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This final overarching study in a series documents research and recommendations RAND offered to the Air Force to help strengthen the development of a new office responsible for monitoring and promoting resilience among Air Force Airmen, civilian employees, and Air Force families. Efforts to boost resilience have become an important military response to suicide and other markers of distress and poor health. The study reviews the concepts and measures of resilience, resilience factors, hardiness and flourishing. It describes how resilience and the military's Total Force Fitness concepts are related. The study brings together highlights from the eight companion studies on each Total Force Fitness domain and characterizes types of Air Force data that could be used to track resilience.

This study examines the relationship between medical fitness and resilience, using key constructs found in the scientific literature that address preventive care, presence and management of injuries and chronic conditions, and health care access.

Excessive alcohol use, especially binge and heavy drinking, represents a serious threat to force readiness across the Department of Defense. Though these behaviors are a matter of individual service member choice, they are influenced by perceptions of the culture of alcohol use in the military. This paper uses data from the 2018 Health Related Behaviors Survey of Active Duty service members to explore associations between perceived alcohol culture and excessive alcohol use, any serious drinking consequences, risky driving behaviors, productivity loss due to drinking, absenteeism, and presenteeism. Results from multivariate logistic regression reveal a strong, positive correlation between positive perceptions of drinking culture in the military and all outcomes. Targeting perceptions of the drinking culture is one way the military can reduce excessive and unhealthy use of alcohol and negative sequelae.

Drawing upon data from the Deployment Life Study, this article examines whether female military spouses (SPs) are disadvantaged relative to matched civilian peers in terms of hours worked and earnings, paying particular attention to gaps among the highest educated women. Female SPs do earn less than comparable civilian peers in terms of raw dollars and percentage earnings. Moreover, military wives who are part of the labor force work as many hours as their civilian counterparts, but still earn significantly less for that work. Contrary to predictions, the most educated SPs are not disproportionately affected compared to spouses with less education. These results suggest that SPs at all education levels could benefit from employment assistance; in particular, women already participating in the labor force may benefit from support in finding higher paying jobs.

Introduction -- Methodology -- Demographics -- Health Promotion and Disease Prevention -- Substance Use -- Mental and Emotional Health -- Physical Health and Functional Limitations -- Sexual Behavior and Health -- Sexual Orientation, Transgender Identity, and Health -- Deployment Experiences and Health -- Summary and Policy Implications -- Appendix A: 2015 DoD Health Related Behaviors Survey -- Appendix B: Invitation Letters and Letters of Support -- Appendix C: 2015 DoD Health Related Behaviors Survey Frequently Asked Questions -- Appendix D: Description of Measures Used in the 2015 DoD Health Related Behaviors Survey.

To better understand sexual harassment and gender discrimination in the Army, RAND Arroyo Center researchers created profiles of active-component soldiers' most serious sexual harassment and gender discrimination experiences. This report describes the most common types of behaviors that occur, characteristics of (alleged) perpetrators, most common times and places in which sexual harassment and gender discrimination occur, and differences between high-risk and non-high-risk installations. Women's and men's experiences of sexual harassment and gender discrimination look broadly the same at high-risk installations compared with non-high-risk installations, and they do not appear to differ across high-risk installations. However, men's and women's experiences of sexual harassment and gender discrimination in the active-component Army are very different. Women are more likely than men to experience gender discrimination, repeated attempts to establish an unwanted romantic or sexual relationship, and sexual comments about their appearance, whereas men are more likely than women to be told that they do not act like a man is supposed to act. Soldiers often experience multiple forms of sexual harassment and gender discrimination; women experience more types of behaviors, on average, than men do. What women's and men's experiences have in common is that they frequently take place at work during the workday and involve exposure to offensive or persistent discussion of and jokes about sex

This article explores how neighborhood theory and social indicators research shed light on quality of life in and around military bases, gaps in the methodology, and how a more in-depth analysis of military installations could be conducted.

Military life presents a variety of challenges to military families, including frequent separations and relocations as well as the risks that service members face during deployment; however, many families successfully navigate these challenges. Despite a recent emphasis on family resilience, the U.S. Department of Defense (DoD) does not have a standard and universally accepted definition of family resilience. A standard definition is a necessary for DoD to more effectively assess its efforts to sustain and improve family resilience. RAND authors reviewed the literature on family resilience and, in this study, recommend a definition that could be used DoD-wide. The authors also reviewed DoD policies related to family resilience, reviewed models that describe family resilience and identified key family resilience factors, and developed several recommendations for how family-resilience programs and policies could be managed across DoD.

For Marine and Family Division (MF) programs and services to remain meaningful, credible, and practical, their effectiveness must be able to be demonstrated. Assessing their offerings will help the U.S. Marine Corps (USMC) to surge and contract the portfolio as resources wax and wane. This program evaluation toolkit is designed to help those responsible for implementing MF programs to determine whether those programs are effective-achieving their intended goals-and ultimately to guide efficient use of scarce resources. This toolkit is composed of two interrelated documents: this User's Guide and a set of Microsoft Excel workbooks that correspond to material presented in the User's Guide about collecting and analyzing data. This toolkit is based on the program evaluation literature and program evaluation toolkits produced by other RAND researchers. A review of relevant Marine Corps Orders; discussions with headquarters, branch, and program staff in MF; and reviews of publicly available websites provided additional background for the specific context of MF, USMC. The contents of this toolkit should be of particular interest to MF and staff in the five branches within the scope of this study: Behavioral Health, Family Care, Family Readiness, Personal and Professional Development, and Semper Fit. It may also be of interest to those who manage or oversee similar programs that provide support to service members and their families

RAND researchers review survey methods, sample demographics, key findings, and policy implications from the 2015 Health Related Behaviors Survey of active-duty service members.

Source: doi:10.3945/ajcn.115.120873 ; Background: Vitamin D deficiency has been described as being pandemic, but serum 25-hydroxyvitamin D [25(OH)D] distribution data for the European Union are of very variable quality. The NIH-led international Vitamin D Standardization Program (VDSP) has developed protocols for standardizing existing 25(OH)D values from national health/nutrition surveys. Objective: This study applied VDSP protocols to serum 25(OH)D data from representative childhood/teenage and adult/older adult European populations, representing a sizable geographical footprint, to better quantify the prevalence of vitamin D deficiency in Europe. Design: The VDSP protocols were applied in 14 population studies [reanalysis of subsets of serum 25(OH)D in 11 studies and complete analysis of all samples from 3 studies that had not previously measured it] by using certified liquid chromatography–tandem mass spectrometry on biobanked sera. These data were combined with standardized serum 25(OH)D data from 4 previously standardized studies (for a total n = 55,844). Prevalence estimates of vitamin D deficiency [using various serum 25(OH)D thresholds] were generated on the basis of standardized 25(OH)D data. Results: An overall pooled estimate, irrespective of age group, ethnic mix, and latitude of study populations, showed that 13.0% of the 55,844 European individuals had serum 25(OH)D concentrations <30 nmol/L on average in the year, with 17.7% and 8.3% in those sampled during the extended winter (October–March) and summer (April–November) periods, respectively. According to an alternate suggested definition of vitamin D deficiency (<50 nmol/L), the prevalence was 40.4%. Dark-skinned ethnic subgroups had much higher (3- to 71-fold) prevalence of serum 25(OH)D <30 nmol/L than did white populations. Conclusions: Vitamin D deficiency is evident throughout the European population at prevalence rates that are concerning and that require action from a public health perspective. What direction these strategies take will depend on European policy but should aim to ensure vitamin D intakes that are protective against vitamin D deficiency in the majority of the European population.