The Effect of a Combined Mindfulness and Yoga Intervention on Soldier Mental Health in Basic Combat Training: A Cluster Randomized Controlled Trial
Background. Depression, anxiety, and sleep problems are prevalent in high-stress occupations including military service. While effective therapies are available, scalable preventive mental health care interventions are needed. This study examined the impact of a combined mindfulness and yoga intervention on the mental health of soldiers in Basic Combat Training (BCT). Methods. U.S. Army soldiers () were randomized by platoon to an intervention or training-as-usual condition. Soldiers in the intervention condition completed Mindfulness-Based Attention Training (MBAT), engaged in daily 15 min mindfulness practice, and participated in 30 minutes of hatha yoga 6 days per week. Surveys were administered at baseline (T1, prior to training), week 4 of BCT (T2), week 6 (T3), and week 9 (T4). Results. A significant time-by-condition interaction predicting positive screens for depression found that screens decreased at a faster rate from T1 to T4 in the intervention condition (-12.6%) compared to training-as-usual (-7.2%) (, , ). While positive anxiety screens decreased over time across conditions, the time-by-condition interaction found no significant differences in the rate of these decreases by condition (, , ). A significant time-by-condition interaction predicting positive screens for sleep problems found that sleep problems decreased in the intervention condition (-1.4%) but increased in training-as-usual (2.0%) (, , ). Conclusion. The mindfulness and yoga intervention was associated with a greater reduction in positive screens for depression and sleep problems among soldiers during high-stress training. Limitations include reliance on self-report and the inability to disaggregate the effects of mindfulness versus yoga. Mindfulness and yoga may enable personnel in high-stress occupations to sustain their mental health even in the context of significant psychological demands.
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.