The following manuscripts have been published or are currently in press. Listings are in chronological order, unless otherwise noted.
| Title | Publication | Date/Location |
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| Chronic Multisymptom Illness: A Comparison of Iraq and Afghanistan Deployers with 1991 Gulf War Veterans | American Journal of Epidemiology | 2014;180(12):1176-1187 |
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Smith TC, Powell TM, Jacobson IG, Smith B, Hooper TI, Boyko EJ, Gackstetter GD These data highlight a difference in CMI reporting when comparing deployed to non-deployed military members. While symptom reporting in this contemporary Cohort occurred less frequently than in the historical 1991 GW cohort, increased CMI reporting was noted among deployed compared to non-deployed contemporary Cohort members. |
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| Changes in Meeting Physical Activity Guidelines After Discharge from the Military | Journal of Physical Activity Health | 2015 May;12(5):666-674 |
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Littman AJ, Jacobson IG, Boyko EJ, Smith TC Using data from Millennium Cohort Study participants, we investigated changes in meeting federal Physical Activity Guidelines for moderate-to-vigorous activity (MVPA) following military discharge. MVPA declined more in those who were discharged than those who were not (-17.8 percentage points vs. -2.7 percentage points), with greater declines in former active-duty personnel, those who had deployed with combat exposures, had 14-25 years of service, and had been discharged more recently (<1 year prior). Reductions in MVPA were substantial and unexpected. Increased understanding of transitional periods that may benefit from interventions to mitigate declines in physical activity will help prevent excess weight gain and physical inactivity-associated health consequences. |
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| Challenges of Self-Reported Medical Conditions and Electronic Medical Records Among Members of a Large Military Cohort | BMC Medical Research Methodology | 2008 Jun;8:37 |
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Smith B, Chu LK, Smith TC, Amoroso PJ, Boyko EJ, Hooper TI, Gackstetter GD, Ryan MAK, for the Millennium Cohort Study Team This report highlights the importance of assessing medical conditions from multiple electronic and self-reported sources. |
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| Cervical cancer screening compliance among active duty service members in the US military | Preventive Medicine Reports | 2022 Apr; 26: 101746 |
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Seay J, Matsuno RK, Porter B, Tannenbaum K, Warner S, Wells N Previous research suggests active duty service members (ADSM) experience higher rates of human papilloma virus infection and cervical dysplasia, which puts them at greater risk for cervical cancer. The current study examined crude rates and correlates of cervical cancer screening compliance in 2003–2015 among screening-eligible ADSM in the Millennium Cohort Study (MCS). Most participants were 21–29 years old (79.4%), non-Hispanic White (60.6%), and enlisted (82.2%). Crude rates of cervical cancer screening compliance increased from 2003 (61.2%) to 2010 (83.1%), and then declined in 2015 (59.8%). Older ADSM and those who had a history of deployment had lower odds of screening compliance. ADSM in the Air Force and those in healthcare occupations had higher odds of screening compliance. Study findings suggest that cervical cancer screening compliance is declining among ADSM. Interventions to improve screening should target groups with lower screening compliance. |
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| Brief Report: Menstrual Suppression Among U.S. Female Service Members in the Millennium Cohort Study | Medical Surveillance Monthly Report | 2022 Sept 29(9), 19-22 |
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Zhu Y, Kolaja CA, Stamas N, Matsuno RK, Rull RP; Millennium Cohort Study Team This study examined the prevalence of self-reported menstrual suppression among U.S. female active duty personnel (N=22,920) at two time points (2008, 2013) by demographic and military characteristics. Menstrual suppression increased significantly overall from 2008 (2.5%) to 2013 (3.8%) and among younger age groups (aged 18-34), non-Hispanic White individuals, Army, Navy, or Air Force personnel. The highest prevalence of menstrual suppression was reported in 2013 among those who deployed in the past year (4.7%) or worked in health care (5.1%) or combat specialties (4.7%). Increased health education is needed to support the health care needs and readiness of female service members. |
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| Body Building, Energy, and Weight Loss Supplements are Associated with Deployment and Physical Activity in US Military Personnel | Annals of Epidemiology | 2012;22:318-330 |
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Jacobson IG, Horton JL, Smith B, Wells TS, Boyko EJ, Lieberman HR, Ryan MAK, Smith TC, for the Millennium Cohort Study Team Nearly half of the population studied reported use of energy, body building, or weight loss supplements, with energy supplements being the most highly endorsed (38%) supplement type. Deployment experience, physical activity, problem drinking, and suboptimal sleep emerged as important characteristics associated with supplement use, which may be of importance to medical planners and military policy makers in targeting adverse event monitoring and for future research determining how supplements affect performance and health over time. |
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| Baseline Self-Reported Functional Health Predicts Vulnerability to Posttraumatic Stress Disorder Following Combat Deployment: Prospective US Military Cohort Study | British Medical Journal | 2009 Apr;338:b1273 |
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LeardMann CA, Smith TC, Smith B, Wells TS, Ryan MAK, for the Millennium Cohort Study Team Military service members who screen in the lowest 15% of health prior to combat exposure are more vulnerable to developing postdeployment PTSD. |
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| Associations of Military Divorce with Mental, Behavioral, and Physical Health Outcomes | BMC Psychiatry | 2015; 15:128 |
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Wang L, Seelig AD, MacDermid Wadsworth S, McMaster HS, Alcarez J, Crum-Cianflone NF This prospective study investigated the associations of recent divorce with health outcomes among US Service members. Findings indicate that recent divorce is associated with adverse mental health outcomes, including new-onset PTSD and depression, and risky behaviors, such as smoking initiation and new-onset alcohol-related problems, after adjusting for relevant demographics and covariates. Given these findings, it is important to make sure resources are available to support recently divorced Service members, since divorce may not only affect personal quality of life, but also military force readiness. |
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| Association of Problematic Anger With Long-term Adjustment Following the Military-to-Civilian Transition | JAMA Network Open | 2022 Jul 1 | doi: 10.1001/jamanetworkopen.2022.23236 |
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Adler AB, LeardMann CA, Villalobos J, Jacobson IG, Forbes D, for the Millennium Cohort Study Team In the Millennium Cohort Study’s third paper documenting the risks associated with problematic anger, 15.9% of active duty service members reported problematic anger two years before military separation. This prevalence essentially doubled to 31.2% two years following separation. Problematic anger around the time of military separation was associated with PTSD, depression, low relationship quality, difficulties coping with parental demands, low social support, and economic difficulties approximately 5 years later, after adjustment for demographics and baseline health. Findings suggest that training in emotion regulation may improve the military-to-civilian transition. |
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| Association of Combat Experiences With Suicide Attempts Among Active-Duty US Service Members | JAMA Network Open | 2021;4(2):e2036065 |
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LeardMann CA, Matsuno R, Boyko EJ, Powell TM, Reger MA, Hoge CW, for the Millennium Cohort Study Team Among 57,841 active-duty service members who had deployed, high combat severity and certain specific combat experiences were associated with suicide attempts. However, these associations were mostly accounted for by mental disorders, especially PTSD. Findings suggest that service members who experience high levels of combat or are exposed to certain types of combat experiences, involving unexpected events or those that challenge moral or ethical norms, may have an increased risk of a suicide attempt, either directly or indirectly through mental disorders. |
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