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Healthy People 2020 for Military and Their Family in Health Promotion

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Association of military life experiences and wellness indicators among military spouses

  • Sharmini Radakrishnan2,
  • Christianna Due south. Williams1,
  • Alicia C. Sparks3,
  • Kelly A. Woodall4,
  • John A. Fairbankfive,6 &
  • Valerie A. Standervii

BMC Public Health book 19, Commodity number:1517 (2019) Cite this article

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Abstruse

Groundwork

The health and well-existence of military machine spouses directly contribute to a robust military force by enabling the spouse to better back up the active duty member's career. In order to understand the overall wellness and well-being of military spouses, we assessed health indicators among armed services spouses using the Healthy People 2020 framework and examined associations of these health indicators with military experiences and psychosocial factors.

Methods

Using information from the Millennium Cohort Family Study, a U.Southward. Department of Defense force-sponsored survey of 9872 spouses of service members with 2–5 years of military service, we examined attainment of Salubrious People 2020 goals for spouses and service members, including healthy weight, exercise, slumber, and booze and tobacco use. Multivariable logistic regression models assessed associations of spouse wellness indicators with stressful military machine life experiences and social back up, adjusting for demographics and military descriptors. The spousal survey was administered nationwide in 2011.

Results

The majority of military spouses met each health goal assessed. All the same, less than half met the good for you weight and the strength training goals. Reporting greater perceived family unit back up from the military was associated with better behavioral wellness outcomes, while having no one to turn to for support was associated with poorer outcomes. Using the Healthy People 2020 objectives every bit a framework for identifying key wellness behaviors and benchmarks, this study identified factors, including military-specific experiences, that may contribute to physical health behaviors and outcomes amidst military spouses. With respect to demographic characteristics, the findings are consequent with other literature that women are more likely to refrain from risky substance apply and that greater education is associated with amend overall health outcomes.

Conclusions

Findings suggest that enhanced social and military support and tailored programming for military spouses may improve wellness outcomes and contribute to the well-being of military couples. Such programming could likewise bolster force readiness and retentiveness.

Peer Review reports

Background

Promoting healthy behaviors and outcomes has long been a priority for the United States armed services, and since 1986, the Department of Defense force (DoD) has emphasized its Health Promotion and Disease Prevention directive, which provides health guidance and encourages healthy living goals amid military personnel and their beneficiaries [1]. Health behaviors that put individuals at risk of physical and social consequences are alarmingly prevalent amidst service members, particularly those involving substance apply [2,3,four]. One DoD study establish that 39.6% of all active duty electric current drinkers reported binge drinking in the by month; and 24.five% of active duty service members reported cigarette use in the past month; additionally, 51.two% of active duty personnel were classified equally overweight, despite the military machine'southward high physical health standards [iii]. Poor health behaviors negatively affect not only the private, but also their families and broader society, causing an increase in missed days from piece of work and health care costs [5]. The wellness and well-beingness of military spouses likewise directly contribute to a robust military force by enabling the spouse to better back up the active duty member'south career [half dozen] and have pregnant health care cost implications. A study of TRICARE beneficiaries (dependents of active duty personnel, military retirees, and dependents of military retirees) found that each year DoD spends approximately $2.1 billion for medical care associated with obesity, alcohol use, and tobacco apply [two].

There is less data available regarding the health of military spouses compared to service members; nonetheless, some studies shed light on potential wellness problems. A 2012 presentation found that one in five Army active duty spouses are overweight, one third are obese [vii] and studies suggest that service fellow member deployment is not a predictor of spouses' overweight or obesity [viii, 9]. Approximately 8.ii% of military spouses married to service members with 2–5 years of experience reported alcohol misuse [ten] and unhealthy alcohol use among military spouses was associated with feeling bothered by advice near the service member'south deployment experiences likewise every bit the spouse feeling stressed by a combat-related deployment or duty assignment [eleven].

In an effort to combat health disparities and to improve health outcomes for all Americans, the U.S. Department of Wellness and Human Services launched a health promotion programme and evaluation measure called the Healthy People initiative [12]. The Healthy People 2010 initiative (HP2010) analyzed 28 dissimilar focus areas containing 467 measurable objectives of physical health from 2000 to 2010, and these objectives were updated for Healthy People 2020 (HP2020) [13]. Although research on the U.S. population shows that particular population groups are disproportionally afflicted past poor wellness outcomes and have less access to preventive intendance (e.g., individuals living below the poverty line, individuals in rural populations, and racial/ethnic/sexual minorities) [14,15,16,17,eighteen], there has been very fiddling research investigating the relative accomplishment of Healthy People objectives amongst military machine populations, and particularly military spouses. In a 2006 study, cocky-reported service members' health behaviors met or exceeded 7 of the xix HP2010 objectives assessed, including those related to obesity and exercise [19]. Kress and colleagues assessed HP2010 objectives among military retirees and their spouses and constitute that fewer retirees and beneficiaries met obesity, exercise, substance use, and healthy eating objectives than national target percentages [twenty]. Existence male person, having less than a higher caste, and less-than-splendid self-reported wellness status were associated with a lower likelihood of meeting the objectives [20, 21].

Despite DoD's commitment to the wellness and well-beingness of all members of the military community, military spouses may exist at greater run a risk for poor health behaviors than their armed services partners or noncombatant counterparts. Military spouses practise non take the same incentives and structure to help them maintain their health, all the same they are exposed to many stressors unique to military life, such as relocation and deployment, that may challenge healthy living [22, 23]. Additionally, access to armed services health promotion programs and support systems that have been shown to reduce poor health behaviors [24,25,26] is uneven, specially for certain subgroups, such every bit male and minority spouses and spouses of those serving in National Baby-sit and Reserve components.

In order to empathise the overall health and well-beingness of war machine spouses, the current study aimed to investigate various health behaviors and indices, including weight, exercise, sleep, and substance apply, using data from the Millennium Cohort Family Study (henceforth referred to as the Family Study), which is a probability-based cohort [27,28,29]. We have used the HP2020 goals framework to assess wellness indicators amongst armed forces spouses and assess associations betwixt these health indicators, operationalized as attainment of HP2020 goals in several domains, and sociodemographic characteristics, military experiences, and psychosocial factors.

Methods

Sample design and study participants

This assay used the Family Study baseline sample, which consists of 9872 service fellow member/spouse dyads. The service members are participants in the Millennium Cohort Study who were married and had two to 5 years of military service as of 2011. Married and female service members were oversampled in the Millennium Cohort Study to ensure that male spouses of female service members were adequately represented in the Family Study. Spouses of participating service members were then recruited in 2012 to complete the dyads. The sample is unique in that it includes a representative sample of young military couples, from all service branches and components (active duty, military Reserve, and National Guard participants).

The Family Report methods are described in more detail elsewhere [27,28,29]. The Family Study was overseen and approved by the Naval Health Enquiry Heart's Institutional Review Board (Protocol 2000.0007) and the Part of Management and Budget (approval number 0720–0029). Written or electronic informed consent was obtained from all participants.

Measures

Service members and their spouses independently completed surveys addressing various aspects of concrete and mental health also equally their wellness behaviors. Additionally, participants provided permission to merge their survey responses with archival information on their military machine personnel and medical treatment records. Although the analyses for this paper focused primarily on the spouses' survey responses regarding health, nosotros did include several predictors and covariates from Millennium Cohort research program data resource, described below.

Health outcomes

Half-dozen dichotomous indicators were used to place spouses who met the HP2020 goals with respect to healthy weight (body mass index; BMI), aerobic practice, forcefulness training, sleep, alcohol apply (risky drinking), and tobacco utilize (current smoking). The criterion definitions for each of the goals map on closely to the respective HP2020 goals and are detailed in Tabular array one. For aerobic practise and forcefulness grooming goals, spouses who stated that they did non or were unable to physically engage in these types of practice were coded as not meeting the goals. Service member health indicators were measured in the same manner as the corresponding spouse wellness measures.

Table 1 Definitions of Health People 2020 Goals

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Social support and armed forces stress experiences

Measures of military and social support were included as independent variables. Armed services back up was measured with 2 items: perceived military support for the spouse and their family and perceived military support for the service member. These are both ordinal variables, where 0 = "Poor", 1 = "Fair", 2 = "Proficient", 3 = "Very proficient", and iv = "Splendid." Four ordinal items addressed social support for the spouse respondent. 1 item from the Patient Wellness Questionnaire (the degree to which you are bothered by not having someone to plow to in the final iv weeks) had iii categories (1 = "Non bothered", 2 = "Bothered a little", 3 = "Bothered a lot"). Spouses were asked 3 additional questions about social support (having someone to turn to when dealing with personal problems, having someone to tell yous honestly how you are treatment problems, and how well family and friends have supported you in the last iv weeks) on 5-point scales (0 = "Strongly disagree" or "Not at all" to 4 = "Strongly agree" or "Extremely").

Other independent variables included 4 aspects of the stress of armed forces life: deployment stress, injury stress, family stress, and stress resulting from one or more permanent change of station (PCS) moves. For each of first three domains: deployment (e.1000., a combat-related deployment or duty assignment for your spouse), injury (e.g., combat-related injury to your spouse), and family stress (e.g., difficulty balancing demands of family unit life and your spouse's war machine duties), the mean of iii items was calculated [27]. Each of the items was scored from 0 to four (0 =never experienced, one =non at all stressful, 2 =slightly stressful, 3 =moderately stressful, 4 =very stressful). The deployments and injuries referred to past these items were experienced by the service fellow member, non the spouse. A single item assessed the perceived stress of PCS moves with the same 0–iv scoring every bit the other war machine stress items.

Covariates

In addition to the independent variables listed above, nosotros included spouse sociodemographics and several service member's military characteristics. Spouses' cocky-reported characteristics included gender, historic period, race and ethnicity, educational attainment, employment status, annual household income, number of children, and prior or current armed forces service. Participants were asked to select from the post-obit race/ethnicity options: White non-Hispanic, Black non-Hispanic, Asian/Pacific Islander, Hispanic, Native American, or Other. For analytic purposes, participant were categorized equally White non-Hispanic, Black non-Hispanic, or Other. Service member military machine characteristics included pay grade (officer vs enlisted), co-operative of service (Regular army, Air Strength, Navy, Marine Corps, Coast Guard), and component (agile duty vs Reserve or National Guard). These information were obtained from administrative records provided by the Defense Manpower Information Center.

Analyses

After generating descriptive statistics on the demographics and measures of stress and back up, nosotros examined attainment of six HP2020 goals for the spouses and service members by calculating the proportions meeting each goal. Additionally, we examined the concordance of spouse-service member pairs with respect to goal attainment in each domain. Finally, nosotros estimated a multivariable logistic regression model for each spouse health outcome to investigate its unique associations with armed forces life experiences and social support, equally well as with the demographic and military machine characteristics. All social and armed services back up independent variables were used every bit continuous measures in the models. Adjusted odds ratios can exist interpreted as the relative change in odds of a particular spouse meeting a health indicator associated with each boosted military stressor experienced or a i-unit increase in perceived social back up. All analyses were weighted to account for the sample pattern and nonresponse; these weights allow the findings to exist generalized to the population of married spouses of service members with 2 to v years of military machine experience [29].

Results

Population clarification

Most spouses were female (86%) and between 25 and 34 (62.i%) years of age (Table 2). More than than 70% were White and 53.2% had some higher experience or an associate degree. Approximately two thirds (63%) had at to the lowest degree 1 child. The vast bulk of spouses (eighty.6%) had no history of war machine service; ix.four% were currently serving in the military. Half of the spouses' service member partners served in the Regular army, followed by 17.4% in the Air Forcefulness, 15.3% in the Marine Corps, xiv.ii% in the Navy, and 2.8% in the Coast Baby-sit.

Table 2 Description of Family Written report Cohort (2012) (N = 9872)

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Good for you People 2020 objectives

Figure 1 shows HP2020 goal attainment by military spouses and service members. Overall, the majority of spouses and service members met each of the HP2020 goals analyzed (as defined in Tabular array ane). More than half of the responding spouses met the goals related to aerobic exercise (69.i%), sleep (lx.7%), alcohol use (75.7%), and tobacco use (79.4%). Only 44.2% of spouses met the healthy weight/BMI goal: three.0% were underweight, 29.ane% were overweight, and 23.7% were obese. Only 42.vi% of spouses met the strength grooming goal of 2 or more days a calendar week. More than than half of the responding service members met the goals related to aerobic exercise (78.three%), forcefulness preparation (68.5%), booze use (65.1%), and tobacco apply (67.iv%). Only 33.7% of service members met the salubrious weight/BMI goal and only 41% met the sleep goal. Goal attainment was more than prevalent for spouses in weight, slumber, alcohol apply, and tobacco use, and more prevalent for service members in aerobic exercise and force training. Table 3 shows the pairwise agreement of couples with respect to each of the health indicators. All show minor agreement, with concordance percentages ranging from 51 to 73% and kappa coefficients ranging from 0.06 to 0.31 (all p < 0.001); dyadic concordance was strongest for booze and tobacco utilize goals.

Fig. one
figure 1

Pct meeting HP2020a goal. Caption: HP2020 Goal Attainment for Family Report Spouses and Service Members. Refer to Table ane for HP2020 goal definitions. Sample sizes vary across goals due to missing values. Sample sizes for spouse goal attainment are 9764 (weight/BMI), 9031 (aerobic exercise), 9655 (force training), 9588 (sleep), 9469 (alcohol use – risky drinking), and 9762 (tobacco use – smoking). Sample sizes for service member goal attainment are 9814 (weight/BMI), 9394 (aerobic practice), 9662 (strength training), 9756 (sleep), 9260 (alcohol use – risky drinking), and 9475 (tobacco use – smoking.). Footnote: aHealthy People is a national study conducted by the Centers for Illness Command and Prevention. Years of data for Healthy People 2020 range from 2005 to 2015

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Table 3 Concordance of spouse pairs with respect to coming together Healthy People 2020 goals in six domains

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Multivariable analyses of wellness behaviors

The multivariable analyses regressing spouse health outcomes on support and armed forces life stressors are shown in Table 4. Of the 6 social and military support independent variables examined, only ii were statistically significantly associated with any of the HP2020 goals analyzed. Spouses reporting being more bothered by having no one to turn to were significantly less likely to achieve the HP2020 salubrious BMI, sleep, risky drinking, and current smoking goals. More than specifically, a 1-unit increase in the degree to which spouses were bothered (e.1000., from "Bothered a picayune" to "Bothered a lot") was associated with a 27% decrease in the odds of meeting the healthy weight/BMI goal, a 32% subtract in the odds of meeting the sleep goal, a 31% decrease in the odds of meeting the risky drinking goal, and a 37% subtract in the odds of coming together the smoking goal. A greater level of perceived support by the military machine to help the spouse and their family unit was associated with a higher likelihood of the spouse meeting the sleep goal. Specifically, a ane-unit increase in perceived support from the military to help the spouse and their family (east.g., from "Fair" to "Proficient") was associated with a 21% increment in the odds of the spouse meeting the slumber goal.

Tabular array 4 Multivariable Logistic Regression Models for Spouse Attainment of Each of Six Healthy People 2020 Goals

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Of the 4 types of armed services stressors included in our models as predictors (deployment, injury, family unit, and PCS), only deployment-related stressors were marginally significantly associated with any of the spouse health indicators. A i-unit increment in stress related to deployment experiences (due east.g. from slightly to moderately stressful) was associated with an 8% increase in the odds of spouses coming together the HP2020 BMI goal.

Spouse demographic characteristics

Female person spouses were much more probable than male person spouses to meet the HP2020 goals for weight also equally both alcohol and tobacco use, with more than twice the odds of meeting the weight and tobacco use goals. Female spouses were considerably less likely to meet the strength training goals. Older spouses, and in particular those over historic period 35, were less likely to meet the salubrious weight goal. Those anile 35 and older were also less likely to encounter either of the exercise goals but more likely to meet the alcohol utilise goal. Compared to Whites, Black non-Hispanic spouses were less likely to meet the weight, aerobic exercise, and sleep goals but much more likely to run across the tobacco utilise goal. Those of other races were also less likely to meet the aerobic exercise goal but more likely to meet both of the substance use goals. Greater educational attainment confers greater likelihood of meeting each of the HP2020 goals, except for slumber for which there was no clan. In general those with a college degree had better outcomes than those with some higher, who in turn did better than those with no college. In item, those with at to the lowest degree a bachelor's degree had iii.v times the odds of those with no college of refraining from tobacco use. Those identifying as homemakers or students were more likely to see the booze employ goal than other employment groups; no other associations between spouse employment status and meeting the HP2020 goals were observed. Spouses with children were less likely to meet the weight, exercise, and sleep goals but more than probable to meet the substance use goals. Compared to those with no personal military experience, spouses who were themselves electric current members of the military were much more likely to meet both exercise goals than not-military machine spouses; nonetheless, they were less probable to meet the sleep goal. Spouses who were formerly in the military were as well less probable to meet the HP2020 goal for sleep and also less likely to meet the goal related to risky booze use.

Service fellow member military characteristics

Spouses of military reserve or National Guard members were less likely to meet the strength preparation goal, only no other differences with respect to military component were observed. Spouses of officers were more than probable to encounter the weight and aerobic practice goals and also had more than iii times the odds of coming together the tobacco use goal compared to spouses of enlisted soldiers. Compared to the spouses of service members in the Army, spouses of Air Force members were more than likely to run into the sleep goal also as both substance use goals. Marine spouses were less probable to meet the risky alcohol goal just more than likely to not utilise tobacco. Navy spouses were as well more likely than Ground forces spouses to encounter the tobacco utilise goal.

Discussion

Overall, the majority of military spouses and service members met nearly of the HP2020 goals analyzed in the study. Notwithstanding, less than half of war machine spouses met the good for you weight/BMI goal or the strength training goal. Spouses were more likely to reach healthy weight, sleep, and alcohol and tobacco use goals than were service members, whereas more service members met the aerobic practice and force training goals likely due to physical health demands of military service. In addition to comparing military spouses with their partners, it is important to contextualize these results past comparing military spouses with the U.S. adult population. To practise so, we compared rates from the current report with the ten-year HP2020 national targets, which represent the aims that the government sets at a population level, acknowledging that these comparisons must exist interpreted cautiously due to demographic differences between the target population of the Family Study and the U.S. adult population [30]. A higher proportion of military machine spouses (44.ii%) met the HP2020 good for you weight/BMI goal compared with the national target of 33.ix%. Relatedly, fewer armed forces spouses were obese (23.7%) compared with the national obesity target of 30.5%. 60-8 percent of military machine spouses met the HP2020 physical activity objective and 42.6% met the force grooming objective, higher than the national targets (47.9 and 24.1%, respectively). The proportion of military spouses meeting the slumber objective (61.3%) was lower than the national target of 70.8%. A comparable proportion of military spouses did not see goal related to risky drinking, compared with the national target (24.three% vs 25.4%). More armed services spouses reported currently smoking than the national target (20.half dozen% vs 12.0%). Overall, compared with the HP2020 targets for the entire U.South. adult population, a higher proportion of military spouses met the objectives for healthy weight, obesity, and concrete activeness than the national targets, while fewer met these targets for sleep and smoking. It is unclear to what extent these differences may be explained by the younger age and other demographic differences between this written report'southward target population and the adult population every bit a whole. The Centers for Illness Control and Prevention (CDC) does not provide demographic breakdowns for its population targets.

Multivariable results suggest that social support and perceived support from the military are associated with armed forces spouses' wellness behaviors. Specifically, spouses who reported being bothered past non having someone to turn to when they were having a trouble were less likely to achieve a healthy weight or sufficient sleep and were more likely to engage in risky alcohol use and to smoke cigarettes. Similarly, when spouses perceived greater efforts by the military machine to support their families, they were more likely to meet the healthy sleep goal. Research suggests that spouses identify multiple ways their military lifestyle makes it hard to maintain strong social connections, including frequent moves, living far from family and friends, and lack of time [31]. Together, these results advise providing resource to assistance spouses in developing social networks and support, and addressing identified barriers to connectedness, may have broader implications on the overall health and well-existence of spouses. Several spouse demographics were associated with health indicators and were controlled for in the multivariable models, including gender, historic period, ethnicity and didactics. Additionally, spouses of officers, compared to enlisted personnel, were more probable to meet the weight, aerobic exercise, and tobacco goals and spouses of Air Forcefulness members were more than likely to run across the sleep and substance employ goals compared to Ground forces spouses.

Based on our results, it is articulate that service member and spouse health behaviors are associated and likely influence i another bidirectionally. These findings suggest that enhanced support and programme for either or both partners may assist the couple and improve family readiness. Although in that location are many existing social support and military wellness promotion programs available, most target service members rather than war machine spouses, and there is a lack of unified family resource programs [32]. Existing family programs include Armed services OneSource, which disseminates information on all military family wellness resources; Operation Alive Well, an initiative to meliorate health and wellness for the entire defence force community, and its Good for you Base Initiative targeting service members, DoD civilians, and their families. The U.S. Army Public Health Center Performance Triad includes a specific resource page for spouses with educational materials and social media resources that aim to improve sleep, concrete activity, and nutrition and operate the Regular army Wellness Centers that are available to military spouses. Edifice upon these existing armed services health promotion and social support programs to be more than attainable and targeted to military spouses could accept directly implications for increasing positive health behaviors synergistically among service members and their spouses.

Armed forces experiences associated with injury, PCS moves, and family unit stress were not significantly associated with the health beliefs outcomes in this study. Interestingly, having more stressful experiences related to deployment was associated with a greater likelihood of having a salubrious BMI. This finding is inconsistent with previous research. For example, Fish and colleagues (2014) found that deployment has no human relationship with good for you weight, but that male Army spouses were more than likely to be obese or overweight than female person spouses [eight]. Padden and colleagues (2011) found that deployment was associated with poorer dietary behaviors [33].In the electric current study, deployment-related stress was associated with but a unmarried wellness outcome, healthy weight/BMI, and that relationship was fairly weak, suggesting that deployment-related stress and PCS moves may not take a strong or consistent influence beyond wellness behaviors. Every bit Family Study follow-up data for this longitudinal effort become available, information technology will exist possible to further investigate these relationships prospectively. Hereafter studies might assess if other military-related stress influences health indicators over time and if there are directional furnishings in terms of behavioral influence betwixt the spouses in meeting the goals, and if they are stronger from the service fellow member to the spouse or vice versa. Such studies could inform the most constructive points of prevention and intervention for military families. Future longitudinal research could as well assess more comprehensive bio-psycho-social models predicting health outcomes for war machine spouses to distinguish the strongest influencing factors, including behavioral wellness predictors such equally Posttraumatic Stress Disorder which has been linked to health outcomes in diverse studies [34,35,36].

Limitations and strengths

In that location are a number of limitations to this study that should be considered. The data are largely based on self-report which tin be vulnerable to bias, and it would be ideal to also have observational or medical data to validate the health outcomes. Withal, CDC measures on the national health objectives are likewise based on self-report, making these measures more comparable. The reports are also retrospective, meaning that spouses and service members reported on their health behaviors over a specified time period (e.g., the last month) and may have experienced poor or biased call up. Additionally, in that location are missing data, especially on the particular related to PCS stress. Finally, merely married couples of the contrary sex activity were included in the study, thus the results may not generalize to lesbian, gay, bisexual, and transgendered spouses or to single-parent households. Despite these limitations, the study has considerable strengths. The cohort includes a representative sample of immature war machine couples across service branches and components, including agile duty, war machine Reserve, and National Guard participants. The study cohort also includes both female person and male military spouses and data acquired from both the spouse and service member. The constructed self-study health measures also closely marshal with the HP2020 objectives, enabling comparisons of military spouses' wellness behaviors and national benchmarks.

Conclusions

Using the HP2020 objectives every bit a framework for identifying key wellness behaviors and benchmarks, this report identified factors, including military-specific experiences that may contribute to physical health behaviors and outcomes among war machine spouses. The findings provide of import insights that could help inform health promotion programs for military families, improve forcefulness readiness and retention, and heighten the well-beingness of armed services families. The report also offers a unique contribution to the HP2020 efforts past revealing the proportion of military spouses, a big and important segment of the population, who meet several central health objectives.

The spouses in this study face similar challenges in maintaining a good for you lifestyle equally individuals in the broader civilian population, but they must too navigate boosted stressors related to their part as part of a armed services dyad. These stressors may include having a spouse who is deployed, not having a strong social support organization, and not feeling supported past the military. It is important that these spouses are provided with the support services and programs to help them maintain and improve their health behaviors and improve the overall wellness and well-being of U.S. military personnel.

Availability of data and materials

The datasets analyzed during the current study are not publicly available; deidentified data are available upon the establishment of a Department of Defence force data utilise agreement.

Abbreviations

APHC:

Ground forces Public Health Center

BMI:

Body mass index

CDC:

Centers for Affliction Control and Prevention

DoD:

Section of Defense

Family unit Study:

Millennium Accomplice Family Report

HP:

Healthy people

PCS:

Permanent change of station

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Acknowledgments

The authors thank the other contributing members of the Millennium Cohort Family unit Study Team from Abt Associates, including Tara Earl, PhD; Samantha Karon, BA Christopher Spera, PhD; and Elle Gault; equally well as members from the Deployment Health Research Department, Naval Health Research Center, including Lauren Bauer, MPH; Carlos Carballo, MPH; Alejandro Esquivel, MPH; Cynthia LeardMann, MPH; Promise McMaster, PhD; Jackie Pflieger, PhD; and Evelyn Sunday, MPH. The authors gratefully admit the members of the Millennium Accomplice Family Study Team from the Eye for Child and Family Health, including Ernestine Briggs-King, PhD; Ellen Gerrity, PhD; Robert Lee, MS; Robert Murphy, PhD; and Angela Tunno, PhD. In addition, the authors express their gratitude to the Family Study participants, without whom this study would non be possible.

Funding

This work was funded to be completed by Abt Associates under Contract #W911QY-16-C-0089, supported by the Naval Health Research Center. The study team at the Naval Wellness Inquiry Eye collected and cleaned the data under the direction of Dr. Valerie Stander, who participated in this study as a co-author.

Author information

Affiliations

  1. Abt Associates, Cardinal Park West, Suite 210, 5001 South Miami Boulevard, Durham, NC, 27703, USA

    Nida H. Corry & Christianna S. Williams

  2. Abt Assembly, 10 Fawcett Street, Cambridge, MA, 02138, USA

    Sharmini Radakrishnan

  3. Abt Associates, 6130 Executive Boulevard, Rockville, Dr., 20852, U.s.

    Alicia C. Sparks

  4. The Henry 1000. Jackson Foundation for the Advocacy of Military Medicine, 6720A Rockledge Bulldoze, Suite 100, Bethesda, MD, 20817, Us

    Kelly A. Woodall

  5. Mid-Atlantic (VISN half dozen) Mental Affliction Inquiry, Education and Clinical Center, Durham VA Health Intendance System, 3022 Croasdaile Dr, Durham, NC, 27705, USA

    John A. Fairbank

  6. Department of Psychiatry and Behavioral Sciences, Duke University Schoolhouse of Medicine, 1121 West Chapel Colina Street, Suite 201, Durham, NC, 27701, The states

    John A. Fairbank

  7. Military Population Health Section, Naval Health Research Center, 140 Sylvester Road, San Diego, CA, 92106, Us

    Valerie A. Stander

Contributions

NC assisted in the development of the analytic program, led the drafting of the manuscript, coordinated the study, and helped interpret findings. SR conducted the data cleaning, coding, and analysis. CW helped anticipate the belittling plan and oversaw all analyses. AS helped develop the study concept and contributed to drafting the manuscript. KW provided input into the analytical plan, helped interpret findings, and assisted in manuscript development and review. JF reviewed the manuscript and provided insight into the results and discussion. VS provided input on the analytic plan, helped interpret findings, and provided critical feedback and revisions to the manuscript. All authors accept read and approve the manuscript.

Authors' data

Disclaimer: I am a military service member or employee of the U.S. Government. This work was prepared as function of my official duties. Title 17, U.S.C. §105 provides that copyright protection nether this title is not bachelor for whatever work of the U.Due south. Government. Title 17, U.s.a.C. §101 defines a U.S. Authorities work equally work prepared by a military service member or employee of the U.S. Government equally part of that person's official duties.

Report No. 18–39 was supported by the U.S. Army Medical Enquiry and Materiel Command nether piece of work unit no. N1240. The views expressed in this article are those of the authors and do not necessarily reflect the official policy or position of the Department of the Navy, Section of Defense, nor the U.Due south. Authorities.

Corresponding writer

Correspondence to Nida H. Corry.

Ethics declarations

Ideals blessing and consent to participate

The report was overseen and approved by the Naval Health Research Center's Institutional Review Board (Protocol 2000.0007) and the Office of Management and Budget (approval number 0720–0029). Written or electronic informed consent was obtained for all participants. This research has been conducted in compliance with all applicable federal regulations governing the protection of human being subjects in research (Protocol NHRC.2015.0019).

Consent for publication

Not applicative.

Competing interests

The authors declare that they have no competing interests.

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Corry, N.H., Radakrishnan, Southward., Williams, C.S. et al. Clan of military life experiences and health indicators amidst armed forces spouses. BMC Public Health 19, 1517 (2019). https://doi.org/x.1186/s12889-019-7804-z

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  • DOI : https://doi.org/10.1186/s12889-019-7804-z

Keywords

  • Military
  • Service member
  • War machine spouse
  • Health behaviors
  • Healthy People 2020

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