National Academies Press: OpenBook
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Strengthening the Military Family Readiness System for a Changing American Society. Washington, DC: The National Academies Press. doi: 10.17226/25380.
×
Page R1
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Strengthening the Military Family Readiness System for a Changing American Society. Washington, DC: The National Academies Press. doi: 10.17226/25380.
×
Page R2
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Strengthening the Military Family Readiness System for a Changing American Society. Washington, DC: The National Academies Press. doi: 10.17226/25380.
×
Page R3
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Strengthening the Military Family Readiness System for a Changing American Society. Washington, DC: The National Academies Press. doi: 10.17226/25380.
×
Page R4
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Strengthening the Military Family Readiness System for a Changing American Society. Washington, DC: The National Academies Press. doi: 10.17226/25380.
×
Page R5
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Strengthening the Military Family Readiness System for a Changing American Society. Washington, DC: The National Academies Press. doi: 10.17226/25380.
×
Page R6
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Strengthening the Military Family Readiness System for a Changing American Society. Washington, DC: The National Academies Press. doi: 10.17226/25380.
×
Page R7
Page viii Cite
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Strengthening the Military Family Readiness System for a Changing American Society. Washington, DC: The National Academies Press. doi: 10.17226/25380.
×
Page R8
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Strengthening the Military Family Readiness System for a Changing American Society. Washington, DC: The National Academies Press. doi: 10.17226/25380.
×
Page R9
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Strengthening the Military Family Readiness System for a Changing American Society. Washington, DC: The National Academies Press. doi: 10.17226/25380.
×
Page R10
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Strengthening the Military Family Readiness System for a Changing American Society. Washington, DC: The National Academies Press. doi: 10.17226/25380.
×
Page R11
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2019. Strengthening the Military Family Readiness System for a Changing American Society. Washington, DC: The National Academies Press. doi: 10.17226/25380.
×
Page R12

Below is the uncorrected machine-read text of this chapter, intended to provide our own search engines and external engines with highly rich, chapter-representative searchable text of each book. Because it is UNCORRECTED material, please consider the following text as a useful but insufficient proxy for the authoritative book pages.

Prepublication Copy Uncorrected Proofs Strengthening the Military Family Readiness System for a Changing American Society Committee on the Well-Being of Military Families Kenneth W. Kizer and Suzanne Le Menestrel, Editors Board on Children, Youth, and Families Division of Behavioral and Social Sciences and Education A Consensus Study Report of PREPUBLICATION COPY, UNCORRECTED PROOFS

THE NATIONAL ACADEMIES PRESS 500 Fifth Street, NW Washington, DC 20001 This activity was supported by a contract awarded to the National Academy of Sciences and funded by the U.S. Department of Defense through Basic Ordering Agreement No. HHSP233201400020B, Task Order No. HHSP23337071. Any opinions, findings, conclusions, or recommendations expressed in this publication do not necessarily reflect the views of any organization or agency that provided support for the project. International Standard Book Number-13: 978-0-309-XXXXX-X International Standard Book Number-10: 0-309-XXXXX-X Digital Object Identifier: https://doi.org/10.17226/25380 Additional copies of this publication are available for sale from the National Academies Press, 500 Fifth Street, NW, Keck 360, Washington, DC 20001; (800) 624-6242 or (202) 334-3313; http://www.nap.edu. Copyright 2019 by the National Academy of Sciences. All rights reserved. Printed in the United States of America Suggested citation: National Academies of Sciences, Engineering, and Medicine. 2019. Strengthening the Military Family Readiness System for a Changing American Society. Washington, DC: The National Academies Press. doi: https://doi.org/10.17226/25380. PREPUBLICATION COPY, UNCORRECTED PROOFS

The National Academy of Sciences was established in 1863 by an Act of Congress, signed by President Lincoln, as a private, nongovernmental institution to advise the nation on issues related to science and technology. Members are elected by their peers for outstanding contributions to research. Dr. Marcia McNutt is president. The National Academy of Engineering was established in 1964 under the charter of the National Academy of Sciences to bring the practices of engineering to advising the nation. Members are elected by their peers for extraordinary contributions to engineering. Dr. C. D. Mote, Jr., is president. The National Academy of Medicine (formerly the Institute of Medicine) was established in 1970 under the charter of the National Academy of Sciences to advise the nation on medical and health issues. Members are elected by their peers for distinguished contributions to medicine and health. Dr. Victor J. Dzau is president. The three Academies work together as the National Academies of Sciences, Engineering, and Medicine to provide independent, objective analysis and advice to the nation and conduct other activities to solve complex problems and inform public policy decisions. The National Academies also encourage education and research, recognize outstanding contributions to knowledge, and increase public understanding in matters of science, engineering, and medicine. Learn more about the National Academies of Sciences, Engineering, and Medicine at www.nationalacademies.org. PREPUBLICATION COPY, UNCORRECTED PROOFS

Consensus Study Reports published by the National Academies of Sciences, Engineering, and Medicine document the evidence-based consensus on the study’s statement of task by an authoring committee of experts. Reports typically include findings, conclusions, and recommendations based on information gathered by the committee and the committee’s deliberations. Each report has been subjected to a rigorous and independent peer-review process and it represents the position of the National Academies on the statement of task. Proceedings published by the National Academies of Sciences, Engineering, and Medicine chronicle the presentations and discussions at a workshop, symposium, or other event convened by the National Academies. The statements and opinions contained in proceedings are those of the participants and are not endorsed by other participants, the planning committee, or the National Academies. For information about other products and activities of the National Academies, please visit www.nationalacademies.org/about/whatwedo. PREPUBLICATION COPY, UNCORRECTED PROOFS

COMMITTEE ON THE WELL-BEING OF MILITARY FAMILIES KENNETH W. KIZER, (Chair), University of California, Davis, School of Medicine (Department of Emergency Medicine), and Betty Irene Moore School of Nursing, and Institute for Population Health Improvement, UC Davis Health DAVID ALBRIGHT, Department of Social Work, The University of Alabama School of Social Work STEPHEN J. COZZA, U.S. Army Retired, Department of Psychiatry, Uniformed Services University of the Health Sciences ELLEN DEVOE, Department of Clinical Practice, Boston University School of Social Work ABIGAIL GEWIRTZ, Department of Family Social Science & Institute of Child Development, and Institute for Translational Research in Children’s Mental Health, University of Minnesota MARY M. KELLER, Military Child Education Coalition PATRICIA LESTER, Department of Child Psychiatry, University of California, Los Angeles, Semel Institute SHELLEY MACDERMID WADSWORTH, Department of Human Development and Family Studies and Military Family Research Institute, Purdue University LAURA L. MILLER, RAND Corporation TRACY NEAL-WALDEN, U.S. Air Force Retired, Steven A. Cohen Military Family Clinic at Easterseals DANIEL F. PERKINS, Department of Agriculture Economics, Sociology, and Education, Clearinghouse for Military Family Readiness, The Pennsylvania State University ASHISH S. VAZIRANI, Armed Services YMCA IVAN C. A. WALKS, Ivan Walks & Associates SUZANNE LE MENESTREL, Study Director DAVID BUTLER, Senior Scholar SHEILA MOATS, Program Officer (February 2018 – June 2018) PRIYANKA NALAMADA, Associate Program Officer (July 2018 – present) STACEY SMIT, Senior Program Assistant JUDITH JONES, Archer Fellow (May 2018 – August 2018) LAURA MINERO, Christine Mirzayan Science and Technology Policy Graduate Fellow (January 2019 – April 2019) SUNDONIA WILLIAMS WONNUM, Consultant, U.S. Air Force PREPUBLICATION COPY, UNCORRECTED PROOFS v 

BOARD ON CHILDREN, YOUTH, AND FAMILIES ANGELA DIAZ, (Chair), Departments of Pediatrics and Preventive Medicine, Icahn School of Medicine at Mount Sinai DAVID V. B. BRITT, (Co-Chair), Sesame Workshop (retired CEO) HAROLYN BELCHER, Kennedy Krieger Institute and Johns Hopkins University School of Medicine RICHARD F. CATALANO, University of Washington School of Social Work DIMITRI CHRISTAKIS, Seattle Children’s Research Institute, University of Washington JEFFREY W. HUTCHINSON, F. Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences STEPHANIE J. MONROE, The Wrenwood Group, LLC JAMES M. PERRIN, Harvard Medical School and Mass General Hospital for Children NISHA SACHDEV, Bainum Family Foundation DONALD F. SCHWARZ, Robert Wood Johnson Foundation MARTIN J. SEPÚLVEDA, Research Division, IBM Corporation (retired) MARTIN H. TEICHER, Harvard Medical School and McLean Hospital JONATHAN TODRES, Georgia State University College of Law NATACHA BLAIN, Director PREPUBLICATION COPY, UNCORRECTED PROOFS vi 

ACKNOWLEDGMENTS Supporting the well-being of military families is essential to ensuring the readiness of military personnel. Military families encompass a broad spectrum of American society and have diverse needs that have materially changed in recent years. In an effort to make sure its efforts to support military families are addressing their needs in a rapidly changing American society, the U.S. Department of Defense asked the National Academies of Sciences, Engineering, and Medicine (the National Academies) to study the challenges and opportunities facing military families and what is known about effective strategies for supporting and protecting military children and families, as well as lessons to be learned from these experiences. The National Academies appointed the Committee on the Well-being of Military Families in 2017 to address this charge. The committee thanks the sponsor of this study, the Office of Military Community and Family Policy, U.S. Department of Defense, for their support of the committee’s activities. This report would not have been possible without the contributions of many people. Special thanks go to the members of the committee who dedicated extensive time, expertise, and energy to the drafting of the report. The committee also thanks the members of the National Academies staff for their significant contributions to the report: Suzanne Le Menestrel, Priyanka Nalamada, David Butler, and Sheila Moats. Stacey Smit provided key administrative and logistical support and made sure that committee meetings ran smoothly. The committee is also grateful to Anthony Bryant, Faye Hillman, and Lisa Alston for their administrative and financial assistance. From the Division of Behavioral and Social Sciences and Education Office of Reports and Communication, Kirsten Sampson Snyder, Viola Horek, Patricia L. Morison, Douglas Sprunger, and Yvonne Wise guided the report through the review and production process and assisted with its communication and dissemination. The committee also thanks the National Academies Press staff, Clair Woolley, Holly Sten, Autumn Rose, and Barbara Murphy for their assistance with the production of the final report; Daniel Bearss and Rebecca Morgan in the National Academies research library for their assistance with fact checking and literature searches; and the report’s editor, Marc DeFrancis, for his expert editing. Finally, throughout the project, Natacha Blain, director of the Board on Children, Youth, and Families, together with Mary Ellen O’Connell and Monica Feit, provided helpful oversight. Many individuals volunteered significant time and effort to address and educate the committee during our public information session. Their perspectives and personal experiences were essential to the committee’s work. We thank: Ashley Broadway-Mack, president, The American Military Partner Association; Karen Ruedisueli, government relations deputy director, National Military Family Association; Chaplain (COL) Jimmy Nichols, installation command chaplain, Fort Sill, Oklahoma; Ed Tyner, associate director, Office of Family Readiness/Office of Special Needs; Kelly Hokanson, spouse of National Guard Bureaus Vice Chief, LTG Daniel R. Hokanson; Jill Marconi, Air Force, director, Airman & Family Readiness; Susan Lukas, director, Legislation & Military Policy/Air Force Reserve Officer Association; Anthony A. Wickham, J1 program director at the National Guard Bureau; Col. (Ret) Anthony Cox, Army, former manager, HQDA Family Advocacy Program; Ellyn Dunford, spouse of Gen. Joseph F. Dunford, chairman of the Joint Chiefs of Staff; Elka Giordano, chief of Naval Operations OMBUDSMAN-at-Large and spouse of Master Chief Petty Officer of the Navy Steven S. Giordano; and Donald R. Neff, United States Special Operations Command. PREPUBLICATION COPY, UNCORRECTED PROOFS vii 

The committee also appreciates the contributions of Sarah Beehler (University of Minnesota), David Chambers (National Cancer Institute), Schelomo Marmor (University of Minnesota), Lisa Militello (The Ohio State University), Nathaniel Mohatt (University of Colorado, Denver), Inbal Nahum-Shani (University of Michigan), Wynne Norton (National Cancer Institute), and Barbara Thompson (retired) for their valuable commissioned papers, which informed our report. We would also like to extend our gratitude to our unpaid consultants, Diana Timba (University of Minnesota) and Sundonia Williams-Wonnum (U.S. Air Force) and our graduate fellows Laura Minero and Judith Jones. Many individuals also submitted memos for the committee’s consideration; a listing of these individuals can be found in Appendix C in this report. This Consensus Study Report was reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise. The purpose of this independent review is to provide candid and critical comments that will assist the National Academies in making each published report as sound as possible and to ensure that it meets the institutional standards for quality, objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the deliberative process. We thank the following individuals for their review of this report: Nicholas J. Armstrong, Research and Evaluation, Institute for Veterans and Military Families, Syracuse University; Ron Avi Astor, School Behavioral Health and Suzanne Dworak-Peck School of Social Work, Rossier School of Education, University of Southern California; Kelly Blasko, Connected Health Branch, Clinical Support Division, Medical Affairs, Defense Health Agency; Kenneth A. Dodge, Sanford School of Public Policy, Duke University; Richard Fabes, School of Social and Family Dynamics, Arizona State University; Eric M. Flake, Developmental Behavioral Pediatrician, Madigan Army Medical Center; Stacy A. Hawkins, Research Facilitation Laboratory, Army Analytics Group; Jay A. Mancini, Human Development and Family Science, The University of Georgia; Ann S. Masten, Institute of Child Development, University of Minnesota, Minneapolis; Sarah O. Meadows, Pardee RAND Graduate School, RAND; Lyndon A. Revere, Military Psychiatry Branch, Center for Military Psychiatry & Neuroscience, Walter Reed Army Institute of Research; and Jonathan Woodson, Institute for Health System Innovation & Policy, Boston University. Although the reviewers listed above provided many constructive comments and suggestions, they were not asked to endorse the conclusions or recommendations of this report nor did they see the final draft before its release. The review of this report was overseen by Dan G. Blazer, Duke University Medical Center, and Bradford H. Gray, The Urban Institute (retired). They were responsible for making certain that an independent examination of this report was carried out in accordance with the standards of the National Academies and that all review comments were carefully considered. Responsibility for the final content rests entirely with the authoring committee and the National Academies. Kenneth W. Kizer, Chair PREPUBLICATION COPY, UNCORRECTED PROOFS viii 

Contents SUMMARY S-1 1 INTRODUCTION 1-1 Context for the Study Study Charge Study Approach Guiding Principles Organization of the Report References 2 FAMILY WELL-BEING, READINESS, AND RESILIENCE 2-1 Linkages Between Family Issues and Military Readiness Defining Family Defining Family Well-Being Military-Focused Definitions of Well-Being Trends in Family Life Implications for the Department of Defense Ecological and Life Course Models of Military Family Well-Being Resilience and Readiness Resilience in the Military Context Measuring Family Readiness and Resilience Conclusions References 3 DEMOGRAPHIC AND MILITARY SERVICE CHARACTERISTICS OF MILITARY FAMILIES 3-1 Information Sources: Within DoD Information Sources: External to DoD Organizational and Individual Characteristics Characteristics that Change Over Time Attention to Intersectionality Veteran Population Conclusions References 4 MILITARY LIFE OPPORTUNITIES AND CHALLENGES 4-1 Opportunities or Challenges? The Context of Military Family Life: Yesterday vs. Today Transition into the Military Pay and Benefits Geographic Assignment and Relocation Training, Sea Duty, and Deployments National Guard and Reserve Service Diversity and Inclusion Transition Out of Military Service Summary Conclusions References PREPUBLICATION COPY, UNCORRECTED PROOFS ix 

5 STRESS, RISK, AND RESILIENCE IN MILITARY CHILDREN 5-1 The Impact of Stress on Youth Development How Parenting Affects the Development of Stress Regulatory Capacities Resilience in Children’s Development Conclusions References 6 HIGH STRESS EVENTS, FAMILY RESILIENCE PROCESSES, AND MILITARY FAMILY WELL-BEING 6-1 Stress and Family Resilience Processes The Effects of High Stress Events on Military Families: Duty-Related Illness, Injury, and Death, Military Family Violence, and Child Maltreatment Opportunities for Bolstering Resilience by Addressing Risk Pathways Conclusions References 7 THE MILITARY FAMILY READINESS SYSTEM: PRESENT AND FUTURE 7-1 The Structure of the Military's Service Member and Family Well-Being Support System A Population-Level System Promoting Well-Being Evidence-Based and Evidence-Informed Policies, Programs, Services, Resources, and Practices Accountability and Measurement Community Engagement and Participatory Partnerships Conclusions References 8 DEVELOPING AND SUSTAINING A LEARNING SYSTEM TO SUPPORT MILITARY FAMILY READINESS AND WELL-BEING 8-1 Background on Family-Based Promotion and Prevention Interventions Barriers to Translating Evidence into Practice Remediating the Bridge from Evidence to Practice Ongoing Adaptation Framework for a Complex Military Family Readiness System Adaptation and Continuous Quality Monitoring Using a Learning System Framework Summary Conclusions References 9 COMMITTEE RECOMMENDATIONS 9-1 Enhance Understanding of Today’s Service Members and Their Families Improve Military Community and Family Policy Programs and Services Strengthen the Broader Military Family Readiness System References APPENDICES A. Biosketches of Committee Members and Project Staff B. Agenda for Public Information Gathering Session C. Authors of Memos Submitted To The Committee D. Acronyms and Glossary of Terms PREPUBLICATION COPY, UNCORRECTED PROOFS x 

BOXES, FIGURES, AND TABLES BOXES S-1 Definitions of Key Terms Used in the Report S-2 Family-Strengthening Goals to Promote Family Resilience and Well-Being S-3 Committee Recommendations 1-1 Definitions of Key Terms Used in the Report 1-2 Statement of Task 1-3 U.S. Code, Title 37, Section 401: Definition of Family Dependent 1-4 Guiding Principles for the Report 1-5 Characteristics, Strengths, and Challenges of the All-Volunteer Force 2-1 The Rise of Digital Technology and Its Impact on Service Member Privacy and Security 2-2 Key Resilience Principles 3-1 Military Student Identifier Reporting 4-1 Examples of Prominent Themes Associated with Transition into and Service in the Military 4-2 Examples of Prominent Themes Associated with Military Pays and Benefits 4-3 Examples of Prominent Themes Associated with Geographic Assignment and Relocation 4-4 Examples of Prominent Themes Associated with Deployments, Sea Duty, and Training Exercises Away From Home 4-5 Examples of Prominent Themes Specific to Members of the National Guard and Reserves 4-6 Examples of Prominent Themes Associated with Diversity and Inclusion 4-7 Examples of Prominent Themes Associated with the Transition from Military to Civilian Life 6-2 Family-Strengthening Goals to Promote Family Resilience and Well-Being 7-1 Clearinghouse for Military Family Readiness: Major Criteria for Program Placements on the Continuum of Evidence 7-2 Community Engagement and Community Participatory Research 7-3 Military Family Voices 8-1 Applying a System-Level Approach: The Building Capacity Consortium 8-2 Adapting a Program Sunsetting: The Joint Family Support Assistance Program 8-3 Just-in-Time Adaptive Interventions (JITAIs): An Example FIGURES 1-1 All family relationships are interdependent 2-1 Bronfenbrenner’s ecological theory of development 3-1 Distribution of service members, by service and component 3-2 Service members’ age (percent distribution) 3-3 Service members’ race (percent distribution) 3-4 Service members who are women, by service and component 3-5 Family status of all service members (percent distribution) 3-6 Family status of active and reserve component service members (percent distribution) 3-7 Ages of military spouses (percent distribution) PREPUBLICATION COPY, UNCORRECTED PROOFS xi 

3-8 Employment status of active and reserve component spouses (percent distribution) 3-9 Ages of children in military families (percent distribution) 4-1 The military family well-being and readiness model and illustrative elements 4-2 Overlapping qualifications of programs serving children with special needs 6-1 Effects of military family stressors at the individual, parent-child, couple, and family level, targets for prevention/intervention, and EBP intervention examples 7-1 Continuum of coordinated support within the Military Family Readiness System 7-2 Donabedian paradigm 7-3 Model for development and measurement of coordinated support policies, programs, services, resources, and practices 7-4 Integrated information infrastructure to support a complex adaptive system, such as MFRS 7-5 Types of outcomes in implementation research 8-1 Dynamic sustainability framework 8-2 Sources of intervention adaptations 8-3 Conceptual model of big data collection, analysis, and dissemination to improve military family readiness and well-being. 9-1 Trends in the Department of Defense’s support costs, 1980–2016 TABLES 2-1 Key factors in the production of resilience 3-1 Total Number of Exceptional Family Members in 2016, by Military Service 3-2 Characteristics of Caregivers of Military Personnel and Veterans Who Served Post-9/11 6-1 Negative Effects of PTSD Symptom Clusters on Family Resilience Processes 6-2 Opportunities for Intervention to Promote Family Resilience and Well-being 7-1 Examples of service–specific information, resource, and referral centers 7-2 Definitions of the Continuum of Coordinated Support domains and program examples 8-1 Big Data Utilization Within a Continuous Learning System Using the IOM Learning System Framework Integrated With Plan-Do-Study-Act (PDSA) Principles PREPUBLICATION COPY, UNCORRECTED PROOFS xii 

Next: Summary »
Strengthening the Military Family Readiness System for a Changing American Society Get This Book
×
Buy Paperback | $90.00
MyNAP members save 10% online.
Login or Register to save!
Download Free PDF

The U.S. military has been continuously engaged in foreign conflicts for over two decades. The strains that these deployments, the associated increases in operational tempo, and the general challenges of military life affect not only service members but also the people who depend on them and who support them as they support the nation – their families.

Family members provide support to service members while they serve or when they have difficulties; family problems can interfere with the ability of service members to deploy or remain in theater; and family members are central influences on whether members continue to serve. In addition, rising family diversity and complexity will likely increase the difficulty of creating military policies, programs and practices that adequately support families in the performance of military duties.

Strengthening the Military Family Readiness System for a Changing American Society examines the challenges and opportunities facing military families and what is known about effective strategies for supporting and protecting military children and families, as well as lessons to be learned from these experiences. This report offers recommendations regarding what is needed to strengthen the support system for military families.

  1. ×

    Welcome to OpenBook!

    You're looking at OpenBook, NAP.edu's online reading room since 1999. Based on feedback from you, our users, we've made some improvements that make it easier than ever to read thousands of publications on our website.

    Do you want to take a quick tour of the OpenBook's features?

    No Thanks Take a Tour »
  2. ×

    Show this book's table of contents, where you can jump to any chapter by name.

    « Back Next »
  3. ×

    ...or use these buttons to go back to the previous chapter or skip to the next one.

    « Back Next »
  4. ×

    Jump up to the previous page or down to the next one. Also, you can type in a page number and press Enter to go directly to that page in the book.

    « Back Next »
  5. ×

    To search the entire text of this book, type in your search term here and press Enter.

    « Back Next »
  6. ×

    Share a link to this book page on your preferred social network or via email.

    « Back Next »
  7. ×

    View our suggested citation for this chapter.

    « Back Next »
  8. ×

    Ready to take your reading offline? Click here to buy this book in print or download it as a free PDF, if available.

    « Back Next »
Stay Connected!