Assessing the Needs of Soldiers and Their Families at the Garrison Level

by Carra S. Sims, Thomas E. Trail, Emily K. Chen, Erika Meza, Parisa Roshan, Beth E. Lachman

This Article

RAND Health Quarterly, 2019; 8(3):6

Abstract

The RAND Arroyo Center conducted a 2014 formal needs assessment survey of active component soldiers at 40 installations. The original study described a broad landscape of needs in such areas as quality of life support services provided to help families cope with a variety of challenges. In this study, new analysis of those survey data explores differences at the garrison level and includes additional focus group data. The analysis suggests that resources providing one-on-one, personalized help should be given priority and it is possible that emphasizing trust between soldiers and their leaders could help fulfill this need. Providing easily accessible information online and staffing services that provide information to soldiers and their families should also be continuing priorities. In intergovernmental support agreements and other community partnership activities, Army garrisons should consider focusing more on partnerships that help meet the needs of soldiers and their families. The Army might consider a series of solutions to achieve the right balance between fostering resilience and helping its soldiers solve problems early. One solution is to expose noncommissioned officers and other soldiers earlier and more frequently in their careers to information regarding what resources are available. Another solution is to set priorities at the aggregate Army level, rather than leaving lower levels to determine how to prioritize the many requirements that are passed down. Finally, the Army should consider strengthening the “no wrong door” policy at Army Community Service and broadening the policy to help soldiers and families navigate resources.

For more information, see RAND RR-2148-A at https://www.rand.org/pubs/research_reports/RR2148.html

Full Text

Background

The U.S. Army makes many demands of its members and, inevitably, their families. A constant cycle of overseas deployments, coupled with the frequent moves that are inherent in military life, places a lot of strain on soldiers and families. The Army has established a wide range of programs to help soldiers and their families cope with the many issues and problems of military life (e.g., deployment cycles). However, it has not always been clear whether these programs meet the most pressing needs of soldiers and their families and help them resolve their problems. To assess the match between Army programs and the needs of soldiers and their families, researchers from the RAND Arroyo Center designed a broad-ranging survey that considered the installation environment, the demographics of the population, the problems encountered, the types of help needed as a result of those problems, the resources soldiers draw on to deal with the problems, the barriers to using both military and civilian resources to meet needs, the effectiveness of the resources used, and, last, attitudes toward military service. That survey, administered to over 7,000 soldiers from September 2014 to January 2015, and the report that followed (Sims, Trail, et al., 2017) took an Army-wide view of how its members used the resources provided to them and whether there were gaps between the perceived needs of soldiers and their families for dealing with problems and the resources available to help with those problems.

Purpose and Approach

Many of the conditions that affect soldiers depend on the local context. Life at an Army post near a major metropolitan center such as Fort Meade, Maryland, differs from one located in a sparsely populated rural area such as Fort Huachuca, Arizona, especially for issues such as housing options. Thus, it is likely that issues confronting soldiers and their families also differ, certainly in degree and possibly in kind. While the Sims, Trail, et al. (2017) report helps the Army determine whether its resources are accomplishing their intended purpose, a more local-level analysis is necessary to determine whether the overall perspective masks local patterns of disparate problems, needs, or resource use.

This study presents this type of analysis: it digs more deeply into what resources soldiers and family members use and provides additional insight into questions raised by the survey. The goal was to understand how soldiers' and families' perceived problems and strategies to cope with them might vary across installations.

This study took a mixed-methods approach to examine soldier and family problems, needs, and resource use at the garrison level. One component of the research used existing survey data from soldiers. The second component used site visits to selected installations as the data source. This mixed-methods approach offers the benefits of more generalizable analysis (i.e., quantitative survey analysis) married with analysis more suited to uncovering processes and local variance (i.e., focus groups and interviews). We were also able to gather the perspectives of spouses and service providers on the challenges faced by soldiers and families, and how they deal with them.

We analyzed survey data from the following 13 garrisons1 to identify the problems soldiers and their family members encountered, the needs those problems generated, and the resources used to deal with the problems:

  • Fort Bragg
  • Fort Campbell
  • Fort Eustis
  • Fort Gordon
  • Fort Hood
  • Fort Huachuca
  • Fort Jackson
  • Fort Knox
  • Fort Leavenworth
  • Fort Meade
  • Fort Polk
  • Fort Rucker
  • Fort Sill

For survey analyses, we compared the selected garrisons to the overall average of all garrisons in the larger sample of 40 installations within the continental United States (CONUS), including those with too few unweighted respondents to be selected for more in-depth study. In addition to our analysis of previously collected survey data, we gathered additional in-depth information through focus groups with soldiers, Army spouses, and service providers at four installations. All told, over 4,500 people from the selected garrisons participated in our survey, interviews, and focus groups.

How to Use This Study

In our findings, areas where there are similarities across garrisons suggest problems, needs, and resource use patterns that require an Army-wide approach to address. Areas where there are differences across garrisons suggest that the local context plays a role in the challenges soldiers and their families face. Differences among garrisons might suggest that a local solution is needed or that the local context, including initiatives by leaders, may help soldiers and their families successfully address the challenges they face. The comprehensive and systematic approach taken by the survey enables leaders to make decisions about garrison needs and priorities based on empirical data describing the Army population. This study provides unique information that enables service providers and garrison leadership to understand where they are doing well in relation to other surveyed garrisons, where their communities still report experiencing challenges in addressing their most pressing problems effectively, and where additional effort might be warranted.

The Survey

The survey sample consisted of active component enlisted soldiers and officers stationed at CONUS installations. Survey respondents received a list of 83 individual issues, which were grouped into nine problem domains that they could indicate they had experienced in the past year. The problem domains (with examples of specific issues) are as follows:

  • Military Practices and Culture (e.g., problems adjusting to military language, organization, culture; lack of guidance or sponsorship)
  • Work/Life Balance (e.g., finding time for sleep, a healthy diet, and physical exercise; finding time for education; nearby and affordable options for stress relief and family time)
  • Household Management (e.g., finding suitable housing, time management)
  • Financial or Legal Problems (e.g., trouble paying debt or bills, child custody/family legal problems)
  • Health Care System (e.g., getting access to military health care, understanding military health benefits)
  • Relationship Problems (e.g., problems communicating/expressing feelings, trouble starting a relationship)
  • Child Well-Being (e.g., childcare problems, child emotional/behavior problems)
  • Soldier's Own Well-Being (e.g., feeling stressed, overwhelmed, or tired; dealing with mood changes, including anxiety and depression)
  • Spouse's Well-Being (e.g., feeling stressed, overwhelmed, or tired; dealing with mood changes, including anxiety and depression)
  • Other Problems (write in responses).

After indicating which problems they had encountered in the last year, respondents were prompted to choose two problems that were the most important or troubling, the "top-two" problems.

Next, each survey respondent was asked to indicate what types of help, if any, he or she needed to deal with the top two specific problems in that domain. The list of types of help was the same for all problem domains and included needs such as "general information," "an advocate: someone to try to get help for you," and "professional counseling." If respondents listed more than two types of help needed for any problem, they were asked to choose the top two types of needs for the problem. The goal of this approach was to generate a sense of whether the types of help typically offered reflected the types of help typically desired, independent of specific resources for assistance.

Then, for each respondent's need, we asked him or her to indicate which resources, if any, he or she had used or tried to use to address the need. The list of resources was the same for all problem domains and needs, and included both Army (e.g., Army Community Service [ACS] or chain of command) and nonmilitary (e.g., private off-post childcare or personal networks of friends and family) resources. For each resource a participant indicated that he or she contacted, he or she was asked to rate "how well each of these contacts you made helped to meet your needs" for each of the top-two problems.

What We Found from the Survey Data

Generally, the top three problems identified in the garrison analysis mirrored those of the Army-wide survey: Military Practices and Culture, Work-Life Balance, and the Soldier's Well-Being. Although the problem domains most frequently chosen were largely the same across garrisons, there was significant variance in the selection of some specific problem domains. For example, compared to the average, Health Care System Problems was more frequently chosen as a top problem by respondents at Fort Meade, and it was ranked as one of the top three problems chosen by Fort Meade respondents. Similarly, Work-Life Balance ranked as a top concern for almost all garrisons, but it was chosen more frequently at Fort Hood, compared with the average. Thus, although our findings illustrated that certain problems are typical, regardless of location, some significant variation in the prevalence of these problems occurred across garrisons.

Also, more variance appeared in the types of help needed to solve problems. Advice, activities, and general information were still seen as highly prioritized sources of help, but the additional need for interpersonal help in the form of counseling, emotional support, and an advocate were cited at some posts. The top problem-need pairings at installations had many similarities with the Army-wide data.

In terms of how effective resources were in solving problems, military resources were widely used to help. However, garrisons varied on which resources were used most frequently. Furthermore, with the exception of Fort Leavenworth, where soldiers used fewer Army resources than average, the number of Army and nonmilitary resources did not differ by garrison. When resources were used to address problems, fewer than 20 percent of respondents at any garrison reported that their needs were unmet (that is, that the resources that they reached out for met their needs in a manner rated less than "all right"), and, compared to the average, soldiers at Fort Polk were less likely to report unmet needs.

Focus Groups and Interviews

We chose garrisons for site visits based on the pattern of survey results by respondents at each garrison across a set of important outcomes: the number and type of problems, the needs reported, the types of resources used, and the percentage of soldiers at the garrison who had unmet needs (that is, all resources used in attempting to address a given problem and need were rated as meeting the need less than "well"). Based on those criteria, we visited four installations: Fort Gordon, Georgia; Fort Hood, Texas; Fort Huachuca, Arizona; and Fort Meade, Maryland. We conducted 12 interviews and 40 focus groups across the installations. None of these installations could be said to be reflective of the average Army garrison, if there is such a thing; all were unique in some way. For example, the missions and duties of soldiers stationed at Forts Gordon, Huachuca, and Meade make gaining and retaining appropriate security clearances of paramount importance for soldiers; Fort Hood is the largest active-duty armored post in the United States. Garrisons were chosen based on their survey profile rather than other characteristics.

In focus groups, we provided participants with a list of the problem categories (with examples) that were used in the survey and asked them what were the most common or most pressing problems soldiers and their families were facing. The top problems cited were the following:

  • Soldier Well-Being
  • Military Practices and Culture
  • Work-Life Balance
  • Health Care System
  • Childcare.

Thus, focus groups identified a somewhat different emphasis, or prioritization, of problems from that identified in the survey. These differences included a greater emphasis on childcare and housing; issues with soldier well-being, including work-related stress (a result of short staff); feelings of isolation and disconnectedness or lack of unit cohesion; working on operational missions while in garrison; and unhealthy diets. From the soldier perspective, the main issue with military practices and culture was a lack of proper guidance or sponsorship. From the leaders' perspective, the main issues with military practices and culture were that soldiers had poor communication with their supervisors and that the many responsibilities piled on leaders took time away from mentoring opportunities.

Focus groups also revealed the interconnected nature of problems. Problems with work-life balance such as the "24-hour Army" and a need to do more with less spilled over into Soldier Well-Being, because a lack of time made it difficult to manage a home life and make as much progress as desired with regard to professional life. Military Practices and Culture challenges exacerbated these issues: as more requirements were piled on, they were seen as contributing to a lack of time to develop relationships with soldiers and foster the ability to provide advice.

Several key themes emerged about health care systems. Lack of direct or convenient access to providers was cited frequently, and causes included a burdensome and invasive triage process and extensive travel time. Long wait times for appointments (often over a month) were also cited and attributed to inadequate system capacity. Concerns were also voiced about malingerers who were avoiding duty by gaming the health care system (and also absorbing capacity) and, on the flip side, were suspected of faking injury or illness. Unsurprisingly, some complaints were installation specific. For example, at Fort Meade, the travel time to medical facilities, which were often not on post, was perceived to be inordinately long. At Fort Huachuca, the lack of on-post facilities and the burden of getting into off-post facilities were cited.

Nearly all of the problems cited with childcare focused on day care. The long wait times for access to Child Development Centers were cited, and having to wait to access childcare was particularly frustrating for dual-military couples and single parents. Operating hours were an additional topic, with soldiers noting that they did not always mesh well with the military work schedules, either closing too early or opening too late.

The focus group findings indicate a culture of self-sufficiency, and accessibility of resources in terms of hours, location, and approachability was noted as both a facilitator and a barrier. ACS and chaplains were the most consistently cited sources for successfully meeting needs, and ACS and noncommissioned officers (NCOs) were recognized as the primary options for seeking help.

What We Recommend

In considering how best to manage challenges faced by soldiers and families while maintaining readiness, the Army should strike a balance between solving problems and supporting resilience. Complex, interrelated problems can demand an array of resources. The Army should support resources that can provide general support for a range of common problems and that can link soldiers with specialized resources when needed. Soldiers at all levels often reported that they wanted to be able—or should be able—to solve their problems themselves without needing to bring leadership into the equation. That sentiment was balanced by the responses of NCOs who expressed a sense of responsibility for their soldiers, along with an awareness that soldiers might wish to maintain their privacy. Respondents pointed out that the downside of this tension can be that, by the time individuals realize they are in over their heads and need assistance, their challenges have evolved into a much knottier problem to untangle.

To manage these ongoing challenges, the Army may consider several options:

  • Early in their career, expose NCOs and other leaders to information they need to help soldiers navigate the system more consistently.
  • Give priority for time for NCOs to develop relationships with their soldiers. These priorities should be set at the Army-wide level rather than leaving it up to individual leaders to set their own priorities among their many tasks.
  • Increase interpersonal help such as counseling and advocacy services at specific installations.
  • Explore community partnerships that help meet soldier and family needs, following partnership best practices discussed in this article.
  • If the budgets for resources that serve as gateways or connectors to other resources must be trimmed or cut completely, stipulate that alternative gateways to resources must be established as a substitute. Strengthening and broadening ACS's "no wrong door" policy might prove advantageous to facilitating navigation through the resource environment as well.

Finally and more specifically, our survey findings suggest a greater need for an advocate at Meade. More generally, information and advice were widely prioritized across installations, which suggests the importance of continuing to provide easily accessible information online, for example (as this was reported as one of the primary sources used to find information on what is available), and continuing to staff services that provide information and advice to soldiers.

References

Sims, Carra S., Thomas E. Trail, Emily K. Chen, and Laura L. Miller, Assessing the Needs of Soldiers and Their Families, Santa Monica, Calif.: RAND Corporation, RR-1893-A, 2017. As of July 16, 2018:
https://www.rand.org/pubs/research_reports/RR1893.html

Note

  • 1 We selected the garrisons that had at least 200 unweighted survey responses for further analysis. A respondent size of 200 was estimated to be the minimum number to provide for a variety of garrisons for analysis while maintaining enough respondents to allow for statistical analysis.

The research described in this article was prepared for the United States Army and conducted by the Personnel, Training, and Health Program within the RAND Arroyo Center.

RAND Health Quarterly is produced by the RAND Corporation. ISSN 2162-8254.