Use of the Operational Stress Injury Social Support (OSISS) Program in a Nationally Representative Sample of Canadian Active Duty Military Personnel
Abstract: Recent research evidence indicates increased mental health needs among Canadian Armed Forces (CAF) personnel. Research evidence also indicates that a portion of CAF personnel with mental health needs do not seek professional mental health care or significantly delay initiating treatment. The current study was designed to examine individual correlates of use for a paraprofessional peer support program available to CAF personnel, veterans, and their families (i.e., Operational Stress Injury Social Support [OSISS]). Participants included 6,700 CAF Regular members. Prevalence estimates were computed for all variables of interest and hierarchical logistic regression analyses served to identify correlates of OSISS use. The results indicate that meeting criteria for posttraumatic stress disorder had the strongest association with OSISS use (OR = 22.31 [95% CI = 13.36-37.28]), but only a small number of CAF personnel (1.2%) seek help from OSISS. Results suggest that OSISS use was limited and tended to occur in conjunction with professional mental health service use. Efforts could be engaged to emphasize the availability of peer support as a resource for all operational stress injuries and to increase the reach of peer support programs for military personnel.
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.