Publications

The following manuscripts have been published or are currently in press. Listings are in chronological order, unless otherwise noted.

Research Publication 2
Title Publication Date/Location
Linking Exposures and Health Outcomes to a Large Population-Based Longitudinal Study: the Millennium Cohort Study Military Medicine 2011 Jul;176(7 Suppl):56-63

Smith TC, for the Millennium Cohort Study Team

Linking Millennium Cohort prospective data to individual-level exposure data is critical for understanding and quantifying any long-term health outcomes potentially associated with unique military occupational exposures.

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Factors associated with human papillomavirus vaccine initiation and compliance among U.S. military service members Military Medicine 2022 Jan 25:usab562

Matsuno RK, Seay J, Porter B, Tannenbaum K, Warner S, Wells N

The goal of this study was to assess factors associated with human papillomavirus (HPV) vaccine initiation and compliance in a cohort of active duty US military service members (SM). We included active-duty participants aged 18-26 years from the Millennium Cohort Study, a longitudinal cohort study of over 200,000 military SMs. The eligible study population included 22,387 female SMs and 31,705 male SMs. Vaccination was assessed over the period 2006-2017. Among female SMs, 37.8% initiated the vaccine and 40.2% of initiators completed the series within a year. Among male SMs, 3.9% initiated the vaccine and 22.1% of initiators completed the series within a year. Differences were observed by sociodemographic factors, deployment status, branch of service, occupation, and smoking status, but not by selected mental health conditions. These results indicated that HPV vaccination uptake may be subpar across all military service branches. Certain subgroups of SMs could be targeted to increase overall HPV vaccine coverage in the US military population.

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Occupation and Risk of Traumatic Brain Injury in the Millennium Cohort Study Military Medicine 2022 Feb 27;usac035

Jannace KC, Pompeii L, Gimeno Ruiz de Porras D, Perkison WB, Yamal JM, Trone DW, Rull RP

Using 2014-16 survey data from active duty 33,646 Millennium Cohort Study participants, we assessed the association between their primary military occupational categories (MOC) and self-reported traumatic brain injury (TBI) sustained during military service. Adjusting for military and demographic characteristics and pre-service TBI, all MOCs except for health care MOCs were statistically significantly more likely to experience service-related TBI compared with “Administration & Executive” MOCs, while those in “Infantry/Tactical Operations” had the highest odds of service-related TBI. Enlisted (28%) personnel were more likely than officers (24%) to experience a service-related TBI. Results highlight the importance of targeting specific occupational categories for TBI risk reduction and a quantification of risk among enlisted MOCs suggests a need for further research into the causes of TBI.

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A Longitudinal Comparison of Posttraumatic Stress Disorder and Depression Among Military Service Components Military Psychology 2014;26(2): 77–87

Schaller EK, Woodall KA, Lemus H, Proctor SP, Russell DW, Crum-Cianflone NF

This study investigated PTSD and depression between Reserve, National Guard and active duty continuously and dichotomously, while adjusting for deployment-related characteristics and other relevant covariates. The findings from this study suggest that Reservists and National Guardsmen do not have significantly higher mean PTSD or depression severity scores nor increased odds of screening positive for PTSD or depression compared with active-duty members over approximately 6 years of follow-up.
Hearing Loss Associated with US Military Combat Deployment Noise and Health 2015 Jan-Feb; 74(17): 34-42

Wells TS, Seelig AD, Ryan MAK, Jones JM, Hooper TI, Jacobson IG, Boyko EJ

This study investigated hearing loss among Service members and Veterans. New-onset hearing loss was associated with combat deployment. Among those who had deployed, new-onset hearing loss was also associated with proximity to improvised explosive devices and experiencing a combat-related head injury. These findings have implications for health care and disability planning, as well as for prevention programs.

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Post-Traumatic Stress Disorder Predicts Future Weight Change in the Millennium Cohort Study Obesity 2015 Apr;23(4):886-92

LeardMann CA, Woodall KA, Littman AJ, Jacobson IG, Boyko EJ, Smith B, Wells TS, Crum-Cianflone NF

Data from Millennium Cohort Study participants (2001-2008), consisting of US Service members and Veterans, were used to prospectively examine the association between posttraumatic stress disorder (PTSD) and weight change. A significant and consistent association of PTSD with subsequent three-year weight gain and the development of obesity was found in adjusted models. Given these findings, weight gain and development of obesity should be considered important comorbidities for PTSD; existing screening and treatment programs should make sure to address these associated conditions.

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Obesity and Associated Adverse Health Outcomes Among US Military Members: Findings from the Millennium Cohort Study Obesity 2016 Jul;24(7):1582-1589

Rush T, LeardMann CA, Crum-Cianflone NF

This study examined body weight among Service members and Veterans over time (2001-2007), finding a doubling of the prevalence of obesity. Obesity rates were significantly higher among veterans, including among those recently discharged from service. The study found that military personnel, even during service time, experienced weight gain and the development of obesity. Individuals with obesity had higher rates of adverse physical, mental, and functional health, suggesting that weight control should be a DoD and national priority.

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Association of deployment with maintenance of healthy weight among active duty service members in the Millennium Cohort Study Obesity Science and Practice 2021; 1- 7. doi:10.1002/osp4.556

Carey FR, Jacobson IG, Roenfeldt KA, Rull RP

Understanding changes in weight in relation to deployment readiness can inform Department of Defense fitness policies. This study examined longitudinal associations between deployment and service branch-specific changes in body mass index (BMI) among active duty participants without obesity (BMI< 30kg/m2) at baseline (n=22,995). Service members, particularly Army and Marine Corps personnel, with longer deployments were less likely to maintain a healthy weight (BMI < 30) than those with shorter deployment lengths. Conversely, each additional deployment increased the likelihood of maintaining a healthy weight post-deployment for personnel in the Army, Marine Corps, and within the pooled population. These results indicate that multiple deployments may support healthy weight maintenance and longer deployments may adversely impact weight maintenance. Fitness policies designed to optimize service member readiness should consider modifiable behaviors related to weight gain among those who are deployed for long periods of time.

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The Impact of Prior Deployment Experience on Civilian Employment After Military Service Occupational and Environmental Medicine 2013; 70: 408-417

Horton JL, Jacobson IG, Wong CA, Wells TS, Boyko EJ, Smith B, Ryan MA, and Smith TC

Employment after military service, in particular after stressful deployment experiences, is a concern for many veterans and policymakers. Among this large cohort of veterans, we found that prior deployment and PTSD were not significantly associated with job status post-service; in contrast, depression, panic/anxiety disorder, and poor physical health increased the risk of unemployment among certain groups. These findings may guide policy for veterans most in need of post-military employment support.

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Mental Health, Physical Health, and Health-Related Behaviors of U.S. Army Special Forces PLOS One 2020 Jun 3;15(6):e023356

Cooper AD, Warner SG, Rivera AC, Rull RP, Adler AB, Faix DJ, Neff RR, Deagle EA, Caserta RJ, LeardMann CA, for the Millennium Cohort Study Team

Using prospective data, Army Special Forces personnel and Ranger Qualified infantrymen reported fewer mental health problems, multiple somatic symptoms, and unhealthy behaviors than General Purpose Forces infantrymen. Findings indicate that the adoption of healthy behaviors, such as adequate sleep and physical activity, may be an efficient and cost-effective approach for preventing adverse health outcomes, regardless of occupational specialization or prior health status.

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