Military specific risk and protective factors for military family health outcomes

General information

Code: J5-1786
Period: 1.7.2019 - 30.6.2023
Range on year: 0.83 FTE | 2019
Project leader at FDV: prof.dr. Janja Vuga Beršnak
External project leader: Fakulteta za družbene vede Univerze v Ljubljani
Co-financiers: Javna agencija za znanstvenoraziskovalno in inovacijsko dejavnost Republike Slovenije
Research activity: Social sciences

Abstract

More on research project available at: https://www.fdv.uni-lj.si/en/research/research-centres/department-of-political-science/defence-research-centre/military-families Through the centuries, the military organization has been subjected to evolution, much like any other organization. Therefore, the position of the military in societies has been changing as well. Similarly, the research on military organizations from the perspective of military sociology has been moving from general themes to very specific ones. The research on military families’ health is congruent with such a development. We have applied the United Nations definition: The family is constituted of at least one adult person or more adults taking care of a child/children. We add that for the purpose of our research one of the parents must be member of Slovenian armed forces and there must be at least one child younger than 18 years, to classify the family as military family. The military as an institution, as well as service members and their families, constitute a significant part of society; consequently, their well-being and health outcomes manifest on various social levels. Research on military families needs to be put into the wider social context, especially social changes in this field during the last fifty years. This enables us to explain specific characteristics of military families and their way of family life and the challenges and problems that they are facing. Particular attention is paid to general trends, characteristic for Western countries, as well as specificities of family life in Slovenia. This is particularly relevant since the majority of literature comes from other Western countries. Among the phenomena that have to be taken into account we find changes in gender roles (gender equality, employment of women), division of labour in the family and reconciliation of work and family responsibilities, and changes in relation to children or new social imperatives regarding parenting (protective child-rearing, continuously increasing norms regarding successful parenting etc.). In the Slovenian context, we must not overlook the fact that despite the predominant model of two-generational families (parents and children), we have strong and well-developed intergenerational and kinship networks and that the third generation (grandparents) plays an important role, especially regarding caring for children/grandchildren, unpaid family work etc., which is an extremely important element in terms of support the family receives in everyday life. All aforementioned needs to be taken into account when analysing military demands (e.g., the demand on service members to devote their lives to the service or take the lives of others in the name of the country). Such demands affect the whole family and often lead to various dysfunctions (e.g., stress in children, family violence, alcohol abuse, depression), which have a long-term negative impact on society (e.g., health, education). Coser (1974) defined both the military and the family as ‘greedy’ institutions. Part 2 will outline the spectrum of demands that military life puts on service members and their families and the effect of these demands on family health outcomes and well-being. Based on indicators identified in previous research and application of the Bronfenbrenner's model, we have developed a causation model of socio-ecological risk/protective factors affecting family health outcomes. We used a top down approach and identified the main problems that should be resolved in order to understand potential negative health outcomes. Those are: identification of key risk/protective factors (including the national and institutional formal/legal frame), developing an appropriate measuring tool to quantify them, as well as understanding the differences between military and civilian environments. Only addressing all aforementioned problems will enable us to identify the full spectrum of negative health outcomes within military families and to develop/propose appropriate interventions. Research objectives 1) Review current national (Slovenian) policies and support programmes, as well as compare general national and specific military support programmes and policies. 2) Modify the list of identified military family health outcomes based on social and cultural specifics and evaluate the appropriateness of the selected measurement tool. 3) Identify key risk/protective factors for each health outcome within an individual socio-ecological level and develop an integrative risk/protective factors model, along with proposals for intervention. 4) Establish whether risk/protective factors are military-specific. We will apply an integrative approach, observing military families from various scientific perspectives (e.g., military sociology, psychology, behavioural science) and on different socio-ecological levels, enabling us to observe the interplay of risk/protective factors on various socio-ecological levels. The measurement tool (scales) has mostly been developed in Western societies and needs to be tested it to find out whether it is appropriate for the Slovenian cultural and social environment. We have developed the model of risk/protective factors for selected military family health outcomes, which will be tested and modified, providing a comprehensive overview of essential issues military families are facing. Simultaneously, we will include a civilian sample to test whether risk/protective factors are military-specific. Our research project is the first integrative research on military families that will include all aforementioned risk protective factors on various socio-ecological levels with the aim to identify how as well as how strongly they affect family health outcomes. Additionally, we will include a comparison with civilian families with the purpose of identifying military specific factors. The civilian testing will open up the possibility for further research on the significance of the effect that military life has on risk/protective factors for family health outcomes. The project will broaden and deepen the research on a specific subfield within military sociology in Slovenia and internationally. Thirdly, the research project will integrate different scientific approaches and perspectives, leading to a comprehensive approach to studying military families. Fourthly, the tested Model of risk/preventive factors for military family health outcomes will enable various stakeholders (e.g., military support structures, military leaders, teachers, social workers, etc.) to recognise the issues pertaining to military families and know how to address them. Based on survey results, we will propose appropriate interventions to prevent negative health outcomes. Testing the interventions will not be a part of this research project.

The phases of the project and their realization

Project phases Project management (0 – 36 months) (WP1) Project management will take place throughout the duration of the research and will be fully dedicated to the management of the project, communication with the supervisor, monitoring the activities, executing the financial and administrative control, reporting obligations, etc. Dissemination and communication (0 – 36 months) (WP2) Communication within the research group and with the stakeholders as well as military families (as object of the research) will take place throughout the whole duration of the project. The last six months will be devoted to distribution of results to the public and the expert and scientific communities, as well as to relevant stakeholders. First phase (0 – 5 months) (WP3) In the first phase, we will apply the qualitative methods to reach the first objective. In the first four months, we will analyse the national and institutional legal frame and state of the art as described in the Detailed description of the work plan. The aim of the first phase is the detailed study of negative health outcomes identified in foreign armed forces. The second phase (6 – 14 months) (WP4) We will discuss the health outcomes and risk/protective factors (as described in the application) with relevant military stakeholders. The aim of the interviews is to discuss the presence of individual health outcomes and risk/protective factors among service members and their spouses. Afterwards, we will upgrade the model (Picture 1) and prepare the questionnaire (see also the Table 1) for the focus groups with selected military families. The partners in the focus groups will also be asked to fill in the survey questionnaire. As explained above, this approach will enable us to measure the family as a unit (service member and spouse). The third phase (15 – 30 months) (WP5) After the conclusion of the first two phases, we will finalize the questionnaire. As described above, we will reach the service members with the assistance of the Slovenian armed forces, who will disseminate the link to service members’ addresses. Service members will be asked to further disseminate the link to their spouses. Our aim is to reach at least 200 families. Obligatory inclusion criteria is that at least one of the parents is employed in the military and the family includes at least one child under the age of 18. Furthermore, we will try to increase the response rate by promoting the survey on a project web page and encouraging military families to participate via the journal Slovenska vojska. To achieve the fourth objective, we will include the civilian sample. Afterwards, the data will be analysed using a statistical tool. We will identify the presence and the strength of health outcomes and risk protective factors on various socio-ecological levels. We will measure the strength of those factors and the impact on the negative health outcomes. We will be able to identify the actual military risk factors by comparing the civilian and the military sample.

Research Organisation

http://www.sicris.si/public/jqm/prj.aspx?lang=eng&opt=2&subopt=403&hits=1&id=17858&search_term=J5-1786

Researchers

http://www.sicris.si/public/jqm/prj.aspx?lang=eng&opt=2&subopt=402&hits=1&id=17858&search_term=J5-1786

Citations for bibliographic records

http://www.sicris.si/public/jqm/prj.aspx?lang=eng&opt=2&subopt=400&hits=1&id=17858&search_term=J5-1786

Results / Key findings

The scientific contribution of our research work over several years is significant, as evidenced by the significant number of research gaps in the Slovenian research landscape that we have filled. Furthermore, we have developed and empirically validated a model of risk factors for the health and well-being of individuals and families, which is also applicable in other settings.

The risk factor model for health outcomes of military families has been found to explain some health outcomes better than others (health outcomes with R2 values higher than 0.200). Post-traumatic stress disorder, self-rated general health, child well-being and depression are explained best.The least explained health outcome in a military family is psychoactive substance abuse. This is an extremely sensitive topic, so a higher level of socially acceptable responses is to be expected compared to other areas, a phenomenon that is particularly true in the military environment where substance abuse is often sanctioned.Conversely, the pattern of abuse of psychoactive substances (in particular drugs, painkillers and stimulants) is well described in the civilian sample.

In the civilian population, the risk factor model provides a more comprehensive explanation of the following health outcomes: depression, post-traumatic stress disorder, self-rated general health, child well-being, parenting, drug abuse and partner satisfaction.In summary, the model offers a more robust explanation of risk factors for health outcomes in the civilian population compared to the military sample.

As illustrated by both schematic representations of the model, the most significant influence of risk factors originates from the micro level, particularly in the context of parental and family stress. These factors are thus deemed to stem from the family environment, exerting influence across a range of domains, including mental health, substance use, marital satisfaction, and child-rearing practices.Noteworthy among the micro level risk factors are workplace stress and financial difficulties. Individual-level factors, on the other hand, manifest less frequently. The most prevalent of these are self-rated health, gender, age of the child, depression, and in the civilian sample, excessive alcohol consumption.At the meso level, two factors are observed: 1) Unemployment of the partner, which is perceived as positive among the members, but as negative in the civil sample. 2) Conflict over the equal sharing of family responsibilities, which is recognised in the civil sample and among the partners, but not among the members. 3) Conflict over the equal sharing of family responsibilities, which is recognised in the civilian sample and among the partners, but not among the members.At the macro level, prolonged absences emerge as a risk factor in the civilian sample, but not, as expected, in the military family. While daily labour migration is present in both samples, it is a negative factor in the civilian sample and a more positive factor in the military family.

In general, it can be concluded that service members and their partners have adapted to the demands of military service and therefore do not feel excessive pressure due to long absences and daily labour migration. However, they do face certain problems that the SAF, in cooperation with external experts, could help to alleviate (e. g. In addition, the EU could assist in the management of these issues by raising awareness among school staff about the challenges faced by children in military families during certain periods or by providing skills (e.g. information on good practices, informal groups, lectures) to help them cope with them. In contrast, the interviews with adult children reveal a different perspective, demonstrating their ability to rationalise the demands of military service, such as long working hours, frequent absences, and extended periods of absence due to stress. However, as adults, they undergo a re-evaluation of the military-specific factors that shaped their childhood and youth. It is evident that they often experienced feelings of absence, whether due to their parents' physical absence due to workload or their own physical absence. Conversely, the participants also highlighted the positive aspects of their military-influenced upbringing, citing the development of responsibility, independence, effective organisation and, potentially, general resilience.

In conclusion, it is evident that military families have demonstrated a higher degree of resilience in comparison to civilian families. The anticipated risk factors, which are predominantly military-specific, did not directly contribute to the adverse health outcomes experienced by service members or their families.In contrast, the study reveals that, while both risk factors are present in the civilian sample, their impact is significantly more pronounced than in military families. This finding suggests that military families may have adapted to a distinct lifestyle and demonstrated resilience through organisational adaptations.

However, it is imperative to acknowledge the potentially detrimental consequences, such as daily work migration, which, while beneficial to the child's financial well-being, may have adverse emotional implications. Furthermore, frequent and prolonged absences have been associated with increased satisfaction in intimate partnerships. Nevertheless, concerns regarding the quality and long-term sustainability of such relationships remain salient.


In the present survey, the SAF has been shown to be mature, professional and responsible. This is evidenced by the fact that the average age of its members is 43 years, which contributes to its maturity. Furthermore, the members of the SAF are able to make sound judgements on a variety of issues, including military professional matters, work-family balance, parenthood, their own health, the health and well-being of their family, and strive for a high quality of life. However, it is important to acknowledge the adverse effects that the demands associated with working in a military organisation can have on the individual. In this context, the family plays a pivotal and positive role in coping with these demands.

Key words

child well-being in military families, health and military families, mental health and military families, military families, military specific risk factors for health and well-being, socioecological modelling

Sustainable Development Goals

SDG3 | Good health and well-being
SDG5 | Gender equality
SDG16 | Peace, justice and strong intitutions