Bringing the Homefront to the Forefront: UK perspectives on critical research with military spouses
Abstract: On the 9th of July 2021, the Rethinking Military Spouses: Critical Research Group hosted a webinar titled ‘Bringing the Homefront to the Forefront: UK Perspectives on Critical Research with Military Spouses’. This report provides some information about the event and includes an overview of the main points of discussion focused on four key themes - access, methodologies, impact, and criticality. When conducting critical research with military spouses, researchers must consider a wide range of issues particular to this specific group. These include: • Challenges around gaining access and the implications that recruitment strategies might have on the voices that are heard. • Choosing a methodological approach and associated methods which enable rich perspectives and experiences to be heard – balancing the needs of research objectives whilst also considering possible benefits to the participants. • Balancing research objectives and activities with expectations of academic institutions, funders, and identified beneficiaries –considering what impact might be and how it can be achieved and accounted for. • Navigating how the dynamics of criticality must be balanced against the need to attract funding, articulate impact, and gain ethics approval from the MOD – with there sometimes being tensions between these factors. Research which centres military spouses is needed in order to understand the impact of military life, power, and processes beyond more obviously militarised phenomena.
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.