Conforte Allison M, DeLeon Patrick H, Engel Charles C, Ling Catherine, Bakalar Jennifer L, Tanofsky-Kraff Marian
Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814.
RAND Corporation, 1200 South Hayes Street, Arlington, VA 22202-5050.
Mil Med. 2017 May;182(5):1572-1580. doi: 10.7205/MILMED-D-17-00002.
As former U.S. Army Surgeon General Horoho points out, a large fraction of what determines the health and readiness of our military families does not occur during appointments with professionals, but rather within the "Lifespace-where health really happens...." Indeed, when children of military families experience psychosocial difficulties, such stress impacts the service members' personal well-being and ability to focus at work, impairing their capacity to attend to the mission. As such, the Department of Defense (DoD) has instituted a family readiness system to bolster resiliency within military families, including children, e.g., by linking families with support networks. Bolstering military family resiliency, including the prevention of and effective intervention for child psychosocial problems, is an important issue at all levels of the DoD. Service members, leaders, and policy makers have a vested interest in promoting mission readiness and a healthy force. Research can play an important role in shaping decision-making by consolidating what is currently known and not known about a particular expertise area. To date, there has been no consolidation of research regarding outcomes associated with military community support and the programs that currently exist to bolster child and family resiliency. Given the importance of military families to mission readiness, a review of the relevant research is warranted.
This commentary article reviews the literature on community support for military children, provides an overview of currently available resources, discusses concerns with the current provision of support services to military families, and offers recommendations for future research, policy, and implementation of military community support programs.
Although there is a dearth of research on available support programs, there appears to be no lack of services available to military families. However, several steps could be taken to make these resources into a more supportive system. Family members must be able to identify what support services exist, distinguish which service is most suitable for their needs, and be able to readily access these services in a resource-conserving manner. Considerable overlap in support services seems to suggest limited coordination between organizations and service providers, particularly in regard to the government/civilian interface, which inherently lies outside of DoD control. This overlap suggests a redundancy, which may not be efficient economically or in regard to accessing support. There also may be some confusion over which support service is most suitable for the consumer's need. Although some overlap is useful, such as the provision of different services to different populations (e.g., having separate programs for the Army, Navy, Air Force, and Marine subcultures), limited organization and parsimonious provision of services makes it particularly difficult for spouses and family members to navigate resources. Initial attempts are being made to organize and consolidate resources in both the government and civilian sectors. However, it is clear that these initiatives have not completely solved problems related to resource access, redundancy, and lack of research-supported efficacy.
正如美国前陆军军医局局长霍罗霍所指出的，决定我们军人家庭健康状况和战备状态的很大一部分因素并非发生在与专业人员的预约就诊期间，而是在“生活空间——健康真正发生的地方……”。事实上，当军人家庭的孩子出现心理社会问题时，这种压力会影响军人的个人幸福感以及他们在工作中的专注能力，进而削弱他们执行任务的能力。因此，美国国防部（DoD）建立了一个家庭战备系统，以增强军人家庭（包括孩子）的恢复力，例如通过将家庭与支持网络联系起来。增强军人家庭的恢复力，包括预防和有效干预儿童心理社会问题，是国防部各级的一个重要问题。军人、领导者和政策制定者在促进任务准备状态和一支健康的部队方面有着既得利益。研究可以通过整合关于特定专业领域目前已知和未知的信息，在塑造决策方面发挥重要作用。迄今为止，尚未对与军事社区支持以及当前存在的增强儿童和家庭恢复力的项目相关的研究进行整合。鉴于军人家庭对任务准备状态的重要性，对相关研究进行综述是必要的。
这篇评论文章综述了关于军事儿童社区支持的文献，概述了目前可用的资源，讨论了当前向军人家庭提供支持服务存在的问题，并为未来的研究、政策以及军事社区支持项目的实施提供了建议。
尽管关于现有支持项目的研究匮乏，但军人家庭似乎并不缺乏可获得的服务。然而，可以采取几个步骤将这些资源整合为一个更具支持性的系统。家庭成员必须能够确定存在哪些支持服务，区分哪种服务最适合他们的需求，并能够以节省资源的方式方便地获得这些服务。支持服务的大量重叠似乎表明各组织和服务提供者之间协调有限，特别是在政府/民间界面方面，这本质上超出了国防部的控制范围。这种重叠意味着冗余，这在经济上或获取支持方面可能都效率不高。对于哪种支持服务最适合消费者的需求也可能存在一些困惑。虽然一些重叠是有用的，例如为不同人群提供不同的服务（例如为陆军、海军、空军和海军陆战队亚文化群体设立单独的项目），但有限的组织和精简的服务提供使得配偶和家庭成员特别难以找到资源。政府和民间部门都在初步尝试组织和整合资源。然而，很明显这些举措尚未完全解决与资源获取、冗余以及缺乏研究支持的效果相关的问题。
