Scientific Rationale and Objectives: Women's wartime exposures and the subsequent impact of these experiences must be considered in order to employ evidence-based prevention and treatment interventions. Whether women's deployment and combat experiences, or their reactions to war, are similar to or unlike that of their male counterparts is relatively unknown. Therefore, it is not fully possible to determine if the needs of women are met by current treatments (e.g., for post-traumatic stress disorder [PTSD]). This study therefore addresses the radically changing Department of Defense (DoD) and Department of Veterans Affairs (VA) health care delivery needs of two priority populations: women exposed to combat and women sexually assaulted during military service. Participants will be drawn from a population of Regular Military women who have served or are currently serving in Operation Enduring Freedom and/or Operation Iraqi Freedom (OEF/OIF). They will be selected by their deployment status (those who are deployed to a combat-related region once, those who are deployed to combat-related regions more than once, those serving in non-combat related areas outside of the continental United States, or those who are not deployed).

The objectives of this study are: (1) To identify and describe organizational, situational, and individual risk factors for physical and sexual assault. (2) To determine associations between PTSD, traumatic brain injury (TBI), and physical and sexual assault during OEF/OIF with current physical and mental health status and health risk behaviors by deployment status. (3) To identify current internal and external barriers to DoD, VA, and civilian health services in relationship to women's deployment and victimization status and the association between PTSD and TBI. (4) To identify and describe differences between Regular Military and Reserve/National Guard populations for each of these objectives by comparison to a concurrent Health Services Research and Development Program-funded study.

Applicability of the Research: Findings are intended to guide prevention, intervention, and treatment practices by the DoD and by the VA.

Who It Will Help and How: Our hope is that servicewomen who are deployed and/or serve in combat will benefit from our better understanding of their experiences, health outcomes and care needs.

Clinical Applications, Benefits and Risks: Findings of this study will aid in the development of best practice guidelines for prevention and treatment of servicewomen with combat-associated PTSD and TBI. DoD and VA mental health practitioners will be better prepared to meet the needs of military women who seek care. Unique needs of Regular as opposed to Reserve and National Guard servicewomen will be better known and consequently able to be addressed.

Projected Timeline: The initial year of the grant will involve hiring and training personnel, completion of focus groups, and interview refinement. In year 2, subjects will be recruited and interviewed. Final data set preparation, data analysis, and development of project reports will follow. Dissemination of findings through submission to peer review journals, VA distribution, and national meetings will be completed in year 3.

Contributions of This Study: It is anticipated that our findings will improve understanding of the health risks and outcomes of deployed Regular Military servicewomen in contrast to women serving in the Reserve and National Guard (with PTSD and TBI as key outcome variables). Our results consequently will have implications for DoD and VA evidence-based interventions for both primary prevention and subsequent health care.