Publications
Research Publication 2
Title Publication Date/Location
Alcohol misuse and separation from military service: A dyadic perspective Addictive Behaviors 2020 Nov;110:106512

Porter B, Rodriguez LM, Woodall KA, Pflieger JC, Stander VA

Poor outcomes result from service member alcohol misuse, but the extent to which military spouses' alcohol misuse impacts service members is unclear. This study evaluated the influence of dyadic patterns of alcohol misuse on likelihood of separating from the military among 7,965 opposite sex married couples with one military and one civilian/veteran spouse. The prevalence of alcohol misuse among military couples was high, but alcohol misuse frequently was reported by only one member of a couple. Results indicated that service member alcohol misuse was more strongly related to military separation than spouse alcohol misuse. Additionally, the study indicated that heavy weekly drinking was a strong predictor of separation among female than male service members. Future research should replicate this finding and further evaluate the implications of this gender difference.

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An experimental comparison of web-push vs. paper-only survey procedures for conducting an in-depth health survey of military spouses BMC Medical Research Methodology 2017 Apr;17:73

McMaster HS, LeardMann CA, Speigle S, Dillman DA

An experiment was conducted to compare two methods for surveying spouses married to U.S. Service members. Military spouses were assigned to either a web-push group (requesting online survey completion initially and then in later contacts offering a paper option) or to a paper-only group (requesting response by paper survey only). The web-push approach produced a significantly higher response rate and was less expensive than the paper-only approach, with no meaningful differences in spouse demographic, military, and health characteristics. Results suggest that a web-approach may be more effective with young military spouses because of their heavy reliance on the internet and that this may also hold true for the general population as they become more uniformly internet savvy.

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Assessing and adjusting for non-response in the Millennium Cohort Family Study BMC Medical Research Methodology 2017 Jan;17:16

Corry NH, Williams CS, Battaglia M, McMaster HS, Stander VA

This paper examines factors contributing to second stage survey non-response during the baseline data collection for the Millennium Cohort Family Study, a large longitudinal study of US service members and their spouses from all branches of the military. Due to its design features, the Family Study offers a unique opportunity to thoroughly examine and adjust for non-response bias among military spouses by analysing extensive data collected from their service member partners on the Millennium Cohort survey, including sociodemographic and psychosocial characteristics. This study contributes to the interpretation and use of the Family Study data by describing the sample and examining and addressing systematic non-response in the baseline sample and provides insights to inform future study designs and recruitment practices involving military spouses.

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Association of military life experiences and health indicators among military spouses BMC Public Health 2019 Nov;19(1):1517

Corry NH, Radakrishnan S, Williams CS, Sparks AC, Woodall KA, Fairbank JA, Stander VA

The purpose of this study was to assess the extent to which military spouses' health behaviors met national physical health goals (Healthy People 2020), and to assess associations between health behaviors and sociodemographic characteristics, military experiences, and psychosocial factors. Attainment of national health goals was measured using six indicators of health: 1) healthy weight (body mass index), 2) aerobic exercise, 3) strength training, 4) sleep, 5) alcohol use (risky drinking), and 6) tobacco use. Overall, the majority of military spouses and service members met most of the HP2020 goals analyzed in the study, and the behaviors of each member of the couple were moderately correlated. Greater social support and perceived support from the military, in addition to several demographic variables, were associated with a greater likelihood of meeting the Healthy People 2020 goals among military spouses.

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Demographic variation in military life stress and perceived support among military spouses Military Medicine In press

Corry NH, Williams CS, Radakrishnan S, McMaster HS, Sparks AC, Briggs-King EC, Karon SS, Stander VA

Military spouses play a critical role in supporting service members and the family unit, and experience unique stressors as a result of military life. Using data from the Millennium Cohort Family Study, a nationwide survey of 9,872 married spouses of service members with 2–5 years of military service, we examined differences in experiences of military life stress and perceived support across multiple subgroups of military spouses to identify groups potentially at risk. Key outcomes included military-related stressors, perceived social support and support from the military, and coping; predictors included spouse sociodemographic, military population, and family characteristics. Certain spouses (>35 years, had a high school diploma or less, fulltime or not employed, had 2+ children, or married to service members in the Army, Navy, or Marine Corps) were more likely to experience heightened military stress, less social support, and/or poorer coping skills. Findings may inform culturally relevant initiatives to enhance social support and connectedness among at-risk military spouses.
Depression among military spouses: Demographic, military, and service member psychological health risk factors Depression and Anxiety 2018 Dec;35(12):1137-1144

Donoho CJ, LeardMann CA, O’Malley CA, Walter KH, Riviere LA, Curry JF, Adler AB

In this study, 4.9% of military spouses had a probable diagnosis of major depression disorder (MDD). Spouses married to enlisted service members or those with PTSD had increased risk for MDD, after adjustment for demographic and military factors. Less education, unemployment, and prior military service among spouses, as well as having more than three children, were also associated with increased risk for MDD. These findings imply that deployment alone may not negatively impact military spouses, but rather adverse mental health of the service member, especially PTSD, may increase the risk for MDD among military spouses.

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Engaging military couples in marital research: Does requesting referrals from service members to recruit their spouses introduce sample bias? BMC Medical Research Methodology 2018 Oct;18(1):114

McMaster HS, Stander VA, Williams CS, Woodall KA, O'Malley CA, Bauer LM, Davila EP

Enrolling couples in research studies is not uncommon; however, most research reports fail to provide details about recruitment strategies or have the ability to examine selection biases. This paper examined two recruitment strategies used to enroll military couples in a longitudinal study, assessing the impact of both strategies on the representativeness of the final study sample. Using data from the Millennium Cohort Program, results suggest that requesting referrals from service members to recruit their spouses introduced minimal bias compared to contacting spouses directly. Service members appeared to be more likely to refer their spouses if they perceived the research topic as relevant to their spouse, and these spouses were more likely to respond for similar reasons. Even though referred spouses were more likely to respond, the overall success rate of using a referral strategy was less than that of recruiting spouses directly.

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High-risk and long-term opioid prescribing to military spouses in the Millennium Cohort Family Study Military Medicine 2020 Sep;185(9-10):e1759-e1769

McDonald DC, Radakrishnan S, Sparks AC, Corry NH, Carballo CE, Carlson K, Stander VA

The use and misuse of opioids by active service members has been examined in several studies, but little is known about their spouses' opioid use. This study estimates the number of military spouses who received high-risk or long-term opioid prescriptions between 2010 and 2014, and addresses how the Military Health System can help prevent risky prescribing in order to improve military force readiness. Using data from the Millennium Cohort Family Study and the Pharmacy Data Transaction Service, this study found that nearly 1 in 10 military spouses received an opioid prescription that put their health at risk. Spouses with physical pain, a lack of social support, and adverse childhood experiences were all associated with receiving higher risk opioid prescriptions.

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Influence of work and life stressors on marital quality among dual and non-dual military couples Journal of Family Issues 2020 Nov;41(11):2045-2064

Woodall KA, Richardson SM, Pflieger JC, Hawkins SA, Stander VA

Maintaining a healthy marriage may be challenging for military couples as they attempt to balance the demands of work and family; for dual-military couples, this can be even more challenging. Using data from the Millennium Cohort Family Study, we examined whether military stress experiences negatively impact marital quality through the mediation of work-family conflict. Spouse gender and dual-military status were included as moderators. Results demonstrated that more military stress experiences was related to lower marital quality, which was mediated by work-family conflict. Additionally, female dual spouses reported lower marital quality than male dual spouses and civilian spouses. Findings from this study highlight the importance of providing support to military spouses for stressful military events and potentially tailoring support services for female dual spouses to improve marital quality.

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Mental health of children of deployed and non-deployed US military service members: The Millennium Cohort Family Study Journal of Developmental & Behavioral Pediatrics 2018 Dec;39(9):683-692

Fairbank JA, Briggs EC, Lee RC, Corry NH, Pflieger JC, Gerrity ET, Amaya-Jackson LM, Stander VA, Murphy RA

Prior research has found that youth in military families were significantly more likely to report higher rates of major depression and use of illicit drugs in comparison to their non-military counterparts. The present study investigated the associations between service member deployment experiences and family demographic factors and children’s mental health and psychological functioning, utilizing data collected from 9,872 Service members/military spouses through both online and mail survey options. The results from the Family Study indicated that while most spouses did not report that their children had mental health, emotional, or behavioral difficulties regardless of parental deployment status, a significant minority of children whose parents had been combat deployed were more likely to have been diagnosed with ADD/ADHD and depression by a doctor or health professional in comparison to youth without a deployed parent. Children with a non-combat deployed service member parent were also more likely to have been assigned a diagnosis of depression in comparison to youth without a deployed parent.

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