social determinants of health for military service members ... · social risk score high before and...

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Social Determinants of Health for Military Service Members Military Family Members and VeteransAMSUS National Meeting ndash 5 Dec 2019

Moderator Joyce Grissom MD CMO HNFS Panelist Gloria Wilder MD

VP Innovation and Preventive Health Centene

Panelist Cynthia Gilman JD Senior VP of Strategic Initiatives for HJF

Panelist Daniel F Perkins PhDPrincipal Scientist and Founder Clearinghouse for Military Family Readiness Pennsylvania State University (Lead Investigator for TVMI Study)


Joyce Grissom has nothing to disclose

2

Disclosure


Social Determinants and the Military Community ndash In Our News


Objectives

1) Identify 3 social or environmental factors significantly affecting active duty service members as they transition from active duty to civilian life

2) Describe how clinicians may bring consideration and engagement of social determinants impacting their patientsrsquo health into their clinical practice and or community service

3) Understand the purpose and study design of The Veterans Metrics Initiative (TVMI)


bull Social Determinants of Health ndash Stabilizing our Service Community - Dr Wilder

bull The Veterans Metrics Initiative-Linking Program Components to Post-Military Well Being - Ms Gilman and Dr Perkins

Agenda

Social Determinants of Health for Military Families and Veterans

Confidential and Proprietary Information 6

Social Determinants of HealthStabilizing our Service Community

Gloria Wilder MD MPH VP Innovation and Health Transformation

Centene Corporation

Disclosures

Gloria Wilder has nothing to disclose

7Confidential and Proprietary Information

Social Determinants of Health

Economic Stability

Neighborhood and Physical Environment

Education NutritionCommunity and Social

Context

HealthcareSystem

bull Employmentbull Incomebull Expensesbull Debtbull Medical billsbull Support

bull Housingbull Transportationbull Safetybull Parksbull Playgroundsbull Walkability

bull Literacybull Languagebull Early

childhood education

bull Vocational training

bull Higher education

bull Hungerbull Access to

healthy options

bull Social integration

bull Support system

bull Community engagement

bull Discrimination

bull Health coverage

bull Provider availability

bull Provider linguistic and cultural competency

bull Quality of care

Health OutcomesMortality Morbidity Life Expectancy Healthcare Expenditures Health Status Functional Limitations


Requirements for a Healthful Life

10Mckinsey Global Institute- Inequality A persisting challenge and its implications June 2019

Social Risk Score High Before and After Entering the

Military Deployment increases Social

Risk Score

What is the social risk score of a military family

11

Quality of HousingAsthma environmental hazards

Broken systems of care-VA Mandated reporter

Transition from service-Job readiness Reintegration initiatives Behavioral Health Stigma Social

Isolation

DeploymentDemobilization cycle Loss of social systems

Economic stress Limited financial literacy High need $

Confidential and Proprietary Information

Food InsecurityWhy are some military families on food stamps

Trauma Adverse Childhood Stress PTSD

Identify the Barriers

12

Work with the communities and members we serve to identify barriers that impede health outcomes

BA

RR

IE

RS


Building a SDOH Framework

13

The intersection of life and health

Policy amp Systems-

Level Change

Providers

Community Assets

Consult inform and influence how integrated social and health policy are developed and implemented across military life

Provider and network services support that builds fosters amp maintains the provider-patient relationship Strengthening the medical home

Individualized and military based interventions that efficiently and effectively unite local area partners to meet the needs for those living there A military base should not be a site of social isolation


Letrsquos Talk

The Veterans Metrics InitiativeLinking Program Components to Post-Military Well-Being

Cynthia L Gilman JDSenior Vice President Strategic InitiativesThe Henry M Jackson Foundation for the Advancement of Military Medicine Inc

Daniel F Perkins PhDPrincipal Scientist and Founder Clearinghouse for Military Family Readinessand Professor Pennsylvania State University

Disclosures

Cynthia Gilman and Daniel Perkins have nothing todisclose

Objectives



3) Understand the purpose and study design of the TVMI Study

VA Benefits

Vocational Rehab

VA Health Administration

Veterans Opportunity

to Work

Program M

Your Community

Housing Assistance

Career Transition Service

Financial Planning

Program C

Program H

Program Q

Program

Program R

Program F

ACMEEmployment

Coaching Great Outdoor

Adventure

Local University

Support Groups

Program O

Program Y

Program K

Program

Program A

Sergeant Smith

Program J

Program B

Military OneSource

DoLDoD Transition Assistance Program

(TAP)Program

W

Is there a clear path to a successful transitionreintegration

Aim 1bull Document veteran well-being in 4 key domains ndash mental and

physical health vocation finances and social relationships ndash over the first 3 years of the transition from military service to civilian life

bull Identify factors associated with better and worse well-being

Aim 2bull Describe programs used by veterans as they reintegrate into civilian

life and distill them into their components identifying common components across programs

Aim 3 bull Identify program components that are associated with

changes in well-being following separation from military service

Research Aims

Study Sponsors

HJFProgram Director

Daniel Perkins

PhDPenn State

Erin Finley PhDSouth TX

VA

Dawne Vogt PhDBoston VA

Laurel Copeland

PhD VA Cent

West Mass

John Boyle PhDICF Intrsquol

20

Research Study Structure

PROGRAM COMPONENTSContent (What)Process (How)Barrier reductionSustainability

NEED-BASED FACTORSDisabilityTrauma exposure

PREDISPOSING FACTORSAge race genderEducationBranchRankYears of serviceFamily (spouse children)

ENABLING FACTORSAccess to servicesAvailable resourcesWillingness to use servicesResilience

PROGRAM CHARACTERISTICS

Government or privateTargeted domainsTarget audienceIOM AreaVeterans servedGeographic areasDurationQuality (implementation

evaluation)Facilitator manualTheory Logic model

VOCATIONEmployment Education status (eg

paid employment student homemaker volunteer)

Employment Education functioningEmployment Education satisfaction

FINANCESFinancial status (eg debt savings)Financial functioningFinancial satisfaction

MENTAL amp PHYSICAL HEALTHHealth status (eg quality of health

health conditions health coverage)Health functioning Health satisfaction

SOCIAL RELATIONSHIPSRelationshipparentalcommunity

involvementRelationshipparentalcommunity

functioningRelationshipparentalcommunity

satisfaction

WELL-BEING

Conceptual Model of Veteran Reintegration

Operational Definitions

Paid employment unpaid work and

schooltraining participation

Income savings debt housing retirement insurance coverage

Chronic mental or physical health

conditions

Quality of work timelinessreliability

interpersonal behavior

Behavior related to cash amp credit management

savings

Being supportive avoiding conflict and

problems etc

Satisfaction with work andor educational experiences (eg

paybenefits work environment)

Satisfaction with ability to afford expenses

savings debt management

Intimate relationship parenting family amp friends community

involvement

Satisfaction with state of physical health mental health and

access to health care

Satisfaction with quality of relationships and

community

Voca

tion

Fina

nces

Heal

thSo

cial

FunctioningBehaviors that reflect

higherlower well-being

Satisfaction Subjective experience

of life domain

StatusObjective experience

role status

Health promotingrisk behavior (eg exercise

engagement in meaningful activities risky drinking)

Sample RepresentativenessPopulation (n=48965)

Wave 1 (n=9566)

Wave 6(n=5258)

Male 841 818 815

Female 159 182 185

Army 321 329 31

Navy 188 192 193

Air Force 135 190 199

Marines 172 159 166

National GuardReserve 184 129 124

E1-E4 Junior Enlisted 414 275 285

E5-E6 MidGrade Enlisted 295 300 299

E7-E9 Senior Enlisted 134 179 167

W1-W5 Warrant Officers 11 16 15

O1-O3 Junior Officers 64 84 90

O4-O10 Senior Officers 81 147 145

Areas of Highest Well-Being

bull Majority of veterans experience high post-military well-beingbull Nearly half experience high well-being across the boardbull Even many veterans with health problems experience at least moderate well-being

in other domains (over 70)

bull Veterans report many areas of resilience

24

High employment and strong workeducational functioning

High level of social connectedness

Strong parental functioning and satisfaction

Areas of Lowest Well-Being

25

bull Despite high employment rate many veterans report financial challenges and exhibit poor financial functioning

bull Suggests need for more attention to financial concerns more emphasis on educating them on money management savings etc

Financesbull Relatively high mental and

especially physical health burden Chronic pain sleep

problems depression and anxiety most commonly reported health problems High screening rate for

alcohol misuse and PTSD If not addressed

proactively could erode well-being in other life domains over time

Health

Predicting Difficulty Adjusting to Civilian Life

19

38

32

58

51

24

35

42

35

27

31

0 10 20 30 40 50 60 70

Probable alcohol misuse

Probable anxiety

Probable depression

Probable PTSD

Probable TBI

Chronic mentalemotional health conditions

Combat exposure

Medium to low resiliency scores

Risky financial status

Not working full-time

High school education

26

Types of Adverse Childhood Experiences by Gender (n=5875)

27

14

3126

39

2216

38

10

18 17

26

611

22

0

10

20

30

40

50

Physicalneglect

Emotionalneglect

Physicalabuse

Emotionalabuse

Sexual abuse Domesticviolence

FamilyHistory of

mentalillness or

alcohol abuse

Females(n=1076)

Males(n=4800)

Family historyof mental illness or

alcohol abuse

(n=1076) (n=4800)

Interaction Between ACEs amp Combat Exposure

28

49

37

7 7

48

12

30

11

0

10

20

30

40

50

60

No ACEs no exposure 3+ ACEs no exposure No ACEs had combatexposure

3+ ACEs had combatexposure

Female (n=678) Male (n=3291)

What Programs are Veterans Using in the Transition to Civilian Life

29

60

1613

7 7

57

15 15

7 7

54

1517

59

50

1517

5

12

52

1517

4

10

0

10

20

30

40

50

60

70

Employment Education Financial Health Social

Wave 1 Wave 2 Wave 3 Wave 4 Wave 5

Common Components

bull Content what does the program teach or what information does it providebull Coping skills information on how to write a resume search for available jobs

bull Process how does it convey information or teach skillsbull Mode of delivery in-person online phonebull Method of delivery lecture format mentoring peer-to-peer interaction

bull Barrier reduction does the program provide tangible supports or does it reduce barriers to accessing the programbull Transportation to the program reducing stigma

bull Sustainability how does the program keep participants engaged once formal programming has endedbull Community referrals alumni groups

Components that Increase Program Access

31

13

6 63 1 1

18

36

30 1

13

6 63 1 1

32

25

5

18 18

7

20

7

13

23

2 3

0

10

20

30

40

50

Lack oftransport to the

program

Lack ofmotivation

Fees Lodging No insurance Stigmaassociated with

program use

Employment Education Legal financial housing Health Social

Barrier Reduction Access to Healthcare

bull Significant predictors of nominating a health program that offers transportation (n=708)bull Currently serving NGR after leaving Active Duty ndash less likelybull Discharge status ndash 69 more likely if medical dischargebull Those who have ever applied for VA or DoD service connected

disability ndash almost 5 times more likelybull Probable PTSD ndash 39 more likelybull TBI symptoms ndash 2 times more likely

162

needs to get

Components that Provide Tangible Supports

163

9 8

45 53

9 8

47

18

5

24

29

11

0

10

20

30

40

50

Discounted pricing on goodsand services

Clothes or other physicalobjects

Housing incl accessibilitymodifications


Questions

cgilmanhjforg

dfp102psuedu

How to Earn CE - If you would like to earn continuing education credit for this activity please visit httpamsuscdspesgcecomHurry CE Certificates will only be available for 30 days after this event


Disclosure


Objectives



Disclosures



Slide Number 10




Slide Number 14


Disclosures

Objectives

Slide Number 18

Research Aims


Slide Number 21


Sample Representativeness







Common Components




Questions



Joyce Grissom has nothing to disclose

2

Disclosure




Objectives







Agenda





Centene Corporation

Disclosures




Economic Stability



Context

HealthcareSystem




childhood education




healthy options


bull Support system


bull Discrimination











Risk Score


11




Isolation







12


BA

RR

IE

RS



13


Policy amp Systems-

Level Change

Providers

Community Assets





Letrsquos Talk




Disclosures


Objectives




VA Benefits

Vocational Rehab



to Work

Program M

Your Community

Housing Assistance


Financial Planning

Program C

Program H

Program Q

Program

Program R

Program F

ACMEEmployment


Adventure

Local University

Support Groups

Program O

Program Y

Program K

Program

Program A

Sergeant Smith

Program J

Program B

Military OneSource


(TAP)Program

W









Research Aims

Study Sponsors

HJFProgram Director

Daniel Perkins

PhDPenn State


VA


Laurel Copeland

PhD VA Cent

West Mass


20


















satisfaction

WELL-BEING







conditions




savings


problems etc






involvement




community

Voca

tion

Fina

nces

Heal

thSo

cial




of life domain


role status




Wave 1 (n=9566)

Wave 6(n=5258)

Male 841 818 815

Female 159 182 185

Army 321 329 31

Navy 188 192 193

Air Force 135 190 199

Marines 172 159 166












24





25








Health


19

38

32

58

51

24

35

42

35

27

31

0 10 20 30 40 50 60 70


Probable anxiety

Probable depression

Probable PTSD

Probable TBI


Combat exposure





26


27

14

3126

39

2216

38

10

18 17

26

611

22

0

10

20

30

40

50

Physicalneglect

Emotionalneglect

Physicalabuse

Emotionalabuse


FamilyHistory of

mentalillness or

alcohol abuse

Females(n=1076)

Males(n=4800)


alcohol abuse

(n=1076) (n=4800)


28

49

37

7 7

48

12

30

11

0

10

20

30

40

50

60





29

60

1613

7 7

57

15 15

7 7

54

1517

59

50

1517

5

12

52

1517

4

10

0

10

20

30

40

50

60

70



Common Components






31

13

6 63 1 1

18

36

30 1

13

6 63 1 1

32

25

5

18 18

7

20

7

13

23

2 3

0

10

20

30

40

50


program

Lack ofmotivation


program use





162

needs to get


163

9 8

45 53

9 8

47

18

5

24

29

11

0

10

20

30

40

50





Questions

cgilmanhjforg

dfp102psuedu



Disclosure


Objectives



Disclosures



Slide Number 10




Slide Number 14


Disclosures

Objectives

Slide Number 18

Research Aims


Slide Number 21









Common Components




Questions





Objectives







Agenda





Centene Corporation

Disclosures




Economic Stability



Context

HealthcareSystem




childhood education




healthy options


bull Support system


bull Discrimination











Risk Score


11




Isolation







12


BA

RR

IE

RS



13


Policy amp Systems-

Level Change

Providers

Community Assets





Letrsquos Talk




Disclosures


Objectives




VA Benefits

Vocational Rehab



to Work

Program M

Your Community

Housing Assistance


Financial Planning

Program C

Program H

Program Q

Program

Program R

Program F

ACMEEmployment


Adventure

Local University

Support Groups

Program O

Program Y

Program K

Program

Program A

Sergeant Smith

Program J

Program B

Military OneSource


(TAP)Program

W









Research Aims

Study Sponsors

HJFProgram Director

Daniel Perkins

PhDPenn State


VA


Laurel Copeland

PhD VA Cent

West Mass


20


















satisfaction

WELL-BEING







conditions




savings


problems etc






involvement




community

Voca

tion

Fina

nces

Heal

thSo

cial




of life domain


role status




Wave 1 (n=9566)

Wave 6(n=5258)

Male 841 818 815

Female 159 182 185

Army 321 329 31

Navy 188 192 193

Air Force 135 190 199

Marines 172 159 166












24





25








Health


19

38

32

58

51

24

35

42

35

27

31

0 10 20 30 40 50 60 70


Probable anxiety

Probable depression

Probable PTSD

Probable TBI


Combat exposure





26


27

14

3126

39

2216

38

10

18 17

26

611

22

0

10

20

30

40

50

Physicalneglect

Emotionalneglect

Physicalabuse

Emotionalabuse


FamilyHistory of

mentalillness or

alcohol abuse

Females(n=1076)

Males(n=4800)


alcohol abuse

(n=1076) (n=4800)


28

49

37

7 7

48

12

30

11

0

10

20

30

40

50

60





29

60

1613

7 7

57

15 15

7 7

54

1517

59

50

1517

5

12

52

1517

4

10

0

10

20

30

40

50

60

70



Common Components






31

13

6 63 1 1

18

36

30 1

13

6 63 1 1

32

25

5

18 18

7

20

7

13

23

2 3

0

10

20

30

40

50


program

Lack ofmotivation


program use





162

needs to get


163

9 8

45 53

9 8

47

18

5

24

29

11

0

10

20

30

40

50





Questions

cgilmanhjforg

dfp102psuedu



Disclosure


Objectives



Disclosures



Slide Number 10




Slide Number 14


Disclosures

Objectives

Slide Number 18

Research Aims


Slide Number 21









Common Components




Questions





Agenda





Centene Corporation

Disclosures




Economic Stability



Context

HealthcareSystem




childhood education




healthy options


bull Support system


bull Discrimination











Risk Score


11




Isolation







12


BA

RR

IE

RS



13


Policy amp Systems-

Level Change

Providers

Community Assets





Letrsquos Talk




Disclosures


Objectives




VA Benefits

Vocational Rehab



to Work

Program M

Your Community

Housing Assistance


Financial Planning

Program C

Program H

Program Q

Program

Program R

Program F

ACMEEmployment


Adventure

Local University

Support Groups

Program O

Program Y

Program K

Program

Program A

Sergeant Smith

Program J

Program B

Military OneSource


(TAP)Program

W









Research Aims

Study Sponsors

HJFProgram Director

Daniel Perkins

PhDPenn State


VA


Laurel Copeland

PhD VA Cent

West Mass


20


















satisfaction

WELL-BEING







conditions




savings


problems etc






involvement




community

Voca

tion

Fina

nces

Heal

thSo

cial




of life domain


role status




Wave 1 (n=9566)

Wave 6(n=5258)

Male 841 818 815

Female 159 182 185

Army 321 329 31

Navy 188 192 193

Air Force 135 190 199

Marines 172 159 166












24





25








Health


19

38

32

58

51

24

35

42

35

27

31

0 10 20 30 40 50 60 70


Probable anxiety

Probable depression

Probable PTSD

Probable TBI


Combat exposure





26


27

14

3126

39

2216

38

10

18 17

26

611

22

0

10

20

30

40

50

Physicalneglect

Emotionalneglect

Physicalabuse

Emotionalabuse


FamilyHistory of

mentalillness or

alcohol abuse

Females(n=1076)

Males(n=4800)


alcohol abuse

(n=1076) (n=4800)


28

49

37

7 7

48

12

30

11

0

10

20

30

40

50

60





29

60

1613

7 7

57

15 15

7 7

54

1517

59

50

1517

5

12

52

1517

4

10

0

10

20

30

40

50

60

70



Common Components






31

13

6 63 1 1

18

36

30 1

13

6 63 1 1

32

25

5

18 18

7

20

7

13

23

2 3

0

10

20

30

40

50


program

Lack ofmotivation


program use





162

needs to get


163

9 8

45 53

9 8

47

18

5

24

29

11

0

10

20

30

40

50





Questions

cgilmanhjforg

dfp102psuedu



Disclosure


Objectives



Disclosures



Slide Number 10




Slide Number 14


Disclosures

Objectives

Slide Number 18

Research Aims


Slide Number 21









Common Components




Questions





Centene Corporation

Disclosures




Economic Stability



Context

HealthcareSystem




childhood education




healthy options


bull Support system


bull Discrimination











Risk Score


11




Isolation







12


BA

RR

IE

RS



13


Policy amp Systems-

Level Change

Providers

Community Assets





Letrsquos Talk




Disclosures


Objectives




VA Benefits

Vocational Rehab



to Work

Program M

Your Community

Housing Assistance


Financial Planning

Program C

Program H

Program Q

Program

Program R

Program F

ACMEEmployment


Adventure

Local University

Support Groups

Program O

Program Y

Program K

Program

Program A

Sergeant Smith

Program J

Program B

Military OneSource


(TAP)Program

W









Research Aims

Study Sponsors

HJFProgram Director

Daniel Perkins

PhDPenn State


VA


Laurel Copeland

PhD VA Cent

West Mass


20


















satisfaction

WELL-BEING







conditions




savings


problems etc






involvement




community

Voca

tion

Fina

nces

Heal

thSo

cial




of life domain


role status




Wave 1 (n=9566)

Wave 6(n=5258)

Male 841 818 815

Female 159 182 185

Army 321 329 31

Navy 188 192 193

Air Force 135 190 199

Marines 172 159 166












24





25








Health


19

38

32

58

51

24

35

42

35

27

31

0 10 20 30 40 50 60 70


Probable anxiety

Probable depression

Probable PTSD

Probable TBI


Combat exposure





26


27

14

3126

39

2216

38

10

18 17

26

611

22

0

10

20

30

40

50

Physicalneglect

Emotionalneglect

Physicalabuse

Emotionalabuse


FamilyHistory of

mentalillness or

alcohol abuse

Females(n=1076)

Males(n=4800)


alcohol abuse

(n=1076) (n=4800)


28

49

37

7 7

48

12

30

11

0

10

20

30

40

50

60





29

60

1613

7 7

57

15 15

7 7

54

1517

59

50

1517

5

12

52

1517

4

10

0

10

20

30

40

50

60

70



Common Components






31

13

6 63 1 1

18

36

30 1

13

6 63 1 1

32

25

5

18 18

7

20

7

13

23

2 3

0

10

20

30

40

50


program

Lack ofmotivation


program use





162

needs to get


163

9 8

45 53

9 8

47

18

5

24

29

11

0

10

20

30

40

50





Questions

cgilmanhjforg

dfp102psuedu



Disclosure


Objectives



Disclosures



Slide Number 10




Slide Number 14


Disclosures

Objectives

Slide Number 18

Research Aims


Slide Number 21









Common Components




Questions


Disclosures




Economic Stability



Context

HealthcareSystem




childhood education




healthy options


bull Support system


bull Discrimination











Risk Score


11




Isolation







12


BA

RR

IE

RS



13


Policy amp Systems-

Level Change

Providers

Community Assets





Letrsquos Talk




Disclosures


Objectives




VA Benefits

Vocational Rehab



to Work

Program M

Your Community

Housing Assistance


Financial Planning

Program C

Program H

Program Q

Program

Program R

Program F

ACMEEmployment


Adventure

Local University

Support Groups

Program O

Program Y

Program K

Program

Program A

Sergeant Smith

Program J

Program B

Military OneSource


(TAP)Program

W









Research Aims

Study Sponsors

HJFProgram Director

Daniel Perkins

PhDPenn State


VA


Laurel Copeland

PhD VA Cent

West Mass


20


















satisfaction

WELL-BEING







conditions




savings


problems etc






involvement




community

Voca

tion

Fina

nces

Heal

thSo

cial




of life domain


role status




Wave 1 (n=9566)

Wave 6(n=5258)

Male 841 818 815

Female 159 182 185

Army 321 329 31

Navy 188 192 193

Air Force 135 190 199

Marines 172 159 166












24





25








Health


19

38

32

58

51

24

35

42

35

27

31

0 10 20 30 40 50 60 70


Probable anxiety

Probable depression

Probable PTSD

Probable TBI


Combat exposure





26


27

14

3126

39

2216

38

10

18 17

26

611

22

0

10

20

30

40

50

Physicalneglect

Emotionalneglect

Physicalabuse

Emotionalabuse


FamilyHistory of

mentalillness or

alcohol abuse

Females(n=1076)

Males(n=4800)


alcohol abuse

(n=1076) (n=4800)


28

49

37

7 7

48

12

30

11

0

10

20

30

40

50

60





29

60

1613

7 7

57

15 15

7 7

54

1517

59

50

1517

5

12

52

1517

4

10

0

10

20

30

40

50

60

70



Common Components






31

13

6 63 1 1

18

36

30 1

13

6 63 1 1

32

25

5

18 18

7

20

7

13

23

2 3

0

10

20

30

40

50


program

Lack ofmotivation


program use





162

needs to get


163

9 8

45 53

9 8

47

18

5

24

29

11

0

10

20

30

40

50





Questions

cgilmanhjforg

dfp102psuedu



Disclosure


Objectives



Disclosures



Slide Number 10




Slide Number 14


Disclosures

Objectives

Slide Number 18

Research Aims


Slide Number 21









Common Components




Questions



Economic Stability



Context

HealthcareSystem




childhood education




healthy options


bull Support system


bull Discrimination











Risk Score


11




Isolation







12


BA

RR

IE

RS



13


Policy amp Systems-

Level Change

Providers

Community Assets





Letrsquos Talk




Disclosures


Objectives




VA Benefits

Vocational Rehab



to Work

Program M

Your Community

Housing Assistance


Financial Planning

Program C

Program H

Program Q

Program

Program R

Program F

ACMEEmployment


Adventure

Local University

Support Groups

Program O

Program Y

Program K

Program

Program A

Sergeant Smith

Program J

Program B

Military OneSource


(TAP)Program

W









Research Aims

Study Sponsors

HJFProgram Director

Daniel Perkins

PhDPenn State


VA


Laurel Copeland

PhD VA Cent

West Mass


20


















satisfaction

WELL-BEING







conditions




savings


problems etc






involvement




community

Voca

tion

Fina

nces

Heal

thSo

cial




of life domain


role status




Wave 1 (n=9566)

Wave 6(n=5258)

Male 841 818 815

Female 159 182 185

Army 321 329 31

Navy 188 192 193

Air Force 135 190 199

Marines 172 159 166












24





25








Health


19

38

32

58

51

24

35

42

35

27

31

0 10 20 30 40 50 60 70


Probable anxiety

Probable depression

Probable PTSD

Probable TBI


Combat exposure





26


27

14

3126

39

2216

38

10

18 17

26

611

22

0

10

20

30

40

50

Physicalneglect

Emotionalneglect

Physicalabuse

Emotionalabuse


FamilyHistory of

mentalillness or

alcohol abuse

Females(n=1076)

Males(n=4800)


alcohol abuse

(n=1076) (n=4800)


28

49

37

7 7

48

12

30

11

0

10

20

30

40

50

60





29

60

1613

7 7

57

15 15

7 7

54

1517

59

50

1517

5

12

52

1517

4

10

0

10

20

30

40

50

60

70



Common Components






31

13

6 63 1 1

18

36

30 1

13

6 63 1 1

32

25

5

18 18

7

20

7

13

23

2 3

0

10

20

30

40

50


program

Lack ofmotivation


program use





162

needs to get


163

9 8

45 53

9 8

47

18

5

24

29

11

0

10

20

30

40

50





Questions

cgilmanhjforg

dfp102psuedu



Disclosure


Objectives



Disclosures



Slide Number 10




Slide Number 14


Disclosures

Objectives

Slide Number 18

Research Aims


Slide Number 21









Common Components




Questions






Risk Score


11




Isolation







12


BA

RR

IE

RS



13


Policy amp Systems-

Level Change

Providers

Community Assets





Letrsquos Talk




Disclosures


Objectives




VA Benefits

Vocational Rehab



to Work

Program M

Your Community

Housing Assistance


Financial Planning

Program C

Program H

Program Q

Program

Program R

Program F

ACMEEmployment


Adventure

Local University

Support Groups

Program O

Program Y

Program K

Program

Program A

Sergeant Smith

Program J

Program B

Military OneSource


(TAP)Program

W









Research Aims

Study Sponsors

HJFProgram Director

Daniel Perkins

PhDPenn State


VA


Laurel Copeland

PhD VA Cent

West Mass


20


















satisfaction

WELL-BEING







conditions




savings


problems etc






involvement




community

Voca

tion

Fina

nces

Heal

thSo

cial




of life domain


role status




Wave 1 (n=9566)

Wave 6(n=5258)

Male 841 818 815

Female 159 182 185

Army 321 329 31

Navy 188 192 193

Air Force 135 190 199

Marines 172 159 166












24





25








Health


19

38

32

58

51

24

35

42

35

27

31

0 10 20 30 40 50 60 70


Probable anxiety

Probable depression

Probable PTSD

Probable TBI


Combat exposure





26


27

14

3126

39

2216

38

10

18 17

26

611

22

0

10

20

30

40

50

Physicalneglect

Emotionalneglect

Physicalabuse

Emotionalabuse


FamilyHistory of

mentalillness or

alcohol abuse

Females(n=1076)

Males(n=4800)


alcohol abuse

(n=1076) (n=4800)


28

49

37

7 7

48

12

30

11

0

10

20

30

40

50

60





29

60

1613

7 7

57

15 15

7 7

54

1517

59

50

1517

5

12

52

1517

4

10

0

10

20

30

40

50

60

70



Common Components






31

13

6 63 1 1

18

36

30 1

13

6 63 1 1

32

25

5

18 18

7

20

7

13

23

2 3

0

10

20

30

40

50


program

Lack ofmotivation


program use





162

needs to get


163

9 8

45 53

9 8

47

18

5

24

29

11

0

10

20

30

40

50





Questions

cgilmanhjforg

dfp102psuedu



Disclosure


Objectives



Disclosures



Slide Number 10




Slide Number 14


Disclosures

Objectives

Slide Number 18

Research Aims


Slide Number 21









Common Components




Questions



12


BA

RR

IE

RS



13


Policy amp Systems-

Level Change

Providers

Community Assets





Letrsquos Talk




Disclosures


Objectives




VA Benefits

Vocational Rehab



to Work

Program M

Your Community

Housing Assistance


Financial Planning

Program C

Program H

Program Q

Program

Program R

Program F

ACMEEmployment


Adventure

Local University

Support Groups

Program O

Program Y

Program K

Program

Program A

Sergeant Smith

Program J

Program B

Military OneSource


(TAP)Program

W









Research Aims

Study Sponsors

HJFProgram Director

Daniel Perkins

PhDPenn State


VA


Laurel Copeland

PhD VA Cent

West Mass


20


















satisfaction

WELL-BEING







conditions




savings


problems etc






involvement




community

Voca

tion

Fina

nces

Heal

thSo

cial




of life domain


role status




Wave 1 (n=9566)

Wave 6(n=5258)

Male 841 818 815

Female 159 182 185

Army 321 329 31

Navy 188 192 193

Air Force 135 190 199

Marines 172 159 166












24





25








Health


19

38

32

58

51

24

35

42

35

27

31

0 10 20 30 40 50 60 70


Probable anxiety

Probable depression

Probable PTSD

Probable TBI


Combat exposure





26


27

14

3126

39

2216

38

10

18 17

26

611

22

0

10

20

30

40

50

Physicalneglect

Emotionalneglect

Physicalabuse

Emotionalabuse


FamilyHistory of

mentalillness or

alcohol abuse

Females(n=1076)

Males(n=4800)


alcohol abuse

(n=1076) (n=4800)


28

49

37

7 7

48

12

30

11

0

10

20

30

40

50

60





29

60

1613

7 7

57

15 15

7 7

54

1517

59

50

1517

5

12

52

1517

4

10

0

10

20

30

40

50

60

70



Common Components






31

13

6 63 1 1

18

36

30 1

13

6 63 1 1

32

25

5

18 18

7

20

7

13

23

2 3

0

10

20

30

40

50


program

Lack ofmotivation


program use





162

needs to get


163

9 8

45 53

9 8

47

18

5

24

29

11

0

10

20

30

40

50





Questions

cgilmanhjforg

dfp102psuedu



Disclosure


Objectives



Disclosures



Slide Number 10




Slide Number 14


Disclosures

Objectives

Slide Number 18

Research Aims


Slide Number 21









Common Components




Questions



13


Policy amp Systems-

Level Change

Providers

Community Assets





Letrsquos Talk




Disclosures


Objectives




VA Benefits

Vocational Rehab



to Work

Program M

Your Community

Housing Assistance


Financial Planning

Program C

Program H

Program Q

Program

Program R

Program F

ACMEEmployment


Adventure

Local University

Support Groups

Program O

Program Y

Program K

Program

Program A

Sergeant Smith

Program J

Program B

Military OneSource


(TAP)Program

W









Research Aims

Study Sponsors

HJFProgram Director

Daniel Perkins

PhDPenn State


VA


Laurel Copeland

PhD VA Cent

West Mass


20


















satisfaction

WELL-BEING







conditions




savings


problems etc






involvement




community

Voca

tion

Fina

nces

Heal

thSo

cial




of life domain


role status




Wave 1 (n=9566)

Wave 6(n=5258)

Male 841 818 815

Female 159 182 185

Army 321 329 31

Navy 188 192 193

Air Force 135 190 199

Marines 172 159 166












24





25








Health


19

38

32

58

51

24

35

42

35

27

31

0 10 20 30 40 50 60 70


Probable anxiety

Probable depression

Probable PTSD

Probable TBI


Combat exposure





26


27

14

3126

39

2216

38

10

18 17

26

611

22

0

10

20

30

40

50

Physicalneglect

Emotionalneglect

Physicalabuse

Emotionalabuse


FamilyHistory of

mentalillness or

alcohol abuse

Females(n=1076)

Males(n=4800)


alcohol abuse

(n=1076) (n=4800)


28

49

37

7 7

48

12

30

11

0

10

20

30

40

50

60





29

60

1613

7 7

57

15 15

7 7

54

1517

59

50

1517

5

12

52

1517

4

10

0

10

20

30

40

50

60

70



Common Components






31

13

6 63 1 1

18

36

30 1

13

6 63 1 1

32

25

5

18 18

7

20

7

13

23

2 3

0

10

20

30

40

50


program

Lack ofmotivation


program use





162

needs to get


163

9 8

45 53

9 8

47

18

5

24

29

11

0

10

20

30

40

50





Questions

cgilmanhjforg

dfp102psuedu



Disclosure


Objectives



Disclosures



Slide Number 10




Slide Number 14


Disclosures

Objectives

Slide Number 18

Research Aims


Slide Number 21









Common Components




Questions


Letrsquos Talk




Disclosures


Objectives




VA Benefits

Vocational Rehab



to Work

Program M

Your Community

Housing Assistance


Financial Planning

Program C

Program H

Program Q

Program

Program R

Program F

ACMEEmployment


Adventure

Local University

Support Groups

Program O

Program Y

Program K

Program

Program A

Sergeant Smith

Program J

Program B

Military OneSource


(TAP)Program

W









Research Aims

Study Sponsors

HJFProgram Director

Daniel Perkins

PhDPenn State


VA


Laurel Copeland

PhD VA Cent

West Mass


20


















satisfaction

WELL-BEING







conditions




savings


problems etc






involvement




community

Voca

tion

Fina

nces

Heal

thSo

cial




of life domain


role status




Wave 1 (n=9566)

Wave 6(n=5258)

Male 841 818 815

Female 159 182 185

Army 321 329 31

Navy 188 192 193

Air Force 135 190 199

Marines 172 159 166












24





25








Health


19

38

32

58

51

24

35

42

35

27

31

0 10 20 30 40 50 60 70


Probable anxiety

Probable depression

Probable PTSD

Probable TBI


Combat exposure





26


27

14

3126

39

2216

38

10

18 17

26

611

22

0

10

20

30

40

50

Physicalneglect

Emotionalneglect

Physicalabuse

Emotionalabuse


FamilyHistory of

mentalillness or

alcohol abuse

Females(n=1076)

Males(n=4800)


alcohol abuse

(n=1076) (n=4800)


28

49

37

7 7

48

12

30

11

0

10

20

30

40

50

60





29

60

1613

7 7

57

15 15

7 7

54

1517

59

50

1517

5

12

52

1517

4

10

0

10

20

30

40

50

60

70



Common Components






31

13

6 63 1 1

18

36

30 1

13

6 63 1 1

32

25

5

18 18

7

20

7

13

23

2 3

0

10

20

30

40

50


program

Lack ofmotivation


program use





162

needs to get


163

9 8

45 53

9 8

47

18

5

24

29

11

0

10

20

30

40

50





Questions

cgilmanhjforg

dfp102psuedu



Disclosure


Objectives



Disclosures



Slide Number 10




Slide Number 14


Disclosures

Objectives

Slide Number 18

Research Aims


Slide Number 21









Common Components




Questions





Disclosures


Objectives




VA Benefits

Vocational Rehab



to Work

Program M

Your Community

Housing Assistance


Financial Planning

Program C

Program H

Program Q

Program

Program R

Program F

ACMEEmployment


Adventure

Local University

Support Groups

Program O

Program Y

Program K

Program

Program A

Sergeant Smith

Program J

Program B

Military OneSource


(TAP)Program

W









Research Aims

Study Sponsors

HJFProgram Director

Daniel Perkins

PhDPenn State


VA


Laurel Copeland

PhD VA Cent

West Mass


20


















satisfaction

WELL-BEING







conditions




savings


problems etc






involvement




community

Voca

tion

Fina

nces

Heal

thSo

cial




of life domain


role status




Wave 1 (n=9566)

Wave 6(n=5258)

Male 841 818 815

Female 159 182 185

Army 321 329 31

Navy 188 192 193

Air Force 135 190 199

Marines 172 159 166












24





25








Health


19

38

32

58

51

24

35

42

35

27

31

0 10 20 30 40 50 60 70


Probable anxiety

Probable depression

Probable PTSD

Probable TBI


Combat exposure





26


27

14

3126

39

2216

38

10

18 17

26

611

22

0

10

20

30

40

50

Physicalneglect

Emotionalneglect

Physicalabuse

Emotionalabuse


FamilyHistory of

mentalillness or

alcohol abuse

Females(n=1076)

Males(n=4800)


alcohol abuse

(n=1076) (n=4800)


28

49

37

7 7

48

12

30

11

0

10

20

30

40

50

60





29

60

1613

7 7

57

15 15

7 7

54

1517

59

50

1517

5

12

52

1517

4

10

0

10

20

30

40

50

60

70



Common Components






31

13

6 63 1 1

18

36

30 1

13

6 63 1 1

32

25

5

18 18

7

20

7

13

23

2 3

0

10

20

30

40

50


program

Lack ofmotivation


program use





162

needs to get


163

9 8

45 53

9 8

47

18

5

24

29

11

0

10

20

30

40

50





Questions

cgilmanhjforg

dfp102psuedu



Disclosure


Objectives



Disclosures



Slide Number 10




Slide Number 14


Disclosures

Objectives

Slide Number 18

Research Aims


Slide Number 21









Common Components




Questions


Objectives




VA Benefits

Vocational Rehab



to Work

Program M

Your Community

Housing Assistance


Financial Planning

Program C

Program H

Program Q

Program

Program R

Program F

ACMEEmployment


Adventure

Local University

Support Groups

Program O

Program Y

Program K

Program

Program A

Sergeant Smith

Program J

Program B

Military OneSource


(TAP)Program

W









Research Aims

Study Sponsors

HJFProgram Director

Daniel Perkins

PhDPenn State


VA


Laurel Copeland

PhD VA Cent

West Mass


20


















satisfaction

WELL-BEING







conditions




savings


problems etc






involvement




community

Voca

tion

Fina

nces

Heal

thSo

cial




of life domain


role status




Wave 1 (n=9566)

Wave 6(n=5258)

Male 841 818 815

Female 159 182 185

Army 321 329 31

Navy 188 192 193

Air Force 135 190 199

Marines 172 159 166












24





25








Health


19

38

32

58

51

24

35

42

35

27

31

0 10 20 30 40 50 60 70


Probable anxiety

Probable depression

Probable PTSD

Probable TBI


Combat exposure





26


27

14

3126

39

2216

38

10

18 17

26

611

22

0

10

20

30

40

50

Physicalneglect

Emotionalneglect

Physicalabuse

Emotionalabuse


FamilyHistory of

mentalillness or

alcohol abuse

Females(n=1076)

Males(n=4800)


alcohol abuse

(n=1076) (n=4800)


28

49

37

7 7

48

12

30

11

0

10

20

30

40

50

60





29

60

1613

7 7

57

15 15

7 7

54

1517

59

50

1517

5

12

52

1517

4

10

0

10

20

30

40

50

60

70



Common Components






31

13

6 63 1 1

18

36

30 1

13

6 63 1 1

32

25

5

18 18

7

20

7

13

23

2 3

0

10

20

30

40

50


program

Lack ofmotivation


program use





162

needs to get


163

9 8

45 53

9 8

47

18

5

24

29

11

0

10

20

30

40

50





Questions

cgilmanhjforg

dfp102psuedu



Disclosure


Objectives



Disclosures



Slide Number 10




Slide Number 14


Disclosures

Objectives

Slide Number 18

Research Aims


Slide Number 21









Common Components




Questions


VA Benefits

Vocational Rehab



to Work

Program M

Your Community

Housing Assistance


Financial Planning

Program C

Program H

Program Q

Program

Program R

Program F

ACMEEmployment


Adventure

Local University

Support Groups

Program O

Program Y

Program K

Program

Program A

Sergeant Smith

Program J

Program B

Military OneSource


(TAP)Program

W









Research Aims

Study Sponsors

HJFProgram Director

Daniel Perkins

PhDPenn State


VA


Laurel Copeland

PhD VA Cent

West Mass


20


















satisfaction

WELL-BEING







conditions




savings


problems etc






involvement




community

Voca

tion

Fina

nces

Heal

thSo

cial




of life domain


role status




Wave 1 (n=9566)

Wave 6(n=5258)

Male 841 818 815

Female 159 182 185

Army 321 329 31

Navy 188 192 193

Air Force 135 190 199

Marines 172 159 166












24





25








Health


19

38

32

58

51

24

35

42

35

27

31

0 10 20 30 40 50 60 70


Probable anxiety

Probable depression

Probable PTSD

Probable TBI


Combat exposure





26


27

14

3126

39

2216

38

10

18 17

26

611

22

0

10

20

30

40

50

Physicalneglect

Emotionalneglect

Physicalabuse

Emotionalabuse


FamilyHistory of

mentalillness or

alcohol abuse

Females(n=1076)

Males(n=4800)


alcohol abuse

(n=1076) (n=4800)


28

49

37

7 7

48

12

30

11

0

10

20

30

40

50

60





29

60

1613

7 7

57

15 15

7 7

54

1517

59

50

1517

5

12

52

1517

4

10

0

10

20

30

40

50

60

70



Common Components






31

13

6 63 1 1

18

36

30 1

13

6 63 1 1

32

25

5

18 18

7

20

7

13

23

2 3

0

10

20

30

40

50


program

Lack ofmotivation


program use





162

needs to get


163

9 8

45 53

9 8

47

18

5

24

29

11

0

10

20

30

40

50





Questions

cgilmanhjforg

dfp102psuedu



Disclosure


Objectives



Disclosures



Slide Number 10




Slide Number 14


Disclosures

Objectives

Slide Number 18

Research Aims


Slide Number 21









Common Components




Questions









Research Aims

Study Sponsors

HJFProgram Director

Daniel Perkins

PhDPenn State


VA


Laurel Copeland

PhD VA Cent

West Mass


20


















satisfaction

WELL-BEING







conditions




savings


problems etc






involvement




community

Voca

tion

Fina

nces

Heal

thSo

cial




of life domain


role status




Wave 1 (n=9566)

Wave 6(n=5258)

Male 841 818 815

Female 159 182 185

Army 321 329 31

Navy 188 192 193

Air Force 135 190 199

Marines 172 159 166












24





25








Health


19

38

32

58

51

24

35

42

35

27

31

0 10 20 30 40 50 60 70


Probable anxiety

Probable depression

Probable PTSD

Probable TBI


Combat exposure





26


27

14

3126

39

2216

38

10

18 17

26

611

22

0

10

20

30

40

50

Physicalneglect

Emotionalneglect

Physicalabuse

Emotionalabuse


FamilyHistory of

mentalillness or

alcohol abuse

Females(n=1076)

Males(n=4800)


alcohol abuse

(n=1076) (n=4800)


28

49

37

7 7

48

12

30

11

0

10

20

30

40

50

60





29

60

1613

7 7

57

15 15

7 7

54

1517

59

50

1517

5

12

52

1517

4

10

0

10

20

30

40

50

60

70



Common Components






31

13

6 63 1 1

18

36

30 1

13

6 63 1 1

32

25

5

18 18

7

20

7

13

23

2 3

0

10

20

30

40

50


program

Lack ofmotivation


program use





162

needs to get


163

9 8

45 53

9 8

47

18

5

24

29

11

0

10

20

30

40

50





Questions

cgilmanhjforg

dfp102psuedu



Disclosure


Objectives



Disclosures



Slide Number 10




Slide Number 14


Disclosures

Objectives

Slide Number 18

Research Aims


Slide Number 21









Common Components




Questions


Study Sponsors

HJFProgram Director

Daniel Perkins

PhDPenn State


VA


Laurel Copeland

PhD VA Cent

West Mass


20


















satisfaction

WELL-BEING







conditions




savings


problems etc






involvement




community

Voca

tion

Fina

nces

Heal

thSo

cial




of life domain


role status




Wave 1 (n=9566)

Wave 6(n=5258)

Male 841 818 815

Female 159 182 185

Army 321 329 31

Navy 188 192 193

Air Force 135 190 199

Marines 172 159 166












24





25








Health


19

38

32

58

51

24

35

42

35

27

31

0 10 20 30 40 50 60 70


Probable anxiety

Probable depression

Probable PTSD

Probable TBI


Combat exposure





26


27

14

3126

39

2216

38

10

18 17

26

611

22

0

10

20

30

40

50

Physicalneglect

Emotionalneglect

Physicalabuse

Emotionalabuse


FamilyHistory of

mentalillness or

alcohol abuse

Females(n=1076)

Males(n=4800)


alcohol abuse

(n=1076) (n=4800)


28

49

37

7 7

48

12

30

11

0

10

20

30

40

50

60





29

60

1613

7 7

57

15 15

7 7

54

1517

59

50

1517

5

12

52

1517

4

10

0

10

20

30

40

50

60

70



Common Components






31

13

6 63 1 1

18

36

30 1

13

6 63 1 1

32

25

5

18 18

7

20

7

13

23

2 3

0

10

20

30

40

50


program

Lack ofmotivation


program use





162

needs to get


163

9 8

45 53

9 8

47

18

5

24

29

11

0

10

20

30

40

50





Questions

cgilmanhjforg

dfp102psuedu



Disclosure


Objectives



Disclosures



Slide Number 10




Slide Number 14


Disclosures

Objectives

Slide Number 18

Research Aims


Slide Number 21









Common Components




Questions


















satisfaction

WELL-BEING







conditions




savings


problems etc






involvement




community

Voca

tion

Fina

nces

Heal

thSo

cial




of life domain


role status




Wave 1 (n=9566)

Wave 6(n=5258)

Male 841 818 815

Female 159 182 185

Army 321 329 31

Navy 188 192 193

Air Force 135 190 199

Marines 172 159 166












24





25








Health


19

38

32

58

51

24

35

42

35

27

31

0 10 20 30 40 50 60 70


Probable anxiety

Probable depression

Probable PTSD

Probable TBI


Combat exposure





26


27

14

3126

39

2216

38

10

18 17

26

611

22

0

10

20

30

40

50

Physicalneglect

Emotionalneglect

Physicalabuse

Emotionalabuse


FamilyHistory of

mentalillness or

alcohol abuse

Females(n=1076)

Males(n=4800)


alcohol abuse

(n=1076) (n=4800)


28

49

37

7 7

48

12

30

11

0

10

20

30

40

50

60





29

60

1613

7 7

57

15 15

7 7

54

1517

59

50

1517

5

12

52

1517

4

10

0

10

20

30

40

50

60

70



Common Components






31

13

6 63 1 1

18

36

30 1

13

6 63 1 1

32

25

5

18 18

7

20

7

13

23

2 3

0

10

20

30

40

50


program

Lack ofmotivation


program use





162

needs to get


163

9 8

45 53

9 8

47

18

5

24

29

11

0

10

20

30

40

50





Questions

cgilmanhjforg

dfp102psuedu



Disclosure


Objectives



Disclosures



Slide Number 10




Slide Number 14


Disclosures

Objectives

Slide Number 18

Research Aims


Slide Number 21









Common Components




Questions







conditions




savings


problems etc






involvement




community

Voca

tion

Fina

nces

Heal

thSo

cial




of life domain


role status




Wave 1 (n=9566)

Wave 6(n=5258)

Male 841 818 815

Female 159 182 185

Army 321 329 31

Navy 188 192 193

Air Force 135 190 199

Marines 172 159 166












24





25








Health


19

38

32

58

51

24

35

42

35

27

31

0 10 20 30 40 50 60 70


Probable anxiety

Probable depression

Probable PTSD

Probable TBI


Combat exposure





26


27

14

3126

39

2216

38

10

18 17

26

611

22

0

10

20

30

40

50

Physicalneglect

Emotionalneglect

Physicalabuse

Emotionalabuse


FamilyHistory of

mentalillness or

alcohol abuse

Females(n=1076)

Males(n=4800)


alcohol abuse

(n=1076) (n=4800)


28

49

37

7 7

48

12

30

11

0

10

20

30

40

50

60





29

60

1613

7 7

57

15 15

7 7

54

1517

59

50

1517

5

12

52

1517

4

10

0

10

20

30

40

50

60

70



Common Components






31

13

6 63 1 1

18

36

30 1

13

6 63 1 1

32

25

5

18 18

7

20

7

13

23

2 3

0

10

20

30

40

50


program

Lack ofmotivation


program use





162

needs to get


163

9 8

45 53

9 8

47

18

5

24

29

11

0

10

20

30

40

50





Questions

cgilmanhjforg

dfp102psuedu



Disclosure


Objectives



Disclosures



Slide Number 10




Slide Number 14


Disclosures

Objectives

Slide Number 18

Research Aims


Slide Number 21









Common Components




Questions



Wave 1 (n=9566)

Wave 6(n=5258)

Male 841 818 815

Female 159 182 185

Army 321 329 31

Navy 188 192 193

Air Force 135 190 199

Marines 172 159 166












24





25








Health


19

38

32

58

51

24

35

42

35

27

31

0 10 20 30 40 50 60 70


Probable anxiety

Probable depression

Probable PTSD

Probable TBI


Combat exposure





26


27

14

3126

39

2216

38

10

18 17

26

611

22

0

10

20

30

40

50

Physicalneglect

Emotionalneglect

Physicalabuse

Emotionalabuse


FamilyHistory of

mentalillness or

alcohol abuse

Females(n=1076)

Males(n=4800)


alcohol abuse

(n=1076) (n=4800)


28

49

37

7 7

48

12

30

11

0

10

20

30

40

50

60





29

60

1613

7 7

57

15 15

7 7

54

1517

59

50

1517

5

12

52

1517

4

10

0

10

20

30

40

50

60

70



Common Components






31

13

6 63 1 1

18

36

30 1

13

6 63 1 1

32

25

5

18 18

7

20

7

13

23

2 3

0

10

20

30

40

50


program

Lack ofmotivation


program use





162

needs to get


163

9 8

45 53

9 8

47

18

5

24

29

11

0

10

20

30

40

50





Questions

cgilmanhjforg

dfp102psuedu



Disclosure


Objectives



Disclosures



Slide Number 10




Slide Number 14


Disclosures

Objectives

Slide Number 18

Research Aims


Slide Number 21









Common Components




Questions






24





25








Health


19

38

32

58

51

24

35

42

35

27

31

0 10 20 30 40 50 60 70


Probable anxiety

Probable depression

Probable PTSD

Probable TBI


Combat exposure





26


27

14

3126

39

2216

38

10

18 17

26

611

22

0

10

20

30

40

50

Physicalneglect

Emotionalneglect

Physicalabuse

Emotionalabuse


FamilyHistory of

mentalillness or

alcohol abuse

Females(n=1076)

Males(n=4800)


alcohol abuse

(n=1076) (n=4800)


28

49

37

7 7

48

12

30

11

0

10

20

30

40

50

60





29

60

1613

7 7

57

15 15

7 7

54

1517

59

50

1517

5

12

52

1517

4

10

0

10

20

30

40

50

60

70



Common Components






31

13

6 63 1 1

18

36

30 1

13

6 63 1 1

32

25

5

18 18

7

20

7

13

23

2 3

0

10

20

30

40

50


program

Lack ofmotivation


program use





162

needs to get


163

9 8

45 53

9 8

47

18

5

24

29

11

0

10

20

30

40

50





Questions

cgilmanhjforg

dfp102psuedu



Disclosure


Objectives



Disclosures



Slide Number 10




Slide Number 14


Disclosures

Objectives

Slide Number 18

Research Aims


Slide Number 21









Common Components




Questions



25








Health


19

38

32

58

51

24

35

42

35

27

31

0 10 20 30 40 50 60 70


Probable anxiety

Probable depression

Probable PTSD

Probable TBI


Combat exposure





26


27

14

3126

39

2216

38

10

18 17

26

611

22

0

10

20

30

40

50

Physicalneglect

Emotionalneglect

Physicalabuse

Emotionalabuse


FamilyHistory of

mentalillness or

alcohol abuse

Females(n=1076)

Males(n=4800)


alcohol abuse

(n=1076) (n=4800)


28

49

37

7 7

48

12

30

11

0

10

20

30

40

50

60





29

60

1613

7 7

57

15 15

7 7

54

1517

59

50

1517

5

12

52

1517

4

10

0

10

20

30

40

50

60

70



Common Components






31

13

6 63 1 1

18

36

30 1

13

6 63 1 1

32

25

5

18 18

7

20

7

13

23

2 3

0

10

20

30

40

50


program

Lack ofmotivation


program use





162

needs to get


163

9 8

45 53

9 8

47

18

5

24

29

11

0

10

20

30

40

50





Questions

cgilmanhjforg

dfp102psuedu



Disclosure


Objectives



Disclosures



Slide Number 10




Slide Number 14


Disclosures

Objectives

Slide Number 18

Research Aims


Slide Number 21









Common Components




Questions



19

38

32

58

51

24

35

42

35

27

31

0 10 20 30 40 50 60 70


Probable anxiety

Probable depression

Probable PTSD

Probable TBI


Combat exposure





26


27

14

3126

39

2216

38

10

18 17

26

611

22

0

10

20

30

40

50

Physicalneglect

Emotionalneglect

Physicalabuse

Emotionalabuse


FamilyHistory of

mentalillness or

alcohol abuse

Females(n=1076)

Males(n=4800)


alcohol abuse

(n=1076) (n=4800)


28

49

37

7 7

48

12

30

11

0

10

20

30

40

50

60





29

60

1613

7 7

57

15 15

7 7

54

1517

59

50

1517

5

12

52

1517

4

10

0

10

20

30

40

50

60

70



Common Components






31

13

6 63 1 1

18

36

30 1

13

6 63 1 1

32

25

5

18 18

7

20

7

13

23

2 3

0

10

20

30

40

50


program

Lack ofmotivation


program use





162

needs to get


163

9 8

45 53

9 8

47

18

5

24

29

11

0

10

20

30

40

50





Questions

cgilmanhjforg

dfp102psuedu



Disclosure


Objectives



Disclosures



Slide Number 10




Slide Number 14


Disclosures

Objectives

Slide Number 18

Research Aims


Slide Number 21









Common Components




Questions



27

14

3126

39

2216

38

10

18 17

26

611

22

0

10

20

30

40

50

Physicalneglect

Emotionalneglect

Physicalabuse

Emotionalabuse


FamilyHistory of

mentalillness or

alcohol abuse

Females(n=1076)

Males(n=4800)


alcohol abuse

(n=1076) (n=4800)


28

49

37

7 7

48

12

30

11

0

10

20

30

40

50

60





29

60

1613

7 7

57

15 15

7 7

54

1517

59

50

1517

5

12

52

1517

4

10

0

10

20

30

40

50

60

70



Common Components






31

13

6 63 1 1

18

36

30 1

13

6 63 1 1

32

25

5

18 18

7

20

7

13

23

2 3

0

10

20

30

40

50


program

Lack ofmotivation


program use





162

needs to get


163

9 8

45 53

9 8

47

18

5

24

29

11

0

10

20

30

40

50





Questions

cgilmanhjforg

dfp102psuedu



Disclosure


Objectives



Disclosures



Slide Number 10




Slide Number 14


Disclosures

Objectives

Slide Number 18

Research Aims


Slide Number 21









Common Components




Questions



28

49

37

7 7

48

12

30

11

0

10

20

30

40

50

60





29

60

1613

7 7

57

15 15

7 7

54

1517

59

50

1517

5

12

52

1517

4

10

0

10

20

30

40

50

60

70



Common Components






31

13

6 63 1 1

18

36

30 1

13

6 63 1 1

32

25

5

18 18

7

20

7

13

23

2 3

0

10

20

30

40

50


program

Lack ofmotivation


program use





162

needs to get


163

9 8

45 53

9 8

47

18

5

24

29

11

0

10

20

30

40

50





Questions

cgilmanhjforg

dfp102psuedu



Disclosure


Objectives



Disclosures



Slide Number 10




Slide Number 14


Disclosures

Objectives

Slide Number 18

Research Aims


Slide Number 21









Common Components




Questions



29

60

1613

7 7

57

15 15

7 7

54

1517

59

50

1517

5

12

52

1517

4

10

0

10

20

30

40

50

60

70



Common Components






31

13

6 63 1 1

18

36

30 1

13

6 63 1 1

32

25

5

18 18

7

20

7

13

23

2 3

0

10

20

30

40

50


program

Lack ofmotivation


program use





162

needs to get


163

9 8

45 53

9 8

47

18

5

24

29

11

0

10

20

30

40

50





Questions

cgilmanhjforg

dfp102psuedu



Disclosure


Objectives



Disclosures



Slide Number 10




Slide Number 14


Disclosures

Objectives

Slide Number 18

Research Aims


Slide Number 21









Common Components




Questions


Common Components






31

13

6 63 1 1

18

36

30 1

13

6 63 1 1

32

25

5

18 18

7

20

7

13

23

2 3

0

10

20

30

40

50


program

Lack ofmotivation


program use





162

needs to get


163

9 8

45 53

9 8

47

18

5

24

29

11

0

10

20

30

40

50





Questions

cgilmanhjforg

dfp102psuedu



Disclosure


Objectives



Disclosures



Slide Number 10




Slide Number 14


Disclosures

Objectives

Slide Number 18

Research Aims


Slide Number 21









Common Components




Questions



31

13

6 63 1 1

18

36

30 1

13

6 63 1 1

32

25

5

18 18

7

20

7

13

23

2 3

0

10

20

30

40

50


program

Lack ofmotivation


program use





162

needs to get


163

9 8

45 53

9 8

47

18

5

24

29

11

0

10

20

30

40

50





Questions

cgilmanhjforg

dfp102psuedu



Disclosure


Objectives



Disclosures



Slide Number 10




Slide Number 14


Disclosures

Objectives

Slide Number 18

Research Aims


Slide Number 21









Common Components




Questions





162

needs to get


163

9 8

45 53

9 8

47

18

5

24

29

11

0

10

20

30

40

50





Questions

cgilmanhjforg

dfp102psuedu



Disclosure


Objectives



Disclosures



Slide Number 10




Slide Number 14


Disclosures

Objectives

Slide Number 18

Research Aims


Slide Number 21









Common Components




Questions



163

9 8

45 53

9 8

47

18

5

24

29

11

0

10

20

30

40

50





Questions

cgilmanhjforg

dfp102psuedu



Disclosure


Objectives



Disclosures



Slide Number 10




Slide Number 14


Disclosures

Objectives

Slide Number 18

Research Aims


Slide Number 21









Common Components




Questions


Questions

cgilmanhjforg

dfp102psuedu



Disclosure


Objectives



Disclosures



Slide Number 10




Slide Number 14


Disclosures

Objectives

Slide Number 18

Research Aims


Slide Number 21









Common Components




Questions




Disclosure


Objectives



Disclosures



Slide Number 10




Slide Number 14


Disclosures

Objectives

Slide Number 18

Research Aims


Slide Number 21









Common Components




Questions


social determinants of health for military service members ... · social risk score high before and...

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