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SHP 08-145 – HSR&D Study

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SHP 08-145
Environmental Exposures Assessment Tool (EE-Tool) for OIF/OEF Veterans
Aaron I Schneiderman
Washington DC VA Medical Center, Washington, DC
Washington, DC
Funding Period: April 2008 - September 2008

BACKGROUND/RATIONALE:
Based on Department of Defense surveillance data from 2007, approximately 16% of active duty soldiers and 28% of reserve soldiers reported exposure concerns immediately following deployment. Three to six months following deployment the reported number of exposure concerns increased to 20% for active duty soldiers and 35% for reserve soldiers. A case series of 56 OEF/OIF veteran patients seen by a VA clinic resulted in a mean of 2.7 exposure concerns. Presently, there are no standardized exposure assessment instruments available that VHA can use to assess veterans' perceptions about exposure concerns. Development of a standardized exposure assessment instrument will allow for systematic monitoring of exposure concerns among OEF/OIF veterans. Understanding veterans' perceptions about deployment exposures can facilitate development of education and preventative health care measures.

OBJECTIVE(S):
This pilot phase of the project focused on the short term objectives which are: 1) Design an exposure assessment instrument that measures OEF /OIF veterans' perceptions about deployment exposures; 2) Perform assessment of content validity through a review of an initial item list by Subject Matter Experts (SME) followed by cognitive interviews among a sample of 9 OEF /OIF veterans; 3) Development of a final exposure assessment instrument based on findings of the validation efforts. Further testing of this tool with a larger sample of OEF/OIF veterans is planned in the next phase of the project.

METHODS:
This study used qualitative and quantitative methods. During Phase I, review of existing focus group data, clinical exposure data, eight questionnaires that were used for exposure assessments elsewhere, and published literature were analyzed to prepare an initial item pool. In Phase II, SME feedback was requested to assess content validity, and the tool was modified as appropriate. In Phase III, a convenience sample of 9 OEF/OIF veterans was recruited by an advertisement within the VA medical center, Washington, DC. These veterans completed 1:1 cognitive interviews to assess face validity of the tool. The tool was tested for ease of understanding, comprehension and the variance of responses given by the participants. Data gathered will be manually reviewed and the compiled results will be analyzed and compared with the focus group data and clinical exposure data by using SPSS and NVivo software programs.

FINDINGS/RESULTS:
The interviewed veterans demonstrated diverse demographics in terms of age, gender, branch of service and MOS. The initial data analysis postulates a reasonable level of ease of understanding for the tool among this diverse population.

IMPACT:
It is important to understand OEF/OIF veterans' perceptions about deployment exposures so that possible misperceptions may be addressed through education and preventative health care measures. Development of a standardized exposure assessment tool will aid VA clinicians to better screen for deployment exposures among OEF/OIF veterans. This pilot project will provide foundational materials and insights for a follow up study to develop an exposure assessment tool that can be implemented as a standardized instrument for exposure assessment throughout VA by health care providers and researchers.

PUBLICATIONS:
None at this time.


DRA: none
DRE: Etiology, Prevention
Keywords: Operation Enduring Freedom, Deployment, Operation Iraqi Freedom
MeSH Terms: none

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