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. 2023 Oct 9;13(10):e079016.
doi: 10.1136/bmjopen-2023-079016.

Health and well-being of serving and ex-serving UK Armed Forces personnel: protocol for the fourth phase of a longitudinal cohort study

Marie-Louise Sharp  1 , Margaret Jones  2 , Ray Leal  2 , Lisa Hull  2 , Sofia Franchini  2 , Niamh Molloy  2 , Howard Burdett  2 , Amos Simms  3 , Steven Parkes  2 , Daniel Leightley  2 , Neil Greenberg  2 , Dominic Murphy  2   4 , Deirdre MacManus  5 , Simon Wessely  2   3 , Sharon Stevelink  2 , Nicola T Fear  2   3
Affiliations

Health and well-being of serving and ex-serving UK Armed Forces personnel: protocol for the fourth phase of a longitudinal cohort study

Marie-Louise Sharp et al. BMJ Open. .

Abstract

Introduction: This is the fourth phase of a longitudinal cohort study (2022-2023) to investigate the health and well-being of UK serving (Regulars and Reservists) and ex-serving personnel (veterans) who served during the era of the Iraq and Afghanistan conflicts. The cohort was established in 2003 and has collected data over three previous phases including Phase 1 (2004-2006), Phase 2 (2007-2009) and Phase 3 (2014-2016).

Methods and analysis: Participants are eligible to take part if they completed the King's Centre for Military Health Research Health and Wellbeing Cohort Study at Phase 3 (2014-2016) and consented to be recontacted (N=7608). Participants will be recruited through email, post and text message to complete an online or paper questionnaire. Data are being collected between January 2022 and September 2023. Health and well-being measures include measures used in previous phases that assess common mental disorders, post-traumatic stress disorder (PTSD) and alcohol misuse. Other areas of interest assess employment, help-seeking and family relationships. New topics include the impact of the British withdrawal from Afghanistan in 2021, complex PTSD (C-PTSD), illicit drug use, gambling and loneliness. Analyses will describe the effect size between groups deployed to Iraq and/or Afghanistan or not deployed, and those who are currently in service versus ex-service personnel, respectively, reporting prevalences with 95% CIs, and ORs with 95% CI. Multivariable logistic and multiple linear regression analyses will be conducted to assess various health and well-being outcomes and associations with risk and protective factors.

Ethics and dissemination: Ethical approval has been granted by the Ministry of Defence Research Ethics Committee (Ref: 2061/MODREC/21). Participants are provided with information and agree to a series of consent statements before taking part. Findings will be disseminated to UK Armed Forces stakeholders and international research institutions through stakeholder meetings, project reports and scientific publications.

Keywords: epidemiologic studies; epidemiology; mental health.

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Conflict of interest statement

Competing interests: M-LS, MJ, LH, SF and NM salaries are funded through a grant by the Office for Veterans’ Affairs (OVA). RL and HB salaries are part funded through a grant by the OVA. AS is a serving Regular member of the British Army, salaried and seconded by the Ministry of Defence (MOD) to King’s College London. DL is a Reservist in the UK Armed Forces. This work has been undertaken as part of his civilian employment. NG is affiliated to the National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Emergency Preparedness and Response at King’s College London in partnership with Public Health England, in collaboration with the University of East Anglia and Newcastle University and is also a trustee with the Faculty and Society of Occupational Medicine. DMu is a trustee of the Forces in Mind Trust (unpaid) and is employed as the Head of Research for Combat Stress, a UK veterans mental health charity. DMa is employed as joint head of service of the London NHS Veterans Mental Health and Wellbeing Service (Op Courage). SS is supported by the NIHR Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and funded by the National Institute for Health and Care Research, NIHR Advanced Fellowship, Dr Sharon Stevelink, NIHR300592. The views expressed in this publication are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care. SW is Honorary Civilian Consultant Advisor in Psychiatry for the British Army (unpaid) and is a board member of NHS England. SW is affiliated to the NIHR HPRU in Emergency Preparedness and Response at King’s College London in partnership with Public Health England, in collaboration with the University of East Anglia and Newcastle University. NTF is a trustee of Help for Heroes—a charity supporting the well-being of veterans and their families, and their salary is part grant funded by the MOD. SP declares no competing interests.

References

    1. Ministry of Defence . Defence people health and wellbeing strategy 2022-2027. 2022.
    1. OVA . Veterans’ Strategy Action Plan 2022-2024. 2022.
    1. Rona RJ, Fear NT, Hull L, et al. Mental health consequences of Overstretch in the UK armed forces: first phase of a cohort study. BMJ 2007;335:603. 10.1136/bmj.39274.585752.BE - DOI - PMC - PubMed
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    1. Ministry of Defence . The Armed Forces Covenant. Ministry of Defence London, 2011.

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