Staff Perspective: Defining Military Families in Research - It’s Not Just Semantics
As with many of my blogs, my research for this one started with one topic and ended up landing on another. While looking for information about how changes in state and federal marijuana policies and laws might impact military families, I stumbled on a 2020 article that piqued my interest and changed my focus: Are we family? A scoping review of how military families are defined in mental health and substance use research (Gribble et al., 2020).
One of my favorite topics to present for the Center for Deployment Psychology (CDP) is the module on the “Military Family Experience”. As a wife, sibling, niece, and granddaughter of Veterans, I love introducing community behavioral health providers to the military family members who support and sacrifice right beside our service members and veterans. It’s a great opportunity to share important data and information alongside personal stories and experiences in a way that makes military families and their experiences more “real” and impactful for our audiences.
But military families also represent a particularly tricky topic to navigate during training events. I often receive questions that, to answer, would require information that just doesn’t exist in the current literature. This includes questions about the prevalence and experiences of people who may not be recognized as military family members in an official capacity or in the majority of research studies. Nevertheless, these individuals are critical parts of many military families and include unmarried partners, male and same sex spouses, non-traditional caretakers, adult children, etc. The list is a long one. As a trainer, I am comfortable giving an “I don’t know, but I will find out and share the information” response. But in military family training events, I find myself more often saying “I’m sorry, I don’t know and I don’t think that information is available in the literature,” without a good explanation for how or why.
But then I found Gribble and colleagues’ (2020) review article. In it, the authors sought a better understanding of how military families are operationalized in research on mental health and substance use and the potential impacts of these choices. Not only did they identify and quantify definitions and samples across nearly 100 studies, they also addressed the questions: Does the current body of evidence accurately reflect the increasing diversity of military families? And to whom can the existing evidence base may be reasonably generalized? To be included in the review, articles published between 2002 and 2017 were required to report on quantitative studies reporting prevalence estimates for a variety of conditions, including depression, post-traumatic stress disorder, stress/distress, or substance use among the spouses, partners, children, and families of reserve components, active duty, or veteran personnel.
Within the 91 articles that met all criteria for inclusion, the majority (41%) focused on spouses or partners followed by studies that examined children or adolescents (29%), those that included a larger family perspective (19%), and studies of caregivers for injured service members or veterans (12%). Across all of these studies, the authors reported that the most commonly represented family structure was a traditional one: a male husband who was an active duty service member (most commonly U.S. Army), a female civilian wife, and multiple children who were under the age of 18. Equally as telling was the list of individuals who were rarely or never represented in the research, including, but not limited to, couples without children, dual-military serving couples, LGBTQ couples/families, male spouses/partners, and single parents.
Issues were not limited to inclusion/exclusion criteria for data collection. The authors also highlighted how specific research practices omitted certain groups or individuals from the outcomes. In multiple studies, findings related to male spouses were purposefully excluded from the analyses due to low numbers/small sample sizes. While there is merit to this choice statistically and methodologically, the result is a continued lack of information about the experiences of male military spouses.
Noting the potential negative impact of continuing to so narrowly define and describe military families (e.g., impacts to who does/does not qualify for supports or benefits, reduced generalizability of findings from studies on mental health/substance use, misdirection of resources based on a lack of understanding about the diversity of military families), the authors provide recommendations to improve inclusion. They suggest that researchers use expanded recruitment methods, more nuanced pre-screening processes, and more representative sampling techniques to populate their samples.
I look forward to a time when I will be able to respond to more of our participants’ questions about diverse military families more definitively. In the meantime, I plan to keep this reference handy and encourage our audiences to keep asking questions that highlight the need for a more inclusive approach to military family research. As providers, it is important that we advocate for accurate representation of military families in research to ensure that the techniques and resources we use to support them are effective and appropriate for ALL of our military family clients.
The full text of the review article, including a listing of the reviewed studies, their recruitment methods, inclusion/exclusion criteria, and composition of final research samples, is included in the publicly available article here.
The opinions in CDP Staff Perspective blogs are solely those of the author and do not necessarily reflect the opinion of the Uniformed Services University of the Health Science or the Department of Defense.
Jenny Phillips, Ph.D., is the Assistant Director of Evaluation for the Center for Deployment Psychology (CDP) at the Uniformed Services University of the Health Sciences in Bethesda, MD.
References:
Gribble, R., Mahar, A. L., Keeling, M., Sullivan, K., McKeown, S., Burchill, S., Fear, N. T., & Castro, C. A. (2020). Are we family? A scoping review of how military families are defined in mental health and substance use research. Journal of Military, Veteran and Family Health, 6(2), 85-119.
As with many of my blogs, my research for this one started with one topic and ended up landing on another. While looking for information about how changes in state and federal marijuana policies and laws might impact military families, I stumbled on a 2020 article that piqued my interest and changed my focus: Are we family? A scoping review of how military families are defined in mental health and substance use research (Gribble et al., 2020).
One of my favorite topics to present for the Center for Deployment Psychology (CDP) is the module on the “Military Family Experience”. As a wife, sibling, niece, and granddaughter of Veterans, I love introducing community behavioral health providers to the military family members who support and sacrifice right beside our service members and veterans. It’s a great opportunity to share important data and information alongside personal stories and experiences in a way that makes military families and their experiences more “real” and impactful for our audiences.
But military families also represent a particularly tricky topic to navigate during training events. I often receive questions that, to answer, would require information that just doesn’t exist in the current literature. This includes questions about the prevalence and experiences of people who may not be recognized as military family members in an official capacity or in the majority of research studies. Nevertheless, these individuals are critical parts of many military families and include unmarried partners, male and same sex spouses, non-traditional caretakers, adult children, etc. The list is a long one. As a trainer, I am comfortable giving an “I don’t know, but I will find out and share the information” response. But in military family training events, I find myself more often saying “I’m sorry, I don’t know and I don’t think that information is available in the literature,” without a good explanation for how or why.
But then I found Gribble and colleagues’ (2020) review article. In it, the authors sought a better understanding of how military families are operationalized in research on mental health and substance use and the potential impacts of these choices. Not only did they identify and quantify definitions and samples across nearly 100 studies, they also addressed the questions: Does the current body of evidence accurately reflect the increasing diversity of military families? And to whom can the existing evidence base may be reasonably generalized? To be included in the review, articles published between 2002 and 2017 were required to report on quantitative studies reporting prevalence estimates for a variety of conditions, including depression, post-traumatic stress disorder, stress/distress, or substance use among the spouses, partners, children, and families of reserve components, active duty, or veteran personnel.
Within the 91 articles that met all criteria for inclusion, the majority (41%) focused on spouses or partners followed by studies that examined children or adolescents (29%), those that included a larger family perspective (19%), and studies of caregivers for injured service members or veterans (12%). Across all of these studies, the authors reported that the most commonly represented family structure was a traditional one: a male husband who was an active duty service member (most commonly U.S. Army), a female civilian wife, and multiple children who were under the age of 18. Equally as telling was the list of individuals who were rarely or never represented in the research, including, but not limited to, couples without children, dual-military serving couples, LGBTQ couples/families, male spouses/partners, and single parents.
Issues were not limited to inclusion/exclusion criteria for data collection. The authors also highlighted how specific research practices omitted certain groups or individuals from the outcomes. In multiple studies, findings related to male spouses were purposefully excluded from the analyses due to low numbers/small sample sizes. While there is merit to this choice statistically and methodologically, the result is a continued lack of information about the experiences of male military spouses.
Noting the potential negative impact of continuing to so narrowly define and describe military families (e.g., impacts to who does/does not qualify for supports or benefits, reduced generalizability of findings from studies on mental health/substance use, misdirection of resources based on a lack of understanding about the diversity of military families), the authors provide recommendations to improve inclusion. They suggest that researchers use expanded recruitment methods, more nuanced pre-screening processes, and more representative sampling techniques to populate their samples.
I look forward to a time when I will be able to respond to more of our participants’ questions about diverse military families more definitively. In the meantime, I plan to keep this reference handy and encourage our audiences to keep asking questions that highlight the need for a more inclusive approach to military family research. As providers, it is important that we advocate for accurate representation of military families in research to ensure that the techniques and resources we use to support them are effective and appropriate for ALL of our military family clients.
The full text of the review article, including a listing of the reviewed studies, their recruitment methods, inclusion/exclusion criteria, and composition of final research samples, is included in the publicly available article here.
The opinions in CDP Staff Perspective blogs are solely those of the author and do not necessarily reflect the opinion of the Uniformed Services University of the Health Science or the Department of Defense.
Jenny Phillips, Ph.D., is the Assistant Director of Evaluation for the Center for Deployment Psychology (CDP) at the Uniformed Services University of the Health Sciences in Bethesda, MD.
References:
Gribble, R., Mahar, A. L., Keeling, M., Sullivan, K., McKeown, S., Burchill, S., Fear, N. T., & Castro, C. A. (2020). Are we family? A scoping review of how military families are defined in mental health and substance use research. Journal of Military, Veteran and Family Health, 6(2), 85-119.