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
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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The Millennium Cohort Study: Answering Long-Term Health Concerns of US Military Service Members by Integrating Longitudinal Survey Data with Military Health System Records Military Health Care From predeployment to post-separation 1st ed. New York, NY: Routledge;2013: 55-77

Crum-Cianflone N

In: Amara J, Hendricks A, eds

This textbook chapter provides a detailed summary of the first decade of the Millennium Cohort Study. The chapter includes an overview of the study methodology and key publications including a review of foundational papers and epidemiologic studies examining the associations of military service experiences with mental, behavioral, and physical health outcomes.

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The Role of Posttraumatic Stress Symptoms and Negative Affect in Predicting Substantiated Intimate Partner Violence Incidents Among Military Personnel Military Behavioral Health 2021;9(4):442–462

Stander, VA, Woodall KA, Richardson SM, Thomsen CJ, Milner JS, McCarroll JE, Riggs DS, Cozza SJ, for the Millennium Cohort Study Team

Increasing rates of posttraumatic stress disorder (PTSD) in military populations may indicate heightened risk for aggression, including aggression among domestic partners. Using longitudinal data from the Millennium Cohort Study, we evaluated the association of PTSD symptom clusters and comorbid conditions as predictors of incidents of met criteria incidents of domestic abuse (physical and psychological) from DoD Family Advocacy Program (FAP) Central Registry data. Among 54,667 active-duty personnel who responded to the 2011 survey, FAP records documented 501 participants (1%) with incidents of emotional or physical met criteria incidents of aggression in the data collection period. Results showed that certain aspects of PTSD and behavioral health problems predicted incidents. In particular, general PTSD symptoms (e.g., anger/irritability, sleep disruption) and comorbid alcohol dependence were stronger predictors than trauma-specific PTSD symptomology (e.g., reexperiencing, hypervigilance). These results indicate that clinicians should consider the interpersonal consequences of PTSD and related behavioral problems.

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Surveillance Snapshot: Cervical Screening among U.S. Military Servicewomen in the Millennium Cohort Study, 2003–2015 Medical Surveillance Monthly Report 2020 Jul;27(7):15

Matsuno RK, Porter B, Warner SG, Wells N for the Millennium Cohort Study Team

Across a 13 year period (2003-2015), the percentage of U.S. service women who were up-to-date with cervical cancer screening peaked in 2010, then declined. Screening was generally highest among Air Force personnel and lowest among Navy personnel. Being up-to-date was higher for servicewomen who had initiated the HPV vaccine than for women who had not.

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Surveillance Snapshot: Human Papillomavirus Vaccination Among U.S. Active Component Service Members in the Millennium Cohort Study, 2006–2017 Medical Surveillance Monthly Report 2019 Jun;26(6):18

Matsuno RK, Porter B, Warner SG, Wells N

Among a sample of active component members under the age of 26, (22,387 service women and 31,705 service men), service more women (37.8%) were more likely than service men (3.9%) to initiate receiving the HPV vaccine. Among those who initiated the vaccine, 40.2% of women and 23.1% of men were adherent to receiving all 3 doses within 1 year. Members of the Air Force and those in healthcare occupations had higher percentages of HPV vaccine initiation and adherence.

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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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US Naval and Marine Corps Occupations, PTSD and Depression Risk and Absenteeism Journal of Workplace Behavioral Health 2014;29(2):91–112

Wells TS, Bagnell ME, Miller SC, Smith TC, Gackstetter GD and Boyko EJ for the Millennium Cohort Study Team

This study investigated whether military occupation was associated with PTSD or depression, and if PTSD or depression was associated with lost workdays among US Navy and US Marine personnel. Navy personnel in service and supply occupations were 85% more likely to screen positive for new-onset PTSD, while those serving in health care were 58% more likely to screen positive for new-onset depression compared to other occupations. In addition, those with new-onset and persistent PTSD were twice as likely to miss one or more days of work. This suggests that early identification and management of these conditions may improve force readiness.

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Is Military Deployment a Risk Factor for Maternal Depression? Journal of Women's Health 2013 Jan; 22(1):9-18

Nguyen S, LeardMann CA, Smith B, Conlin AMS, Slymen DJ, Hooper TI, Ryan MAK, Smith TC, for the Millennium Cohort Study Team

This study found that military women who recently gave birth and then deployed with combat experience had an increased risk for depression. Combat experience primarily increased the risk for depression, rather than childbirth itself. In addition, deployment without combat experience was not significantly associated with maternal depression among women who recently gave birth.

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Recent Sexual Trauma and Adverse Health and Occupational Outcomes Among US Service Women Journal of Traumatic Stress 2015 Aug;28(4):298-306

Millegan J, Schaller EK, LeardMann CA, Street AE, Williams D, Trone DW, Crum-Cianflone NF

Findings from this study indicate that recent sexual trauma is associated with potential adverse physical health, mental health, and occupational outcomes among women serving in the US armed forces, after adjustment for demographics, prior sexual trauma, mental health, and military factors. Given these findings and the increasing role of women in the military, prevention and mitigation of sexual trauma should remain a high priority and more effective strategies should be developed to prevent sexual trauma.

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