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Child and Family Programs

Current and past research studies under the Child and Family program have focused on three content areas (bereavement, combat injury, child maltreatment/neglect):

Bereavement

National Military Family Bereavement Study

(NMFBS: militarysurvivorstudy.org)

This study aims to identify experiences of bereaved military family members (adults and children) — how psychological and/or physical outcomes of bereavement are influenced by family members’ pre-existing psychological and physical health, genetic factors, support and unique factors associated with military death. Participants completed online questionnaires and participated in interviews with study staff. Expert consultants from other academic centers across the country are assisting with analyses.

Stepping Forward in Grief

(SFG: http://steppingforwardstudy.org/)

The Stepping Forward in Grief Study is testing two online/app programs that were developed in response to findings from the National Military Family Bereavement Study, which suggested that grief-related challenges among bereaved military survivors can continue, even many years following a loss, and that many survivors desire additional support. This prolonged distress puts them at risk for harmful long-term changes in physical and mental health. Recognizing the need to help bereaved military families and friends, the research team at USU formed a partnership with the Center for Complicated Grief at Columbia University to create a program for bereaved military families and friends to adapt to their loss. Participants who enroll are randomly assigned to one of two programs, GriefSteps or WellnessSteps. The study will compare how people in each group do in overall improvement of grief severity and adaptation to loss. Both groups will have guides who can help or answer questions about the intervention. If these programs are successful, they would be a helpful resource for current and future survivors who suffer the death of a military loved one.

VOICES of 9-11

The Center for Study of Traumatic Stress and VOICES of September 11 partnered to examine long-term positive and negative bereavement outcomes (including grief, traumatic symptoms, resilience characteristics and post-traumatic growth) following a terrorism-related death. Participants were family members bereaved by the bombing of Air India Flight 182 on June 23, 1985 or by the events of September 11, 2001. Participants completed an online questionnaire about their experiences related to the aftermath of these events and the death of their family member(s). The questionnaire assessed the following: background factors; characteristics of the death; availability of post-death resources; media involvement; memorialization; psychological functioning; and life changes. This information will be used to develop preliminary working models for understanding risk and protective factors for bereaved family members of terrorism-related deaths. These results will inform ongoing research and guide training and counsel for disaster and terrorism victims and their families. Specifically, this work will help identify at-risk groups within the community, and will provide guidance for future policy regarding the delivery of notifications involving human remains identification, which has complex consequences for the traumatically bereaved relatives of terrorism and/or disaster victims.

Understanding and Meeting the Needs of Children Following Family Member Death

This study, funded by Sesame Workshop, was the Center for the Study of Traumatic Stress Child and Family Program’s preliminary research initiative into the area of family bereavement. It studied the impact of a multimedia program produced by Sesame Workshop in families with young children affected by family member death. The study also addressed the impact of parental death on children and their caretakers in both military and civilian populations by evaluating the helpfulness of a Sesame Workshop DVD and supplemental materials designed for grieving families. The study collected data on the health and well-being of surviving children (ages 2–18. These children lost a parent after September 11, 2001 and the data were observations from their current caretaker.

Combat Injury

Impact of Combat Injury on Military Service Families and Children

In order to determine how combat injury affects family members and their children, three studies were conducted. Families participated in (1) a study conducted at the National Military Family Association Operation Purple Healing Adventures Camps, (2) a longitudinal study comparing combat injured and non-injured families from Walter Reed National Military Medical Center, San Antonio Military Medical Center and Fort Stewart, GA, and (3) FOCUS-CI, a pilot randomized-controlled trial that tested the effectiveness of a newly-developed family-centered, strength-based intervention to be used with severely combat-injured service members and their families. Data collected from these three sources will inform programmatic intervention that can better address the needs of service members and their families.

Results from this work have involved efforts to support healthy communication related to injury both within families (including children) and among health care providers and family members. Courage to Talk resources are available at https://www.courage2talk.org/

Child Maltreatment

Deployment Family Stress: Child Neglect and Maltreatment in U.S. Army Families

The goal of this Child Neglect study is to describe the characteristics of substantiated child neglect cases in the Army, and to identify factors within the family, the military community and the civilian community that contribute either to family health or child maltreatment.. Data were collected from 1,088 questionnaires representing 26 Army installations in the United States, and 400 records of substantiated child neglect cases around the country.  Analyses of these data defined the varying types, subtypes and severity of neglect occurring within families, highlighting the importance of varied public health strategies to minimize risk.

Military-related Risk for Child Neglect in DoD Families

Child abuse and neglect among military families negatively impacts military family health. According to the U.S. Department of Defense (DoD), the number of incidents of child maltreatment (both abuse and neglect) reported to the Family Advocacy Program (FAP) that met DoD criteria for substantiation rose steadily from 4.8 per 1,000 children in 2009 to 7.3 per 1,000 children in 2014. From 2013 to 2014 alone, the rate of incidents increased by 14.1 percent. The steady rise was primarily driven by an increase in the number of cases involving child neglect. From 2013 to 2014, the rate of neglect incidents in DoD families increased by 14 percent. Child neglect is currently the most prevalent type of child maltreatment in military families.

The goal of our study is to advance understanding of the factors underlying these trends by identifying the family-level and military service related factors associated with the changing rates of child abuse and neglect in military communities. Specifically, Phase I of our study will examine the socio-demographic, family-related, and military-related correlates of child maltreatment incidents reported in 2014 among active duty military families. Phase II will build on findings from Phase I by examining longitudinal data related to family events (e.g., marriage, divorce, birth), military service events (e.g., promotion, PCS, deployment, disciplinary actions), and health characteristics (e.g., physical and mental health diagnoses, pharmacy records) to develop a comprehensive model of risk and protective factors associated with child maltreatment across the military family life course. Results from this congressionally mandated research will inform DoD clinical practice and policy regarding child maltreatment prevention and respond to House Report 114-577.