Cohort profile update: the US Millennium cohort study-evaluating the impact of military experiences on service members and Veteran health
Abstract: This paper provides an update to the original cohort profile paper published a decade ago. The Millennium Cohort Study is the largest, longest-running, prospective study of current and former United States (US) military personnel and is sponsored by the US Departments of Defense (DoD) and Veterans Affairs (VA). While the original study aim, evaluating the health impact of serving in the military, has remained consistent, the spectrum of research topics has expanded to include areas such as social determinants of health. 260 228 military personnel enrolled across 5 panels between 2001 and 2021 (baseline age range: 25-35 years); participants are surveyed every 3-5 years. The original 21-year follow-up period was extended through 2068 to examine health across the lifespan. Longitudinal survey data are linked to data from DoD, VA, and external sources (e.g. medical records, deployment histories, vital statistics, and geospatial data).
Abstract: INTRODUCTION: Substance use disorders (SUDs) are an ongoing public health crisis in the United States. A large body of research indicates an urgent need for increased training in SUD research and treatment for trainees in mental health service disciplines. The VA Health Care System is well positioned, as the largest trainer and employer of health service psychologists and other mental health professionals, to address the SUD training gap and serve as a leader in training the upcoming health care workforce. METHOD: To this end, we conducted two pilot studies to (1) examine the feasibility of implementing supplemental SUD training for VA health service trainees, among current VA mental health service providers in psychology, social work, and medical care (N = 37) and (2) the efficacy of a single 2-hour interdisciplinary SUD training seminar for VA health service trainees in mental health (N = 13). The training seminar consisted of several components including lecture, facilitated discussion, and role play, aimed at increasing trainee self-efficacy in assessing and diagnosing SUDs. RESULTS: Findings suggest that current providers are supportive of supplemental SUD training for VA trainees and believe that such training is beneficial for those wishing to pursue a career within the VA Health Care System. Additionally, results suggest that a single session didactic seminar improved trainees' self-reported efficacy in the assessment and referral of veterans diagnosed with SUDs. CONCLUSIONS: Overall, the above studies support additional feasibility investigations that would pave the way for successful implementation of widespread SUD training programs across the VA Health Care System and beyond. Successful implementation would then serve to reduce the increasingly critical SUD provider shortage, thus leading to significant public health gains.