Pub Date : 2021-06-06DOI: 10.1080/21635781.2021.1927917
A. Mahar, H. Cramm, A. Aiken, Lixia Zhang, Simon Chen, B. Ouellette, L. Manser, P. Kurdyak
Abstract The spouses of military members experience frequent geographic mobility, absences, risk, and other lifestyle dimensions that may cause a greater need for mental health services and barriers to their use, relative to civilians. This was a retrospective, matched cohort study of female spouses of Canadian Armed Forces (CAF) members posted between 04/01/2008 and 03/31/2013 with follow-up to 03/31/2017. 3,358 military-connected spouses were identified and 13,342 civilians matched 4:1 on age, sex, and region of residence. Psychiatric hospitalizations and emergency department (ED) visits, psychiatrist visits, and mental health-related primary care visits were studied. Almost one third of spouses of CAF members visited a family physician for mental health reasons, while a minority visited an ED, a psychiatrist or were hospitalized. Spouses of CAF members were as likely to see a primary care physician, less likely to visit a psychiatrist, visited all measured outpatient sources of mental health services less frequently than the general population and had a longer interval to their first psychiatrist visit than the general population. Information on how mental health services are accessed in the public health system are critical to understanding pathways of care, and the planning and delivery of mental health services to military-connected families.
{"title":"A Retrospective Cohort Study Comparing the Use of Provincially Funded Mental Health Services between Female Military Spouses Living in Ontario and the General Population","authors":"A. Mahar, H. Cramm, A. Aiken, Lixia Zhang, Simon Chen, B. Ouellette, L. Manser, P. Kurdyak","doi":"10.1080/21635781.2021.1927917","DOIUrl":"https://doi.org/10.1080/21635781.2021.1927917","url":null,"abstract":"Abstract The spouses of military members experience frequent geographic mobility, absences, risk, and other lifestyle dimensions that may cause a greater need for mental health services and barriers to their use, relative to civilians. This was a retrospective, matched cohort study of female spouses of Canadian Armed Forces (CAF) members posted between 04/01/2008 and 03/31/2013 with follow-up to 03/31/2017. 3,358 military-connected spouses were identified and 13,342 civilians matched 4:1 on age, sex, and region of residence. Psychiatric hospitalizations and emergency department (ED) visits, psychiatrist visits, and mental health-related primary care visits were studied. Almost one third of spouses of CAF members visited a family physician for mental health reasons, while a minority visited an ED, a psychiatrist or were hospitalized. Spouses of CAF members were as likely to see a primary care physician, less likely to visit a psychiatrist, visited all measured outpatient sources of mental health services less frequently than the general population and had a longer interval to their first psychiatrist visit than the general population. Information on how mental health services are accessed in the public health system are critical to understanding pathways of care, and the planning and delivery of mental health services to military-connected families.","PeriodicalId":37012,"journal":{"name":"Military Behavioral Health","volume":"9 1","pages":"404 - 415"},"PeriodicalIF":0.0,"publicationDate":"2021-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/21635781.2021.1927917","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45730722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-05-27DOI: 10.1080/21635781.2021.1927916
J. Martindale-Adams, Jeffrey K Zuber, M. Graney, R. Burns, L. Nichols
Abstract Caregivers of the approximately 9 million individuals in the US with Posttraumatic Stress Disorder (PTSD) face burdens that may seem overwhelming. In 2017, VA implemented the first national clinical program for caregivers of veterans with PTSD. Previous interventions have focused on caregivers more as adjuncts of persons with PTSD or included PTSD caregivers with other types of military/veteran caregivers. The REACH VA behavioral intervention, 4 one-hour sessions during 2 to 3 months, focusing on caregiver coping and managing PTSD-related concerns, was delivered centrally by telephone. In a pre/post intervention design, the 161 caregivers experienced statistically significant improvement in burden, depression, anxiety, frustrations, general stress, time providing care, number of and bother about troubling behaviors, and safety risks. Pre and post intervention improvements in burden and anxiety were also clinically significant. Reducing caregivers’ psychological distress can improve ability to provide care and positively affect health and safety of persons with PTSD. With REACH, VA has made major steps to support caregivers of veterans. The positive results of this implementation may also serve as a model to support PTSD caregivers in the general population.
{"title":"Effect of a Behavioral Intervention on Outcomes for Caregivers of Veterans with PTSD","authors":"J. Martindale-Adams, Jeffrey K Zuber, M. Graney, R. Burns, L. Nichols","doi":"10.1080/21635781.2021.1927916","DOIUrl":"https://doi.org/10.1080/21635781.2021.1927916","url":null,"abstract":"Abstract Caregivers of the approximately 9 million individuals in the US with Posttraumatic Stress Disorder (PTSD) face burdens that may seem overwhelming. In 2017, VA implemented the first national clinical program for caregivers of veterans with PTSD. Previous interventions have focused on caregivers more as adjuncts of persons with PTSD or included PTSD caregivers with other types of military/veteran caregivers. The REACH VA behavioral intervention, 4 one-hour sessions during 2 to 3 months, focusing on caregiver coping and managing PTSD-related concerns, was delivered centrally by telephone. In a pre/post intervention design, the 161 caregivers experienced statistically significant improvement in burden, depression, anxiety, frustrations, general stress, time providing care, number of and bother about troubling behaviors, and safety risks. Pre and post intervention improvements in burden and anxiety were also clinically significant. Reducing caregivers’ psychological distress can improve ability to provide care and positively affect health and safety of persons with PTSD. With REACH, VA has made major steps to support caregivers of veterans. The positive results of this implementation may also serve as a model to support PTSD caregivers in the general population.","PeriodicalId":37012,"journal":{"name":"Military Behavioral Health","volume":"9 1","pages":"357 - 367"},"PeriodicalIF":0.0,"publicationDate":"2021-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/21635781.2021.1927916","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43654103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-04-28DOI: 10.1080/21635781.2021.1904065
M. McCue, Ashlee N. Fisher, Kristina R. Johnson, Antonella Bariani, Marvin M. Cabral, Shaylee Edmonds, C. Allard, Q. Tiet
Abstract The nature of America’s Post 9/11 wars has often placed service members in close proximity to not only enemy and friendly forces, but also civilian noncombatants. The unique psychological consequences of witnessing, attempting to save, or feeling responsible for causing harm to noncombatants are relatively understudied. However, guilt has been shown to be both a direct predictor of suicidal ideation and also to act as a moderator and mediator in the relationship between trauma exposure and suicidality. Despite its established importance, there are few studies attempting to quantitatively explain the specific sources of guilt for combat veterans who may have been exposed to multiple and varied traumas. This study used a hierarchical multiple regression of self-report online survey data from Post 9/11 veterans of Iraq and/or Afghanistan (n = 184) to test the hypothesis that combat experiences with civilian casualties would predict guilt above and beyond other personal, military, and deployment characteristics and experiences. The results show a strong correlation between guilt and suicide and a moderate association between experiences involving civilian casualties and guilt. Additionally, feeling personally responsible for killing or wounding civilian noncombatants results in stronger feelings of guilt than either witnessing or providing medical assistance to them. The outcome of this study offers insights for tailoring interventions for veterans who report having combat experiences involving civilian casualties in order to improve how we address guilt and suicide risk. In doing so, the field may provide more comprehensive and relevant mental health support to combat veterans.
{"title":"Exposure to Civilian Casualties Is Related to Guilt and Suicidality in Post 9/11 Veterans of Iraq and Afghanistan","authors":"M. McCue, Ashlee N. Fisher, Kristina R. Johnson, Antonella Bariani, Marvin M. Cabral, Shaylee Edmonds, C. Allard, Q. Tiet","doi":"10.1080/21635781.2021.1904065","DOIUrl":"https://doi.org/10.1080/21635781.2021.1904065","url":null,"abstract":"Abstract The nature of America’s Post 9/11 wars has often placed service members in close proximity to not only enemy and friendly forces, but also civilian noncombatants. The unique psychological consequences of witnessing, attempting to save, or feeling responsible for causing harm to noncombatants are relatively understudied. However, guilt has been shown to be both a direct predictor of suicidal ideation and also to act as a moderator and mediator in the relationship between trauma exposure and suicidality. Despite its established importance, there are few studies attempting to quantitatively explain the specific sources of guilt for combat veterans who may have been exposed to multiple and varied traumas. This study used a hierarchical multiple regression of self-report online survey data from Post 9/11 veterans of Iraq and/or Afghanistan (n = 184) to test the hypothesis that combat experiences with civilian casualties would predict guilt above and beyond other personal, military, and deployment characteristics and experiences. The results show a strong correlation between guilt and suicide and a moderate association between experiences involving civilian casualties and guilt. Additionally, feeling personally responsible for killing or wounding civilian noncombatants results in stronger feelings of guilt than either witnessing or providing medical assistance to them. The outcome of this study offers insights for tailoring interventions for veterans who report having combat experiences involving civilian casualties in order to improve how we address guilt and suicide risk. In doing so, the field may provide more comprehensive and relevant mental health support to combat veterans.","PeriodicalId":37012,"journal":{"name":"Military Behavioral Health","volume":"9 1","pages":"110 - 117"},"PeriodicalIF":0.0,"publicationDate":"2021-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/21635781.2021.1904065","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47711306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-04-28DOI: 10.1080/21635781.2021.1904064
G. Reger
Abstract U.S. Army combat operational stress control doctrine and techniques are effective resources for military leaders preparing for prolonged operations in hostile environments. This doctrine provides an understanding of common sources of stress, stress reactions, and effective leader actions to help mitigate the effects. However, it may be less relevant to Army National Guard members activated to support their states during domestic emergencies. This article reviews the observations of one Behavioral Health Officer activated during the novel coronavirus 19 (COVID-19) pandemic and describes the operational stress experienced by Army National Guard members. Adaptive and maladaptive stress reactions to the stress of the COVID-19 operations are reviewed. The author calls for new or revised combat operational stress doctrine that is relevant to part time, citizen-soldiers activated for domestic emergencies. Aggregating Army National Guard lessons learned in the context of COVID-19 may also help support soldiers in the case that unfortunate future waves of the virus occur and to prepare for future pandemics.
{"title":"Operational Stress Control during a Pandemic: An Army National Guard Perspective on Lessons Learned during the Response to COVID-19","authors":"G. Reger","doi":"10.1080/21635781.2021.1904064","DOIUrl":"https://doi.org/10.1080/21635781.2021.1904064","url":null,"abstract":"Abstract U.S. Army combat operational stress control doctrine and techniques are effective resources for military leaders preparing for prolonged operations in hostile environments. This doctrine provides an understanding of common sources of stress, stress reactions, and effective leader actions to help mitigate the effects. However, it may be less relevant to Army National Guard members activated to support their states during domestic emergencies. This article reviews the observations of one Behavioral Health Officer activated during the novel coronavirus 19 (COVID-19) pandemic and describes the operational stress experienced by Army National Guard members. Adaptive and maladaptive stress reactions to the stress of the COVID-19 operations are reviewed. The author calls for new or revised combat operational stress doctrine that is relevant to part time, citizen-soldiers activated for domestic emergencies. Aggregating Army National Guard lessons learned in the context of COVID-19 may also help support soldiers in the case that unfortunate future waves of the virus occur and to prepare for future pandemics.","PeriodicalId":37012,"journal":{"name":"Military Behavioral Health","volume":"9 1","pages":"11 - 16"},"PeriodicalIF":0.0,"publicationDate":"2021-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/21635781.2021.1904064","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43975612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-03-29DOI: 10.1080/21635781.2021.1904063
Sara Kintzle, Hazel R. Atuel
Abstract The use of Role Play (RP) and Standardized Actor Patients (SAP) have significantly impacted the behavioral health field’s ability to train clinicians in clinical practice and the development of clinical skills. The purpose of this study was to test and compare the effects of RP and SAP in training graduate social work students in the development of military specific clinical skills. Masters of social work students (n = 156) at a university were enrolled in a quasi-experimental study and provided clinical training with the use of either RP or SAP. Participants were measured on their ability to clinically engage with clients and their ability to recognize and responds to symptoms of PTSD and suicide ideation. Participants in both groups demonstrated increases in self-efficacy, clinical engagement, recognizing, and responding to PTSD and suicidal symptoms, and overall performance. Overall significant differences were not found in the development of clinical skills between RP and SAP groups with an exception related to developing a collaborative relationship, with participants in the RP group scoring higher than those in the SAP group. These findings suggest that though SAP and RP appear to be equally effective training modalities, RP may provide advantages in the development of the therapeutic relationship.
{"title":"Clinical Skills in Military Behavioral Health Education: Efficacy of Role Play vs Standardized Actor Patient Training","authors":"Sara Kintzle, Hazel R. Atuel","doi":"10.1080/21635781.2021.1904063","DOIUrl":"https://doi.org/10.1080/21635781.2021.1904063","url":null,"abstract":"Abstract The use of Role Play (RP) and Standardized Actor Patients (SAP) have significantly impacted the behavioral health field’s ability to train clinicians in clinical practice and the development of clinical skills. The purpose of this study was to test and compare the effects of RP and SAP in training graduate social work students in the development of military specific clinical skills. Masters of social work students (n = 156) at a university were enrolled in a quasi-experimental study and provided clinical training with the use of either RP or SAP. Participants were measured on their ability to clinically engage with clients and their ability to recognize and responds to symptoms of PTSD and suicide ideation. Participants in both groups demonstrated increases in self-efficacy, clinical engagement, recognizing, and responding to PTSD and suicidal symptoms, and overall performance. Overall significant differences were not found in the development of clinical skills between RP and SAP groups with an exception related to developing a collaborative relationship, with participants in the RP group scoring higher than those in the SAP group. These findings suggest that though SAP and RP appear to be equally effective training modalities, RP may provide advantages in the development of the therapeutic relationship.","PeriodicalId":37012,"journal":{"name":"Military Behavioral Health","volume":"9 1","pages":"239 - 246"},"PeriodicalIF":0.0,"publicationDate":"2021-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/21635781.2021.1904063","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45440376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-03-22DOI: 10.1080/21635781.2021.1900956
James D. Whitworth, Casey N. O’Brien, C. Stewart
Abstract Introduction: Military chaplains play a vital role in helping the military accomplish their missions. These chaplains can be exposed to traumatic experiences during their deployments with some of them developing posttraumatic stress disorder (PTSD). Method: Using in-depth interviews with 17 former and active-duty chaplains who have been diagnosed with PTSD, this study employs classical grounded theory to formulate a conceptual model explaining key factors that contribute to their trauma resiliency. Results: The conceptual model derived from grounded theory analysis of the interviews theorizes that chaplains with PTSD who have a greater number of overall and religious/spiritual protective factors and fewer overall and religious/spiritual risk factors are more resilient to military-related trauma experiences. Alternatively, chaplains who have more overall and religious/spiritual risk factors and fewer of these protective factors demonstrate decreased resiliency. Key risk factors included high levels of guilt, perceived weakness and stigma associated with symptoms, heavy work demands during deployments, competitive work environments, isolation, and unhelpful leadership responses. Discussion: Implications for military behavioral health to support military chaplains are highlighted. They include recommendations for increased and targeted psychoeducation efforts, expanded use of camaraderie-based approaches/fostering informal support, incorporation of chaplain’s faith/spirituality, increased use of narrative and cognitive interventions, and advocating for chaplains.
{"title":"Understanding Post-Traumatic Stress Responses among Military Chaplains: Implications for Military Behavioral Health","authors":"James D. Whitworth, Casey N. O’Brien, C. Stewart","doi":"10.1080/21635781.2021.1900956","DOIUrl":"https://doi.org/10.1080/21635781.2021.1900956","url":null,"abstract":"Abstract Introduction: Military chaplains play a vital role in helping the military accomplish their missions. These chaplains can be exposed to traumatic experiences during their deployments with some of them developing posttraumatic stress disorder (PTSD). Method: Using in-depth interviews with 17 former and active-duty chaplains who have been diagnosed with PTSD, this study employs classical grounded theory to formulate a conceptual model explaining key factors that contribute to their trauma resiliency. Results: The conceptual model derived from grounded theory analysis of the interviews theorizes that chaplains with PTSD who have a greater number of overall and religious/spiritual protective factors and fewer overall and religious/spiritual risk factors are more resilient to military-related trauma experiences. Alternatively, chaplains who have more overall and religious/spiritual risk factors and fewer of these protective factors demonstrate decreased resiliency. Key risk factors included high levels of guilt, perceived weakness and stigma associated with symptoms, heavy work demands during deployments, competitive work environments, isolation, and unhelpful leadership responses. Discussion: Implications for military behavioral health to support military chaplains are highlighted. They include recommendations for increased and targeted psychoeducation efforts, expanded use of camaraderie-based approaches/fostering informal support, incorporation of chaplain’s faith/spirituality, increased use of narrative and cognitive interventions, and advocating for chaplains.","PeriodicalId":37012,"journal":{"name":"Military Behavioral Health","volume":"9 1","pages":"390 - 403"},"PeriodicalIF":0.0,"publicationDate":"2021-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/21635781.2021.1900956","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45786561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-03-16DOI: 10.1080/21635781.2021.1895922
I. Gutierrez, Elizabeth A. Alders, Zainah Abulhawa, P. Deuster
Abstract Spiritual Fitness is one of eight components of the Department of Defense’s Total Force Fitness (TFF) model of warfighter health, readiness, and performance. To date, the lack of a shared framework for describing the beliefs and practices that optimize human performance has hampered the identification, measurement, and operationalization of spiritual fitness within the military. To address this need, we propose a values-centered model of spiritual fitness —VICTORS—that defines military spiritual fitness in terms of Values, Integrity, Calling, Tolerance, Openness, Routine, and Selfless Service. The VICTORS framework comprises a broad set of inclusive traits and capabilities that characterize the spiritually fit warfighter within the definition of spiritual fitness as established by instruction of the Chairman of the Joint Chiefs of Staff (CJCSI). The application of this framework includes; (1) measurement, (2) training and consultation, (3) supporting chaplaincy, and (4) leadership development. We believe that VICTORS will provide a common military language for the essential components of spiritual fitness and become an actionable framework for enhancing spiritual fitness across the Armed Forces.
{"title":"VICTORS: A Conceptual Framework for Implementing and Measuring Military Spiritual Fitness","authors":"I. Gutierrez, Elizabeth A. Alders, Zainah Abulhawa, P. Deuster","doi":"10.1080/21635781.2021.1895922","DOIUrl":"https://doi.org/10.1080/21635781.2021.1895922","url":null,"abstract":"Abstract Spiritual Fitness is one of eight components of the Department of Defense’s Total Force Fitness (TFF) model of warfighter health, readiness, and performance. To date, the lack of a shared framework for describing the beliefs and practices that optimize human performance has hampered the identification, measurement, and operationalization of spiritual fitness within the military. To address this need, we propose a values-centered model of spiritual fitness —VICTORS—that defines military spiritual fitness in terms of Values, Integrity, Calling, Tolerance, Openness, Routine, and Selfless Service. The VICTORS framework comprises a broad set of inclusive traits and capabilities that characterize the spiritually fit warfighter within the definition of spiritual fitness as established by instruction of the Chairman of the Joint Chiefs of Staff (CJCSI). The application of this framework includes; (1) measurement, (2) training and consultation, (3) supporting chaplaincy, and (4) leadership development. We believe that VICTORS will provide a common military language for the essential components of spiritual fitness and become an actionable framework for enhancing spiritual fitness across the Armed Forces.","PeriodicalId":37012,"journal":{"name":"Military Behavioral Health","volume":"9 1","pages":"375 - 389"},"PeriodicalIF":0.0,"publicationDate":"2021-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/21635781.2021.1895922","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46310428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-03-09DOI: 10.1080/21635781.2021.1888828
Margaret Sala, Noel Quinn, J. T. Freeman
Abstract Obesity is highly prevalent in the U.S. veteran population. The present study aimed to examine predictors of weight loss within VA Connecticut Healthcare System’s (VACT) behavioral weight management program, MOVE!®. Participants were 159 veterans receiving care at VACT who enrolled in MOVE!. Participants attended an average of 8.8/16 MOVE! sessions and had an average 5.3 lb (2.1%) total body weight loss; 15.1% of participants lost a clinically significant amount of weight (>5%). The number of sessions that participants attended was associated with weight loss, such that participants who attended 7–12 sessions lost an average of 7.2 lbs and participants who attended 13+ sessions lost an average of 8.6 lbs, whereas participants who attended 7 or fewer sessions lost an average of 1.4 lbs. Teleconferencing in from a community-based outpatient clinic (CBOC) location was also associated with weight loss, such that participants who were at a CBOC lost an average of 7.5 lbs, whereas participants at the main campus lost an average of 3.5 lbs. Results from this single-site observation study suggest a dose-response relationship within MOVE!, where participants who attended more sessions lost more weight. Teleconferencing in from CBOCs was an effective manner to deliver MOVE!.
{"title":"Factors Associated with Weight Loss Within a Blended Virtual and Face-to-Face MOVE!® Program: A Retrospective Study","authors":"Margaret Sala, Noel Quinn, J. T. Freeman","doi":"10.1080/21635781.2021.1888828","DOIUrl":"https://doi.org/10.1080/21635781.2021.1888828","url":null,"abstract":"Abstract Obesity is highly prevalent in the U.S. veteran population. The present study aimed to examine predictors of weight loss within VA Connecticut Healthcare System’s (VACT) behavioral weight management program, MOVE!®. Participants were 159 veterans receiving care at VACT who enrolled in MOVE!. Participants attended an average of 8.8/16 MOVE! sessions and had an average 5.3 lb (2.1%) total body weight loss; 15.1% of participants lost a clinically significant amount of weight (>5%). The number of sessions that participants attended was associated with weight loss, such that participants who attended 7–12 sessions lost an average of 7.2 lbs and participants who attended 13+ sessions lost an average of 8.6 lbs, whereas participants who attended 7 or fewer sessions lost an average of 1.4 lbs. Teleconferencing in from a community-based outpatient clinic (CBOC) location was also associated with weight loss, such that participants who were at a CBOC lost an average of 7.5 lbs, whereas participants at the main campus lost an average of 3.5 lbs. Results from this single-site observation study suggest a dose-response relationship within MOVE!, where participants who attended more sessions lost more weight. Teleconferencing in from CBOCs was an effective manner to deliver MOVE!.","PeriodicalId":37012,"journal":{"name":"Military Behavioral Health","volume":"9 1","pages":"297 - 302"},"PeriodicalIF":0.0,"publicationDate":"2021-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/21635781.2021.1888828","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44014566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-03-03DOI: 10.1080/21635781.2021.1888827
Ariana Dichiara, David Brandwein, D. Marks, Emily R. Edwards, Joseph C. Geraci
Abstract Many returning Operation Enduring Freedom/Operation Iraqi Freedom veterans may benefit from psychological services as recent estimates suggest high rates of suicide, trauma, and psychopathology within this population. However, only a small portion of veterans ever seek mental health services, presumably due to various barriers to treatment. A better understanding of barriers to treatment may ensure that these populations seek the services they require. Data from a randomized controlled trial (RCT) of a peer-mentor program was examined to assess the extent to which common barriers to treatment precluded veterans from requesting medical or mental health assistance. The relationship between elevated scores on posttraumatic stress disorder (PTSD) and alcohol misuse measures was examined as they relate to veterans’ choices to seek assistance with health care, along with score profiles on a variety of measures (including quality of life, somatization, combat exposure, and demographic variables). Results indicated that having PTSD was a significant predictor of health service seeking, although this relationship was no longer significant once quality of life was added into analyses. Alcohol misuse and combat exposure were not significantly predictive of seeking health services, while elevated somatic symptoms were. Cumulative disadvantage theory is used to explore these findings and treatment implications.
{"title":"Mental Health Service Use amongst Veterans in a Peer-Mentor Intervention: An Analysis of Barriers to Treatment","authors":"Ariana Dichiara, David Brandwein, D. Marks, Emily R. Edwards, Joseph C. Geraci","doi":"10.1080/21635781.2021.1888827","DOIUrl":"https://doi.org/10.1080/21635781.2021.1888827","url":null,"abstract":"Abstract Many returning Operation Enduring Freedom/Operation Iraqi Freedom veterans may benefit from psychological services as recent estimates suggest high rates of suicide, trauma, and psychopathology within this population. However, only a small portion of veterans ever seek mental health services, presumably due to various barriers to treatment. A better understanding of barriers to treatment may ensure that these populations seek the services they require. Data from a randomized controlled trial (RCT) of a peer-mentor program was examined to assess the extent to which common barriers to treatment precluded veterans from requesting medical or mental health assistance. The relationship between elevated scores on posttraumatic stress disorder (PTSD) and alcohol misuse measures was examined as they relate to veterans’ choices to seek assistance with health care, along with score profiles on a variety of measures (including quality of life, somatization, combat exposure, and demographic variables). Results indicated that having PTSD was a significant predictor of health service seeking, although this relationship was no longer significant once quality of life was added into analyses. Alcohol misuse and combat exposure were not significantly predictive of seeking health services, while elevated somatic symptoms were. Cumulative disadvantage theory is used to explore these findings and treatment implications.","PeriodicalId":37012,"journal":{"name":"Military Behavioral Health","volume":"9 1","pages":"335 - 344"},"PeriodicalIF":0.0,"publicationDate":"2021-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/21635781.2021.1888827","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49047604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-02-19DOI: 10.1080/21635781.2020.1864525
S. M. MacDermid Wadsworth, Dave Topp, Kathy M. Broniarczyk, S. Edwards, D. Riggs, H. Hughes
Abstract Service members, veterans, and their families frequently have difficulties finding trained behavioral health providers who have knowledge of military culture and issues specific to the military population. This paper documents the design, implementation, effectiveness, and proximal outcomes of the Star Behavioral Health Providers training program (SBHP). We created SBHP as a dissemination effort in response to elevated levels of mental health problems among community-dwelling military and veteran families (CDMVF), limitations in provider capacity in the Departments of Defense (DoD) and Veterans Affairs (VA), and uneven preparation of civilian providers to serve military and veteran families. The goals of the initiative were to: Improve the preparation of community-based professionals to work with CDMVF. Increase providers’ use of evidence-informed information and practices. Strengthen the behavioral health infrastructure for treating CDMVF. The program provides military-specific training to community-based behavioral health providers and provides a mechanism for those seeking such services to find trained providers. Evaluation data, though limited by the lack of comparison or control groups, provided correlational evidence consistent with each program goal.
{"title":"Building Community Capacity to Care for Military and Veteran Families: The Star Behavioral Health Providers Program","authors":"S. M. MacDermid Wadsworth, Dave Topp, Kathy M. Broniarczyk, S. Edwards, D. Riggs, H. Hughes","doi":"10.1080/21635781.2020.1864525","DOIUrl":"https://doi.org/10.1080/21635781.2020.1864525","url":null,"abstract":"Abstract Service members, veterans, and their families frequently have difficulties finding trained behavioral health providers who have knowledge of military culture and issues specific to the military population. This paper documents the design, implementation, effectiveness, and proximal outcomes of the Star Behavioral Health Providers training program (SBHP). We created SBHP as a dissemination effort in response to elevated levels of mental health problems among community-dwelling military and veteran families (CDMVF), limitations in provider capacity in the Departments of Defense (DoD) and Veterans Affairs (VA), and uneven preparation of civilian providers to serve military and veteran families. The goals of the initiative were to: Improve the preparation of community-based professionals to work with CDMVF. Increase providers’ use of evidence-informed information and practices. Strengthen the behavioral health infrastructure for treating CDMVF. The program provides military-specific training to community-based behavioral health providers and provides a mechanism for those seeking such services to find trained providers. Evaluation data, though limited by the lack of comparison or control groups, provided correlational evidence consistent with each program goal.","PeriodicalId":37012,"journal":{"name":"Military Behavioral Health","volume":"9 1","pages":"206 - 222"},"PeriodicalIF":0.0,"publicationDate":"2021-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/21635781.2020.1864525","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48105237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：