The effect of non-operational family separations on family functioning and well-being among Royal Navy/Royal Marines families
Abstract: Military families can experience a variety of different separations due to the occupational demands of Service personnel. The most prominent of these is the deployment of personnel on operational and combat missions. Previous international research has demonstrated how separations related to deployment can negatively affect the functioning and health and wellbeing of military families. However, little is known about how this might compare to shorter, but more frequent separations unrelated to operational deployments – non-operational family separations. This form of family separation is more common among the UK Naval Service community, many of whom do not live near military bases or move with personnel but instead reside within local civilian communities across the UK. An estimated 24% of UK Armed Forces families live separately from personnel during the working week, increasing to 36% among Naval Service families (Ministry of Defence 2016). While this can have benefits for Naval Service families in providing increased stability to support spouse/partner employment and the education of children, it often results in serving Naval personnel living away from the family home during the working week - referred to as “weekending”. Such separations can also occur in additional to operational deployments, increasing the time Naval Service families may be apart. To help understand non-operational family separations and how they influence family functioning and well-being among Royal Navy/Royal Marines (RN/RM) families, a research project was commissioned by the Naval Families Federation, with funding from Greenwich Hospital. This report presents the findings of this study and makes recommendations for future research and potential interventions to support military families experiencing this type of separation.
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.