{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T06:08:49Z","timestamp":1778911729620,"version":"3.51.4"},"reference-count":49,"publisher":"SAGE Publications","issue":"11","license":[{"start":{"date-parts":[[2025,8,11]],"date-time":"2025-08-11T00:00:00Z","timestamp":1754870400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Henry Jackson Foundation","award":["HJF 311204-8.00-66014, HU0000117-2-0001"],"award-info":[{"award-number":["HJF 311204-8.00-66014, HU0000117-2-0001"]}]},{"name":"Henry Jackson Foundation","award":["National Center for Complementary and Integrative"],"award-info":[{"award-number":["National Center for Complementary and Integrative"]}]},{"name":"Henry Jackson Foundation","award":["National Institute on Drug Abuse\/R01DA030150"],"award-info":[{"award-number":["National Institute on Drug Abuse\/R01DA030150"]}]},{"name":"Henry Jackson Foundation","award":["National Institute on Mental Health and Office of"],"award-info":[{"award-number":["National Institute on Mental Health and Office of"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Women's Health"],"published-print":{"date-parts":[[2025,11,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Studies have found increasing rates of excessive drinking among women and high levels of psychiatric comorbidity. This follow-up study replicated our predominantly male study to identify multimorbidity clusters among the subsample of military women with postdeployment at-risk drinking and to examine the association of cluster membership with health care utilization and military readiness.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      Participants consisted of Army women who screened positive for postdeployment at-risk alcohol use (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 12,066). Latent class analysis (LCA) categorized participants into classes using 31 indicators of mental and physical health, alcohol, and tobacco use. Cox proportional hazard models estimated the relative hazards of classes with health care utilization and military readiness outcomes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>LCA identified a 5-class model as optimal: Class 1\u2014relatively healthy\/pain (50.6%), Class 2\u2014pain\/tobacco (16.7%), Class 3\u2014mental health (MH)\/pain\/sleep (16.7%); Class 4\u2014heavy drinking\/MH\/pain\/tobacco\/sleep (8.9%); and Class 5\u2014heavy drinking\/pain\/tobacco (7.2%). Pain diagnoses (i.e., musculoskeletal, headache\/migraine, and visceral\/pelvis) and tobacco use were particularly elevated in certain classes and differed in nuanced ways from the full-sample study. Compared to Class 1, women in Classes 2\u20135 had increased risk for health care utilization and adverse military readiness outcomes. Class 4 had the highest odds of adverse readiness outcomes, including a higher hazard for self-harm\/suicide attempt compared to the comparable class from the full-sample study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>This study of women soldiers with at-risk postdeployment alcohol use found similarities with the predominantly male full-sample study, with some important differences, including a higher prevalence of pelvic pain and migraines and a greater hazard for self-harm\/suicide attempt. Findings inform the need for targeted, integrated treatment for women soldiers at the highest risk for negative outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15409996251365144","type":"journal-article","created":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T17:05:53Z","timestamp":1759856753000},"page":"1381-1390","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Postdeployment At-Risk Drinking Among Active Duty Women: Health Care Utilization and Military Readiness Outcomes"],"prefix":"10.1177","volume":"34","author":[{"given":"Rachel Sayko","family":"Adams","sequence":"first","affiliation":[{"name":"Department of Health Law, Policy &amp; Management, Boston University School of Public Health, Boston, Massachusetts, USA."},{"name":"Heller School for Social Policy and Management, Brandeis University, Institute for Behavioral Health, Waltham, Massachusetts, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mary Jo","family":"Larson","sequence":"additional","affiliation":[{"name":"Heller School for Social Policy and Management, Brandeis University, Institute for Behavioral Health, Waltham, Massachusetts, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natalie","family":"Moresco","sequence":"additional","affiliation":[{"name":"Heller School for Social Policy and Management, Brandeis University, Institute for Behavioral Health, Waltham, Massachusetts, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Ogan","sequence":"additional","affiliation":[{"name":"Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Setzer","sequence":"additional","affiliation":[{"name":"Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Grant A.","family":"Ritter","sequence":"additional","affiliation":[{"name":"Heller School for Social Policy and Management, Brandeis University, Institute for Behavioral Health, Waltham, Massachusetts, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steven","family":"Dufour","sequence":"additional","affiliation":[{"name":"Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA."},{"name":"Naval Medical Center Portsmouth, Portsmouth, Virginia, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Noel","family":"Vest","sequence":"additional","affiliation":[{"name":"Department of Community Health Sciences, Boston University School of Public Health, Boston, Massachusetts, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charles S.","family":"Milliken","sequence":"additional","affiliation":[{"name":"Office of the Army Surgeon General, Substance Use Disorder Clinical Care, Falls Church, Virginia, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joshua C.","family":"Gray","sequence":"additional","affiliation":[{"name":"Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,8,11]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.yfrne.2021.100939"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1111\/acer.12815"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1111\/acer.14082"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1111\/add.16262"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2023.26346"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1089\/jwh.2023.0497"},{"key":"e_1_3_3_8_2","volume-title":"2018 Department of defense Health Related Behaviors Survey (HRBS)","author":"Meadows SO","year":"2021","unstructured":"Meadows SO, , Engel CC, , Collins RL, et al. 2018 Department of defense Health Related Behaviors Survey (HRBS). 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