Suchergebnisse

OBJECTIVE: To examine the relative importance of harassment-tolerant norms emanating from troops' senior officers, immediate supervisors, and units on troops' sexual stressor experiences and to see if associations differed by sex. METHOD: Cross-sectional survey of all 681 willing and confirmed active duty troops enrolled in the VA National Enrollment Database between 1998 and 2002. Findings extended an earlier analysis. RESULTS: After adjusting for other significant correlates, senior officers' perceived tolerance of sexual harassment was not associated with the severity of sexual harassment troops reported (p = 0.64) or with the numbers of sexual identity challenges they reported (p = 0.11). Harassment-tolerant norms emanating from troops' units and immediate supervisors were associated with reporting severer sexual harassment and more sexual identity challenges (all p's < 0.003). Findings generalized across sex. CONCLUSIONS: Senior officers' norms did not appear to affect troops' reports of military sexual stressors, but unit norms and immediate supervisors' norms did.

BACKGROUND: Failure to adhere to treatment recommendations has significant impact on the health outcomes of the individual and health care systems. Health coaching is a promising care model that has gained interest in the medical field. This study focused on the impact of health coaching on health behaviors that may have direct impact on successful patient outcomes. PRIMARY STUDY OBJECTIVE: The objective of this study was to assess the impact of health coaching administered through the Polytrauma Integrative Medicine Initiative (PIMI). METHODS/DESIGN: This study was a quasiexperimental cohort study. SETTING: This study occurred at a specialized polytrauma rehabilitation center. PARTICIPANTS: Participants were divided into 3 cohorts: (1) 33 patients who served through PIMI enrollment, (2) 22 patients who declined PIMI, and (3) a control cohort of 30 random patients who were not referred to PIMI. Patients were primarily male active duty or veteran military personnel. INTERVENTION: The intervention consisted of personalized health coaching by trained, certified personnel. PRIMARY OUTCOME MEASURES: Outcome measures included the following (1) Self-assessment: utilizing the Personal Health Inventory (PHI) at enrollment and at 3 mo; (2) treatment adherence: the percentage of scheduled appointments fulfilled by patients; and (3) post hoc analysis: for no-show and cancellation rates; 2-tailed paired t tests for PHI data and post hoc within groups; 2-tailed independent samples t tests for treatment adherence percentages and post hoc between groups. RESULTS: There was no significant difference in treatment adherence rates between the 3 cohorts (all P > .45). PIMI patients had significantly higher cancellation rates than no-show rates for both clinical, 20.8%/5%, and coaching appointments, 17.3%/7.5%, (P < .05). PIMI patients had significantly lower no-show rates, 5%, than control patients, 15.8% (P = .007). PHI data suggest PIMI patients believe they are making improvements in many areas of health coaching focus. ...

OBJECTIVE: Several researchers have identified associations between exposure to occupational sexual stressors (e.g., sexual harassment) and severer psychiatric symptoms in military personnel. However, few controlled for participants' exposures to other high-magnitude stressors, which could have confounded results. We examined the unique association between military sexual stress and severity of participants' psychiatric symptoms after controlling for their other high-magnitude stressor experiences. Organizational- and individual-level predictors of military sexual stress were also assessed. METHOD: We surveyed by mail all active duty troops registered in the Department of Veterans Affairs' Enrollment Database (2001–2003). The questionnaire contained well-validated measures. RESULTS: Eighty-four percent responded (total sample N = 611); of these 56% reported at least one sexual stressor exposure. A highly significant association between military sexual stress and psychiatric symptoms attenuated by two thirds and lost statistical significance once other stressor experiences were controlled. Besides sociodemographics, the strongest correlates of military sexual stress were working in an environment perceived to tolerate sexual harassment, reporting severer childhood maltreatment, and reporting more high-magnitude stressors. A gender-stratified analysis generated similar findings for men and women. CONCLUSIONS: Little unique variance in psychiatric symptom reporting was explained by military sexual stressor exposure after controlling for other stressors. Childhood maltreatment and other high magnitude stressors acted as risk factors for and confounders of military sexual stress. Understanding how and why these stressors inter-relate could lead to better, more effective interventions to reduce them all—and their sequelae. Findings also highlight the need to routinely include men in sexual stress research.

The Department of Defense's "gold standard" sexual harassment measure, the Sexual Harassment Core (SHCore), is based on an earlier measure that was primarily developed in college women. Furthermore, the SHCore requires a reading grade level of 9.1. This may be higher than some troops' reading abilities and could generate unreliable estimates of their sexual harassment experiences. Results from 108 male and 96 female soldiers showed that the SHCore's temporal stability and alternative forms reliability was significantly worse in soldiers without college experience compared to soldiers with college experience and in men compared to women. For men without college experience, almost 80% of the temporal variance in SHCore scores was attributable to error. A plain-language version of the SHCore had mixed effects on temporal stability, depending on education and gender. The SHCore may be particularly ill suited for evaluating population trends of sexual harassment in military men without college experience.