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BACKGROUND/RATIONALE:
Based on Department of Defense surveillance data from 2007, approximately 16% of active duty soldiers and 28% of reserve soldiers reported exposure concerns immediately following deployment. Three to six months following deployment the reported number of exposure concerns increased to 20% for active duty soldiers and 35% for reserve soldiers. A case series of 56 OEF/OIF veteran patients seen by a VA clinic resulted in a mean of 2.7 exposure concerns. Presently, there are no standardized exposure assessment instruments that VHA uses to assess veterans' perceptions about exposure concerns. Development of a standardized exposure assessment instrument is important to allow for systematic monitoring of exposure concerns among OEF/OIF veterans. Prior research has shown that Gulf War (GW) veterans with more deployment exposure concerns were at increased risk for adverse health outcomes and higher health care utilization rates. There is considerable research sugegsting that people's perceptions about health exposures may play a role in negatively influencing health behaviors. Anecdotal evidence from the WRIISC clinical programs shows that combat veterans may have inaccurate perceptions about health effects related to deployment exposures. Consequently, it is important to understand OEF/OIF veterans' perceptions about deployment exposures so that possible misperceptions may be addressed proactively through education and preventative health care measures.
OBJECTIVE(S):
Short term objectives are 1) design an exposure assessment instrument that measures OEF /OIF veterans' perceptions about deployment exposures; and 2) perform initial validation measures among a small sample of OEF /OIF veterans. Long term objectives are 1) test this exposure assessment instrument among a larger sample of OEF /OIF veterans to determine reliability and validity; 2) estimate the prevalence and types of exposure perceptions among OIF and OEF veterans; 3) determine if OEF /OIF veterans' perceptions of deployment exposures differ over time; 4) determine if there is a relationship between OEF /OIF veterans' perceptions of deployment exposures and development of adverse health outcomes; and 5) develop targeted risk communication that clarify possible OEF /OIF misperceptions regarding deployment exposures.
METHODS:
This study will use both qualitative and quantitative methods. During Phase I, review of existing focus group data, clinical exposure data, and published literature will be analyzed to prepare an initial item pool. In Phase II, subject matter expert feedback will be requested to assess content validity, and the tool will be modified as appropriate. In Phase III, a convenience sample of OEF/OIF veterans will be recruited to complete 1:1 cognitive interviews to assess face validity. All qualitative data will be analyzed using both NVivo qualitative software and manual reviews. For the newly developed exposure assessment instrument, maximum and minimum scores for the instrument's subscales and item variances and item means will be calculated for the surveyed sample. Cronbach's alpha will be tested to measure variability of scores for the OEF/OIF veteran population surveyed. Because of the small sample size and short time frame of this study, factor analysis and test-retest reliability measures will not be calculated at this stage. All quantitative data will be analyzed using SPSS software.
FINDINGS/RESULTS:
No results at this time.
IMPACT:
Through the development of a standardized exposure assessment tool, this pilot project will provide important insight about OEF/OIF veterans' perceptions regarding deployment exposures. Documentation of the development and evaluation process used during the creation of this assessment tool will provide foundational materials and insight to support the development a follow-up study. Subsequent efforts will focus on development of an exposure assessment tool that can be readily implemented by health care providers and researchers throughout VHA. Study results should help VA clinicians better understand how to screen for deployment exposure concerns among OEF/OIF veterans.
PUBLICATIONS:
None at this time.
DRA:
Special (Underserved, High Risk) Populations
DRE:
Prevention, Quality of Care, Etiology
Keywords:
Deployment, Operation Enduring Freedom, Operation Iraqi Freedom
MeSH Terms:
none
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