Skip main navigation

Military Health System

Clear Your Browser Cache

This website has recently undergone changes. Users finding unexpected concerns may care to clear their browser's cache to ensure a seamless experience.

A Summary of the U.S. Marine Recruit Assessment Program Procedures and Survey from 2003 to 2021

Image of 1RAP. The Recruit Assessment Program is a cross-sectional, baseline survey of U.S. Marine recruits administered at Marine Corps Recruit Depot, San Diego.

The Recruit Assessment Program is a cross-sectional, baseline survey of U.S. Marine recruits administered at Marine Corps Recruit Depot, San Diego. This report presents RAP study procedures and survey content that was administered to 229,015 participants between 2003 and 2021. Self-reported data were collected on recruit demographics, physical and mental health, adverse life experiences, lifestyle and risky behaviors, and substance use. In 2013, the survey was updated to remove questions with other linkable and reliable sources and those with low completion rates and low relevance to Marine health research; the removal of these items allowed for the addition of instrument measures for major depression, post-traumatic stress disorder, anger, and resilience with no significant change to overall survey length. Average completion rates are approximately 95%. Multiple studies have shown the utility of RAP data collected thus far as a robust data repository of pre-service health and behavioral measures.

What are the new findings?

By surveying Marine recruits within days of arrival, RAP can more accurately obtain information on their lives and experiences prior to military service. RAP establishes a comprehensive profile of a recruit, creating a robust resource that takes into consideration each recruit’s unique history when assessing future experiences and concerns.

What is the impact on readiness and force health protection?

The purpose of the RAP survey is to increase understanding of how pre-service exposures may affect a recruit’s health and readiness while in service, and thereby inform policy decisions that protect Marines’ mental and physical health while sustaining military readiness. RAP data can also be linked to other military data sources to assess how past experiences influence future decisions, behaviors, and outcomes that may affect operational health and readiness. Utilization of this additional level of information aids policy and intervention improvement efforts.

Background

A major limitation in military health research is the inability to account for events that occurred prior to military service. A Presidential Review Directive,1 Institute of Medicine reports,2 and military advisory boards have emphasized the need for collection of baseline health data for pre-existing health conditions and risks.3,4 To further investigate concerns related to pre-service health and behavioral measures and military health and career progression, the Recruit Assessment Program was developed by the Naval Health Research Center.

RAP was implemented in June 2001 among male recruits at the Marine Corps Recruit Depot, San Diego.5 While initially established with the goal of automating recruit enrollment within the electronic medical record system, RAP has evolved to focus on assembling a comprehensive profile of U.S. Marine recruits’ experiences prior to military duty. 

The RAP survey consists of measures of Marine recruits’ pre-service health and behaviors not collected elsewhere. Collected during recruit training, RAP contributes to the understanding of a Marine recruit’s pre-service mental, physical, social, and behavioral health, and it can inform prevention and intervention strategies for adverse outcomes such as sexual assault and military attrition.6,7 RAP provides baseline data for health risk assessments during general service in the Marine Corps, as well as those associated with operational deployments and within military occupational specialties. The ever-changing demographics of Marine recruit populations emphasize the need for self-reported, autonomous, baseline data to properly account for pre-service exposures when assessing the effects of military life.

Marine recruit training is a 13-week process, during which a recruit leaves civilian life and adapts to a Marine Corps lifestyle. Training takes place at MCRD, Parris Island, South Carolina, or at MCRD, San Diego, California. Thus far, RAP has collected data exclusively on recruits at MCRD San Diego, where each receiving company of 250 to 645 Marine recruits are offered the opportunity to complete a RAP survey. 

This report summarizes survey administration and content for the RAP versions 4 and 5 (2003-2021), the predominant versions that provided 87.7% of all RAP data collected. The survey has gone through multiple revisions, with the first version in 2001 (n=17,424),5 versions 2 and 3 in 2002 (n=14,673),8,9 version 4 in 2003-2013 (n=134,761),8 followed by version 5, currently in use (n=94,254). Prior reports have provided detailed reviews of survey versions 1 through 3.5,8-10 Survey approval was obtained by the U.S. Marine Corps Survey Office. All data were collected voluntarily from participants who provided informed consent, with the approval of the Institutional Review Board at the NHRC.

Methods

Survey Content

Survey content was developed utilizing standardized survey instruments in combination with subject matter expert and stakeholder recommendations. Approximately 32% of the content in version 4 was removed from version 5, with new content in version 5 comprising 13% (Table 1). Removal of version 4 questions that had other linkable and reliable sources, low completion rates, or low relevance to Marine health stakeholders allowed the addition of instrument measures for major depression, post-traumatic stress disorder, anger, and resilience.

Click on the table to access a 508-compliant PDF version

Demographics

Demographic data collected include date of birth, most recent home location, race and ethnicity, education, marital status, handedness, height, and current and past year weights. Family demographic data include familial structure, education, and ability to provide essential needs. Military demographic data collected include prior service, reason for joining, and parental military service.

Health

Physical Health

Physical health questions were adapted from the Seabee Survey of Health Conditions,11 the 12-Item Short Form Survey (SF-12),12 and the 36-Item Short Form Survey (SF-36).13 Specific health symptoms surveyed, ranging from chronic cough to muscle aches, were reduced from 23 to 16 questions in versions 4 and 5, respectively.

Mental Health

Version 4 included SF-36 questions about reasoning and problem-solving, forgetfulness, attention, and concentration within the past year.13 Version 5 included the following validated instrument measures: the 8-item Patient Health Questionnaire depression scale14; the Primary Care PTSD Screen for DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition) (PC-PTSD-5)15; the 7-item Pearlin Mastery Scale16; and one question assessing self-perception of resilience.17

Medical Care

Version 4, but not version 5, included questions about medical care during the past five years such as care received, reasons for recommended preventive care (e.g., medical or dental checkup), hospitalizations, and prescription use.

Life Experiences

Lifestyle and Risky Behaviors

Multiple questions focus on lifestyle habits, as well as risky behaviors, including diet, sleep, television, schooling, driving safety, sexual activity, emotional behavior, social support, and religious activities. Age at first sexual intercourse, condom use, and sexually transmitted infection diagnoses were ascertained in both versions. Questions about anger were expanded to include the Dimensions of Anger Reactions (DAR-5) scale.18,19

Adverse Experiences

Ten standardized questions on adverse childhood experiences were included in the survey,20 in addition to questions about adverse experiences throughout life as well as in the past year (e.g., self-harm, attack, rape, arrest, etc.). Questions about attention-deficit/hyperactivity disorder were reduced in version 5. Three questions on traumatic brain injury, adapted from the Post Deployment Health Assessment, were added in version 5.21 Past occupational exposures were collected for participants who had worked in a position for more than one month.

Substance Use

Questions about tobacco use were adapted from prior military health surveys such as the Seabee Health Study11 and the National Health Survey of Persian Gulf War Era Veterans.22 Questions specific to cigarettes focused on age at first use, cessation attempts, last use, and typical use. Use of pipes, hookahs, cigars, and smokeless tobacco products were also surveyed. Detailed questions about alcohol use, age at first use, frequency, quantity, and behavior were included with the Cut, Annoyed, Guilty, and Eye23 instrument and 3-item Alcohol Use Disorders Identification Test (AUDIT)-C.24 Version 5 also included the full 10-item AUDIT.25

Survey Administration

RAP was designed to be a self-reported, paper and pencil-based survey that could be completed within 45 minutes, administered in various induction settings, and generalizable to a culturally diverse population.9 Once a week, Drill Instructors led receiving recruits into an auditorium-style classroom, where blank RAP survey booklets were placed at each seat. 

To allow for autonomy, DIs were not present during the survey’s introduction, when recruits were provided an approximately 15-minute verbal briefing on RAP and their option for voluntary participation. NHRC researchers presented slides reviewing the survey’s “Consent to Participate in Research” section, addressing: 1) voluntary participation, 2) benefits and risks, 3) data confidentiality and security, and 4) if desired, guidance for study withdrawal. Version 5 included options for consent to use of the data in future research beyond the RAP protocol purview, along with a Health Insurance Portability and Accountability Act authorization for permission to link to protected health information.

Following each briefing, recruits were given time to independently review the consent forms and discuss questions or concerns with the research team. Once the allotted hour for survey completion passed, recruits returned their surveys and were dismissed to their DIs. All recruits returned their survey, whether completed or not.

Survey Processing

Surveys were processed at NHRC. Surveys without consent or with consent withdrawn were destroyed. Surveys with consent were scanned using Teleform software (OpenText Corporation, Waterloo, Ontario, Canada) and entered into the RAP SQL database. A sample of 3-5% of surveys were manually checked for accuracy.

SAS version 9.4 (SAS Institute, Cary, NC) was used to manage and prepare the final analytic RAP database. Self-reported identifiers (e.g., Social Security number, date of birth, name) were verified with Defense Manpower Data Center records and entered if necessary. Implausible outliers for variables such as age, height, and weight were set to ‘missing.’ Survey versions were cleaned separately, prior to consolidation in a final analytic dataset, as they differed in question order, response options, skip patterns, and study domains. Questions from different survey versions were standardized when possible, with raw variables retained.

Historically, participation rates were calculated from denominators generated from DMDC records, which were prone to misclassification. In 2012, participation rate accuracy was improved by documenting the total numbers of recruits present.

Results

Participants

From 2003 through 2021, 229,015 recruits completed the survey; 134,761 participants completed version 4 (2003-2013) and 94,254 completed version 5 (2013-2021). DMDC demographic data were utilized to verify 99.6% of participants as Marine service members. Peaks in enrollment count mirrored peak recruitment periods, with highest participation in June. The average number of participants enrolled was approximately 12,000 recruits per year, with a high of 17,198 (7.51%) enrolled in 2005 and a low of 5,945 (2.60%) in 2020, when survey administration was paused from April through August due to the COVID-19 pandemic. As MCRD San Diego exclusively enrolled male Marine recruits until March 2021, RAP version 5 was the first to include female participants (n=109).

Completion Rates

This figure comprises two separate bar charts, each oriented along the y-, or vertical axis. The two charts graphically represent the completion rates of selected questions from versions four and five of the Marine Recruit Assessment Program (or RAP) survey. The first graph, depicting version four of the RAP survey, comprises 188 discrete vertical bars, each of which represents a separate survey question. The second graph, which depicts version five, comprises 176 vertical bars representing 176 questions. Both charts demonstrate a gradual decline of completion rates over the course of the survey, but only a small number of questions in both versions had less than a 91 percent completion rate: only seven questions in version four, and 12 in version five. No question represented in the figure has less than an 87 percent completion rate. Notably, the reorganization of the survey resulted in markedly lower completion rates for occupational exposure questions in version five, with nine of the 12 questions with less than 91 percent completion within that domain—although none of those nine questions had below an 89 percent completion rate. The reorganization of the survey resulted in much better completion rates for questions relating to “family’s ability to provide” in version five, which in version four provided the questions with the two lowest response rates—one at 88% and the other at 87 percent; in version five, however, completion rates for “family’s ability to provide” questions rose within the section, from 93 percent to 94 percent. “Other tobacco use” questions had markedly lower rates of completion in version five, with a question about tobacco pipe use completed the least frequently, but response rates immediately rose to above 95 percent in the following section, on Alcohol use.

Average participation rates were 88.1% between 2012 and 2021, with a high of 97.8% in 2017, which decreased in 2020 and 2021 to 74.4% and 69.3%, respectively, due to implementation of guidelines for COVID-19 pandemic restrictions on movement. Average completion rates for individual survey questions were 94.5% and 95.3% for versions 4 and 5, respectively, and accounted for skip questions (Figure). The minimum completion rate was approximately 87% for both surveys. Completion rates for the final question declined to 89.9% and 88.2% for the final questions of versions 4 and 5, respectively.

Lower completion rates were observed in both surveys for questions not applicable to most participants (e.g., SF-12 questions about general health; use of tobacco products other than cigarettes, such as pipes; past occupational exposures). Marine recruits are a young and healthy population less likely to suffer from physical health issues that limit daily activities. Approximately 28% of participants reported themselves to be smokers, with a 97% completion rate in version 4 for smoking habit questions, and only 94% for pipe and cigar questions, which declined to 96% and 89%, respectively, in version 5. Completion rates were lower for questions discussing sensitive topic areas, although some improved after survey question reordering, specifically familial ability to provide essential needs (87.9%, version 4; 94.1%, version 5), family medical history (95.8-98.2%, version 4), prior health care provision (88.7-89.5%, version 4), alcohol use (91.4-96.5%, version 4; 95.3-99.5%, version 5), and risky behaviors (91.2-94.9%, version 4; 96.3-98.5%, version 5).

RAP Publications

RAP has demonstrated its capacity as a cross-sectional, individual resource26,27 that is also readily linkable to other data sources for longitudinal assessment of military health research (Table 2).6,7,26,28-36 Past RAP studies have successfully linked with data from the DMDC,6,26,33 PDHAs,28 the Naval Criminal Investigative Service Consolidated Law Enforcement Operations Center,7 and Department of Defense Medical Mortality Registry33; as well as other self-reported epidemiological data such as the RAP II,30,34 a follow-up survey for deployed RAP participants, and the Millennium Cohort Study, the largest self-reported, longitudinal military cohort study.36 More importantly, the study domains included in RAP surveys have demonstrated relevancy to military outcomes of interest, through findings from prior literature.

Click on the table to access a 508-compliant PDF version

Discussion

RAP data are proven to complement personnel data, which may not be as candid due to their collection during assessment for military duty. RAP data should be evaluated within the context of certain limitations. Currently, RAP administration is limited to MCRD San Diego and does not represent recruitment for the eastern U.S. Thus far, research studies using RAP data are limited to male participants, as MCRD San Diego did not include female recruits until 2021. Inherent limitations of self-reported, paper-and-pencil survey studies include low participation rates, misreporting of sensitive topics, and resource-intensive administration. Lastly, the lengthy RAP survey is administered during a strenuous time in a recruit’s career, which can increase respondent fatigue. Although question completion rates decreased nearer the survey’s end, they remained high, however, at 87%. 

SME and stakeholder reviews have guided survey revisions that will allow future research on pre-service mental health and psychosocial factors as predictors for retention, mental health care provision, and suicide ideation and completion. Ongoing survey content considerations include media use, marijuana use, diversity and inclusion, sexual orientation, and women’s reproductive health. The ever-changing demographics of Marine recruit populations emphasize the need for resources such as RAP, which continues to evolve with changing needs for military operational health and readiness. 

Author Affiliations

Military Population Health Directorate, Naval Health Research Center, San Diego, CA: Lt Col Rohrbeck; Leidos, Inc.: Dr. Khodr, Dr. McAnany, Mr. Haile, Ms. Perez

Acknowledgments

We greatly acknowledge the support of additional Recruit Assessment Program team members: Lauren Jackson, BS, and Lani Pinon, BS. The contributions from Cynthia LeardMann, MPH to study procedure development, data management, and survey content have been integral to RAP operations. We thank MCRD San Diego and its Drill Instructors for facilitating and supporting ongoing administration of this study. Most importantly, we thank the U.S. Marine recruits who voluntarily participate in RAP and provide their invaluable time and information.

Disclaimers

Lt Col Rohrbeck is a military service member. This work was prepared as part of official duties. Title 17, U.S.C. §105 provides that copyright protection under this title is not available for any work of the U.S. Government. Title 17, U.S.C. §101 defines a U.S. Government work as work prepared by a military service member or employee of the U.S. Government as part of that person’s official duties. Report 23-31 was supported by the Military Operational Medicine Research Program under work unit 60002.

The views expressed in this article are those of the authors and do not necessarily reflect the official policy nor position of the Department of the Navy, Department of Defense, or the U.S. Government.

This study protocol was reviewed and approved by the Institutional Review Board of the Naval Health Research Center, in compliance with all applicable Federal regulations governing human subject participant protection. Research data were derived from an approved Naval Health Research Center Institutional Review Board protocol NHRC.2000.0003.

References

  1. National Science and Technology Council Presidential Review Directive 5: A National Obligation: Planning for Health Preparedness for and Readjustment of the Military, Veterans, Their Families After Future Deployments. Executive Office of the President, Office of Science and Technology Policy; 1998.
  2. Institute of Medicine Committee on Strategies to Protect the Health of Deployed, U. S. Forces. Protecting Those Who Serve: Strategies to Protect the Health of Deployed US Forces. National Academies Press (US); 2000.
  3. Persian Gulf Veterans Coordinating Board. Unexplained illnesses among Desert Storm veterans. a search for causes, treatment, and cooperation. Arch Intern Med. 1995;155(3):262-268. doi:10.1001/archinte.155.3.262
  4. Mallon TM. Progress in implementing recommendations in the National Academy of Sciences reports: "protecting those who serve: strategies to protect the health of deployed U.S. Forces". Mil Med. 2011;176(7 Suppl):9-16. doi:10.7205/milmed-d-11-00092
  5. Lane SE, Young SY, Bayer L, et al. Recruit Assessment Program: Implementation at Marine Corps Recruit Depot, San Diego. Technical Report 02-17. Naval Health Research Center; 2002. https://apps.dtic.mil/sti/citations/ADA418976
  6. White MR, Phillips CJ, Vyas KJ, Bauer L. Demographic and psychosocial predictors of early attrition for drug use in U.S. Marines. Mil Med. 2016;181(11):e1540-e1545. doi:10.7205/milmed-d-15-00507
  7. LeardMann CA, Haile YG, McAnany J, et al. Pre-service factors associated with sexual misconduct among male U.S. marines. PLoS One. 2022;17(12):e0278640. doi:10.1371/journal.pone.0278640
  8. Young SY, Leard CA, Hansen CJ, et al. The Recruit Assessment Program (RAP) Experience with Adverse Childhood Experiences (ACE) Questions. Technical Report 06-04. Naval Health Research Center; 2006. https://apps.dtic.mil/sti/citations/ADA450579
  9. Young SYN, Gibson RL, Ryan MA. Collection of accession health data. In: DeKoning BL, ed. Recruit Medicine. The Office of The Surgeon General, TMM Publications; 2006:81-87. 
  10. Hyams KC, Barrett DH, Duque D, et al. The Recruit Assessment Program: a program to collect comprehensive baseline health data from U.S. military personnel. Mil Med. 2002;167(1):44-47.
  11. Gray GC, Reed RJ, Kaiser KS, Smith TC, Gastañaga VM. Self-reported symptoms and medical conditions among 11,868 Gulf War-era veterans: the Seabee Health Study. Am J Epidemiol. 2002;155(11):1033-1044. doi:10.1093/aje/155.11.1033
  12. Ware J Jr, Kosinski M, Keller SD. A 12-Item Short-Form Health Survey: construction of scales and preliminary tests of reliability and validity. Med Care. 1996;34(3):220-233. doi:10.1097/00005650-199603000-00003
  13. Ware JE, Jr., Gandek B. Overview of the SF-36 health survey and the International Quality of Life Assessment (IQOLA) project. J Clin Epidemiol. 1998;51(11):903-112. doi:10.1016/s0895-4356(98)00081-x
  14. Kroenke K, Strine TW, Spitzer RL, et al. The PHQ-8 as a measure of current depression in the general population. J Affect Disord. 2009;114(1-3):163-173. doi:10.1016/j.jad.2008.06.026
  15. Prins A, Bovin MJ, Smolenski DJ, et al. The primary care PTSD Screen for DSM-5 (PCPTSD-5): development and evaluation within a veteran primary care sample. J Gen Intern Med. 2016;31(10):1206-1211. doi:10.1007/s11606-016-3703-5
  16. Pearlin LI, Schooler C. The structure of coping. J Health Soc Behav. 1978;19(1):2-21.
  17. Smith BW, Dalen J, Wiggins K, et al. The brief resilience scale: assessing the ability to bounce back. Int J Behav Med. 2008;15(3):194-200. doi:10.1080/10705500802222972
  18. Hawthorne G, Mouthaan J, Forbes D, Novaco RW. Response categories and anger measurement: do fewer categories result in poorer measurement? development of the DAR5. Soc Psychiatry Psychiatr Epidemiol. 2006;41(2):164-172. doi:10.1007/s00127-005-0986-y
  19. Forbes D, Hawthorne G, Elliott P, et al. A concise measure of anger in combat-related posttraumatic stress disorder. J Trauma Stress. 2004;17(3):249-256. doi:10.1023/B:JOTS.0000029268.22161.bd
  20. Felitti VJ, Anda RF, Nordenberg D, et al. Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: the Adverse Childhood Experiences (ACE) study. Am J Prev Med. 1998;14(4):245-258. doi:10.1016/s0749-3797(98)00017-8
  21. Terrio HP, Nelson LA, Betthauser LM, Harwood JE, Brenner LA. Postdeployment traumatic brain injury screening questions: sensitivity, specificity, and predictive values in returning soldiers. Rehabil Psychol. 2011;56(1):26-31. doi:10.1037/a0022685
  22. Kang HK, Mahan CM, Lee KY, Magee CA, Murphy FM. Illnesses among United States veterans of the Gulf War: a population-based survey of 30,000 veterans. J Occup Environ Med. 2000;42(5):491-501. doi:10.1097/00043764-200005000-00006
  23. Ewing JA. Detecting alcoholism: the CAGE questionnaire. JAMA. 1984;252(14):1905-1907. doi:10.1001/jama.252.14.1905
  24. Bush K, Kivlahan DR, McDonell MB, Fihn SD, Bradley KA. The AUDIT alcohol consumption questions (AUDIT-C): an effective brief screening test for problem drinking. Ambulatory Care Quality Improvement Project (ACQUIP). Alcohol Use Disorders Identification Test. Arch Intern Med. 1998;158(16):1789-1795. doi:10.1001/archinte.158.16.1789
  25. Saunders JB, Aasland OG, Babor TF, de la Fuente JR, Grant M. Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO collaborative project on Early Detection of Persons with Harmful Alcohol Consumption-II. Addiction. 1993;88(6):791-804. doi:10.1111/j.1360-0443.1993.tb02093.x
  26. Horton JL, Phillips CJ, White MR, LeardMann CA, Crum-Cianflone NF. Trends in new U.S. Marine Corps accessions during the recent conflicts in Iraq and Afghanistan. Mil Med. 2014;179(1):62-70. doi:10.7205/milmed-d-13-00329
  27. Young SY, Hansen CJ, Gibson RL, Ryan MA. Risky alcohol use, age at onset of drinking, and adverse childhood experiences in young men entering the US Marine Corps. Arch Pediatr Adolesc Med. 2006;160(12):1207-1214. doi:10.1001/archpedi.160.12.1207
  28. Larson GE, Booth-Kewley S, Highfill-McRoy RM, Young SY. Prospective analysis of psychiatric risk factors in marines sent to war. Mil Med. 2009;174(7):737-744. doi:10.7205/milmed-d-02-0308
  29. LeardMann CA, Smith B, Ryan MA. Do adverse childhood experiences increase the risk of postdeployment posttraumatic stress disorder in U.S. marines? BMC Public Health. 2010;10:437. doi:10.1186/1471-2458-10-437
  30. Phillips CJ, Leardmann CA, Gumbs GR, Smith B. Risk factors for posttraumatic stress disorder among deployed US male marines. BMC Psychiatry. 2010;10:52. doi:10.1186/1471-244x-10-52
  31. Booth-Kewley S, Highfill-McRoy RM, Larson GE, Garland CF. Psychosocial predictors of military misconduct. J Nerv Ment Dis. 2010;198(2):91-98. doi:10.1097/NMD.0b013e3181cc45e9
  32. Feinberg JH, Ryan MA, Johns M, et al. Smoking cessation and improvement in physical performance among young men. Mil Med. 2015;180(3):343-349. doi:10.7205/milmed-d-14-00370
  33. Phillips CJ, LeardMann CA, Vyas KJ, Crum-Cianflone NF, White MR. Risk factors associated with suicide completions among US enlisted marines. Am J Epidemiol. 2017;186(6):668-678. doi:10.1093/aje/kwx117
  34. Bauer LJ, Jacobson IG, Phillips CJ. Effects of Deployment on Risky Health-Related Behaviors Among U.S. Marines. Technical Report 20-17. Naval Health Research Center; 2020. https://apps.dtic.mil/sti/pdfs/AD1105965.pdf
  35. Williams D, Yea JC, Zhu Y. Summary of Recruit Assessment Program Survey Prediction of Military Personnel Outcomes. Technical Report 21-75. Naval Health Research Center; 2021. https://apps.dtic.mil/sti/citations/AD1158054
  36. Reed-Fitzke K, LeardMann CA, Wojciak AS, et al. Identifying at-risk marines: a person-centered approach to adverse childhood experiences, mental health, and social support. J Affect Disord. 2023;325:721-731. doi:10.1016/j.jad.2023.01.020
  37. MacGregor AJ, Dougherty AL, Khodr ZG, et al. Pre-service and early career predictors of new-onset alcohol misuse in male U.S. marines. In preparation.

You also may be interested in...

Topic
May 8, 2024

Medical Surveillance Monthly Report

The Medical Surveillance Monthly Report, a peer-reviewed journal launched in 1995, is the Armed Forces Health Surveillance Division's flagship publication. The MSMR provides monthly evidence-based estimates of the incidence, distribution, impact, and trends of health-related conditions among service members.

Article
Apr 1, 2024

Reportable Medical Events at Military Health System Facilities Through Week 9, Ending March 2, 2024

This report provides a monthly updatea of Reportable Medical Events documented in the Disease Reporting System internet (DRSi) by health care providers and public health officials throughout the Military Health System. Reportable Medical Events are a critical tool for monitoring, controlling, and preventing the occurrence and spread of diseases of ...

Article
Mar 1, 2024

Coverage of HIV Pre-Exposure Prophylaxis Within the Active Duty U.S. Military, 2023

This study provides the first estimate of HIV pre-exposure prophylaxis coverage in the U.S. military, defined as the proportion of the persons taking HIV PrEP out of the estimated number of persons who had indications for it, that is also comparable to U.S. civilian estimates. The population with indications for HIV PrEP was obtained from the ...

Article
Mar 1, 2024

Mid-Season Influenza Vaccine Effectiveness Estimates Among DOD Populations: A Composite of Data Presented at VRBPAC—the Vaccines and Related Biological Products Advisory Committee—2024 Meeting on Influenza Vaccine Strain Selection for the 2024-2025 Influenza Season

This is an introduction to a composite of three Surveillance Snapshots of Department of Defense data on mid-season influenza vaccine effectiveness that were presented at the 2024 VRBPAC meeting.

Article
Mar 1, 2024

Tobacco and Nicotine Use Among Active Component U.S. Military Service Members: A Comparison of 2018 Estimates from the Health Related Behaviors Survey and the Periodic Health Assessment

This study compared estimates of the prevalence of and risk factors for tobacco and nicotine use obtained from the 2018 Health Related Behaviors Survey and Periodic Health Assessment survey. The HRBS and the PHA are important Department of Defense sources of data on health behavior collected from U.S. military service members.

Skip subpage navigation
Refine your search
Last Updated: March 11, 2024
Follow us on Instagram Follow us on LinkedIn Follow us on Facebook Follow us on X Follow us on YouTube Sign up on GovDelivery