Understanding resilience as it affects the transition from the UK Armed Forces to civilian life
Abstract: In the years following the release of the UK Ministry of Defence’s (MOD) Armed Forces Covenant1 and Strategy for Veterans, there has been growing interest among policy officials, charity representatives and academic experts in understanding the transition process for Service leavers. While recent evidence suggests that resilience is important to successful transition, no systematic review has been undertaken on the subject of UK Service leaver resilience and transition prior to this study. To address this research gap, RAND Europe was commissioned by the Forces in Mind Trust (FiMT) to undertake a literature review comprised of a systematic review of academic literature, a Rapid Evidence Assessment (REA) of academic and grey literature, and a scoping review of ongoing research on UK Service leaver resilience and transition. This study aims to improve understanding of whether, and if so how, resilience can affect transition pathways and outcomes for UK Service leavers.
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.