Military service assimilates individuals into a socially cohesive force to address dangerous and traumatic situations that have no counterpart in civilian life. Upon leaving active duty, many veterans experience a “reverse culture shock” when trying to reintegrate into civilian institutions and cultivate supportive social networks. Poor social reintegration is associated with greater morbidity and premature mortality in part due to adoption of risky health behaviors, social isolation, and inadequate engagement in health care services. Although institutions like the Veterans Health Administration (VA) do much to address the complex psychosocial and health care needs of veterans and their families with evidence-based care, only 61% of Operations Enduring and Iraqi Freedom (OEF/OIF) Veterans are enrolled in VA care and there are numerous perceived barriers to care for enrollees. To address this gap, a community-based nonprofit organization, Team Red, White & Blue (RWB), was created to help veterans establish health-enriching social connections with communities through the consistent provision of inclusive and locally tailored physical, social, and service activities. This article provides an overview of the development and refinement of a theory-based framework for veteran health called the Enrichment Equation, comprised of three core constructs: health, people, and purpose. By operationalizing programming activities and roles, we describe how theoretical components were translated into a social networking implementation package that enabled rapid national spread of Team RWB. We conclude with future opportunities to partner with researchers and other organizations to understand program impact, and to identify effective intervention components that could be adapted for similar vulnerable groups.

No abstract

The Enriched Life Scale (ELS) is a 40-item measure developed by the military veteran service organization, Team Red, White & Blue (RWB), to systematically capture and quantify the lived experiences of military veterans transitioning to civilian life. As Team RWB’s mission is to “enrich veterans’ lives,” veterans who conceived of and co-developed the ELS as a psychometric instrument defined what an “enriched life” would entail. Exploratory factor analysis (EFA) of the ELS revealed a five-factor structure capturing the domains of: physical health, mental health, genuine relationships, sense of purpose, and engaged citizenship. The goal of the current study was to use confirmatory factor analysis to validate the factor structure of the ELS in a sample of veterans not affiliated with Team RWB. We also sought to explore convergent validity with the Military to Civilian Questionnaire, a measure of military to civilian reintegration challenges. Five hundred and twenty-nine veterans participated in the study. We estimated three models, one-factor, four-factor, and five-factor model via maximum likelihood estimation with robust Huber-White standard errors. The five-factor model showed the best fit to the data (RMSEA = 0.05, CFI = 0.90, TLI = 0.90, SRMR = 0.06). Additionally, the five-factor model demonstrated convergent and discriminant validity, as well as internal consistency reliability (genuine relationships, α = 0.90; sense of purpose, α = 0.93; engaged citizenship, α = 0.89; mental health, α = 0.88; and physical health, α = 0.78). Overall, the ELS is a valid and reliable measure of veteran enrichment and could potentially be used in conjunction with diagnostic instruments that capture strain-related transition challenges (to include mental health disorders) to capture post-military service wellbeing.

The purpose of the present study was to examine regional differences in average self-reported BMI, obesity prevalence, and frequent exercise (FE) among members of Team Red, White, and Blue (Team RWB) – a military veteran service organization founded to increase physical activity in veterans. A total of 10,015 military veterans participated in a needs assessment conducted by Team RWB between December 2014 and August 2016. Multivariate regression analysis with bootstrapped coefficients revealed that: BMI was highest in the Midwest region (M = 28.282) of the United States, F(20, 9882) = 105.560, p < 0.001; obesity prevalence was highest in the Southcentral (32.300%) and Southeast (32.200%) regions, x2(9731) = 10,850, p < 0.001; and FE was most prevalent in the Mid-Atlantic region (67.3%), x2(9882) = 11,291, p < 0.001.The results of this study closely mirror results found in studies of the general population. A better understanding of the geographic distribution of these outcomes could guide the targeting of sub-populations for public health programs. In particular, Team Red, White & Blue community growth and other fitness based public health programs could be expanded to reach more veterans.

No abstract