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
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

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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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

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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Cervical cancer screening compliance among active duty service members in the US military Preventive Medicine Reports 2022 Apr; 26: 101746

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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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

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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Changes in Meeting Physical Activity Guidelines After Discharge from the Military Journal of Physical Activity Health 2015 May;12(5):666-674

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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Chronic Multisymptom Illness: A Comparison of Iraq and Afghanistan Deployers with 1991 Gulf War Veterans American Journal of Epidemiology 2014;180(12):1176-1187

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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Cigarette Smoking and Military Deployment: A Prospective Evaluation American Journal of Preventive Medicine 2008 Dec;35(6):539-46

Smith B, Ryan MAK, Wingard DL, Patterson TL, Slymen DJ, Macera CA, for the Millennium Cohort Study Team

Findings suggest an increase in smoking initiation and recidivism among deployers and highlight the importance of prevention strategies pre, during, and post deployment.

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Cigarette smoking patterns among U.S. military service members before and after separation from the military PLoS One 2021 Oct 4;16(10):e0257539

Nieh C, Mancuso JD, Powell TM, Welsh MM, Gackstetter GD, Hooper TI.

Millennium Cohort Study data were used to examine smoking behavior at enrollment into the study and through their first follow-up survey, approximately 3 years later. Time remaining in service from baseline until separation or the first follow-up survey was the main exposure of interest. The baseline prevalence of smoking in the Cohort was higher among those who eventually separated (20.1%) than among those who remained on active service (17.4%), but the overall prevalence of current smokers significantly declined over the observation period. Factors significantly associated with greater likelihood of smoking at follow- up were baseline smoking, non-White Hispanic individuals, being non-married, enlisted rank, underweight or healthy BMI, active duty component, any alcohol consumption, experiencing two or more stressful life events, and screening positive for either PTSD or depression. Including smoking prevention and/or cessation programs in pre-separation counseling sessions and developing smoking screening and cessation programs targeting high-risk subgroups may reduce smoking among Service members and veterans.

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Cohort Profile Update: The US Millennium Cohort Study—evaluating the impact of military experiences on service members and veteran health International Journal of Epidemiology 2023 Aug 2 | doi: 10.1093/ije/dyad088

Castañeda SF, Belding JN, Kolaja CA, LeardMann CA, Jacobson IG, Rivera AC, Carey FR, Boparai S, Walstrom JL, Sheppard BD, Boyko EJ, Ryan MAK, Rull RP

This paper provides an update to the original cohort profile paper published a decade ago. The Study includes 260,228 military personnel enrolled across 5 panels between 2001 and 2021 (baseline age range: 25-35 years), where participants are surveyed every 3-5 years through 2068. Longitudinal survey data are linked to administrative and medical data from DoD, VA, and external sources. The breadth of research topics has expanded over the past decade with the continued aim of contributing to policies and programs that improve service member and Veteran health and wellbeing.

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Combat and Trajectories of Physical Health Functioning in U.S. Service Members American Journal of Preventative Medicine 2019 Nov;57(5):637-644

Porter B, Bonanno GA, Bliese PD, Phillips CJ, Proctor SP for the Millennium Cohort Study Team

Combat is detrimental to long-term physical health functioning among deployed service members, but other pre-deployment modifiable factors like body size and smoking status had stronger associations with subsequent trajectories. This indicates the negative impact of combat may be mitigated through pre-deployment healthy behaviors.

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