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
Survey response over 15 years of follow-up in the Millennium Cohort Study BMC Medical Research Methodology 2023 Sep 9 | doi: 10.1186/s12874-023-02018-z

Kolaja CA, Belding JN, Boparai SK, Castañeda SF, Geronimo-Hara TR, Powell TM, Tu XM, Walstrom JL, Sheppard BD, Rull RP; Millennium Cohort Study Team

Across a 3-15 year follow-up period, the average response rate among almost 198,833 Millennium Cohort Study participants was 60%. Factors associated with follow-up survey response over time included increased educational attainment, married status, female sex, older age, military deployment, greater life stress, and poorer mental/physical health status.

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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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Single and repeated high-level blast, low-level blast, and new-onset self-reported health conditions in the U.S. Millennium Cohort Study: An exploratory investigation Frontiers in Neurology 2023 Mar 21 | doi: 10.3389/fneur.20

Belding JN, Kolaja CA, Rull RP, Trone DW for the Millennium Cohort Study Team

This study examined whether single and repeated high-level blast exposure (e.g., from incoming munitions) and low-level blast exposure (e.g., from outgoing munitions) were associated with 45 different self-reported diagnoses of illness and injury. Outcomes examined included PTSD, depression, hearing loss, tinnitus, chronic fatigue syndrome, and migraines. Findings suggest that blast exposure elevated risks for more than 20 different diagnoses and that repeated exposure was associated with worse outcomes.

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Pre-incentive Efficacy in Survey Response Rates in a Large Prospective Military Cohort Field Methods 2023 Mar 17 | doi: 10.1177/1525822X231163668

Powell TM, Geronimo-Hara TR, Tobin LE, Donoho CJ, Sheppard BD, Walstrom JL, Rull RP, Faix DJ

U.S. military and veteran populations are challenging to retain in longitudinal studies as they span the globe, frequently move, and are heavily surveyed. This study tested the effectiveness of multiple pre-incentives ($2 bill, $5 gift card, magnet, and Apple iPad® lottery entry) on increasing the response rate to the 2014 survey of the Millennium Cohort Study. Findings suggest that providing participants a monetary pre-incentive was an effective way to increase response rates and participant retention as well as re-engage participants who did not respond to a previous follow-up survey.

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Identifying at-risk marines: A person-centered approach to adverse childhood experiences, mental health, and social support Journal of Affective Disorders 2023 Mar 15 | doi: 10.1016/j.jad.2023.01.020

Reed-Fitzke K, LeardMann CA, Wojciak AS, Ferraro AJ, Hamilton A, Duncan JM, Rull RP

In a sample of male Marines (n=3,881), five subgroups based on adverse childhood experiences were identified. One in five Marines reported moderate to elevated levels of childhood adversity. A history of varying types of childhood adversity characterized by parental absence was associated with greater PTSD and depression symptomology and lower levels of social support. When attempting to identify Marines most at-risk for mental health concerns, the identification of specific patterns of childhood adversity, particularly regarding parental absence, may be more valuable.

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Contribution of Post-Trauma Insomnia to Depression and Posttraumatic Stress Disorder in Women Service Members: Findings from the Millennium Cohort Study Sleep 2023 Mar 9 | doi: 10.1093/sleep/zsac313

Carlson GC, Sharifian N, Jacobson IG, LeardMann CA, Rull RP, Martin JL

Post-trauma insomnia contributed to the development of depression and PTSD among women service members and veterans; screening for insomnia may help mitigate the development of posttraumatic mental health conditions.

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Risk and Protective Factors for Cancer Mortality Among United States Service Members and Veterans (2001-2018) Cancer Epidemiology, Biomarkers & Prevention 2023 May 1 | doi: 10.1158/1055-9965.EPI-22-0943

Sharifian N, Carey FR, Seay JS, Castaneda SF, Boyko EJ, Rull RP

This longitudinal study used data from the Millennium Cohort Study (2001-2018) to examine risk and protective factors for cancer mortality among service members and veterans . Compared with those who deployed without combat experiences, non-deployers were more likely to die from cancer, consistent with the healthy deployer effect.

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The bi-directional relationship between post-traumatic stress disorder and obstructive sleep apnea and/or insomnia in a large U.S. military cohort Sleep Health 2022 December | doi: 10.1016/j.sleh.2022.07.005

Chinoy ED, Carey FR, Kolaja CA, Jacobson IG, Cooper AD, Markwald RR

Study findings indicate a bi-directional relationship between the development of sleep disorders and PTSD. Military-related factors associated with new onset PTSD or sleep disorders, such as combat deployment, recent military separation, and rank, should be considered in prevention efforts for sleep disorders and PTSD.

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Health Disparities Among Lesbian, Gay, and Bisexual Service Members and Veterans American Journal of Preventive Medicine 2022 Oct | doi: 10.1016/j.amepre.2022.04.034

Carey FR, LeardMann CA, Lehavot K, Jacobson IG, Kolaja CA, Stander VA, Rull RP, Millennium Cohort Study Team

This study examined whether differences in mental, physical, and behavioral health exist by sexual orientation among active duty and Reserve/National Guard service members and veterans (N=96,930). Lesbian, gay, and bisexual (LGB) individuals (3.6% of the sample) were more likely to screen positive for post-traumatic stress disorder, depression, anxiety, binge eating, problematic anger, multiple somatic symptoms, and insomnia than heterosexual individuals. LGB women reported more adverse health outcomes (overweight and obesity, smoking, problem/risky drinking) than heterosexual women. Gay and bisexual men reported some adverse health outcomes (e.g., smoking and problem drinking) but better physical health (e.g., less overweight/obesity) than heterosexual men. These results suggest that LGB service members experience health disparities, despite many having equal eligibility for health care, highlighting the need for improved equity initiatives that promote cultural responsiveness, acceptance, and approaches to support the healthcare needs of LGB military members.

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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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