The Transition Mapping Study -Understanding the Transition Process for Service Personnel Returning to Civilian Life
Abstract: Since the Armed Forces Covenant was published in 2000, there has been increased interest in the process of helping Service people transition from the Armed Forces into civilian life. In 2006 this process was formalised when the Ministry of Defence published its Strategy for Veterans. The Forces in Mind Trust (FiMT), which has been set up to improve the transition process, commissioned The Futures Company to review existing research, to understand how the transition process currently works, how it is viewed by stakeholders and by recent Service leavers, to develop a model that quantified the costs of poor transition to the UK as a whole, and to make recommendations on how to reduce the number of poor transitions. The research focussed on fulltime personnel, not reservists. Transitioning from military service into civilian life is inevitable for almost all Armed Forces personnel; only a tiny proportion proceeds through to a full career. Most transitions are successful. One of the reasons for this is because of the resources invested in them by the Armed Forces. At the same time, a “good transition” is undefined. For the purposes of this project we developed with help from stakeholders the following definition: “A good transition is one that enables ex-Service personnel to be sufficiently resilient to adapt successfully to civilian life, both now and in the future. This resilience includes financial, psychological, and emotional resilience, and encompasses the ex-Service person and their immediate families.”
Abstract: Introduction: Persistent inequities exist in obstetric and neonatal outcomes in military families despite universal health care coverage. Though the exact underlying cause has not been identified, social determinants of health may uniquely impact military families. The purpose of this study was to qualitatively investigate the potential impact of social determinants of health and the lived experiences of military individuals seeking maternity care in the Military Health System. Materials and methods: This was an Institutional Review Board-approved protocol. Nine providers conducted 31 semi-structured interviews with individuals who delivered within the last 5 years in the direct or purchased care market. Participants were recruited through social media blasts and clinic flyers with both maximum variation and homogenous sampling to ensure participation of diverse individuals. Data were coded and themes were identified using inductive qualitative research methods. Results: Three main themes were identified: Requirements of Military Life (with subthemes of pregnancy notification and privacy during care, role of pregnancy instructions and policies, and role of command support), Sociocultural Aspects of the Military Experience (with subthemes of pregnancy as a burden on colleagues and a career detractor, postpartum adjustment, balancing personal and professional requirements, pregnancy timing and parenting challenges, and importance of friendship and camaraderie in pregnancy), and Navigating the Healthcare Experience (including subthemes of transfer between military and civilian care and TRICARE challenges, perception of military care as inferior to civilian, and remote duty stations and international care). Conclusions: The unique stressors of military life act synergistically with the existing health care challenges, presenting opportunities for improvements in care. Such opportunities may include increased consistency of policies across services and commands. Increased access to group prenatal care and support groups, and increased assistance with navigating the health care system to improve care transitions were frequently requested changes by participants.