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

 描述(申请人提供)：尽管许多军人家庭似乎能有效地应对与战时服兵役相关的压力源，但越来越多的经验证据表明，相当大一部分与军队有联系的儿童正在经历不利的后果，包括身心健康问题、药物使用和自杀的比率增加。这些结果是一个公共卫生问题，因为它们会对健康、积极的发展产生长期影响。他们建议需要探讨压力因素和保护性因素的累积影响，这些因素可能有助于军人家庭的复原力进程，并为军人青年带来更好的结果。这个项目是对陆军综合士兵和家庭健身(CSF2)数据和国防部管理数据集的二次分析，将使用以人为中心的统计模型，包括潜在类别分析，以检查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联，军人配偶对军人家庭中的青年的福祉至关重要。将把配偶结果对青年的连锁影响纳入与青年的角色表现以及健康和心理健康结果有关的风险和保护因素简介。有关风险因素的数据，包括部署、家庭搬迁和经济压力，将来自行政数据集，包括国防招生资格报告系统和国防人力数据中心。CSF2数据将为保护性因素提供信息，包括获得社会支持和积极应对技能。 通过国防卫生局为所有服役人员及其家属提供的健康和精神健康结果将包括医疗预约和收到的任何诊断的ICD-9代码。数据集将通过使用人-事件数据环境进行链接，这是一个在线门户网站，用于分析陆军持有的大量行政数据。有计划的分析将阐明多个同时存在的应激源对与军队有关联的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。发展这一领域的新知识涉及尤尼斯·肯尼迪·施莱弗国家儿童健康和人类发展研究所儿科创伤和危重病分部的计划优先事项，包括探索暴露在战争、暴力和其他人为灾难中对儿童健康的影响。此外，拟议的项目将为申请者提供研究和培训机会，以培养在她职业生涯的下一个阶段成为一所以研究为重点的大型大学的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.