Suchergebnisse

Private contractors have been deployed extensively around the globe for the past decade and may be exposed to many of the stressors that are known to have physical and mental health implications for military personnel. Results from a RAND survey offer preliminary findings about the mental and physical health of contractors, their deployment experiences, and their access to and use of health care resources

This article identifies factors associated with changes in outcomes for soldiers who received Army behavioral health (BH) specialty care and provides recommendations to improve BH care and outcomes. RAND researchers identified three samples of soldiers who received Army BH care with diagnoses of posttraumatic stress disorder (PTSD), depression, or anxiety and whose symptoms were assessed during their care. Multivariate analyses included 141 patient and treatment variables to identify factors associated with symptom improvement. Analyses also examined patterns in how the symptoms changed over time. Analyses suggest that the Behavioral Health Data Portal, an online system that allows for collection of multiple patient- and clinician-reported measures, is widely used to track symptoms of PTSD, depression, and anxiety, but there are opportunities to expand symptom tracking. Two treatment factors—therapeutic alliance and receipt of benzodiazepines—were associated with treatment outcomes. Specifically, a stronger therapeutic relationship or alliance with providers, as reported by soldiers, was associated with improved PTSD, depression, and anxiety outcomes. Further, receipt of more than a 30-day supply of benzodiazepines was associated with poorer PTSD, depression, and anxiety outcomes. Many soldiers' trajectories of symptom change did not demonstrate improvement. Recommendations include providing feedback and guidance to providers on how to strengthen alliance with their patients, expanding tracking and feedback on benzodiazepine prescribing, and increasing provider use of measurement-based BH care.

Deployed contractors may be exposed to the same stressors as military personnel. A RAND survey examined the mental and physical health of contractors, their deployment experiences, and their access to and use of health care resources.

The Army is introducing a new fitness test for the first time in more than 40 years. The six-event Army Combat Fitness Test (ACFT) is designed to (1) ensure soldiers are ready to perform combat tasks, (2) reduce preventable injuries, and (3) promote a culture of fitness throughout the Army. In this report, the authors conduct an independent review of the ACFT and provide recommendations to support the Army's implementation decisions. The authors find that the Army's evidence base for the ACFT supports some, but not all, aspects of the test. In particular, some events have not been shown to predict combat task performance or reduce injuries, and justification is needed for why all fitness events and minimum standards apply equally to all soldiers. Relatedly, ACFT scores collected by the Army during the diagnostic phase show some groups failing at noticeably higher rates--the implications of which need to be investigated. Evidence suggests that scores and pass rates can improve with training and that soldiers want more access to the right training and equipment. To address these concerns and because it must continuously monitor the ACFT after its full-scale implementation, the Army should establish a permanent, institutionalized process for overseeing and refining the ACFT