Military adolescents’ experiences of change and discontinuity: Associations with psychosocial factors and school success
Abstract: Objective: Drawing from the contextual model of family stress, social support and depressive symptoms were examined as two psychosocial factors that may link experiences of change and discontinuity common to military families to military adolescents’ school success (i.e., academic achievement, school engagement, and homework commitment). Background: Many military adolescents experience frequent changes that create discontinuity (e.g., parental deployments, relocations) and can impact their school success. Research has not examined psychosocial factors as a possible mechanism explaining the link between family change and discontinuity and adolescents’ school success. Method: A path model based on 821 military adolescents’ responses examined how experiences of family discontinuity were associated with adolescents’ psychosocial factors and, in turn, their school success after accounting for grade level, sex, and racial/ethnic minority status. Indirect effects between family discontinuity and school success were also evaluated. Results: For adolescents attending public school off the military installation, parental deployment was significantly associated with less social support, and recent relocation was significantly associated with elevated depressive symptoms. Both psychosocial factors were associated with adolescents’ academic achievement, school engagement, and homework commitment. Implications: Prevention and intervention efforts directed at enhancing both social support and positive mental health are discussed at various systemic levels including families, schools, and communities.
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.