We also know that sevicemembers do not serve alone—greater than 50% are married with families. Historically, the physical and psychological healthcare needs of military-connected children have gone unrecognized outside of military health care settings. Military children make tremendous sacrifices in support of a parent(s) military service. Over 2 million children have a parent who is serving or has served in the Armed Forces since the onset of the wars in Iraq and Afghanistan. Military children make tremendous sacrifices in support of one or more parents. While “resilient” is the word used to describe most military children, it is important that we recognize the stresses/stressors of military life—that military children serve too—in order to support and care for them. Research indicates that military-connected children are at higher risk of physical, psychological, and behavioral health issues than their civilian counterparts and could be at potential risk for toxic stress.
Military-connected children are subjected to unique stressors not experienced by their civilian counterparts. Military-connected children, both active duty and reserve, experience stress and anxiety when a parent deploys. If the parent is injured or dies, there are additional stressors, not only from grief but also from moving from a military culture into the civilian environment The unique health care needs of military-connected children include higher risk for abuse and neglect, substance use, and suicide when compared with non-military-connected children; stress and depression related to parental deployment or post deployment physical/psychological injuries; behavior and academic issues secondary to emotional distress, frequents moves or a parental deployment; and anxiety that can lead to changes in appetite, disrupted sleep patterns, and impaired immune response which can impact overall physical and psychological health of military-connected children. While these findings might suggest that the majority of military-connected children experience adverse childhood experiences (ACE), the evidence to support this assumption is varied and suggests that the outcome for children is highly dependent upon the health of the at-home parent.
Methods: Upwards of 33% of military- connected children are considered “at risk” or “high risk” for psychosocial morbidity or maltreatment, to include abuse, neglect, and psychosocial maladjustment, when a service member initially deploys and immediately following reunification—a percentage that has increased since the onset of military action in Iraq and Afghanistan. A Department of Defense report on military-connected children found that when a parent deploys, children tend to exhibit depressive symptoms, experience a decline in academic performance, and an increase in behavioral problems secondary to emotional distress. In addition, suicide ideation is higher in military-connected children than children with no connection to the military. While routine medical care for military-connected children decreases during the deployment of a parent, there is an increase in emergency, urgent, and specialist care, and often military-connected children present with somatic symptoms such as increase in blood pressure and heart rate, appetite changes, and disruptions in sleep secondary to nightmares and anxiety. Identification of military-connected children in pediatric civilian healthcare settings, knowledge regarding the deployment cycle with associated risks, and vulnerabilities is critical to ensuring the health and wellbeing of military.
Results: Currently there are no existing guidelines or resources for pediatric primary care providers, including advanced practice registered nurses (APRN), to identify unique physical, psychological, and behavioral healthcare needs of military-connected children, or, to screen for physical, psychological, and behavioral co-morbidities secondary to parental military service. The use of clinical guidelines and pocketcards have been used successfully in clinical practice by healthcare providers to improve health care quality and are associated with improved outcomes. BootsMiller et al. found that clinical guidelines have the potential to “reduce wide practice variations, improved quality of care, and control escalating medical costs”. Both the American Academy of Nursing and the Veterans Administration have developed pocketcards for use by healthcare providers caring for veterans in the civilian sector—the “Have you ever served?” Campaign and Military Health history Pocket Card for health Professions Trainees & Clinicians respectively.
Conclusion: Authors of this abstract have developed an initiative called I Serve 2. Civilian healthcare professionals provide 2/3 of the healthcare for the over 2 million military children in the United States. Many healthcare providers are unaware that the patient is a military connected child and even more are unfamiliar with the potential physical, psychological, and behavioral health risks associated with parental military service. Policies and initiatives focused on addressing the impact of parental military service must be addressed to minimize the physical, psychological, and behavioral health impact on military-connected children. The I Serve 2: A Pocketcard for Healthcare Providers Caring for Military Children attempts to fill the gap in knowledge and understanding of methods to support and strengthen military families and improve care in this population.
I Serve 2: A Pocketcard for Healthcare Providers Caring for Military Children was developed by APRNs and researchers who care for military children. This presentation will provide guidance for utilization in civilian clinical practice to better identify physical, psychological, and behavioral health risk factors and co-morbidities in military connected children. In addition, the I Serve 2: A Pocketcard for Healthcare Providers Caring for Military Children provides civilian providers with community resources aimed at supporting military connected children and families. The pocketcard will serve as a valuable resource for APRNs who care for military connected children and families.