New Study Spotlight: Military Children 'Promote, Protect, Prevent'

Welcome to ‘New Study Spotlight’, where we interview researchers about their new studies to raise awareness and keep you up to date with current research focused on the Armed Forces community. Read on to learn about new research, its importance and relevance, aims, and intended impact and benefit for the Armed Forces community. To learn about all current UK research with the Armed Forces community, you can search Ongoing Research here.

In this issue, we interviewed Dr Paul Watson from The Northern Hub for Veterans and Military Families Research about the new research he is leading: Military Children’ Promote, Protect, Prevent.

This research aims to understand the experiences of military connected children and young people (MCCYP) through the lens of Social Determinants of Health (SDH) which are non-medical factors (e.g., access to health care, social community, neighbourhood and environment, education, and economic stability) that influence health and well-being outcomes.

Why is this research important, and why now?

Now is the ideal time for this research for several key reasons. First, there is an increasing recognition of the unique needs of military families, yet the specific challenges faced by MCCYP are still not fully understood. This gap in knowledge needs to be addressed to ensure that support services are adequately tailored to their needs, particularly in light of the evolving nature of military life and the pressures on Service families.

Second, with the Ministry of Defence (MoD) placing more focus on improving military family well-being, there is a critical need for robust data to inform evidence-based policies. Understanding how military life impacts the SDH for MCCYP will provide the insights necessary for developing effective policies and services that directly address these children’s needs.

The ongoing socio-political climate, including military operations and changing defence policies, may further strain Service families. Therefore, understanding how these challenges affect children’s health and well-being is urgent. Additionally, the current push for inclusive and equitable approaches in public health and social services highlights the need for research that ensures fair treatment of all military families across the four devolved nations.

Moreover, the rise of co-design and community engagement in public health research presents an opportunity to directly involve MCCYP and their families in developing solutions. This participatory approach not only ensures that their lived experiences shape the research but also strengthens the community's capacity for sustained support. With advanced tools and data collection methods now available, it is possible to gather comprehensive data that will inform the MoD and other agencies on how to best support military families and address their unique health challenges.

What is the problem in the world that this aims to address?

SDH are the non-medical factors that influence health outcomes, shaped by economic, social, and environmental conditions. These include education, which provides the knowledge and skills to make informed health decisions; socioeconomic status (SES), which determines access to resources and healthcare based on income, employment, and education; housing, where poor conditions and instability can negatively impact physical and mental health; and access to healthcare, which ensures timely medical care and preventive services.

Other important SDH include community networks, which provide social support and resources, and the neighbourhood and built environment, encompassing factors like air quality, green spaces, and access to healthy food.

These SDH are deeply interconnected and influence each other, often contributing to health inequalities. In the UK, health inequalities have widened due to austerity policies, the COVID-19 pandemic, and the cost-of-living crisis, which have exacerbated challenges such as housing instability, food insecurity, and reduced access to healthcare. Children are particularly vulnerable to the effects of SDH, which may be increased for those in military families due to unique pressures such as frequent relocation and parental deployment. Understanding the intersection of SDH and the military experience is critical for addressing the specific needs of MCCYP and improving their health and well-being. This research aims to provide insight into these challenges, explore what is currently understood from a UK perspective, identify potential UK-specific knowledge gaps, and inform policies and services for military families.

What questions will the research aim to answer?

1. What are the lived experiences of MCCYP regarding the social determinants of health?

This question will explore how military life influences the health, well-being, and daily experiences of MCCYP, with a specific focus on SDH. The research will achieve this by co-designing three age-related surveys (8-11 years, 12-15 years, 16-18 years) with MCCYP, allowing the children’s perspectives to shape the understanding of how military life impacts them. This will provide a deeper understanding of the challenges and experiences these children and young people may face, from their own point of view.

2. How can a survey be developed to support service provision and reduce inequalities within the military-connected children and young people population?

The research will aim to develop an integrated survey that can be used as a tool for the MoD, its military facing partners, and other relevant agencies to address the unique needs of MCCYP. This self-completion survey will help monitor and assess the health and social challenges faced by MCCYP. By identifying these challenges, the survey will play a crucial role in supporting military service provision and reducing health and social inequalities within this population, ensuring that services are effectively targeted to meet the needs of MCCYP.

How will it answer these questions (the research method)?

The research will employ a mixed methods approach, organised into four phases, to provide a comprehensive understanding of the lived experiences of MCCYP in relation to SDH.

• Phase 1. Review of the literature
  • Phase 1a. A systematic narrative scoping review of current national and international research evidence and policy regarding SDH of all children and young people. This will bring together the existing evidence and policy to enable the research team to identify prior research on SDH, describe any gaps within the current body of evidence, and inform phase two of the study.
  • Phase 1b. A preliminary focus group with 10 MCCYP to consider the existing evidence identified in the review to bring it together with the research team through the perspective of the MCCYP. This process will allow the research team to develop the first set of questions for the first co-design event (phase 2).

• Phase 2.  Co-production events  will seek to understand the lived experiences of MCCYP. The outcomes from the literature review in phase 1 will inform the development of questions for collective interviews, which will be conducted during seven co-production events across the UK, engaging 200 MCCYP (50 per event). These events aim to explore how military life impacts SDH and how support service provision can improve outcomes. Co-production will ensure MCCYP have a voice in decisions that affect their social connections, education, and well-being. This will also lead to the development of a survey to be used in phase 3.
• Phase 3.  Online survey developed in phase 2, will be distributed to MCCYP via relevant service providers. The survey aims to gather responses from over 500 MCCYP. The survey will collect information on the MCCYP-SDH, as well as demographic information, for example their postcode.
• Phase 4. Data analysis. The data from the co-production collective interviews and the survey will be analysed to identify key themes and provide insights into MCCYP SDH that will inform policy and practice related to MCCYP’s social determinants of health.

What are the intended impact and outcomes of the research?

The intended impact and outcomes of the research are as follows:

1. Enhanced Understanding of MCCYP’s Lived Experiences: The research will provide a deeper, evidence-based understanding of how military life affects the SDH for MCCYP. By capturing the voices of MCCYP themselves through co-production events, the research will ensure that their lived experiences are central to the findings, shedding light on the challenges they face in areas such as social connections, education, building community capacity, and emotional health and well-being.
2. Identification of Gaps in Existing Research: Through a systematic narrative scoping review, the research will identify gaps in current literature and policy regarding the SDH of children and young people, with a specific focus on MCCYP. This will provide the research community, policymakers, and service providers with a clearer picture of what has been explored and what still needs to be addressed, informing future research and policy decisions.
3. Development of Co-Designed Tools: The research will produce a co-designed survey, developed in collaboration with MCCYP, that will serve as a valuable tool for monitoring and assessing the SDH of MCCYP. This survey will enable the MoD, its partners and other stakeholders to collect meaningful data on the well-being of MCCYP, helping to identify and address inequalities within this population.
4. Improved Policy and Service Provision: The research findings will inform the development of policies and services aimed at improving the health and well-being of MCCYP, and support building community capacity. The co-design approach will ensure that policies and services are more effectively tailored to the unique needs of this group, helping to reduce health and social inequalities and enhance outcomes for MCCYP.
5. Increased Awareness and Empowerment: By involving MCCYP directly in the research process, the study will empower them to have a voice in shaping the changes that affect their lives. This will help to foster greater recognition of their needs by service providers, military families, and governmental agencies, ultimately leading to better support structures and services for military-connected families.
6. Long-Term Impact on Military Family Well-Being: Ultimately, the research aims to improve the overall well-being of military families, enhancing their ability to navigate military life successfully. By addressing the SDH of MCCYP and strengthening the support services available, the research will have long-term benefits for children, families, and serving personnel, promoting resilience and better outcomes for all involved.

Who is funding the research?

The Northern Hub for Veterans and Military Families Research at Northumbria University, in collaboration with The Centre for Military Research, Education, and Public Engagement, Edinburgh Napier University, the King’s Centre for Military Health Research, King’s College London, the Veterans and Families Institute for Military Social Research, Anglia Ruskin University, and RAND Europe,  has received almost £125,000 in funding from the Armed Forces Covenant Fund Trust.

What are the project's key milestones (e.g. recruitment, analysis, results available)?

The project will run for 12 months from 02/09/24 and consist of 4 phases:

• Phase 1 Literature review:  Sept 24 - Feb 25
• Phase 2 Co-production events:  Feb 25 – April 25
• Phase 3 Online survey:  April 25 – June 25
• Phase 4 Data analysis:  July 25 - Sept 25

Many thanks to Dr Paul Watson for authoring this New Study Spotlight.

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