A Delphi Study to Determine Military Women's Health Research Priorities

Background: In 2016, the U.S. Armed Forces implemented full gender integration of women into all military occupations, including combat and combat support roles. As the burgeoning roles of women afford them the opportunities to perform in all combat and combat support assignments, the impact of all environmental, occupational, physical, and psychosocial factors inherent in military training and operations on their health must be considered. A robust foundation of knowledge is necessary to ascertain, prevent, and treat the potential impacts on women’s health. However, a systematic review of the literature from 2000 to 2010 revealed widespread gaps in scientific knowledge of the musculoskeletal, psychological, occupational, and reproductive
health of military women. As evident in this decade of publications, military medicine was inadequately informed by science to address the impact of military service on the health of women.
Purpose: To determine priorities for military women’s health research that will serve to fill these gaps in knowledge. The Specific Aims are to 1) conduct a gap analysis between existing evidence and MHS utilization data and to determine the gaps in knowledge relevant to military women’s health conditions, 2) utilize the Delphi method of consensus to determine military women’s health research priorities and 3) generate a Military Women’s Health Research Agenda (MWHRA) that will guide future research efforts and funding mechanisms.
Methods: This study will consist of three phases. In Phase 1, an Advisory Group (AG) of senior military and women’s health experts will compare the findings from an extensive scoping review of research literature on military women’s health published from 2000-2015 to MHS utilization data that indicate the most common diagnoses and medications for military women. In a structured gap analysis process, the AG will consider 3 key questions: What is the current state of evidence? What are the key gaps in evidence? What research could address the gaps? The end result will be a broad list of initial research topics for consideration as military women’s health research priorities.
In Phase 2, a modified e-Delphi study will be conducted with a panel of subject matter experts who will judge the relevance and feasibility of the initial research topics, as well as suggest further topics for consideration. This iterative process will be conducted in rounds of internet-based surveys until consensus on priorities for military women’s health research is reached. Between rounds, qualitative data will be analyzed using content analysis methods. Analysis of quantitative data includes descriptive statistics and measures of convergence. The e-Delphi survey rounds will continue until a minimum of 80% concurrence by statistical analysis has been achieved. This will indicate that consensus has been reached on research priorities in military women’s health.
In Phase 3, the study team will generate the Military Women’s Health Research Agenda based on the top research priorities. Findings will be reviewed with the Advisory Group and the study team will develop a communication plan to provide the MWHRA to stakeholders involved in the funding and conduct of research in military women’s health.
Military Relevance: A Military Women’s Health Research Agenda will promote enduring efforts to improve the health of Servicewomen through research. Moreover, this study will provide a sound way forward for nurse scientists who are dedicated to generating the evidence that is required to ensure evidence-based practices and health policies for military women.