Health and Mental Health Outcomes Associated with Profiles of Risk and Resilience among Military-Connected Youth

 描述（由申请人提供）：虽然许多军人家庭似乎有效地科普与战时兵役相关的压力源，越来越多的经验证据表明，一个相当大的子集军事连接的儿童正在经历不良后果，包括身体和精神健康问题，物质使用和自杀率的增加。这些结果是一个公共卫生问题，因为它们对健康，积极的发展产生长期影响。他们建议，有必要探讨压力源和保护因素的累积影响，这些因素可能有助于军人家庭的复原过程，并为军人青年带来更好的结果。该项目是对陆军综合士兵和家庭健身（CSF 2）数据和国防部相关行政数据集的二次分析，将使用以人为本的统计模型，包括潜在类别分析，以研究军人家庭中自然发生的风险和保护因素模式。风险和保护因素的概况将与军人配偶的角色表现以及健康和心理健康结果相关，军人配偶对军人家庭中青年的福祉至关重要。配偶结果对青年的级联效应将被纳入与青年的角色表现以及健康和心理健康结果相关的风险和保护因素简介。有关风险因素的数据，包括部署，家庭搬迁和财务压力，将从包括国防登记资格报告系统和国防人力数据中心在内的管理数据集中提取。CSF 2数据将为保护因素提供信息，包括获得社会支持和积极应对技能。 健康和心理健康结果，可通过国防卫生局为所有服务人员及其家属，将包括医疗保健预约和ICD-9代码的任何诊断收到。数据集将通过使用人-事件数据环境（Person-Event Data Environment）进行链接，这是一个用于分析陆军大量行政数据的在线门户网站。计划的分析将阐明多个，并发的压力对军事相关家属的结果的集体影响，并可能突出可能的干预点，以改善这一人群的结果。在这一领域开发新知识，解决了尤尼斯肯尼迪施莱佛国家儿童健康和人类发展研究所儿科创伤和危重病分支的计划优先事项，包括探索暴露于战争，暴力和其他人为灾害对儿童健康的影响。此外，拟议的项目将为申请人提供研究和培训机会，以培养在其职业生涯的下一阶段成为一名大型研究型大学独立研究员所需的技能。

 DESCRIPTION (provided by applicant): Although many military families appear to cope effectively with stressors associated with wartime military service, mounting empirical evidence has suggested that a sizeable subset of military-connected children are experiencing adverse outcomes, including increased rates of physical and mental health problems, substance use, and suicidality. These outcomes are a public health concern because of their long-term consequences for healthy, positive development. They suggest the need to explore the cumulative impact of stressors and protective factors that may contribute to resilient processes in military families and lead to better outcomes for military youth. This project, a secondary analysis of Army Comprehensive Soldier and Family Fitness (CSF2) data and linked Department of Defense administrative datasets, will use person-focused statistical models, including latent class analysis, to examine naturally occurring patterns of risk and protective factors in military families. Profiles of risk and protective factors will be associated with role performance and health and mental health outcomes for military spouses, who are critical to the well-being of youth in military families. The cascading effects of spouse outcomes on youth will be incorporated into risk and protective factor profiles associated with role performance and health and mental health outcomes for youth. Data on risk factors, including deployments, family relocations, and financial strain, will be drawn from administrative datasets including the Defense Enrollment Eligibility Reporting System and Defense Manpower Data Center. CSF2 data will inform protective factors, including access to social support and positive coping skills. Health and mental health outcomes, available through the Defense Health Agency for all service members and their dependents, will include health care appointments and ICD-9 codes for any diagnoses received. Datasets will be linked through the use of the Person-Event Data Environment, an online portal for analyzing the Army's vast administrative data holdings. Planned analyses will elucidate the collective impact of multiple, concurrent stressors on outcomes for military-connected dependents and may highlight possible points of intervention to improve outcomes for this population. Developing new knowledge in this area addresses program priorities of the Pediatric Trauma and Critical Illness Branch of the Eunice Kennedy Shriver National Institute of Child Health and Human Development, including exploring consequences for child health of exposure to war, violence, and other man-made disasters. Further, the proposed project will provide the applicant with research and training opportunities to develop skills needed to become an independent researcher in a large, research- focused university setting at the next stage of her career.