Why It Is Difficult for Military Personnel to Quit Smoking: From the Perspective of Compensatory Health Beliefs
Abstract: Compensatory health beliefs are barriers to healthy behavior. In an effort to understand how the prevalence of these beliefs can be reduced in individuals, 376 valid questionnaires were collected from combat troops in Taiwan. The collected data were analyzed using partial least squares structural equation modelling. It was found that positive attitudes towards smoking cessation had significant negative effects on compensatory health beliefs, while negative attitudes towards smoking cessation significantly enhanced the level of compensatory health beliefs. The motivation for smoking cessation was also found to reinforce the negative effect of positive attitudes towards compensatory health beliefs, while it did not have any significant effect on the relationship between negative attitudes and compensatory health beliefs. Three subconstructs of compensatory health beliefs (exercise, eating habits, and amount of smoking) were found to have simultaneous effects for military personnel. Finally, this study explored the causes of the above-mentioned phenomena, and measures that could reduce the prevalence of compensatory health beliefs were suggested.
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.