1
|
Khodr ZG, McAnany J, Haile YG, Perez VG, Rohrbeck P. A summary of the U.S. Marine Recruit Assessment Program (RAP) procedures and survey from 2003 to 2021. MSMR 2024; 31:2-8. [PMID: 38466968 PMCID: PMC10957181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/13/2024]
Abstract
The Recruit Assessment Program (RAP) is a cross-sectional, baseline survey of U.S. Marine recruits administered at Marine Corps Recruit Depot, San Diego. This report presents RAP study procedures and survey content that was administered to 229,015 participants between 2003 and 2021. Self-reported data were collected on recruit demographics, physical and mental health, adverse life experiences, lifestyle and risky behaviors, and substance use. In 2013, the survey was updated to remove questions with other linkable and reliable sources and those with low completion rates and low relevance to Marine health research; the removal of these items allowed for the addition of instrument measures for major depression, post-traumatic stress disorder, anger, and resilience with no significant change to overall survey length. Average completion rates are approximately 95%. Multiple studies have shown the utility of RAP data collected thus far as a robust data repository of pre-service health and behavioral measures.
Collapse
Affiliation(s)
| | | | | | | | - Patricia Rohrbeck
- Military Population Health Directorate, Naval Health Research Center, San Diego, CA
| |
Collapse
|
2
|
Harbertson J, Hale BR, Tran BR, Thomas AG, Grillo MP, Jacobs MB, McAnany J, Shaffer RA. Self-reported HIV-positive status but subsequent HIV-negative test result using rapid diagnostic testing algorithms among seven sub-Saharan African military populations. PLoS One 2017; 12:e0180796. [PMID: 28686678 PMCID: PMC5501598 DOI: 10.1371/journal.pone.0180796] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Accepted: 06/21/2017] [Indexed: 11/19/2022] Open
Abstract
HIV rapid diagnostic tests (RDTs) combined in an algorithm are the current standard for HIV diagnosis in many sub-Saharan African countries, and extensive laboratory testing has confirmed HIV RDTs have excellent sensitivity and specificity. However, false-positive RDT algorithm results have been reported due to a variety of factors, such as suboptimal quality assurance procedures and inaccurate interpretation of results. We conducted HIV serosurveys in seven sub-Saharan African military populations and recorded the frequency of personnel self-reporting HIV positivity, but subsequently testing HIV-negative during the serosurvey. The frequency of individuals who reported they were HIV-positive but subsequently tested HIV-negative using RDT algorithms ranged from 3.3 to 91.1%, suggesting significant rates of prior false-positive HIV RDT algorithm results, which should be confirmed using biological testing across time in future studies. Simple measures could substantially reduce false-positive results, such as greater adherence to quality assurance guidelines and prevalence-specific HIV testing algorithms as described in the World Health Organization’s HIV testing guidelines. Other measures to improve RDT algorithm specificity include classifying individuals with weakly positive test lines as HIV indeterminate and retesting. While expansion of HIV testing in resource-limited countries is critical to identifying HIV-infected individuals for appropriate care and treatment, careful attention to potential causes of false HIV-positive results are needed to prevent the significant medical, psychological, and fiscal costs resulting from individuals receiving a false-positive HIV diagnosis.
Collapse
Affiliation(s)
- Judith Harbertson
- Department of Defense HIV/AIDS Prevention Program, Naval Health Research Center, San Diego, California, United States of America
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, United States of America
- Leidos, Inc., Reston, Virginia, United States of America
- * E-mail:
| | - Braden R. Hale
- Department of Defense HIV/AIDS Prevention Program, Naval Health Research Center, San Diego, California, United States of America
- University of California, San Diego, La Jolla, California, United States of America
| | - Bonnie R. Tran
- Department of Defense HIV/AIDS Prevention Program, Naval Health Research Center, San Diego, California, United States of America
- Leidos, Inc., Reston, Virginia, United States of America
| | - Anne G. Thomas
- Department of Defense HIV/AIDS Prevention Program, Naval Health Research Center, San Diego, California, United States of America
- Leidos, Inc., Reston, Virginia, United States of America
| | - Michael P. Grillo
- Department of Defense HIV/AIDS Prevention Program, Naval Health Research Center, San Diego, California, United States of America
| | - Marni B. Jacobs
- Department of Defense HIV/AIDS Prevention Program, Naval Health Research Center, San Diego, California, United States of America
- Leidos, Inc., Reston, Virginia, United States of America
| | - Jennifer McAnany
- Department of Defense HIV/AIDS Prevention Program, Naval Health Research Center, San Diego, California, United States of America
- Leidos, Inc., Reston, Virginia, United States of America
| | - Richard A. Shaffer
- Department of Defense HIV/AIDS Prevention Program, Naval Health Research Center, San Diego, California, United States of America
| |
Collapse
|
3
|
Harbertson J, Scott PT, Moore J, Wolf M, Morris J, Thrasher S, D'Onofrio M, Grillo MP, Jacobs MB, Tran BR, Tian J, Ito SI, McAnany J, Michael N, Hale BR. Sexually transmitted infections and sexual behaviour of deploying shipboard US military personnel: a cross-sectional analysis. Sex Transm Infect 2016; 91:581-8. [PMID: 26586849 DOI: 10.1136/sextrans-2015-052163] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Sexually transmitted infection (STI) prevalence and risk behaviour may differ at different phases of deployment. We examined STI prevalence and sexual behaviour in the predeployment time period (12 months prior) among recently deployed shipboard US Navy and Marine Corps military personnel. METHODS Data were collected from 1938 male and 515 female service members through an anonymous, self-completed survey assessing sexual behaviours and STI acquisition characteristics in the past 12 months. Cross-sectional sex-stratified descriptive statistics are reported. RESULTS Overall, 67% (n=1262/1896) reported last sex with a military beneficiary (spouse, n=931, non-spouse service member, n=331). Among those with a sexual partner outside their primary partnership, 24% (n=90/373) reported using a condom the last time they had sex and 30% (n=72/243) reported their outside partner was a service member. In total, 90% (n=210/233) reported acquiring their most recent STI in the USA (88%, n=126/143 among those reporting ≥1 deployments and an STI ≥1 year ago) and a significantly higher proportion (p<0.01) of women than men acquired the STI from their regular partner (54% vs 21%) and/or a service member (50% vs 26%). CONCLUSIONS Findings suggest a complex sexual network among service members and military beneficiaries. Findings may extend to other mobile civilian and military populations. Data suggest most STI transmission within the shipboard community may occur in local versus foreign ports but analyses from later time points in deployment are needed. These data may inform more effective STI prevention interventions.
Collapse
Affiliation(s)
- Judith Harbertson
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland, USA Department of Defense HIV/AIDS Prevention Program (DHAPP), Naval Health Research Center, San Diego, California, USA
| | - Paul T Scott
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA
| | - John Moore
- Third Fleet, US Navy, San Diego, California, USA
| | - Michael Wolf
- Third Fleet, US Navy, San Diego, California, USA
| | - James Morris
- Third Fleet, US Navy, San Diego, California, USA
| | | | - Michael D'Onofrio
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA
| | - Michael P Grillo
- Department of Defense HIV/AIDS Prevention Program (DHAPP), Naval Health Research Center, San Diego, California, USA
| | - Marni B Jacobs
- Department of Defense HIV/AIDS Prevention Program (DHAPP), Naval Health Research Center, San Diego, California, USA
| | - Bonnie R Tran
- Department of Defense HIV/AIDS Prevention Program (DHAPP), Naval Health Research Center, San Diego, California, USA
| | - Jun Tian
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland, USA
| | - Stanley I Ito
- Department of Defense HIV/AIDS Prevention Program (DHAPP), Naval Health Research Center, San Diego, California, USA
| | - Jennifer McAnany
- Department of Defense HIV/AIDS Prevention Program (DHAPP), Naval Health Research Center, San Diego, California, USA
| | - Nelson Michael
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA
| | - Braden R Hale
- Department of Defense HIV/AIDS Prevention Program (DHAPP), Naval Health Research Center, San Diego, California, USA Division of Infectious Diseases, Department of Medicine, University of California School of Medicine, San Diego, California, USA
| |
Collapse
|
4
|
Hurtado SL, Simon-Arndt CM, McAnany J, Crain JA. Acceptability of mental health stigma-reduction training and initial effects on awareness among military personnel. Springerplus 2015; 4:606. [PMID: 26543741 PMCID: PMC4628072 DOI: 10.1186/s40064-015-1402-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Accepted: 10/06/2015] [Indexed: 11/23/2022]
Abstract
The purpose of this paper is to report on the development of a mental health stigma reduction toolkit and training, and the acceptability and level of stigma awareness following the stigma-reduction training for military personnel. The overall aims of the training were to provide discussion tools highlighting the experiences of Marines seeking help for stress concerns, improve communication between leaders and their Marines around the issue of help seeking, and familiarize Marines with behavioral health treatment. Senior enlisted leaders and officers (N = 52) from a Marine Corps battalion participated in a pretest, 2-h stigma-reduction training and immediate posttest. Acceptability of the training was measured by querying participants about the usefulness and helpfulness of the training among other factors, and stigma awareness was measured with 10 items about mental health stigma. The stigma-reduction training and materials were well accepted by participants. In addition, there was a significant improvement in four of ten stigma-reduction awareness concepts measured before and immediately after the training, which included an increase in agreement that mental health treatments are usually effective in reducing stress reactions [t(51) = −3.35, p = 0.002], and an increase in disagreement that seeking counseling after a deployment will jeopardize future deployments [t(51) = −3.05, p = 0.004]. Level of agreement with several statements including those regarding perceptions of invincibility, and malingering, among others, did not change significantly after the training. The stigma-reduction training containing educational and contact strategies was highly acceptable to the leaders and may have promise for initially dispelling myths associated with seeking help for stress concerns among military service members; however, results indicate that there is clearly more work to be done in combatting stigma.
Collapse
Affiliation(s)
- Suzanne L Hurtado
- Health and Behavioral Sciences, Naval Health Research Center, 140 Sylvester Road, San Diego, CA 92106-3521 USA
| | - Cynthia M Simon-Arndt
- Health and Behavioral Sciences, Naval Health Research Center, 140 Sylvester Road, San Diego, CA 92106-3521 USA
| | - Jennifer McAnany
- Health and Behavioral Sciences, Naval Health Research Center, 140 Sylvester Road, San Diego, CA 92106-3521 USA
| | - Jenny A Crain
- Health and Behavioral Sciences, Naval Health Research Center, 140 Sylvester Road, San Diego, CA 92106-3521 USA
| |
Collapse
|