Predictors of military veterans' engagement in bespoke recovery pathways and health and well-being outcomes.

PURPOSE/OBJECTIVE: The objective of this cross-sectional study was to assess how psychosocial variables predict U.K. military veterans' level of engagement in bespoke recovery pathways (Aim 1) and a sports-specific recovery pathway (Aim 2). A further purpose of this study was to test whether predictor variables indirectly predict outcome variables of physical health (Aim 3), mental health (Aim 4), and subjective vitality (Aim 5), when mediated through level of engagement with all recovery pathways and the sport recovery pathway. Research Method/Design: A cross-sectional battery of questionnaires were completed by 514 military veterans who had been enrolled in Help for Heroes recovery pathways (e.g., sports recovery pathway) from 3 months to 10 years. Data were analyzed by multinomial logistic and multiple linear regressions and mediation analyses using the PROCESS SPSS macro. RESULTS: Engagement in all recovery pathways (i.e., frequency and duration of attendance) was predicted by basic psychological needs frustration and perceived social support (Nagelkerke R² = .16). Sport-related social support (p < .05) and competence satisfaction (p < .001) were directly positively associated with mental health, and competence satisfaction with physical health (p < .001) and well-being (p < .001) on the sport recovery pathway. While perceived stress was directly negatively associated with mental health and well-being (p < .001). Mediation analyses revealed no significant, indirect effects of psychosocial variables on health and wellbeing through level of engagement. CONCLUSIONS/IMPLICATIONS: In sum, engagement in recovery pathways does not mediate the effects of psychosocial variables on veterans' health and well-being. Perceived social support, satisfaction of veterans' needs, and perceived stress were better predictors of health and well-being outcomes and should be an important focus of future research and recovery. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Perceived barriers to, and benefits of physical activity among British military veterans that are wounded, injured, and/or sick: a Behaviour Change Wheel perspective.

PURPOSE: Many British military veterans that are wounded, injured, and/or sick (WIS) face significant physical, psychological and social challenges following discharge from the military. There is increasing evidence to support the application and benefit of physical activity for veterans that are WIS. Understanding engagement in physical activity is therefore imperative so that physical activity interventions and initiatives can be designed effectively, and their benefits optimised. Therefore, the aim of this study is to identify the perceived barriers to, and benefits of physical activity among veterans that are WIS. MATERIALS AND METHODS: Nine semi-structured interviews were conducted to explore perceived barriers to, and benefits of physical activity amongst veterans that are WIS. A thematic analysis was conducted, and themes mapped to the Behaviour Change Wheel's capability, opportunity, motivation-behaviour (COM-B) model. RESULTS: Perceptions related to physical capability, psychological capability, physical opportunity and reflective motivation were predominant barriers to engagement in physical activity. As well providing opportunities to socialise, the perceived benefits of engagement in physical activity seemed to mirror the perceived barriers, suggesting a reciprocal relationship. CONCLUSIONS: Using the Behaviour Change Wheel, incentivisation, education, persuasion, enablement and environmental restructuring were identified as potentially beneficial intervention functions when seeking to increase levels of physical activity among veterans that are WIS living within the United Kingdom.IMPLICATIONS FOR REHABILITATIONUK-based veterans that are wounded, injured, and/or sick (WIS) often face significant challenges with respect to physical, mental, and social well-being.Perceived barriers, in the form of limited opportunities and a self-perceived lack of capability impact on levels of motivation and are viewed as obstacles to becoming physically active by veterans that are WIS.Providing education and complementary incentives may help reduce the extent of perceived barriers in veterans that are WIS.Approaches that allow veterans that are WIS to socialise while developing self-efficacy will likely increase physical activity engagement.

Military veteran athletes' experiences of competing at the 2016 Invictus Games: a qualitative study.

PURPOSE: Previous research has championed sport as a form of recovery for military veterans. Nevertheless, there is a lack of research on military veterans' experiences of international sporting competitions. The aim of this study was to explore military veterans' experiences of participation at the 2016 Invictus Games. METHODS: Fifteen military veterans (10 male, 5 female) who participated in the 2016 Invictus Games were recruited. Semi-structured interviews were conducted to explore experiences pre, during, and post-competition, and analyzed using applied thematic analysis. RESULTS: Three overarching themes were identified: Sources of motivation consisted of a range of veteran specific motives for getting involved with and continuing participation with the Games. Team and culture stressors encapsulated organizational demands related to the attitudes and behaviors of a sports team operating within the context of the Invictus Games. Impact of the games comprised veterans' perceptions of positive and negative consequences of being involved with the Games. CONCLUSIONS: The study provides insight into the multitude of motives military veterans have for engaging in sport, whilst also demonstrating the novel organizational demands that veteran athletes encounter. The findings also offer preliminary insight regarding the impact of the Games and the potential for psychoeducation program implementation to support athletes post-Games.Implications for RehabilitationThe Invictus Games were created for military veterans to use the power of sport to inspire recovery, support rehabilitation, and generate wider understanding and respect.Findings highlight that military veterans have unique motives to compete at the Invictus Games, including "reconnection with previously military life" and "being a role model".Whilst veterans encounter team and culture organizational stressors while competing, they share similar post-Games experiences to full-time athletes, including the concept of "post-games blues".Experiences shared by military veterans at the Invictus Games can aid in the promotion of sport as a viable form of recovery.Primary and secondary stress management strategies should be implemented with military veterans to reduce organizational stressors and their responses to them.Psychoeducation programmes should be introduced pre-Games to better prepare military veterans for their post-Games experience.

A Longitudinal Examination of Military Veterans' Invictus Games Stress Experiences.

This study explored patterns of change in stress variables (i.e., stressors, appraisals, emotions) encountered by wounded, injured, and sick military veterans in the build up to, during, and following an international sporting competition. The study also examined interactions between psychosocial variables and salivary biomarkers of stress and how these relate to veterans' health, well-being, illness, and performance. 40 Invictus Games (IG) athletes and a control group of 20 military veteran athletes completed questionnaires at seven time points over a 12-week period. Furthermore, participants provided morning and evening saliva samples at four time points to measure cortisol and secretory immunoglobulin A. Multilevel growth curve analyses revealed significant changes in growth trajectories of stress-related variables. For example, team and culture stressors and anger and dejection emotions significantly increased in the build up to competition, whilst challenge appraisals and excitement and happiness emotions significantly decreased over the same time-frame. A number of the stress related variables also predicted performance, well-being, and mental health. Specifically, organizational stressors and threat appraisals were found to negatively relate to performance, well-being, and mental health. Furthermore, whilst challenge appraisals and problem focused coping positively related to veterans' well-being, adopting emotion-focused and avoidance coping strategies negatively predicted well-being and mental health. Turning to emotions, experiencing anger, anxiety, and dejection negatively related to mental health, well-being and performance; whereas happiness and excitement displayed a positive relationship with these outcomes. The findings also highlighted that organizational stressor intensity was positively related to cortisol exposure at competition. To conclude, this study not only provides a novel, longitudinal, interdisciplinary insight into psychological and biological markers of the stress response as it relates to the performance, health, and well-being of military veterans, but also further contributes to theoretical understanding on the transactional nature of stress. Moreover, the findings significantly contribute to practice regarding how best to support this unique population in adaptively responding to and engaging with competitive sport.