process through which communal support can be established among veteran couples and families. Background On the basis of the social organization theory of action and change, a sense of community is crucial for military veterans' well-being and may serve as a resource for intervention. Method We interviewed service providers (n = 8) and corroborated their perspectives by triangulating evaluations from veteran family participants (n = 143). Data were analyzed using grounded theory techniques. Results Providers suggested promoting a sense of community in prevention and intervention programming by (a) establishing a safe and empowering space, (b) bridging existing gaps within family and community systems, and (c) encouraging interpersonal healing by promoting connection and facilitating the sharing of common experiences. Providers also described challenges to facilitating the program, including logistics, time, and funding constraints. Conclusion According to our results, fostering community among veterans and their family members may be achieved by applying an integrative approach that goes beyond siloed individual, couple, and group therapy orchestrated by practitioners. Implications We recommend multicomponent interventions that create synergy between different levels and forms of social support. Providers recommended being intentional about the program structure to focus on community strengths and shared connection.
Collapse
Affiliation(s)
- J. Kale Monk
- Department of Human Development and Family Science, University of Missouri, Columbia, MO
| | - Lauren Ruhlmann
- Department of Human Development and Family Science, Auburn University, Auburn, AL
| | | | - Matthew Ogan
- Department of Human Development and Family Science, University of Missouri, Columbia, MO
| | | |
Collapse
|
5
|
Sparks AC, Williams CS, Pflieger JC, Jacobson I, Corry NH, Radakrishnan S, Stander VA. Longitudinal Patterns of Military Spousal Alcohol Consumption: Findings From the Millennium Cohort Family Study. J Stud Alcohol Drugs 2022; 83:546-555. [PMID: 35838432 PMCID: PMC9318701 DOI: 10.15288/jsad.2022.83.546] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 01/11/2022] [Indexed: 08/16/2023] Open
Abstract
OBJECTIVE Alcohol use in the military is prevalent and has short- and long-term health, safety, and career consequences. Although several studies have examined service members' alcohol consumption, few have focused on alcohol use among military spouses. This study assessed factors at individual, interpersonal, and organizational levels to determine associations with risky alcohol use among military spouses. METHOD Data from baseline and first follow-up of the Millennium Cohort Family Study were used (N = 5,475; 4,923 female) to model spousal self-reported risky drinking (heavy and/or binge drinking) at follow-up. Predictors included demographic characteristics, spousal adverse childhood experiences and mental health, smoking status, marital status, family satisfaction, social support, military stress, and service member military characteristics. Logistic regression models assessed the adjusted associations between spouse and service member characteristics and spousal risky drinking at follow-up. RESULTS Among spouses in this sample, 19% were risky drinkers at follow-up. Baseline alcohol use status was associated with risky drinking at follow-up. Most spouses (64.2%) did not change their drinking behavior between baseline and follow-up; those who did change were nearly evenly split between an increasing (17.0%) versus decreasing (18.7%) pattern. Risk factors included male gender, cigarette smoking, elevated symptoms of post-traumatic stress, marital separation, and service member deployment with combat. CONCLUSIONS Although most military spouses were not engaging in risky drinking, one in five were, with about half of these having moved into the risky drinking category over time. Risky alcohol use among spouses has ramifications for themselves, the service member, and the family unit.
Collapse
Affiliation(s)
- Alicia C. Sparks
- Division of Health and Environment, Abt Associates, Rockville, Maryland
| | | | - Jacqueline C. Pflieger
- Leidos, San Diego, California
- Deployment Health Research Department, Naval Health Research Center, San Diego, California
| | - Isabel Jacobson
- Leidos, San Diego, California
- Deployment Health Research Department, Naval Health Research Center, San Diego, California
| | - Nida H. Corry
- Division of Health and Environment, Abt Associates, Durham, North Carolina
| | | | - Valerie A. Stander
- Deployment Health Research Department, Naval Health Research Center, San Diego, California
| |
Collapse
|
6
|
Sparks AC, Williams CS, Pflieger JC, Jacobson I, Corry NH, Radakrishnan S, Stander VA. Longitudinal Patterns of Military Spousal Alcohol Consumption: Findings From the Millennium Cohort Family Study. J Stud Alcohol Drugs 2022; 83:546-555. [PMID: 35838432 PMCID: PMC9318701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 01/11/2022] [Indexed: 07/04/2023] Open
Abstract
OBJECTIVE Alcohol use in the military is prevalent and has short- and long-term health, safety, and career consequences. Although several studies have examined service members' alcohol consumption, few have focused on alcohol use among military spouses. This study assessed factors at individual, interpersonal, and organizational levels to determine associations with risky alcohol use among military spouses. METHOD Data from baseline and first follow-up of the Millennium Cohort Family Study were used (N = 5,475; 4,923 female) to model spousal self-reported risky drinking (heavy and/or binge drinking) at follow-up. Predictors included demographic characteristics, spousal adverse childhood experiences and mental health, smoking status, marital status, family satisfaction, social support, military stress, and service member military characteristics. Logistic regression models assessed the adjusted associations between spouse and service member characteristics and spousal risky drinking at follow-up. RESULTS Among spouses in this sample, 19% were risky drinkers at follow-up. Baseline alcohol use status was associated with risky drinking at follow-up. Most spouses (64.2%) did not change their drinking behavior between baseline and follow-up; those who did change were nearly evenly split between an increasing (17.0%) versus decreasing (18.7%) pattern. Risk factors included male gender, cigarette smoking, elevated symptoms of post-traumatic stress, marital separation, and service member deployment with combat. CONCLUSIONS Although most military spouses were not engaging in risky drinking, one in five were, with about half of these having moved into the risky drinking category over time. Risky alcohol use among spouses has ramifications for themselves, the service member, and the family unit.
Collapse
Affiliation(s)
- Alicia C. Sparks
- Division of Health and Environment, Abt Associates, Rockville, Maryland
| | | | - Jacqueline C. Pflieger
- Leidos, San Diego, California
- Deployment Health Research Department, Naval Health Research Center, San Diego, California
| | - Isabel Jacobson
- Leidos, San Diego, California
- Deployment Health Research Department, Naval Health Research Center, San Diego, California
| | - Nida H. Corry
- Division of Health and Environment, Abt Associates, Durham, North Carolina
| | | | - Valerie A. Stander
- Deployment Health Research Department, Naval Health Research Center, San Diego, California
| |
Collapse
|
7
|
Speed S, Branscum P, Gresla A. Comparing Predictors of Intention for Physical Activity Participation between Normal and Overweight Military Spouses. AMERICAN JOURNAL OF HEALTH EDUCATION 2022. [DOI: 10.1080/19325037.2022.2071363] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
|
8
|
Seagle ES, Xu J, Edwards N, McComb SA. Social Networking, Social Support, and Well-being for the Military Spouse. J Nurse Pract 2021. [DOI: 10.1016/j.nurpra.2020.12.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|