EVIDENCE BASE FOR SPORT
Australian Veterans and Sport
Sport has often had a strong connection to Australia’s military. The teamwork, competitive, and physical aspects of many sports have been considered a useful and enjoyable adjunct to training, as well as the comfort and connection of playing sports from home while overseas. 1, 2, 3, 4, 5
Sport can also support the physical, mental and social wellbeing of all veterans and contribute to the rehabilitation of those injured during service. 3, 6, 7, 8, 9, 10
While existing research identifies potential benefits, facilitators, barriers, good practice policies and programs for veterans’ sport, each veteran is unique. Every veteran has individual backgrounds and perspectives that will impact how they experience and respond to specific events. There remains a need for more high-quality research and coordination of programs to better understand and maximise the benefits of sport for all. 8, 11, 12
In 2021, 581,000 Australians had served (496,000) or were serving (60,300 in the regular service and 24,600 in the reserves) in the Australian Defence Force (ADF). The majority of current and former ADF members were male (86%). 13
DEFINITION
In line with the Australian Institute of Health and Welfare (AIHW) and the Department of Veterans’ Affairs (DVA) we have defined veterans as current or ex-serving members of the Australian Defence Force (ADF), including both permanent members and Reservists. Non-veterans are those who have never served in the ADF. 13, 14
KEY HEALTH STATISTICS
Veterans who are currently serving, whether full time or reservists, tend to have better overall physical, mental, and social wellbeing than those who are no longer actively serving, or have never served in the ADF. 13, 15, 16
In 2021-22, Australian veterans experienced similar or better social connectedness than the broader Australian population. However, veterans in poor physical or mental health were at higher risk of issues with social connectedness than other veterans. 18
In 2021-22, 19% of veterans volunteered and 40% were active members of clubs or associations. These rates were higher than those who had never served in the ADF (14% and 29%). Some subgroups of veterans had especially high rates of volunteering and club membership. 18
Veterans who involuntarily separate or transition from the ADF, especially for medical reasons (around 1 in 5), are more likely to have negative health and wellbeing, including lower physical, social, and mental wellbeing, education achievement, and workforce engagement. 13, 16, 17
In 2018 nearly 46% of transitioned ADF members were estimated to have had a mental disorder in the previous 12 months. 25% were estimated to meet the criteria for posttraumatic stress disorder (PTSD), and just over 20% had had experienced suicidal ideation, plans or attempts, with 2% having attempted suicide. 17
In 2018, 33% of transitioned ADF members experienced very high levels of psychological distress compared to 13% of the broader Australian community. 17
BENEFITS
Many of the benefits of participation in sport and physical activity for veterans are consistent with those experienced by the broader population, including benefits to physical, mental, and social wellbeing, improvements in behaviour and employment, and more. 8, 25, 26
Sports organisations can also benefit from engaging with veterans as they are often well educated, trained in organisational and leadership skills, and interested in volunteering and being active members of clubs and associations. In 2021-22, 19% of veterans volunteered and 40% were active members of clubs or associations, compared to those who had never served in the ADF (14% and 29% respectively). Some subgroups of veterans had especially high rates of volunteering and club membership (including veterans with disability and those not in the labour force). 16, 18, 26
Health and wellbeing
Sport—particularly team-based—can support resilience and mental health, social connectedness, and the likelihood of continuing physical activity long term.
Benefits
Health and well-being
Available evidence supports a positive impact of sport and active recreation participation on health, wellbeing, and quality of life for veterans. 8, 25, 27, 28, 29, 30
- An analysis of program participants in the University of South Australia, Invictus Pathways Program (IPP) found that it was beneficial for the participating veterans, irrespective of their physical and psychological health status. Participants described positive impacts on their physical fitness, social engagement, and sense of belonging. Participants perceived the IPP to be an opportunity for them to ‘give back’ by contributing to the education of the students delivering the IPP. Participants also reported the intention to continue being physically active. For some, this meant selection in an Invictus Games team; for others, getting involved in community sporting organisations. 31
- A 2023 study of 146 active-duty personnel in the United Kingdon (UK) who attended a five-day multiactivity and adventurous training courses (MAC) twelve months prior found 74% reported positive behaviour changes. The authors suggest that recovery support programmes like the MAC – that encompass health coaching adventurous activities – can initiate long-term positive behaviour change for military personnel recovering from injuries. 3
- Analysis of a 2022 intervention for physically injured military veterans using competitive motorsport found various psychological and physical benefits, including an increased sense of accomplishment, opportunity to socialise in a non-clinical environment, embracement of body image, and adoption of a healthier lifestyle. 10
- An analysis of the DVA Active Choices program in 2021 found that the number of participants meeting physical activity guidelines (150mins/week of moderate-to-vigorous PA) increased from 16% to 40%. 46% also felt more socially connected by the end of the program, and 76% reported psychological wellbeing benefits such as improved mood and sense of achievement through self-managing their physical activity regimes. Self-reported anxiety and depression also improved, with 40% reporting no issues at follow-up, compared to 26% at baseline. Many participants also spent less time and money seeing exercise physiologists and/or physiotherapists and had increased their ability to self-manage their conditions. 32
- A 2021 study of 74 veterans in the United States (US) who attended a 5-day recreation program found that the program reduced depression/anxiety among participants and increased positive affect and social functioning. Improvements were found regardless of which activities (cycling, surfing, sailing, kayaking, and archery/pickleball) were undertaken, or in what order. However, the outcomes weren’t maintained, returning to baseline levels by the 3-month follow-up. The authors suggest that continued engagement in similar activities is required to maintain social and mental wellbeing gains. 33
- A study of Australian Defence Force (ADF) veterans who participated in training and preselection for the Invictus and Warrior Games form 2018-2020 found that 78% of respondents reported greater engagement in physical activity after participation, and 89% reported that they had experienced a positive effect on their rehabilitation pathway. 34
- A 2021 study investigated a dedicated, 9-day sport program identified improved self-representations related to both the person and their body, and reduced PTSD symptoms in veterans. The authors suggest that sport can be a path to the reappropriation of a positive image of the self, by improving the representation of the body and that rehabilitation programs for people with chronic PTSD should include sporting activities as well as highlighting the benefits of sport to participants. 35
- Analysis of a US based one-day adaptive kayaking and sailing activity (Heroes on the Hudson) indicated that the event had an acute positive influence on the quality of life of veteran participants, with improvements observed in perceived overall health, quality of life, and quality of social life. 36
- A study in the UK with Armed Forces Veterans experiencing Post-Traumatic Stress Disorder (PTSD) found that participating in peer outdoor experiences (including angling, equine care, archery and falconry combined) led to significant reductions in PTSD symptoms, and that these types of experiences could be complement other existing treatments and services for veterans with PTSD. 37
- A 2019 evaluation of 15 veterans participating in a program that provided scuba diving qualifications alongside a peer support buddy system (Deptherapy) reported improvements in levels of anxiety, depression and social functioning, and a reduction in insomnia. Semi-structured interviews indicated that the improvements were more pronounced in those whose injuries were predominantly psychological, rather than physical. 38
- A 2018 evaluation of the experiences of 95 US veterans who participated in a surfing program found that participants experienced an average 36% decrease in PTSD symptoms, a 47% decrease in depression, and a 68% increase in self-efficacy. 39
- A 2018 survey of participants in the National Veterans Wheelchair Games (NVWG) found that 50% of the respondents stated that the NVWG made a difference in attaining employment. Those currently working were 1.5 times more likely to say that the NVWG had a positive effect on employment than those not currently working. Those who felt that the NVWG had a positive effect on employment attended 3-4 more wheelchair games on average than those reporting that the NVWG did not have an impact on employment. The authors suggests that participating in the NVWG provides psychosocial support to the veterans and may have a positive influence in employment outcomes. 40
- In a 2018 US study of wounded military personnel, noncompetitive activities (e.g. rock wall climbing, community golf driving range) significantly increased positive physical activity affect and tranquillity, while reducing negative affect from pre to post within Group 1. Group 2 participated in a wheelchair basketball tournament and did not appear to have the same positive impact as Group 1 activities. A significant increase between pre and post activities existed for fatigue within each group. 41
- A 2017 longitudinal study utilising a convenience sample of 163 veterans (91 sports-participants and 72 non-participants) matched on disability type with a variety of disabilities found that those who participated in sports, exercise, and recreation (SER) activities had significantly higher self-esteem, posttraumatic growth, and quality of life (QOL), and significantly lower depression scores than non-participants. Individuals participating in a combination of SER activities had significantly higher self-esteem scores than those only participating in individual events. The psychosocial benefits investigated appeared to be more related to the participation in SER itself and not necessarily the type or intensity of the activity. 29
- A case study of participants at the 2016 Invictus Games found that participants improved their physical abilities and competence, and that competing in sport activities could contribute to positive psychological changes through providing a sense of purpose and a release for aggression. 6
- A 2016 study of female US veterans participation in outdoor sports and recreation found that the activities provided novel environments where physical skills and emotional capacities could be developed. This included establishing social networks and bonding, facilitating a sense of freedom from constraints, and providing opportunities to redefine or recapture participants' identities. 7
- A 2015 study of US veterans found significant reductions in moderate-to-vigorous physical activity (MVPA) post-discharge including for those who had discharged more recently. The authors suggested interventions during early transitional stages could help veterans to remain engaged in physical activity, which could in turn prevent excess weight gain and other negative health consequences linked to physical inactivity. 42
- A 2015 study found that surfing facilitated a sense of respite from PTSD in combat veterans. Regular surfing facilitated respite by helping the participants stay focused on experiences in the present and avoiding dwelling on the traumatic memories. Surfing also gave the veterans a context to relate to one another in a positive fashion, and something concrete to look forward to that helped prevent them from ruminating over their memories in between bouts of respite (surfing). The authors highlighted how nature-based physical activity (the ‘blue gym’) could promote well-being among combat veterans. 43
- A 2014 systematic review found that sport and physical activity could enhance motivation for living as well as subjective well-being in veterans through active coping and doing things again, reducing PTSD symptoms, positive affective experiences, activity in nature/ecotherapy, and quality of life. 28
- A study of 98 US veterans who attended extended group-based nature recreation experiences (4–7-day programs with activities like fishing, kayaking, whitewater rafting, backpacking, hiking, mountain biking, paddle boarding, and canoeing) found significant improvements in psychological wellbeing, social functioning, and life outlook one week after participation. Some improvements lasted over the next month, but to a lesser extent. 44
Challenges
Once the competition, short-term program, or event ends some veterans report feeling a lack of motivation and goals, ‘the blues’. This suggests that for long-term health and wellbeing benefits it’s important to help veterans to understand that this might occur, and to have alternative and/or longer-term activities available. 33, 43, 44, 45
Several reviews and research papers have also highlighted that the physical, mental and social health of veterans are interconnected, and that programs should provide integrated approaches to improve overall health and wellbeing. 11, 25,46, 47, 48
Identity
Sport and physical activity programs can help veterans to develop new, post-service and/or injury identities.
Benefits
Identity
Sport and physical activity programs, including competitive sport programs, can help veterans to develop new, post-service and/or injury identities. 49
Some research suggests that veterans who can combine a military and civilian or family social identity are more likely to feel a sense of belonging, and to have more successful transitions. This can include through involving their families or peers in their sport or physical activities. 25, 50, 51
Challenges
For many participants a connection to, or restoration of, their previous military identity can be a positive factor, but for others it can be a source of stress. 25, 49, 50
Studies of participants in competitive sports, including those participating in the Invictus Games, have found that there are many reasons for individuals to engage with these events, and this can lead to stressors such as: 45, 52
- Conflicting goals (e.g. win at all costs vs experience and personal growth).
- Interpersonal issues (e.g. teammates acting superior or as if they are ‘in charge’).
- Different levels of support available to members of the same team (e.g. financial or media engagement).
- An increase of negative emotions such as anger and dejection and decrease in happiness and excitement in the build-up to or post-competition.
To provide the best outcomes for participants it is important to help veterans understand and manage potential negative effects. 52
Motivators
There are some factors identified in the literature that are recognised as having a high impact on participation for veterans.
Increasing health and fitness (including injury rehabilitation and improving physical function). 45. 53. 54
Reconnecting with previous military life and/or an environment that feels similar (e.g. teamwork, challenge, competition). 45, 49
Seeing other veterans being role models and wanting to inspire others as well. 45
Facilitators and barriers
Facilitators
- Social connections and sense of belonging. 6, 10, 32, 43, 45, 50, 53, 55, 56, 57, 58, 59, 60
- Family and friends engagement and support. 45, 50, 55, 57
- Quality programs (including instruction, location, equipment, and being tailored to participants’ needs). 26, 32, 54, 56, 61
- Participating with people with shared experiences (e.g. other veterans and/or people with disability). 6, 10, 25, 26, 34, 43, 44, 45, 50, 57
- Sense of mastery and challenge (including learning new skills across different sports and experiences). 7, 10, 43, 45, 50, 56, 57, 58, 60
- Meaning (achieving personal and/or social goals). 26, 32, 45, 58, 60
Barriers
- Poor health, illness, and/or injury. 53, 54, 62
- Low self-efficacy or perceived capability. 54, 57, 59
- Insufficient resources or support. 54, 61
- Too much hassle. 54
- Limited opportunities. 59
POLICIES, PROGRAMS, AND SUPPORTING STRUCTURES
Policies, procedures, and supporting structures
History
A brief timeline of key international and Australian events related to sport in the lives of veterans.
1941
The National Fitness Act 1941, which was in effect 1941 to 1994, was passed during the Second World War. The purpose of this Act was to improve the fitness of Australian young people, and better prepare them for work in the armed services and industry. It made federal funding available to state-based fitness councils to coordinate promotional campaigns, programs, education, and infrastructure. Most of this work was accomplished by volunteers with a focus on playgrounds, clubs, and camping programs for children and youth, and the development of physical education in schools. 19
1948
On 29 July 1948, the day of the Opening Ceremony of the London 1948 Olympic Games, Dr. Ludwig Guttmann organised the first competition for wheelchair athletes which he named the Stoke Mandeville Games, in Great Britain. Sixteen (16) injured servicemen and women took part in archery. 20
1952
Dutch ex-service veterans join the Stoke Mandeville Games, making it the first International Games. 20
1960
The Stoke Mandeville Games became the Paralympic Games. The Rome 1960 Summer Paralympic Games featured 400 athletes from 23 countries. The Games were no longer solely for ex-service people, although they remain an important cohort. 20
2014
The first international Invictus Games launched in London, United Kingdom. The biennial Invictus Games use competitive adaptive sport to aid recovery for international wounded, injured and sick service personnel and veteran. The spirit of the Games therefore lies not in elite sport, but the delivery of a high-profile, international, adaptive sports event where rehabilitation of the individual is at the core. 21
2018
20-27 October - The Invictus Games are held in Sydney. 22
26 October – Veteran Sport Australia (VSA) is announced as a key legacy of the 2018 Sydney Invictus Games. A nationwide program supporting the health and wellbeing of veterans and their families through sport. The creation of VSA was led and enabled by the Returned and Services League (RSL), Australia’s longest-established national veterans’ charity. RSL Welfare and Benevolent Institution NSW, Australian International Military Games, and Clubs NSW all contributed financially to establish the VSA. 23
2019
December – Veteran Sport Australia commenced operations with the appointment of key staff. 23
2021
Veteran Sport Australia becomes Invictus Australia. 24
2023
Adaptive sport programs for Australian Defence Force veterans, Senate Foreign Affairs, Defence and Trade References Committee, Parliament of Australia, (May 2023). The committee conducted an inquiry to examine the role of adaptive sport programs [and sport more broadly] for Australian Defence Force veterans in addressing issues identified by the ongoing Royal Commission into Defence and Veteran Suicide.
2024
Invictus Australia expanded its national and regional presence through increased regional workforce and formal sporting partnerships with NSOs.
Policies, procedures, and supporting structures
Federal Government
Australian Federal Government agencies and programs that support veterans' wellbeing including participation in sport, active recreation, and physical activity.
- Australian Defence Force Sport. The Australian Defence Force (ADF) Sports Cell, in collaboration with the three Services, sets the strategic direction for sport in the ADF. This creates an environment for all ADF members to participate and benefit from sport as a competitor, coach or administrator, and recognises the inherent connections between sport, exercise, health, and the overall wellbeing of ADF personnel.
- Adaptive Sports Program (ASP). The focus of the ASP is to support the recovery, rehabilitation and reintegration of participants and, through their stories, raise awareness of the issues faced by veterans and families and the life-changing power of sport.
- Team Australia. The ADF partners with Invictus Australia to support serving and former serving military members to participate in events such as the Invictus Games and Warrior Games.
- Engage: Staying active. Provides links to information, support, and programs to promote physical fitness, exercise, and an active lifestyle.
- The Department of Veterans' Affairs (DVA) works to support those who serve or have served in the defence of our nation and commemorate their service and sacrifice.
- Work and social life programs. Provides links to information, support, and programs to improve individuals' health, work, and social life including how to make social contacts in your community.
Strategies
- Defence and Veteran Mental Health and Wellbeing Strategy 2024 Exposure Draft, Australian Government, Department of Defence and Department of Veterans' Affairs, (December 2024). Defence and DVA have been working together to develop a new joint Defence and Veteran Mental Health and Wellbeing Strategy 2024-2029. The strategy aims to improve the mental health and wellbeing of the Defence and veteran community. The strategy sets out the joint approach of the Department of Defence (Defence) and Department of Veterans’ Affairs (DVA) over the next five years to promoting and supporting wellbeing, through early intervention and prevention, timely access to care and support, and a positive and connected community, while focussing on suicide prevention, and using data to drive positive outcomes. Consultation on the Exposure Draft will close at 5:00 pm Friday 7 March 2025.
- Defence and Veteran Family Wellbeing Strategy and First Action Plan, Australian Government, Department of Defence and Department of Veterans' Affairs, (December 2024). Over the next 5 years, this Strategy will guide how the Department of Defence (Defence) and the Department of Veterans’ Affairs (DVA) provide targeted support to Defence and veteran families. The Strategy outlines how families will be supported, reaffirms a commitment to understanding their needs, and prioritises stronger engagement and ongoing support to enhance their wellbeing. The First Action Plan outlines the actions that Defence and DVA will initially take to achieve the Strategy’s objectives. Defence and DVA will update the Action Plan as actions progress, with the most current version available here.
Reports
- Rapid Evidence Assessment to identify strategies to support and sustain healthy behaviour as part of active ageing in Australian veterans: Summary Report, N Warren, B Barbosa Neves, K Hutton Burns, et al., Monash University for the Australian Government, Department of Veterans’ Affairs, (February 2022). Findings suggest that successful and healthy ageing interventions should be informed by a set of core priorities, namely: 1) address social isolation and loneliness, 2) promote movement and physical exercise, 3) cognitive functioning, 4) quality of life and wellbeing, 5) consider veteran identity, and 6) reduce risk behaviours and mitigate risk factors.
- Active Choices: A ‘stepped-down’ program to promote self-managed physical activity in DVA clients: Summary Report, Nicholas Gilson, University of Queensland for the Australian Government, Department of Veterans' Affairs, (December 2021). Self-managing physical activity can be challenging and programs that help DVA clients to manage their own physical activity regimes are needed. This project developed and trialled a new physical activity support program for DVA clients called Active Choices. The Active Choices program is based on a strong theoretical framework and incorporates evidence based BCTs to support clients as they transition to self-managed PA.
- ‘Stepped-down’ Intervention Programs to Promote Self-managed Physical Activity in Service Veterans and their Dependants: Summary of the Rapid Evidence Assessment, Gilson ND, Papinczak ZE, Mielke GI, et al., University of Queensland for the Australian Government, Department of Veterans' Affairs, (November 2019). The aim of this Rapid Evidence Assessment (REA) was to: 1) examine the scientific literature for evidence on the effectiveness of interventions to promote self-managed physical activity in service veterans and/or their dependants; 2) assess studies that compared the effectiveness of ‘stepped-down’ models of PA self-management to ‘usual care’ controls and; 3) identify key behaviour change techniques that have been used in these studies to successfully promote physical activity change.
- Adaptive Sports for Disabled Veterans, Nancy Greer, et al., prepared for Department of Veterans Affairs (USA), (February 2019). The purpose of this report is to systematically review the available evidence on the benefits and harms of adaptive sports participation and the barriers to and facilitators of participation. The report was intended to guide the VHA in developing, making available, and evaluating regional and national adaptive sports programs for Veterans that go beyond general recommendations to participate in sports.
- Mental Health Prevalence, Mental Health and Wellbeing Transition Study, Van Hooff M, Lawrence-Wood E, Hodson S, et al., the Department of Defence and the Department of Veterans’ Affairs, (2018). This report investigates the prevalence of 12-month and lifetime mental disorders, trauma exposure, suicidal ideation and self-reported mental health symptoms among Transitioned ADF members. Comparisons are also made between the self-reported mental health symptoms in Transitioned ADF with 2015 Regular ADF members and where possible, with the Australian Community.
- Physical Health Status Summary Report, Mental Health and Wellbeing Study, Kelsall, H., Sim, M., Van Hooff, M., et al., Australian Government, Department of Defence and the Department of Veterans’ Affairs, (2018). This Physical Health Status Study compared the self-reported physical health of Transitioned ADF members who had transitioned out of full-time regular service in the five years between January 2010 and December 2014 with that of Regular ADF members in 2015, using general health indicators as well as indicators relevant to several body systems. Overall, Transitioned ADF members were more likely to report poorer physical health, to have increased lifestyle risk factors, and to report poorer self-perceived health, satisfaction and quality of life than 2015 Regular ADF. Among the Transitioned ADF, poorer physical health outcomes overall were reported for DVA clients compared with those who were not DVA clients, for Ex-Serving members compared with Active Reservists or Inactive Reservists, and for those who had been medically discharged compared with those who had been discharged for other reasons.
- What are the physical and mental wellbeing benefits veterans achieve through participating in sporting activities? A Rapid Evidence Assessment: Summary Report, Milanese, S, Crocker, M, Ransom, M, et al., for the Australian Government Department of Veterans’ Affairs, (2018). The aim of this Rapid Evidence Assessment (REA) was to examine the evidence to investigate the physical and mental wellbeing benefits veterans achieve through participating in sporting activities and whether these benefits are linked to the type of sporting activity being undertaken. Reflecting the broad definition used in this review, the sporting activity interventions featured in this review fell into six categories: structured competitive sport; supervised aerobic exercise; supervised mind body exercise; supervised combined aerobic and anaerobic exercise; unmonitored unsupervised physical activity and structured recreational physical activity.
- The Australian Institute of Health and Welfare (AIHW) is an independent statutory Australian Government agency producing authoritative and accessible information and statistics to inform and support better policy and service delivery decisions, leading to better health and wellbeing for all Australians.
- AIHW-DVA strategic partnership. In 2017 the Department of Veterans’ Affairs (DVA) and the Australian Institute of Health and Welfare (AIHW) established a strategic partnership to implement the Veterans’ Health and Welfare: whole-of-population approach program of work (the Work Program). The overarching aim of the partnership is to develop a comprehensive profile of the health and welfare of Australia’s veteran population. It continues to take a coordinated, whole of-population approach to monitoring and reporting on health and welfare outcomes of veterans and their families, in support of and to inform DVA’s strategic, research, data and policy needs.
Reports
- Health of veterans, (31 October 2024). While good health is a requirement for joining the Australian Defence Force, the experience of military service means current and ex-serving ADF members may have different health challenges compared to other Australians.
- Serving and ex-serving Australian Defence Force members who have served since 1985: suicide monitoring 1997 to 2022, (24 September 2024). This report is the seventh annual update monitoring suicides among permanent, reserve and ex-serving Australian Defence Force (ADF) members. The population of ADF members under consideration are those who served between 1985 and 2022. Permanent and reserve male ADF members die by suicide at about half the rate of Australians of similar age, while ex-serving male ADF members have a higher rate than Australian males.
- Veterans' use of alcohol, tobacco, e-cigarettes and other drugs, (30 August 2024). This article examines Australian Defence Force veterans’ use of alcohol, tobacco, e-cigarettes and other drugs, using the 2022–2023 National Drug Strategy Household Survey.
- Characteristics of ex-serving Australian Defence Force members hospitalised for suicidality and intentional self-harm, (31 July 2024). This is the first report using a newly established data set on the health service use of ex-serving Australian Defence Force (ADF) members. It examines the characteristics of hospitalised ex-serving members to better understand their hospital care needs, particularly for conditions associated with suicidal behaviour, including mental health-related care and intentional self-harm.
- Ex-serving ADF members' income and sources of income, (6 March 2024). Using linked data, this report investigates the income circumstances of ex-serving Australian Defence Force (ADF) members. The analysis expands information on the veteran-centred model's income and finance domain, as part of an ongoing body of work in partnership with the Department of Veterans’ Affairs. This report is based on ex-serving ADF members who had at least one day of service on or after 1 January 2001 and uses multiple data sources to inform income outcomes.
- Veteran social connectedness, (26 October 2023). This report presents key insights into the social connectedness of Australians who have ever served in the Australian Defence Force (ADF), using data from the Household, Income and Labour Dynamics in Australia (HILDA) Survey. The analysis expands information on the Social Support domain of the AIHW's Veteran-centred model, and forms part of an ongoing body of work in partnership with the Department of Veterans’ Affairs (DVA). It aims to explore both risk and protective factors for social isolation, loneliness, and poor community participation among Australia’s veterans, as well as how these compare with people who have never served in the ADF.
- Socioeconomic characteristics of ex-serving ADF members who died by suicide, (11 October 2022). Suicide by ADF members, like suicide in the Australian population, is an ongoing and complex public health issue. Ex-serving ADF members as a population group are at increased risk of suicide (AIHW 2021a, 2021b). This report investigates socioeconomic characteristics for ex-serving ADF males with at least one day of service since 1 January 2001 in relation to deaths by suicide between 9 August 2011 and 31 December 2018. This analysis was prepared for the Royal Commission into Defence and Veteran Suicide for their interim report that was published 11 August 2022.
- Understanding the wellbeing characteristics of ex-serving ADF members, (1 September 2022). The nature of military service makes understanding the wellbeing of those who have served of vital importance. This report examines wellbeing outcomes such as employment status, income, education qualifications, housing circumstances, and social support for ex-serving Australian Defence Force (ADF) members and their families. Using linked data, this report expands information on the Veteran-centred model as part of an ongoing body of work in partnership with the Department of Veterans’ Affairs. This report is based on ex-serving ADF members who had served at least one day of service on or after 1 January 2001 and were ex-serving as of 31 December 2015 and uses the 2016 Census data as the primary source of data to inform wellbeing outcomes.
- Full list of reports relating to Australian veterans available on the AIHW website.
Policies, procedures, and supporting structures
Invictus Australia
Invictus Australia (formerly Veterans' Sport Australia) is owned and operated by Australian International Military Games, the not-for-profit responsible for organising the Sydney 2018 Invictus Games, and licensed from the Invictus Games Foundation. They carry on the legacy of the Games in local communities, as all veterans and their families can benefit from involvement with sporting communities, particularly ‘at risk’ veterans. As well as promoting the physical, social, and emotional benefits of sport, Invictus Australia highlight the unique needs of younger veterans and the challenges they face as they transition from military to civilian life.
Sporting Opportunities. Invictus Australia partner with sporting organisations to deliver opportunities for veterans and their families across sport at a local level. They also work on programs, initiatives, and offers to encourage the Australian Defence community to become involved – and stay involved – with sport.
- Current sports include adventure activities, archery, biathlon, bowls, cycling, dragon boat, esports, indoor rowing, pickleball, rugby league, rugby union, running and walking, sailing, surf life saving, surfing, table tennis, water polo, wheelchair sports, and yoga.
- Team Veteran. Join veterans and their families all over Australia, to find a local, supportive sporting community suited to you. Originally starting as a running group for veterans has expanded to include all veterans, family members and anyone in the community wanting to show their support, including other ex-service organisations (ESOs). Team Veteran now enters teams in multiple sporting and recreational events around Australia, including True Grit military-inspired obstacle events, Dragon Boating, pickleball, the Pan Pacs and more. Get in touch to find out how you can get involved with Team Veteran, no matter what sport you’re into.
Adaptive Sport Program. working with the Australian Defence Force to deliver the national Program for veterans who are wounded, injured, or ill – including supporting the Australian Invictus Games and Warrior Games teams. Invictus Australia is responsible for the former serving contingent.
Case studies. Be inspired by stories of the unconquered human spirit.
Volunteering partnership. In September 2024 Invictus Australia and Volunteering Australia announced a strategic partnership to enhance community connections for veterans and their families through volunteering. within sporting organisations across the country.
Policies, procedures, and supporting structures
National
Australian national non-government organisations that support veterans' wellbeing including participation in sport, active recreation, and physical activity.
- Open Arms provides mental health and wellbeing support to anyone who has served at least one day of continuous fulltime service in the ADF and their immediate families. They offer a range of services to current serving, transitioning, ex-serving members, partners, family, children, parents, and siblings of veterans. Provides some general information on the benefits of exercise, physical activity, and social activities.
- Soldier On is a not-for-profit organisation delivering holistic support services that enable current and former Australian Defence Force personnel and their families to lead meaningful civilian lives. Includes support for health and wellbeing, employment, learning and education, participation and connection.
- RSL Active. Recreation, events and activities for veterans and their families. Programs and events are created for the veteran community to help connect with other veterans, improve physical and mental well-being and enhance their support circle. There are regular RSL Active events held through RSL sub-branches across Australia, as well as large-scale national events, virtual RSL Active Strava Clubs. Veterans can connect with their RSL State Branch to see a list of activities taking place in their state. You do not need to be an RSL member to participate in RSL Active.
- All-Veterans Wellness Toolbox, RSL Active and the Resilience Shield, (accessed 6 November 2024). A series of short videos created by veterans for veterans to provide insights into how they can assess and build their resilience. The Resilience Shield model was developed by Dr Dan Pronk, Ben Pronk, and Tim Curtis, all of whom are Australian SAS veterans with combat experience in theatres, including Afghanistan, Iraq, Sierra Leone, and Timor Leste. Their service experience furnished them with an understanding of leadership under pressure and drove a deep desire to understand exactly what resilience was and how it could be developed and improved in individuals and organisations. In this video series, they share the important things that we can do to maintain our health and wellbeing and become more resilient every day.
Policies, procedures, and supporting structures
State and territory
Australian state and territory based, government and non-government organisations that support veterans' wellbeing including participation in sport, active recreation, and physical activity.
ACT Office for Veterans
ACT Office for Veterans coordinate policy about issues affecting veterans and their families in the ACT and administer grants to improve the lives of the local veteran community.
- Towards Greater Veteran Wellbeing: A Feasibility Study to Support Veterans and their Families in the ACT - Final report, Yellow Edge for the ACT Government and the Department of Veterans' Affairs, (December 2020). In early 2020, the ACT Government, in partnership with DVA, agreed to commission an independent feasibility study to explore potential services as well as opportunities to tap into, and contribute to centres of veteran research excellence. Findings suggest that the vast majority of veterans in the ACT are in a reasonably good position. Many of their needs continue to bet met through a combination of services provided by DVA, mainstream ACT Government services and a broad range of services provided by the veteran services sector.
- The exact number of ACT veterans living in the ACT remains unknown. The '2020 ACT Region Veteran Community Service Needs and Awareness survey', commissioned as part of this Feasibility Study, captured the perspectives, and needs of 210 ACT veterans and their family members, it represents a small fraction of the veteran community.
- The services environment for veterans and their families appears to be a vibrant one. There are many small and large providers providing a range of services. The ex-service and veteran service organisations operating in the ACT provide services in the area of entitlements and advocacy, psychological and counselling services, welfare and referral services, outreach programs and a large number of social and sporting activities including yoga classes, coffee catchups, peer mentoring, dragon boating, and self-defence classes.
Invictus Australia
Local Engagement. Invictus Australia employs Veteran Engagement Managers in local communities, building connections with veterans, families, Ex-service organisations (ESOs), sporting partners and relevant services. To keep up to date with upcoming events local Facebook groups are available.
NSW Office for Veterans Affairs (OVA)
NSW Office for Veterans Affairs (OVA) manages state programs commemorating and assisting veterans and their families in collaboration with all NSW Government agencies, the Australian Government, and community stakeholders. OVA also leads heritage and commemoration activities, and targeted programs and grants that support veterans to access employment and education opportunities that are critical for long-term wellbeing.
- NSW Veterans Strategy 2021–2024: A whole-of-government strategy and a whole-of-community approach for veterans and their families, NSW Government, (2021). The Strategy outlines the focus NSW will take to Veterans Affairs during the next 4 years. The Action Plan outlines specific commitments and targets to achieve those goals and will be updated during the course of the Strategy. Theme 3: Community and volunteering, highlights the role that sport can play in enhancing veterans' social connection, physical health, and overall wellbeing.
- NSW Veterans Action Plan 2023–2024. Action item 3.3 Community and volunteering: Expanding volunteering opportunities in sport. Using funding provided by the Office of Sport under the VetFit grant to Veteran Sport Australia, develop opportunities, including a digital platform, to support volunteering by veterans in sport and active recreation. Action item 3.9 Community and volunteering: Sport. The Office of Sport will explore opportunities for collaboration and partnership between veteran organisations and sporting organisations to increase participation by veterans in sport and active recreation.
- NSW Veterans Strategy 2021–2022 Progress Report. Highlights some of the programs and services provided through partnerships between Invictus Australia and the NSW Office of Sport under the Community and volunteering theme.
Invictus Australia
Local Engagement. Invictus Australia employs Veteran Engagement Managers in local communities, building connections with veterans, families, Ex-service organisations (ESOs), sporting partners and relevant services. To keep up to date with upcoming events local Facebook groups are available.
RSL NSW
Sport and Recreation Program. A social connection and wellbeing program inclusive of all veterans and their families. Program includes a variety of sub-Branch-led activities, both sport and recreation focused.
Invictus Australia
Local Engagement. Invictus Australia employs Veteran Engagement Managers in local communities, building connections with veterans, families, Ex-service organisations (ESOs), sporting partners and relevant services. To keep up to date with upcoming events local Facebook groups are available.
RSL Queensland
Rec Connect. Rec Connect helps veterans and their families connect through a diverse calendar of recreational events. Be it active, creative, outdoors or indoors, each RSL Rec Connect event is designed to help participants feel happier and more connected with others.
Invictus Australia
Local Engagement. Invictus Australia employs Veteran Engagement Managers in local communities, building connections with veterans, families, Ex-service organisations (ESOs), sporting partners and relevant services. To keep up to date with upcoming events local Facebook groups are available.
University of South Australia
WAVES Program, (accessed 5 November 2024). WAVES offers a variety of wellbeing activities for current and past serving veterans, first responders and their families. The aims of the program are to provide pathways for community reintegration, rehabilitation and recovery programs, goal setting and peer to peer activities to support wellbeing. WAVES has three current programs: Invictus Pathways Program (IPP) - 1:1 training with UniSA students on campus at UniSA; Community Adaptive Sports Program (CASP) - facilitated in the community; and Heart Health Program - a group exercise program delivered by UniSA students on campus at UniSA.
- Funded by Military and Emergency Services Health Australia (MESHA), in partnership with The Hospital Research Foundation, the IPP offered a fully funded PhD scholarship to investigate the long-term effect participation has on personnel’s health and wellbeing. Details of studies from the PhD are listed on the website.
Department of Premier and Cabinet
Veterans Programs. Community Policy and Engagement conducts many programs and services for Tasmania's veterans including grant funding, wellbeing initiatives, and commemoration events.
- Veteran Wellbeing Voucher Program. The objective of the Program is to enable veteran’s participation in healthy activities that will support their health and wellbeing and assist in developing social networks.
- Veterans' Active Recreation Program. Point Assist will receive $225,000 over three years to provide an outdoor recreation experience for returned service personnel in a National Park environment, which provides a challenging outdoor experience, with a focus on mental health and wellbeing, and links to training pathways and employment in outdoor education or eco-tourism.
Invictus Australia
Local Engagement. Invictus Australia employs Veteran Engagement Managers in local communities, building connections with veterans, families, Ex-service organisations (ESOs), sporting partners and relevant services. To keep up to date with upcoming events local Facebook groups are available.
Invictus Australia
Local Engagement. Invictus Australia employs Veteran Engagement Managers in local communities, building connections with veterans, families, Ex-service organisations (ESOs), sporting partners and relevant services. To keep up to date with upcoming events local Facebook groups are available.
RSL Victoria
RSL Active,. Provides a way to connect with other veterans and develop social networks, share ideas, tell stories, enhance support circles, and improve physical and mental health.
Invictus Australia
Local Engagement. Invictus Australia employs Veteran Engagement Managers in local communities, building connections with veterans, families, Ex-service organisations (ESOs), sporting partners and relevant services. To keep up to date with upcoming events local Facebook groups are available.
RLS WA
RSL Active. Spanning a range of activities from kickboxing to yoga and everything in between, RSL Active have a range of programs and events to suit everyone. It’s not just about staying active; it’s about having fun, meeting new friends, and thriving in your post-Defence life.
Policies, procedures, and supporting structures
Sport and physical activity
Australian programs that support veterans' wellbeing through participation and community engagement in sport and physical activity.
- Adaptive Sport Program, Invictus Australia, (accessed 5 February 2025). Working with the Australian Defence Force to deliver the national Program for veterans who are wounded, injured, or ill – including supporting the Australian Invictus Games and Warrior Games teams. Invictus Australia is responsible for the former serving contingent.
- Invictus Australia also partners with a range of sporting organisations, as well as the Australian Sports Commission, to help provide access to many sports for veterans and their families. This includes adaptive formats, with opportunities for participation, volunteering and spectating at both a grassroots and international level.
- True Grit, Invictus Australia, (accessed 5 February 2025). Invictus Australia has partnered with True Grit. renowned for its demanding obstacle course races, to provide opportunities for members of ‘Team Veteran’, to compete and challenge themselves at events around the nation.
- Archery, Invictus Australia, (accessed 5 February 2025). Information on archery as a sport for veterans, including collaboration with Archery Australia through the ‘VETS into Sport’ program.
- parkrun, Invictus Australia, (accessed 5 February 2025). Information on how veterans can get involved in walking and running through parkrun, a free 5km event held on Saturday mornings in local communities across Australia and the world. Invictus Australia established the 'Team Veteran Running Group' in 2019 and continues to work with parkrun to promote veterans and their families getting involved.
- Biathlon, Invictus Australia, (accessed 5 February 2025). Information on biathlon as a sport for veterans, including collaborating with organisations such as Biathlon East Australia and VESPA (Veterans and Emergency Services Parabiathlon Australia) to introduce veterans and their families to the sport.
- Bowls, Invictus Australia, (accessed 5 February 2025). Information on how veterans and their families can get involved in bowls through a partnership with Bowls Australia and initiatives such as ‘family days’ to try the sport and running a ‘NSW Regional Bowls Tour’.
- Cycling, Invictus Australia, (accessed 5 February 2025). Information on cycling as a sport for veterans, including mountain biking, road cycling, and BMX.
- Dragon Boating, Invictus Australia, (accessed 5 February 2025). Information on dragon boat as a sport for veterans, including collaboration with the Australian Dragon Boat Federation to promote the sport and the many benefits it provides.
- Esports, Invictus Australia, (accessed 5 February 2025). Information on esports as an activity for veterans, as well as plans to develop partnerships to provide competitive opportunities for veterans and their families.
- Pickleball, Invictus Australia, (accessed 5 February 2025). Information on pickleball as a sport for veterans, including working with Pickleball Australia to provide opportunities and pathways for veterans and their families, of all abilities to participate.
- Rowing, Invictus Australia, (accessed 5 February 2025). Information on rowing as a sport for veterans, including working with Rowing Australia on different initiatives to get veterans and their families rowing, such as the annual ANZAC Challenge between Australia and New Zealand and opportunities for veterans to get involved in Rowing Australia’s coaching structures.
- Battlefields to Footy Fields, National Rugby League (NRL), (accessed 6 November 2024). An NRL initiative providing nationally recognised training for current and ex-serving ADF members and their immediate family. The program provides an opportunity to hone newfound skills, make long lasting connections, and participate in something that gives a renewed sense of belonging.
- NRL providing support network through Battlefields to Footy Fields initiative, Cameron Mee, NRL.com, (23 April 2024). The Battlefields to Footy Fields program commenced by providing veterans with the opportunity to complete refereeing courses but has expanded significantly since its creation. Now, Defence Force personnel have the chance to engage in coaching and sports training courses while assistance is also provided to help children of veterans to play junior rugby league. More than 200 people have directly graduated from courses, with thousands benefiting from the Battlefield to Footy Fields initiative.
- Rugby League, Invictus Australia, (accessed 5 February 2025). Information on rugby league as a sport for veterans, including the Invictus Australia partnership with the NRL on the Batllefields to Footy Fields program.
- Rugby Union, Invictus Australia, (accessed 5 February 2025). Information on rugby as a sport for veterans, including non-contact sevens, fifteen-a-side, and wheelchair rugby.
- Sailing, Invictus Australia, (accessed 5 February 2025). Information on sailing as a sport for veterans and their families, including creating opportunities to participate through sailing clubs around Australia.
- Surf Life Saving, Invictus Australia, (accessed 5 February 2025). Information on surf life saving for veterans, including working with Surf Life Saving Australia through initiatives such as having a Team Invictus Australia at the 2024 Lifesaving World Championships and establishing Club Open Days.
- Surfing, Invictus Australia, (accessed 5 February 2025). Information on surfing for veterans, including initiatives such as the Association of Veteran Surfers (AVS) and Waves of Wellness (WOW), a mental health and surf therapy charity.
- Table Tennis, Invictus Australia, (accessed 5 February 2025). Information on table tennis as a sport, including working with Table Tennis Australia to introduce this vibrant, skilful, and enjoyable sport to Defence communities nationwide.
- Water Polo, Invictus Australia, (accessed 5 February 2025). Information on water polo including working with Water Polo Australia to provide opportunities, pathways, encouragement and support for veterans and their families, of all abilities, to participate in the sport.
- Wheelchair sports, Invictus Australia, (accessed 5 February 2025). Brief information on wheelchair sports opportunities including playing rugby, basketball, or AFL at community, state or international levels.
- Yoga, Invictus Australia, (accessed 5 February 2025). Information on yoga as an activity for veterans and their families, including working with partners Frontline Yoga and local studios in communities across Australia to help provide access to trauma informed yoga classes, pathways for anyone interested in training to become a trauma-informed yoga teacher, and encouraging trauma-informed principles to be introduced to other sporting organisations.
EVENTS
Events
Invictus Games
The Invictus Games are an international multi-sport event for wounded, injured and ill servicemen and women, both current and former serving personnel. The Games focus on adaptive sports and have been held globally since inception in 2014 by the Duke of Sussex.
Team Australia is delivered by the Australian Defence Force in partnership with Invictus Australia.
Invictus Games Sydney 2018
The 2018 Invictus Games were held in Sydney, Australia.
The event hosted 491 competitors and 1,000 family and friends from 18 nations from 20-27 October. The Games featured medal competition in 11 sports alongside golf and wheelchair tennis with events held across Greater Sydney, including Sydney Olympic Park and Sydney Harbour.
An important outcome of hosting the Games was the creation of Invictus Australia (originally Veterans Sport Australia) to carry on the legacy of the Games every day in local communities.
Invictus Australia is the first legacy organisation to be officially licensed by the Invictus Games Foundation. They promote the physical, social and emotional benefits of sport, as well as shine a light on the unique needs of younger veterans and the challenges they face as they transition from military to civilian life.
Events
Warrior Games
The Warrior Games is a multi-sport event organised by the United States Department of Defense (DoD). It is for wounded, injured or ill service men and women, for current and former serving personnel. The Warrior Games inspired the creation of the Invictus Games.
Team Australia has a standing invitation to attend the Warrior Games in years where there is no Invictus Games.
Events
Local events
Not all events are large or exclusive. Many local events and activities are held in Australia throughout the year to help veterans engage with their communities and improve the physical and mental health.
Invictus Australia
Calendar of upcoming events. Find activities and events happening around Australia.
RSL Active
Events. Find links to national and state-based programs and activities.
Further reading
Further reading
Articles
- Fallen Olympian honoured with graveside ceremony in France, Australian Olympic Committee, (18 July 2024). Olympians Kaarle McCulloch and Michelle Ford have honoured the memory of the late Cecil Healy, the only Australian Olympic gold medallist to die in combat. Cecil Healy, the gold and silver medal winning swimmer from the Stockholm 1912 Games was gunned down at the Somme in France on August 29th, 1918 - just 73 days before World War One ended.
- Veteran sport a social connector to build mental wellness, Vanessa Bernardo, Invictus Australia, (accessed 6 November 2024). The Australian veteran community is an important and significant piece of the nation’s identity, deeply rooted in the rich tapestry of our history, values, and culture. For some veterans, the process of returning to civilian society following service may encompass difficulties, such as reestablishing a sense of purpose, finding suitable employment, acclimating to different routines and expectations, and rebuilding social connections, particularly those who are wounded, injured or ill, or involuntarily discharged.
- Can sport combat alarming defence statistics? New research sheds light, Sara Pizzinato, Invictus Australia, (May 2024). Multiple research papers suggest that the positive benefits of sport and social connection could translate to this group in a beneficial way, a concept that underpins Invictus Australia’s grassroots and international programs, collaborative approach and focus on building supportive communities. With transition being identified as both a cause of this problem and an opportunity to improve the wellbeing of veterans, the positives of sport and social connection are beneficial to veterans at all stages of their Defence career.
- Invictus Games participants saw positive benefits from competitive sports according to new research, Forces in Mind Trust, (7 May 2024). The evaluation of competitors and non-competitors is the first study on the long-term benefits of international competitive sports in wounded, injured and sick serving and former personnel.
- Sport and Australian military life. Department of Veterans’ Affairs, Anzac Portal, (November 2021). For Australians, the connection between sport and military service dates to the colonial era. Through more than a century of war, conflict and peacekeeping operations, military personnel have found enjoyment, exercise, competition and release in sport. Sport reaches across cultural and linguistic boundaries, bringing together people who may have little else in common, helping service personnel on deployment establish relations with their counterparts from other nations and with local civilians. Just as today's service men and women participate in or watch sporting contests at every stage of their military careers, so generations before hold memories of sporting moments as some of the happiest of their service lives.
- War and sport, Tasmania. Department of Prime Minister and Cabinet, Centenary of ANZAC, (2014?). The Centenary of ANZAC provides an opportunity to tell remarkable stories of the importance of sport to Australians serving overseas, as well as the war-time experiences of some of most loved sporting stars. Through the Centenary of ANZAC website, you may view stories about some of Tasmania’s top sportsmen and women who have played an important role in Tasmania’s military history.
Access to resources
Where possible, direct links to full-text and online resources are provided. However, where links are not available, you may be able to access documents directly by searching our licenced full-text databases (note: user access restrictions apply). Alternatively, you can ask your institutional, university, or local library for assistance—or purchase documents directly from the publisher. You may also find the information you’re seeking by searching Google Scholar.
Further reading
Books
- War, Sport and the Anzac Tradition, Kevin Blackburn, Springer, (2016). Commemoration of war is done through sport on Anzac Day to remember Australia's war dead. War, Sport and the Anzac Tradition traces the creation of this sporting tradition at Gallipoli in 1915, and how it has evolved from late Victorian and Edwardian ideas of masculinity extolling prowess on the sports field as fostering prowess on the battlefield.
Access to resources
Where possible, direct links to full-text and online resources are provided. However, where links are not available, you may be able to access documents directly by searching our licenced full-text databases (note: user access restrictions apply). Alternatively, you can ask your institutional, university, or local library for assistance—or purchase documents directly from the publisher. You may also find the information you’re seeking by searching Google Scholar.
Further reading
Reports
- Health of veterans, Australian Institute of Health and Welfare (AIHW), (31 October 2024). While good health is a requirement for joining the Australian Defence Force (ADF), the experience of military service means current and ex-serving ADF members may have different health challenges compared to other Australians. This is why monitoring of the health and wellbeing of the ADF veteran population is important. According to the 2021 Census of Population and Housing, more than half a million Australians (581,000) have ever served in the ADF, representing 2.8% of Australians aged 15 and over. Around 84,900 (15%) are currently serving ADF members (60,300 permanent and 24,600 reservists), and over 496,000 (85%) are ex-serving. Veterans are mostly male – 86% (497,000) compared to 48% of non-veterans aged 15 and over. Fourteen per cent (84,100) of veterans are female. Ex-serving veterans are an older population – 53% (263,000) are aged 65 years and over, compared with 20% of the non-veterans aged 15 and over.
- In 2020–21, male veterans were less likely to rate their health as excellent or very good than male non-veterans (45% compared with 57%, respectively), and reported a higher prevalence of several long-term health conditions than male non-veterans. This may be explained by the older age of Australia’s male veteran population.
- Data on mental health conditions are complicated due to methological differences between data sources. In 2020–21 NHS, male veterans were more likely to self-report a current and long-term mental or behavioural condition than male non-veterans (27% compared with 17%, respectively). In particular, they were nearly twice as likely (21%) to report having a long-term anxiety-related disorder compared with male non-veterans (11%).
- According to self-reported data from the 2020–21 NHS, almost 2 in 5 (37%) male veterans had a disability with a limitation or restriction, while 1 in 5 (20%) had a disability but with no limitation or restriction. These proportions were around twice as high as those of male non-veterans (17% and 12%, respectively).
- Between 1997 and 2022, males currently serving in the permanent or reserve forces were around half as likely to die by suicide as all Australian males. However, ex-serving males were 26% more likely to die by suicide than all Australian males. While the rate of suicide for ex-serving females was lower than that for ex-serving males, ex-serving females were more than twice as likely to die by suicide than all Australian females. The suicide rate for ex-serving males who separated involuntarily for medical reasons was around three times the rate of those who separate voluntarily (62.7 compared with 22.0 per 100,000 population per year). However, the suicide rate for ex-serving females was similar between those who separated involuntarily for medical reasons and those who separated voluntarily.
- Beyond The Finish Line: Research report, Celina H. Shirazipour, Emily Mayhew, Jessica Capaldi, et al., for Invictus Games Foundation, Forces of Mind Trust, (May 2024). The current report provides, to our knowledge, the first international longitudinal investigation of the benefits of international adapted sport competition for Service Members and Veterans experiencing physical and/or psychological illnesses and injuries. Having examined approaches to military sport recovery programming across 23 countries, we also present the first global guide to evidence-based best practices for competitive military adapted sport, with 71 best practice strategies identified that can support quality participation and outcomes in military sport recovery programming.
- Competitors in the Invictus Games Sydney 2018 experienced greater positive impacts on their wellbeing compared to non-competitors.
- The research highlighted the importance of the “between Games” activities to maintain health and wellbeing levels and found that the strategies that provide the most benefit were centred more on mental fitness skills and resilience training than on sports development.
- The benefit to participating in the Invictus Games was clearest during training when individuals are coming together regularly with their community and taking on new challenges, or when participating in the Invictus Games. In the long-term post-Sydney, when non-competitors were included in the Invictus community and provided with access to Hague 2020 training opportunities, including sport camps, selection trials, and eSport programming, they began to demonstrate improvements in well-being, sometimes narrowing the gap with competitors.
- The strategies that promote optimal outcomes from sport recovery programming are less about sport development and more about focusing on mental fitness skills by integrating formal resilience training alongside sport, as well as reinforcing resilience training after competition.
- Programming and sport strategies are often siloed with a focus on either physical or psychological illnesses or injuries. However, the experience of illness and injury is multi-faceted. Individuals experiencing both physical and psychological illness and injury often demonstrated poorer health outcomes regardless of whether an individual was a competitor or a non-competitor.
- Veteran social connectedness, Australian Institute of Health and Welfare (AIHW), (26 October 2023). Social connectedness plays a significant role in the health and wellbeing of veterans both during and after service. Strong social connectedness has been associated with an increase in social support networks and general happiness levels with reduced severity of Post Traumatic Stress Disorder (PTSD) symptoms and lower suicidality (Flack and Kite 2021). However, the risk and protective factors against poor social connectedness are not well researched in Australia’s veteran population. Analysis of Wave 21 HILDA data found that overall, Australia's veterans experienced similar or better social connectedness than the broader Australian population. However, analysis also revealed that some subgroups of veterans, such as those in poor general or mental health, were often at higher risk of issues with social connectedness than other veterans.
- Social isolation among veterans (9.4%) was similar to people who had never served in the ADF (11%). However, some subgroups of veterans were at greater risk than others.
- Loneliness among veterans (18%) was similar to people who had never served in the ADF (19%). However, some subgroups of veterans were at greater risk than others.
- Nearly 1 in 5 (19%) veterans volunteered. This was higher than people who had never served in the ADF (14%). Some subgroups of veterans had particularly high rates of volunteering.
- Two in 5 (40%) veterans were active members of clubs or associations. This was higher than people who had never served in the ADF (29%). Some subgroups of veterans had particularly high rates of active club or association membership.
- Over a quarter (27%) of veterans did not feel part of their local community. This was similar to people who had never served in the ADF (26%). However, this pattern differed among subgroups of veterans.
- Just over 1 in 5 veterans (22%) had infrequent social contact with persons outside their household (that is, once every three months or less). This was similar to people who had never served in the ADF (20%). However, some subgroups of veterans were at greater risk of infrequent social contact than others.
- Adaptive sport programs for Australian Defence Force veterans, Senate Foreign Affairs, Defence and Trade References Committee, Parliament of Australia, (May 2023). The committee conducted an inquiry to examine the role of adaptive sport programs [and sport more broadly] for Australian Defence Force veterans in addressing issues identified by the ongoing Royal Commission into Defence and Veteran Suicide. The committee recognises the overwhelming evidence of the benefits that adaptive sports have provided and continue to provide to veterans and their families. The committee notes the range of activities that are now available across the sporting paradigm for veterans to participate in, and acknowledges the role that many organisations, sporting bodies, and codes have played to ensure these activities are available. That said, the benefits to veterans could be better realised through greater coordination and a stronger focus on the role of sport in supporting veteran wellbeing.
- Understanding the wellbeing characteristics of ex-serving ADF members, Australian Institute of Health and Welfare (AIHW), (1 September 2022). Findings from this report show that the majority of ex-serving ADF members were doing well in 2016. Many had attained higher education qualifications, were employed, earned higher incomes than the Australian population, owned their own homes (including those paying mortgages), and were socially connected by living in a family type household. It is important to note however this was not the case for everyone. Those who separated from the ADF involuntarily for medical reasons experienced wellbeing challenges such as higher unemployment rates, had lower levels of education qualifications, and were receiving lower incomes in 2016 than those who separated for any other reason. Those who served fewer years or who separated from the Navy experienced similar wellbeing challenges as mentioned above when compared to those who served longer or who served in the Army or Air Force.
- Rapid Evidence Assessment to identify strategies to support and sustain healthy behaviour as part of active ageing in Australian veterans: Summary Report, N Warren, B Barbosa Neves, K Hutton Burns, et al., Monash University for the Australian Government, Department of Veterans’ Affairs, (February 2022). Findings suggest that successful and healthy ageing interventions should be informed by a set of core priorities, namely: 1) address social isolation and loneliness, 2) promote movement and physical exercise, 3) cognitive functioning, 4) quality of life and wellbeing, 5) consider veteran identity, and 6) reduce risk behaviours and mitigate risk factors. A military identity can contribute to a sense of connection among veterans. It can change over time and result in both positive and negative outcomes. Those who can combine a military and civilian/family social identity have more stable transitions and civilian re-integrations characterized by a heightened sense of belonging. Studies suggest that veterans may be more likely to take part in peer support programs run by veterans than in non-veteran programs.
- Exercise provides a wide range of physical, cognitive, mental, and other health benefits for midlife and older people. Many of the intervention articles contained in the REA supported maintaining physical movement as an important aspect of active ageing.
- Active Choices: A ‘stepped-down’ program to promote self-managed physical activity in DVA clients: Summary Report, Nicholas Gilson, University of Queensland for the Australian Government, Department of Veterans' Affairs, (December 2021). Self-managing physical activity can be challenging and programs that help DVA clients to manage their own physical activity regimes are needed. This project developed and trialled a new physical activity support program for DVA clients called Active Choices. The Active Choices program is based on a strong theoretical framework and incorporates evidence based BCTs to support clients as they transition to self-managed PA. These BCTs include education, goal setting, goal review, self-monitoring, action planning and social support. 35 participants were recruited into the study. Participants were typically older male veterans (mean age = 61 years; 77% male), who lived with their partner, children, or both (68%); were retired (56%) and had acquired an educational qualification past high school (80%). The majority of the sample (94%) were non-smokers. Most (62%) met current nutrition guidelines for fruit consumption, but few (6%) met guidelines for vegetable consumption. The majority (68%) did not engage in hazardous drinking, or only did so less than monthly. Most of the sample (68%) were overweight or obese (average BMI = 29 kg/m²).
- The most successful recruitment strategy involved advertising the program directly to clients through DVA and ex-service organisation communication channels. 75% of expressions of interest and participant sign-ups came from these sources, highlighting this recruitment process as a preferred option for future work.
- Device-based measures indicated that only 16% of the sample were meeting the recommended guidelines for PA (i.e., 150 minutes/ week of moderate-intensity PA) at baseline. At the end of the program, this had increased to 42%.
- Self-accountability was a key mechanism underpinning this PA change. Participants frequently identified three BCTs within the program which they believed drove their motivation and accountability, and consequently, improved their PA levels: self-monitoring, action planning and goal setting.
- 46% of the sample reported at the end-program interview that their social connectivity had improved as a result of the program. This was achieved through attending the program’s meet-and-greets and engaging in group-based PA opportunities that were supported through Active Choices.
- At interview, 76% of participants reported benefits to psychological wellbeing. Process and interview data identified improvements in mood, and a sense of achievement that was experienced through selfmanagement of PA regimes. Survey scores on anxiety and depression were seen to reduce over time, with the proportion of participants reporting no issues increasing from 26% at baseline to 40% at follow-up.
- Participants incurred less costs for EP and physiotherapy services during the study ($60.51/week) than the ‘average’ DVA client who accessed these services in 2020 ($97.06/week), although caution should be used in assuming this was due to the intervention given the absence of a comparative group. At the follow-up interview, 36% of participants (n = 9) identified that they were seeing their EP or physiotherapist less frequently or not at all and had, through the support of the program, started selfmanaging their condition more regularly at home.
- The data provides evidence that Active Choices had a positive impact on those DVA clients who participated in the program. There was evidence of an increase in PA across the program and into follow-up, with participant feedback highlighting a move towards more self-managed PA. Improvements in social connectivity and support networks were observed, with this facilitated by Active Choices: A ‘stepped-down’ program to promote self-managed physical activity in DVA clients engagement with local PA communities. Aspects of psychological wellbeing, such as positive mood, were also seen to improve over the duration of the study.
- ‘Stepped-down’ Intervention Programs to Promote Self-managed Physical Activity in Service Veterans and their Dependants: Summary of the Rapid Evidence Assessment, Gilson ND, Papinczak ZE, Mielke GI, et al., University of Queensland for the Australian Government, Department of Veterans' Affairs, (November 2019). The aim of this Rapid Evidence Assessment (REA) was to: 1) examine the scientific literature for evidence on the effectiveness of interventions to promote self-managed physical activity in service veterans and/or their dependants; 2) assess studies that compared the effectiveness of ‘stepped-down’ models of PA self-management to ‘usual care’ controls and; 3) identify key behaviour change techniques that have been used in these studies to successfully promote physical activity change.
- Overall, 64% (n=18) of studies (service veterans only) found positive intervention effects (physical activity, physical function/fitness, psychological health or social support).
- When considering only those selected studies that compared a ‘stepped-down’ intervention to a ‘usual care’ group (n=14), 79% of studies (n=11) observed a positive between-group intervention effect in the primary outcome of physical activity; the mean magnitude of change was 53 minutes/week of self-reported moderate intensity physical activity.
- All included studies were from the United States. The REA found no Australian based studies that met inclusion criteria, or positive intervention effects with dependants. The generalisability of findings to DVA clients was therefore rated as: Unknown – insufficient evidence of beneficial effect, and further research required.
- Adaptive Sports for Disabled Veterans, Nancy Greer, et al., prepared for Department of Veterans Affairs (USA), (February 2019). The purpose of this report is to systematically review the available evidence on the benefits and harms of adaptive sports participation and the barriers to and facilitators of participation. The report was intended to guide the VHA in developing, making available, and evaluating regional and national adaptive sports programs for Veterans that go beyond general recommendations to participate in sports.
- What are the physical and mental wellbeing benefits veterans achieve through participating in sporting activities? A Rapid Evidence Assessment: Summary Report, Milanese, S, Crocker, M, Ransom, M, et al., for the Australian Government Department of Veterans’ Affairs, (2018). The aim of this Rapid Evidence Assessment (REA) was to examine the evidence to investigate the physical and mental wellbeing benefits veterans achieve through participating in sporting activities and whether these benefits are linked to the type of sporting activity being undertaken. Reflecting the broad definition used in this review, the sporting activity interventions featured in this review fell into six categories: structured competitive sport; supervised aerobic exercise; supervised mind body exercise; supervised combined aerobic and anaerobic exercise; unmonitored unsupervised physical activity and structured recreational physical activity.
- Based on the findings of this REA, sporting activity was overall categorised as ‘promising’ as a means to benefit veteran mental wellbeing but received a ranking of ‘unknown’ for its effect on veteran physical wellbeing.
- The evidence base of this REA is at a relatively low level, due to a reliance on cohort studies and the small number of higher level of evidence studies (2 SRs, 2 RCTs). Therefore, the findings of this REA need to be interpreted in this context and future, more rigorous studies are required to investigate the relationship between sporting activity and veteran mental and physical wellbeing.
- Based on the evidence contained in this REA, and the small number of reported adverse events, any form of sporting activity could be considered as a supplement to any veteran, mental wellbeing program.
- Mental Health Prevalence, Mental Health and Wellbeing Transition Study, Van Hooff M, Lawrence-Wood E, Hodson S, et al., the Department of Defence and the Department of Veterans’ Affairs, (2018). This report investigates the prevalence of 12-month and lifetime mental disorders, trauma exposure, suicidal ideation and self-reported mental health symptoms among Transitioned ADF members. Comparisons are also made between the self-reported mental health symptoms in Transitioned ADF with 2015 Regular ADF members and where possible, with the Australian Community.
- Approximately, 84% of the Transitioned ADF were either working or engaged in some purposeful activity with 62.8% being employed. Just over 5.5% of the Transitioned ADF had retired.
- Just over one-fifth of the Transitioned ADF were estimated to have been medically discharged.
- Almost three in four Transitioned ADF members are estimated to have met criteria for a mental disorder at some stage in their lifetime that is either, prior to, during or after their military career.
- Anxiety and (46.1%) Alcohol disorders (47.5%) were the most common classes of lifetime disorder.
- One quarter of Transitioned ADF members were estimated to have met criteria for posttraumatic stress disorder (PTSD) in their lifetime (24.9%).
- Just over half of the Transitioned ADF had not experienced a mental disorder in the previous 12 months. 46.4% of Transitioned ADF members are estimated to have experienced a mental disorder in the previous 12 months.
- Anxiety disorders were the most common type of 12-month mental disorder among the Transitioned ADF with over one in three (37.0%) experiencing an anxiety disorder in the last 12 months. PTSD (17.7%), panic attacks (17.0%), agoraphobia (11.9%) and social phobia (11.0%) were the most common types of anxiety disorders in the Transitioned ADF.
- One in five (23.1%) Transitioned ADF are estimated to have experienced an affective disorder in the last 12 months. The most common affective disorder type in Transitioned ADF was depressive episodes (11.2%).
- 12.9% of the Transitioned ADF met criteria for an alcohol disorder in the last 12 months.
- Just over 20 per cent of Transitioned ADF experienced suicidal ideation, plans or attempts in the last 12 months, with 2.0% of Transitioned ADF reported having attempted suicide.
- Transitioned ADF who had been medically discharged had significantly higher rates of affective, anxiety and alcohol disorders and suicidality than those who discharged for other reasons.
- Compared to 2015 Regular ADF, nearly twice as many Transitioned ADF had high to very high psychological distress (33.1% vs 18.7%).
- Levels of psychological distress in the Transitioned ADF were significantly higher than the Australian Community, with almost three times more Transitioned ADF reporting high to very high psychological distress (33.1%) compared to the Australian Community (12.8%). Patterns of psychological distress were similar in the Australian community and the Transitioned ADF for males and females and consistent across all age bands.
- Frequency of alcohol consumption in the last 12 months was similar for the Transitioned ADF compared to the Australian Community, but results varied by age and sex. A significantly higher proportion of Transitioned ADF females reported drinking daily, weekly and monthly compared to Australian Community females.
- Physical Health Status Summary Report, Mental Health and Wellbeing Study, Kelsall, H., Sim, M., Van Hooff, M., et al., Australian Government, Department of Defence and the Department of Veterans’ Affairs, (2018). This Physical Health Status Study compared the self-reported physical health of Transitioned ADF members who had transitioned out of full-time regular service in the five years between January 2010 and December 2014 with that of Regular ADF members in 2015, using general health indicators as well as indicators relevant to several body systems. Overall, Transitioned ADF members were more likely to report poorer physical health, to have increased lifestyle risk factors, and to report poorer self-perceived health, satisfaction and quality of life than 2015 Regular ADF. Among the Transitioned ADF, poorer physical health outcomes overall were reported for DVA clients compared with those who were not DVA clients, for Ex-Serving members compared with Active Reservists or Inactive Reservists, and for those who had been medically discharged compared with those who had been discharged for other reasons.
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Further reading
Research
- Military Sports Recovery Athletes’ Perspectives on Role of the Coach in Athletes’ Well-Being: The Importance of Supporting Basic Psychological Needs, Nicola Jordan, Stephen Macdonald, Justine Allen, Adapted Physical Activity Quarterly, Volume 42(1), pp.114-132, (2025). The purpose of this study was to investigate the experiences of athletes in a competitive military sports recovery program with a specific focus on the extent to which coaches supported, or frustrated, athletes’ basic psychological needs. Eight military veteran athletes competing in parasport took part in semistructured interviews. The accounts of their experiences of working with coaches in this context and their influence on their psychological needs and well-being were thematically analyzed. Results demonstrated that coaches’ behaviors that support basic psychological needs can have positive effects on athletes’ well-being and support their wider rehabilitation. Furthermore, frustration of these needs through controlling behaviors contributed to psychological ill-being. Findings suggest practical implications to help inform coaching practice to support optimal recovery and an environment that promotes well-being.
- The Contribution of Sport in the Rehabilitation Process of Disabled Military Veterans: A Case Study of the 2016 Invictus Games, Ian Brittain, Kyle Bunds, Jason Bocarro, Journal of Global Sport Management, Volume 9(1), pp.62-85, (2024). A growing body of research highlights the positive impacts of sport and physical activity upon the physical and mental well-being of traumatically injured military personnel. This study, conducted at the 2016 Invictus Games in Orlando, Florida, sought to understand the role of sport in the rehabilitation process of military personnel who have undergone traumatic injury or have experienced chronic illness. Data were derived from in-depth focus groups, semi-structured interviews, and open-ended questions with competitors, team managers, and family members. Findings indicated that the use of sport and physical activity has been an effective rehabilitation tool for those who competed. Tactics such as goal setting and team mentality, often critical components of both sport and military training, are helpful in allowing these competitors to reconnect with their military identity, without the negative implications of self-comparison. However, following conventional rehabilitation to optimise all available function, participants in this study found that sport or competitive rehabilitation, as some called it, brought with it several potential benefits that assisted them in moving towards some semblance of post traumatic growth. Overall, it would appear that the participants taking part in the Invictus Games had, through participation in sport/ competitive rehabilitation, achieved a level of post traumatic growth that helped them undergo a significant improvement upon their outlook on life. This helped them adjust to their new situation to such an extent that they no longer concentrate on their physical loss and their change in physical ability, but instead have developed an appreciation of their existing ability i.e., they have achieved, or are at least moving steadily towards, a new ‘normal’.
- Benefits identified included connection to others and sense of belonging stemming from their military identities and a renewed sense of (military) camaraderie and social relatedness, improved strength and function. Sport offered an opportunity to improve the athletes’ physical competence through improving physical ability post-injury.
- Two subthemes became clear from the research participants regarding exactly how rehabilitation through sport might assist in positive psychological changes amongst the competitors - sport providing a purpose and sport as a release for aggression.
- Physical Activity Participation, Quality of Life, and Behavioral Health Disorders for Veterans with PTSD, McDonagh, Krista; Bennett, Jessie; Geden, Sarah, Therapeutic Recreation Journal, Volume 58(1), pp.96-114, (2024). The growing prevalence of behavioral health disorders in veterans has triggered a wide-spread effort to identify and provide complementary interventions. This study investigated physical activity as a complementary treatment option for veterans with posttraumatic stress disorder (PTSD) for recreational therapy (RT) programs. A correlational survey research design was used to examine relationships between participation in three types of physical activity (traditional indoor fitness, outdoor adventure activity, and mind-body practices) and four psychosocial measures for veterans with PTSD (depression, anxiety, health-related quality of life [HRQoL], and substance use). A total of 102 participants completed the online survey. Results indicated that the frequency and duration of traditional indoor fitness activities and outdoor adventure activities were significantly associated with higher HRQoL, lower reoccurrence of substance use risk, substance use, and depression. Implications for the use of physical activity in recreational therapy for veterans with behavioral health disorders and future research studies were presented.
- Unveiling the Influence of Competitive Sports on the Sense of Self and Identity of Disabled Veterans: A Systematic Review and Mixed-Methods Synthesis, Anna Hendrick, Eve Binks, Neil Ferguson, et al, Identity: An International Journal of Theory and Research, Volume 24(3), pp.194-212, (2024). Veterans can encounter identity struggles upon departure from the military which are intensified if veterans have sustained a disability or life altering injury. Physical activity has been shown to empower disabled veterans to cultivate a positive post injury identity. The purpose of this systematic review was to synthesize the evidence available on disabled veterans’ experience participating in competitive sport and explore the impact competing has on their self-identity. Studies were eligible if they were: 1) Published in English between 2012–2023 in a peer reviewed journal; 2) included veterans with a disability who participated in competitive sports; 3) explored veterans’ self-identity. Searches were conducted in four databases: SportDiscus; PsycInfo; Psycharticles; EBSCO. Nine articles met the eligibility criteria. Studies were assessed and a convergent integrated mixed methods synthesis was carried out. Findings were aggregated into three themes: 1) The importance of social connections for self-identity; 2) Self-views and quality of life; 3) Sport and the establishment of a new self. Competitive sport enables disabled veterans to cultivate a positive post-injury identity, whilst also restoring an affiliation with their previous military identity. Findings suggest that competing in sports positively impacts disabled veterans’ identity recovery.
- Process evaluation of the Invictus Pathways Program, Dannielle Post, Amy Baker, Steven Milanese, PLOS One, (November 2023). UniSA’s Invictus Pathways Program (IPP), a service program, was originally developed to assist veterans to train for and participate in the Invictus Games. More recently, the scope of the IPP has widened to support and improve wellbeing and facilitate post traumatic growth and recovery among participants who are living with physical and mental health injuries and conditions. This paper describes the components of the IPP and reports its process evaluation. This process evaluation has demonstrated that the physical activity training components of the IPP were delivered with high levels of fidelity, and that satisfaction with the IPP is mostly high, although there are areas that could be improved. There is a need for a more structured approach to the ongoing evaluation of the IPP. This includes ensuring that program staff have a shared understanding of the purpose of evaluation activities and that these activities occur as intended. Beyond this is the need to secure funding to support the sustainability of the IPP, so that it can continue to contribute to the wellbeing of veterans living with physical and mental health conditions, and their families.
- The physical, psychological, and social impacts of participation in the Invictus Pathways Program: A qualitative analysis of veterans’ perceptions and experiences, Dannielle Post, Amy Baker, Steven Milanese, et al., PLOS One, (October 2023). UniSA’s Invictus Pathways Program (IPP) is motivated by the spirit of the Invictus Games to mobilise the benefits of sport to aid physical, psychological, and social wellbeing. Originally developed to assist veterans to train for and participate in the Invictus Games, the program has extended its scope to promote recovery and wellbeing for all veterans through physical activity. This paper describes the expectations and experiences of the IPP from the perspective of program participants. The qualitative analysis identified five higher order themes: Life experiences prior to participation in the IPP, Making a choice to participate in the IPP, Expectations of participation in the IPP, Impact of participation in the IPP, and Future Plans. There were perceptions that the IPP was beneficial for the participating veterans, irrespective of their physical and psychological health status. Participants described the positive impact of the IPP on their physical fitness, their social engagement, and their sense of belonging within the IPP and the university. Participants perceived the IPP to be an opportunity for them to ‘give back’ by contributing to the education of the students delivering the IPP. Participants reported the intention to continue being physically active. For some, this meant selection in an Invictus Games team, for others, this meant getting involved in community sporting organisations.
- I AM FAMILY: Understanding the adapted sport experiences of family members of military personnel with physical and psychological illnesses and injuries through the lens of the Invictus Games, Amber Duong, Lauren Roberts, Heidi Cramm, et al., Psychology of Sort and Exercise, Volume 68, 102457, (September 2023). The current study sought to explore the experiences of families in adapted sport through the context of the Invictus Games, an international adapted sport competition for military personnel with physical and psychological illnesses and injuries that is unique in its inclusion of family programming. Family members (n = 21; partners, parents, siblings, and children) of Invictus Games Toronto 2017 competitors participated in semi-structured interviews. Data were analyzed using reflexive thematic analysis. Three themes were identified: recognition of family experiences during service and after onset of disability; creating a sense of belonging; and improving family knowledge and perceptions. This study provides insight regarding how adapted sport events can support the well-being of both individuals with illnesses and injuries and their families.
- The effectiveness of the National Veterans Summer Sports Clinic for veterans with probable posttraumatic stress disorder, Kristen Walter, Nicholas Otis, Michal Kalli Hose, et al., Frontiers in Psychology, Volume 14, (July 2023). The sample included 74 U.S. veterans who participated in the National Veterans Summer Sports Clinic (NVSSC), an annual, week-long adaptive sports program in San Diego, California. Participants were categorized into two subgroups: those who met criteria for probable PTSD using the PTSD Checklist for DSM-5 (n = 20) and those who did not (n = 54). Participants completed self-report assessments before and after each daily activity, before and after the program, and 3 months following program completion. Over the course of NVSSC program participation, the diagnostic subgroups (probable PTSD vs. no PTSD) did not significantly differ on changes in depression, positive affect, negative affect, or insomnia. Compared to those without PTSD, veterans with PTSD experienced greater reduction in generalized anxiety during the program). Veterans with PTSD also experienced significant improvements in PTSD symptoms at postprogram. For both groups, significant benefits were shown during the program but rebounded by the 3-month follow-up. Over the course of each daily activity, positive affect and depression/anxiety scores significantly decreased, with no differences between PTSD diagnostic groups across time.
- Sustained positive behaviour change of wounded, injured and sick UK military following an adaptive adventure sports and health coaching recovery course, Sutton RJ, Kay CWP, McKenna J, et al., BMJ Military Health, Volume 169(6), pp.499-504, (2023). A rising trend has occurred in the physical and mental health challenges faced by recovering UK service personnel. To support these individuals, bespoke inclusive multiactivity and adventurous training courses (MAC) have been developed. Unlike many outdoor adventure therapy programmes, the MAC is delivered to recovering UK military personnel who are still serving in the armed forces, although they may have discharged from the service prior to the 1 year follow-up. This study investigated the MAC’s influence on participants’ ability to sustain day-to-day changes that facilitate positive mental health and psychological need satisfaction. The 146 UK service personnel who participated in this study attended a five-day MAC 12 months ago. Positive behaviour changes were reported by 74% of the respondents. These changes align with positive psychological well-being (98%). Impactful elements of the course experienced by participants mostly aligned with the three basic psychological needs of autonomy (34%), competence (36%) and relatedness (61%). Recovery support programmes that encompass health coaching adventurous activities, such as the MAC, can initiate long-term positive behaviour change for recovering military personnel. In this specific context, the concurrence of the self-determination theory concepts that underpin the course delivery and participant outcomes is a powerful endorsement of implementation fidelity.
- Wounded warriors: Multiple identities, physical activity and life satisfaction, Martin, Jeffrey; Martin, Adam; Snapp, Erin; et al., Acta Universitatis Carolinae: Kinanthropologica, Volume 59(1), pp.5-17, (2023). The purpose of the current study was to examine a model specifying that military, athlete, exercise, and disability identities would predict life satisfaction as mediated by physical activity (PA). Methods: Seventy-one military veterans (N = 71) with impairments participated and completed Exercise, Athlete, Disability, Military, identity scales and Life Satisfaction and PA questionnaires. Results: A mediation model indicated the indirect effect of the four identities on life satisfaction through PA was not significant However, PA was predicted by the 4 identities, [F (4, 66) = 2.49, p = 0.05] and accounted for 13% of the variance, with disability identity having the only significant beta weight. Life satisfaction was also predicted by the 4 identities and PA ([F (5, 65) = 4.88, p = 0.001] and accounted for 27% of the variance. However, only the military and athletic identities had significant beta weights. Conclusions: Our findings provide preliminary support for the value of military veterans maintaining a military identity and holding an athletic identity. The current findings suggest that sport psychologists and rehabilitation professionals take a more nuanced and open-minded perspective about veterans who desire to maintain a military identity when becoming civilians
- The Impact of Adaptive Sports and Physical Activity for Veterans with Disabilities: A Synthesis Project [masters thesis], Rachel Mezzoni, The College at Brockport, (December 2022). Over the years, adaptive sports and physical activity has become more prominent to support individuals with disabilities. Veterans with a disability tend to have a more unique situation while living with a disability because of the demands from being in service. While reviewing existing research, it has shown that adaptive sports and physical activity impact veterans who have a disability in multiple different facets. Three key themes were found in the research: the physical, psychological, and social benefits, the impact of community engagement, and the access veterans have to programs and the conditions within the program. The purpose of this synthesis project was to review the literature on the impact adaptive sports and physical activity has on veterans with physical disabilities.
- Acute influence of an adaptive sporting event on quality of life in veterans with disabilities, Alexis Sidiropoulos, Jonathan Glasberg, Timothy Moore, et al., PLOS One, (November 2022). Veterans with disabilities can experience poor quality of life following military service due to the associated negative physical and psychological ramifications. However, participation in physical activities has shown to induce both physical and mental benefits and improve the quality of life of this population. Adaptive sports, an innovative approach to address the unique physical and psychosocial needs of veterans with disabilities, are becoming more widely used as a rehabilitation tool to improve the quality of life for these veterans. This study aimed to determine the acute influence of participation in a single-day, veteran-based, adaptive kayaking and sailing event on the perceived overall health, quality of life, and quality of social life of veterans with varying disabilities. It was hypothesized that all three categories and the sum score of quality of life would reflect a positive acute response after participation in the community-based physical activity event. Veterans responded to three quality of life-related questions using a 5-point Likert scale before and directly after participating in the event. Findings indicated that an adaptive sporting event can have an acute positive influence on the quality of life of veteran participants, with improvements observed in all three categories of perceived quality of life. Therefore, it is advantageous for the whole-health rehabilitation of veterans with disabilities for the Department of Veterans Affairs to continue to provide opportunities for veterans to participate in non-traditional, community-based activities.
- Is exercise/physical activity effective at reducing symptoms of post-traumatic stress disorder in adults — A systematic review, Ferozkhan Jadhakhan, Nichola Lambert, Nicola Middlebrook, et al., Frontiers in Psychology, Volume 13, (August 2022). Thirteen studies, including several that included military veteran participants, from four countries involving a total of 531 patients were selected for inclusion. Individual forms of exercise/physical activity examined showed some effect on reducing PTSD symptoms but combined exercises (resistance training, aerobic, strength and yoga) administered over a 12 week period, three times a week for 30–60 min showed greater effects on PTSD symptoms. The authors concluse that the limited evidence suggests that a combined exercise intervention has the best evidence for a having a beneficial effect on PTSD symptoms.
- ‘More Important Than Winning’: a Retrospective Online Research Survey Evaluating the Effects of Participating in an Adaptive Sports Program for Wounded, Injured and Ill Australian Defence Force Veterans. Lewis, A. Journal of Military and Veterans’ Health. Volume 30(3). (July 2022). The Australian Defence Force (ADF) Adaptive Sports Program offers participation in recreational and competitive sports to wounded, injured or ill veterans to support rehabilitation, recovery and social reintegration. There has been limited research on the impact of sport participation on the physical and mental health and wellbeing of current and former serving ADF veterans. A survey was sent to 210 ADF Adaptive Sports Program participants in training camps for preselection for the Invictus Games and Warrior Games 2018–2020. Survey questions invited participants to reflect on their involvement in the program over the previous 2 years. Responses were received from 29% of program participants.
- Among the 60 respondents, 78% reported greater engagement in physical activity after participation, and 89% reported that they had experienced a positive effect on their rehabilitation pathway.
- These preliminary findings demonstrate that the Adaptive Sports Program increases physical activity and supports rehabilitation, recovery and reintegration for engaged participants competing in local and international events.
- Further research is needed to identify outcomes in the wider group of program participants and confirm that the program is an effective strategy for supporting wounded, injured and ill veterans.
- Targeted program promotion to veterans discharging from ADF, particularly the 18% discharging for medical reasons, with timely follow-up at designated intervals (e.g. at 3, 6 and 12 months), has the potential to engage veterans early in their transition and rehabilitation pathway. The ASP requires appropriate resources, financial and personnel, to support this. Providing veterans with funding through subsidies and grants could also facilitate engagement in community sport. Ongoing participation in community sport should precede enrolment in key events such as Invictus Games or Warrior Games.
- Extreme sport as an intervention for physically injured military veterans: the example of competitive motorsport, Danai Serfioti, Nigel Hunt, Disability and Rehabilitation, Volume 44(24), pp.7566-7574, (2022). Physically or psychologically injured military veterans are motivated and benefited by physical activity or sport that may involve high levels of achievement. The aim of this study was to provide an in-depth insight into the impact of Competitive Motorsport (CM) on physically injured/disabled veterans’ subjective well-being and in turn determine if it improves the quality of their lives. Two sets of semi-structured interviews were conducted with 14 male British military veterans including a 6-month follow-up. All participants were subjected to a permanent, moderate or severe, physical injury/disability. Five key elements (familiar environment, team spirit, adrenaline rush, competition and equality) made CM a unique experience for physically injured/disabled veterans. Various psychological and physical benefits were found, including an increased sense of accomplishment, opportunity to socialise in a non-clinical environment, embracement of body image and adoption of a healthier lifestyle. Since physical activity and sport are among growing research on alternative interventions for military veterans, they deserve serious consideration as part of the treatment regimens and rehabilitation programmes to improve physically inured/disabled veterans’ physical and mental health.
- Perceived barriers to, and benefits of physical activity among British military veterans that are wounded, injured, and/or sick: a Behaviour Change Wheel perspective, Robert Walker, Martin Colclough, Caroline Limbert, et al., Disability and Rehabilitation, Volume 44(6), pp.900-908, (2022). Many British military veterans that are wounded, injured, and/or sick (WIS) face significant physical, psychological and social challenges following discharge from the military. There is increasing evidence to support the application and benefit of physical activity for veterans that are WIS. The aim of this study is to identify the perceived barriers to, and benefits of physical activity among veterans that are WIS. Nine semi-structured interviews were conducted to explore perceived barriers to, and benefits of physical activity amongst veterans that are WIS. A thematic analysis was conducted, and themes mapped to the Behaviour Change Wheel’s capability, opportunity, motivation–behaviour (COM-B) model. Perceptions related to physical capability, psychological capability, physical opportunity and reflective motivation were predominant barriers to engagement in physical activity. As well providing opportunities to socialise, the perceived benefits of engagement in physical activity seemed to mirror the perceived barriers, suggesting a reciprocal relationship. Using the Behaviour Change Wheel, incentivisation, education, persuasion, enablement and environmental restructuring were identified as potentially beneficial intervention functions when seeking to increase levels of physical activity among veterans that are WIS living within the United Kingdom.
- Quality Participation in Military Veterans with an Acquired Physical Disability, Hannah Strasdin, Stephanie M. Flood, Celina Shirazipour, Canadian Disability Participation Project, (November 2021). This knowledge translation bulletin summarizes published research that examines the experiential elements of quality participation and pathways through which military veterans with an acquired physical disability initiate and maintain physical activity long-term. Four experiential elements and three pathways were identified and can be integrated into programming to promote long-term physical activity participation for adults with acquired disabilities.
- Self-Representations of Military Veterans Suffering From Chronic Post-traumatic Stress Disorder: The Role of Sport, Celia Belrose, Anais Duffaud, Dominique Levy, et al., Frontiers in Psychiatry, Volume 12, (November 2021). This exploratory qualitative study examined the self-representation of veterans with chronic PTSD before a sport rehabilitation program. Veterans were given the prompts “body” and “person” and asked to free associate. PTSD severity and the mind–body connection were assessed using the Posttraumatic Stress Disorder Checklist for DSM-5, and the Freiburg Mindfulness Inventory, respectively. Parasympathetic activity was recorded at rest. A subgroup of the population volunteered to participate in a post-program session to record the same semantic, psychological, and physiological variables. Although before the program, veterans gave more negatively than positively valenced words, no relation was observed between the overall number of negative words and PTSD severity. Post-program, changes were observed in terms of valence. Specifically, some negatively-valenced categories of words disappeared, and some positive categories appeared. At the same time, there was a fall in PTSD severity, an increase in the mind–body connection, and a decrease in parasympathetic activation. This study highlighted that veterans with chronic PTSD have a negative representation of the self. A dedicated, 9-day program that included regular sport improved self-representations related to both the person and their body, and reduced PTSD symptoms. The findings underline the importance of ensuring that programs for patients suffering from chronic PTSD should include sporting activity, and highlight the benefits. Sport appears to be a path to the reappropriation of a positive image of the self, by improving the representation of the body. This relationship could be consistent with improved interoception, but our results need further investigation.
- Demographic and Functional Characteristics of National Veterans Wheelchair Games Participants: A Cross-sectional Study, Cecelia Rose Lee-Hauser, Richard Schein, Vince Schiappa, et al., Military Medicine, Volume 186(7-8), pp.e749-755, (July-August 2021). The purpose of this study was to establish a baseline of common characteristics of the Veteran population that participated in the National Veterans Wheelchair Games (NVWG) in 2017 and 2018, including their perception on how their participation is associated with function and social factors. A sample of 426 Veterans, 87% who were male and an average population age of 56 years old, reported high FMA scores on each of 10 items (daily routine, comfort, health, operate, reach, transfer, personal care, indoor mobility, outdoor mobility, and transportation) along with SPORTACUS scores scoring above 5, based on a 1-6 scoring scale (1 being “completely disagree” and 6 being “completely agree”), on each domain indicating sports participation is associated with their ability to function and participate in the community. Based on these results, it can be concluded for this military Veteran population that participation in a large, organized adaptive sports programs such as the NVWG has a positive association with daily function, quality of life, community participation, and use of higher quality assistive technology.
- The National Veterans Summer Sports Clinic: Change and duration of psychological outcomes, Kristen Walter, Nicholas Otis, A.C. Del Re, et al., Psychology of Sport and Exercise, Volume 55, 101939, (July 2021). The current study evaluated the psychological outcomes of attendees of the 2017 and 2018 National Veterans Summer Sports Clinic (NVSSC) in San Diego, California. Seventy-four veteran participants completed self-report assessments before and after the week-long program, as well as 3 months following program completion. In addition, participants completed brief assessments before and after each of the daily recreational activities (cycling, surfing, sailing, kayaking, and archery/pickleball). Findings showed that depression, anxiety, social functioning, and positive and negative affect significantly improved from pre-to postprogram, but returned to baseline levels at 3-month follow-up. Within sessions, depression/anxiety and positive affect significantly improved each day, with no differences in the amount of change across days. Depression/anxiety and positive affect also significantly improved within each activity, regardless of order, with no differences in the magnitude of change across activities. The NVSSC produced significant changes in psychological outcomes among veteran participants within immediate and short-term time periods; however, gains were not maintained longer-term. Follow-on engagement in exercise activities is likely necessary for continued benefit; future research, including studies with control groups, would provide greater clarity.
- Qualitative Analysis of a Supervised Exercise Program for Older Veterans With PTSD, Julia Browne, Alyssa Medenblik, Michelle Pebole, et al., The American Journal of Geriatric Psychiatry, Volume 29(6), pp.565-572, (June 2021). Older veterans with post-traumatic stress disorder (PTSD) experience substantial physical and mental health challenges. Given the well-known and wide-reaching benefits of exercise, exploring the impact of interventions designed specifically for this population would be valuable. As such, the present study explored perspectives from older veterans with PTSD who participated in Warrior Wellness, a 12-week supervised exercise intervention designed for older veterans with PTSD. This study was aimed at evaluating 1) facilitators of engagement, 2) perceived benefits from the intervention, and 3) recommendations about possible modifications to the intervention.
- Shared experience, program features, camaraderie during workouts, and accountability emerged as facilitators of engagement. Perceived benefits spanned physical health, mental health, and behavioral domains.
- Gender Differences in Psychological Outcomes Following Surf Therapy Sessions among U.S. Service Members, Lisa Glassman, Nicholas Otis, Betty Michalewicz-Kragh, et al., International Journal of Environmental Research and Public Health, Volume 18(9), 4634, (April 2021). This study compared changes in depression/anxiety (Patient Health Questionnaire-4), positive affect (Positive and Negative Affect Schedule), and pain (Numerical Pain Rating Scale) between U.S. service men and women (N = 74) during six weekly surf therapy sessions. Overall, participants reported decreased depression/anxiety and increased positive affect, but no change in pain rating following each session. Significant gender differences were found in the magnitude of changes in depression/anxiety and positive affect during surf sessions, despite no differences in pre-session scores on either outcome. Women showed greater improvements in depression/anxiety and positive affect compared with men—an important finding, given that surfing and military environments are often socially dominated by men. Future research is needed to replicate these findings in other samples, extend this research to other underrepresented populations, and identify barriers and facilitators of the sustainable implementation of surf therapy across populations.
- Experiences of Military Veterans in a Therapeutic Horseback Riding Program, Johnson RA, Albright DL, Marzolf JR, et al., Clinical Nursing Research, Volume 30(7), pp.923-933, (2021). Posttraumatic stress disorder commonly occurs among U.S. military veterans. Therapeutic horseback riding (THR) has emerged as an adjunct therapy. We explored 20 veterans’ perceived benefits, drawbacks and views of a 6-week THR program. Participants had confirmed diagnoses of posttraumatic stress disorder, traumatic brain injury, or both. Veterans rode the same horse weekly, the same day, at the same time. Data were collected as part of a randomized clinical trial testing the effects of THR on Post-Traumatic Stress Disorder. Veterans responded to an open-ended questionnaire. Content analysis was used for data analysis. Benefits were “Connection to the Horse,” “Relaxing,” “180 Degree Change,” and “Meeting New People.” Drawbacks were “None,” “Struggle to Get There,” “Pain,” “Too Short,” and “It is Structured.” Overall perceptions were “I Absolutely Loved It,” “Feel Again,” “The Horse,” “The People,” and “No Worries.” Participants viewed THR as positive. Findings may elucidate why THR may be clinically beneficial.
- Military veteran athletes’ experiences of competing at the 2016 Invictus Games: a qualitative study, Gareth Roberts, Rachel Arnold, Fiona Gillison, et al., Disability and Rehabilitation, Volume 43(24), pp.3552-3561, (2021). The aim of this study was to explore military veterans’ experiences of participation at the 2016 Invictus Games. Fifteen UK military veterans (10 male, 5 female) who participated in the 2016 Invictus Games were recruited. Semi-structured interviews were conducted to explore experiences pre, during, and post-competition, and analyzed using applied thematic analysis. Some key findings and recommendations include:
- Findings highlight that military veterans have unique motives to compete at the Invictus Games, including “reconnection with previously military life” and “being a role model”.
- Whilst veterans encounter team and culture organizational stressors while competing, they share similar post-Games experiences to full-time athletes, including the concept of “post-games blues”.
- Experiences shared by military veterans at the Invictus Games can aid in the promotion of sport as a viable form of recovery.
- Primary and secondary stress management strategies should be implemented with military veterans to reduce organizational stressors and their responses to them.
- Psychoeducation programmes should be introduced pre-Games to better prepare military veterans for their post-Games experience.
- University-Based Adaptive Sport Camps as a Model for Engaging Injured Military Veterans in Community Development, Arthur-Banning, Skye; Garst, Barry; Young Suk Oh; et al., Journal of Park & Recreation Administration, Volume 39(3), pp.105-119, (2021). As more veterans return home from active duty with injuries or retire with disabilities and seek to reintegrate into the community, adaptive sport programming is an important recreational opportunity. Specifically, improved quality of life, more fluid community reintegration, positive psychosocial outcomes, and overall improved health are all stated benefits of participation in adaptive sport programs for individuals with disabilities. This program engaged veterans or members of the armed forces with disabilities in a unique university-based adaptive soccer camp experience with three main goals in mind: (1) to expose the veterans to the adaptive soccer sports of CP/TBI soccer and blind soccer, (2) to provide U.S. Soccer grassroots coach certification, (3) and to identify talent for the U.S. Soccer Paralympic National Team. In addition to facilitating this experience for veterans, we evaluated the camp program based on three main research questions: (1) How do injured military veterans and professionals serving veterans with disabilities evaluate satisfaction in an importance by performance analysis? (2) To what extent is a university-based VA Adaptive Sport Camp a promising setting for learning soccer related skills? and (3) What do injured military veterans and professionals serving veterans with disabilities identify as barriers to participation? Evaluation findings indicated that veterans wanted more information about coaching, the students, and additional community opportunities and were not concerned about the accommodations or food choices at camp, further highlighting the importance of the adaptive sport nature of the program itself. Veterans identified several camp elements that worked well in a university-based setting such as student interaction, scheduling, and balance between being a participant and learning coaching skills and would encourage other colleagues to attend in the future. Finally, participants identified perceived barriers to future participation were based largely on travel distance and costs. Subsequently, the programmers have sought to provide more programs around the country with partner agencies and in so doing, reduce travel time and costs. Overall, this programming model has significant promise for growth and has already provided results consistent with positive community reintegration and increased veteran participation in soccer-related activities, which can pave the pathway for more in-depth program analysis.
- Pathways for Long-Term Physical Activity Participation for Military Veterans With a Physical Disability, Shirazipour CH; Latimer-Cheung AE, Adapted Physical Activity Quarterly, Volume 38(1), pp.1-24, (2021). A gap in knowledge exists regarding how to maintain physical activity (PA) for individuals with acquired disabilities following initial introductory experiences. The current study aimed to contribute to filling this gap by exploring the PA pathways of military veterans with a physical disability, particularly those who maintain long-term PA, from impairment to the present. Veterans with a physical disability (N = 18) participated in interviews exploring their PA history and experiences. A reflexive thematic analysis was conducted to generate common pathways in PA participation, as well as to examine which elements of participation supported PA maintenance. Three long-term pathways were identified—two parasport pathways and one recreational PA pathway. Four elements of participation (i.e., mastery, challenge, belongingness, meaning) supported to maintain PA at key junctures. This knowledge provides further understanding of how to promote long-term PA for individuals with acquired disabilities and can support advancements in theory, as well as program development.
- Outdoor recreational activity experiences improve psychological wellbeing of military veterans with post-traumatic stress disorder: Positive findings from a pilot study and a randomised controlled trial, Mark Wheeler, Nicholas Cooper, Leanne Andrews, et al., PLOS One, (November 2020). Exposure to the natural environment is increasingly considered to benefit psychological health. Recent reports in the literature also suggest that outdoor exposure that includes recreational pursuits such as surfing or fishing coupled with opportunities for social interaction with peers may be beneficial to Armed Forces Veterans experiencing Post-Traumatic Stress Disorder (PTSD). Two studies were conducted to evaluate this possibility. In particular, these studies aimed to test the hypothesis that a brief group outdoor activity would decrease participants’ symptoms as assessed by established measures of PTSD, depression, anxiety and perceived stress, and increase participants’ sense of general social functioning and psychological growth. Experiment one employed a repeated measures design in which UK men and women military veterans with PTSD (N = 30) participated in a group outdoor activity (angling, equine care, or archery and falconry combined). Psychological measures were taken at 2 weeks prior, 2 weeks post, and at 4 month follow up. We obtained a significant within participant main effect indicating significant reduction in PTSD symptoms. Experiment two was a waitlist controlled randomised experiment employing an angling experience (N = 18) and 2 week follow up. In experiment 2 the predicted interaction of Group (Experimental vs. Waitlist Control) X Time (2 weeks pre vs. 2 weeks post) was obtained indicating that the experience resulted in significant reduction in PTSD symptoms relative to waitlist controls. The effect size was large. Additional analyses confirmed that the observed effects might also be considered clinically significant and reliable. In sum, peer outdoor experiences are beneficial and offer potential to complement existing provision for military veterans with Post Traumatic Stress Disorder.
- Pilot randomized controlled trial of exercise training for older veterans with PTSD, Katherine Hall, Miriam Morey, Hayden Bosworth, et al., Journal of Behavioral Medicine, Volume 43, pp.648–659, (2020). Exercise training positively impacts mental health, yet remains untested in older adults with posttraumatic stress disorder (PTSD). We conducted a randomized controlled pilot trial to test the feasibility and acceptability of exercise training in older veterans with PTSD. Fifty-four veterans ≥ 60 years, with a DSM-V diagnosis of PTSD, were randomized to supervised exercise (n = 36) or wait-list (WL; n = 18). Primary outcomes included recruitment rates, attendance, satisfaction, and retention. Secondary outcomes included changes in PTSD symptoms, depression, health-related quality of life, and sleep quality; assessed at baseline and 12 weeks. There were no adverse events. Attrition was minimal (14%), and adherence to the exercise intervention was high (82%). Clinically significant improvements in PTSD and related conditions were observed following exercise. Exercise training is safe and acceptable in older adults with PTSD, may improve PTSD symptoms, and broadly impacts PTSD-related conditions. Future definitive trials are warranted.
- ‘Sport was the centre of my memories’: the performance of sport in Australia’s Asian garrisons, Sean Brawley, Mathew Radcliffe, Sport in History, Volume 40(1), pp.28-55, (2020). For better or worse, sport mirrors and mediates much of everyday life. Within both the military and colonial spheres, the physical attributes of sport are especially prized as tangible representations of social and cultural hierarchies. In turn, this further enhances the prestige and influence of sport within these two particular environments. Sport becomes particularly potent in instances where military forces undertake garrison duties in overseas colonial and post-colonial environs. This paper highlights the centrality of sport to the lives of the Australian service personnel and their families who were posted to Australia’s garrisons in the decades after World War II. The myriad roles of sport within these overseas garrison environments – as comforter, connector, healer and reinforcer on the one hand, and as isolator, oppressor and subverter on the other – are explored. This paper suggests that, for a variety of reasons, participation in sports served as the central organising force for most Australian service personnel and their families in these Australian military communities.
- A Longitudinal Examination of Military Veterans’ Invictus Games Stress Experiences, Gareth Roberts, Rachel Arnold, James Turner, Frontiers in Psychology, Volume 10, (August 2019). This study explored patterns of change in stress variables (i.e., stressors, appraisals, emotions) encountered by wounded, injured, and sick military veterans in the build up to, during, and following an international sporting competition. 40 Invictus Games (IG) athletes and a control group of 20 military veteran athletes completed questionnaires at seven time points over a 12-week period. Furthermore, participants provided morning and evening saliva samples at four time points to measure cortisol and secretory immunoglobulin A. Team and culture stressors and anger and dejection emotions significantly increased in the build up to competition, whilst challenge appraisals and excitement and happiness emotions significantly decreased over the same time-frame. A number of the stress related variables also predicted performance, well-being, and mental health. Specifically, organizational stressors and threat appraisals were found to negatively relate to performance, well-being, and mental health. Furthermore, whilst challenge appraisals and problem focused coping positively related to veterans’ well-being, adopting emotion-focused and avoidance coping strategies negatively predicted well-being and mental health. Turning to emotions, experiencing anger, anxiety, and dejection negatively related to mental health, well-being and performance; whereas happiness and excitement displayed a positive relationship with these outcomes. By understanding this study’s findings, practitioners and organizations can help to proactively prevent organizational demands and aid individuals in optimally responding and adapting to encounters, which can ultimately, help to mitigate negative outcomes and proliferate the positive outcomes for military veterans participating in competitive sport.
- Insights Following Implementation of an Exercise Intervention in Older Veterans with PTSD, Michelle Pebole, Katherine Hall, International Journal of Environmental Research and Public Health, Volume 16(14), (July 2019). Individuals with post-traumatic stress disorder (PTSD) face numerous barriers to exercise. Little is known about behavioral strategies to promote participation in this population. This is a secondary analysis of individual barriers and goals, exercise prescription characteristics, and patient perceptions of the Warrior Wellness program, a pilot randomized controlled trial of a 12-week, community-based, randomized controlled exercise trial targeting older adults with PTSD, (N = 45; mean age = 68; male = 91%). The exercise sessions were held from 9:00–10:30 a.m. at a community-based fitness center located in close proximity to the Durham Veterans Affairs Medical Center (VAMC). Veterans exercised in a group, but each received their own prescription and completed it separately. The most common cited goals for participating included weight loss (65%) and increasing strength (65%). Exercise mode varied among those who completed the program (n = 37), with 14 (38%) using exclusively treadmill; eight (22%) using only bike, and 15 (41%) utilizing a combination. Patient-reported exercise duration and intensity progressively increased over the 12 weeks, and duration differed by mode of exercise. We observed high rates of attendance (84%) and completion (88%) to the program. Patient-reported barriers to attendance most often included health problems (62%) and medical appointments (55%). Participant responses to a program evaluation revealed high levels of satisfaction, preferences for group-based programs, and insights about the acceptability of the exercise environment (physical and social).
- Can scuba diving offer therapeutic benefit to military veterans experiencing physical and psychological injuries as a result of combat? A service evaluation of Deptherapy UK, Alice Morgan, Harriet Sinclair, Alexander Tan, et al, Disability and Rehabilitation, Volume 41(23), pp.2832-2840, (2019). This study took the form of a service evaluation of Deptherapy, a UK-based niche charity offering support to military veterans who have experienced life-changing injuries. Deptherapy provides scuba diving qualifications, consisting of theory and practical diving experience, to participants alongside a Peer Support Buddy scheme that provides continuing support to servicemen involved with the charity. A total of 15 male veterans were invited to take part in the study. The methodology comprised retrospective and current quantitative measures of mental well-being and functional ability, utilising the General Health Questionnaire-28, and subsequent semi-structured interviews with participants, their families and health professionals. Participants reported an improvement in levels of anxiety, depression and social functioning, and a reduction in insomnia, following their involvement in organised scuba diving activities. There was a mean average difference of 14.3 points improvement on the General Health Questionnaire-28 scale variants between prior interaction with Deptherapy and current perceptions following engagement with the programme. The positive perceptions, as indicated from the semi-structured interviews, were more pronounced in those whose injuries were predominantly psychological, rather than physical. Scuba diving can offer significant therapeutic benefits, particularly for ex-military amputees experiencing co-morbid anxiety and/or chronic psychological adjustment disorders, notably in terms of improvements in social dysfunction and symptomology of depression.
- Military-Tailored Yoga for Veterans with Post-traumatic Stress Disorder, Robin E Cushing, Kathryn L Braun, Susan W Alden, et al., Military Medicine, Volume 183(5-6), pp.e223-e231, (May-June 2018). Eighteen Operation Enduring Freedom, Operation Iraqi Freedom, and Operation New Dawn veterans completed the pre- and post-intervention self-report questionnaires. Age ranged from 26 to 62 yr (median = 43 yr), length of service ranged from 2 to 34 yr (median = 18.8 yr), and 13 (72.2%) had completed college. This study demonstrates that a trauma-sensitive yoga intervention may be effective for veterans with PTSD symptoms, whether as stand-alone or adjunctive therapy. The impressive decrease in PTSD symptomatology may be due to the tailored military-specific nature of this intervention and the fact that it was led by a veteran of post-9/11 conflicts. More research is needed with a larger sample and a more diverse veteran population.
- Perception of Employment by the Veterans Participating in the National Veterans Wheelchair Games: A Survey Study, William Kim, Leah Lee, Daniel Lans, et al., PM&R, Volume 10(3), pp.263-268, (March 2018). A total of 50% of the participants stated that the NVWG made a difference in attaining employment. Those currently working were 1.5 times more likely to say that the NVWG had a positive effect on employment than those not currently working. Those who felt that the NVWG had a positive effect on employment attended 3-4 more wheelchair games on average than those reporting that the NVWG did not have an impact on employment. Positive responses were obtained from the Likert scale distribution. Our study suggests that participating in the NVWG provides psychosocial support to the veterans and may have a positive influence in employment outcomes.
- Veterans Group Exercise: A randomized pilot trial of an Integrative Exercise program for veterans with posttraumatic stress, Lizabeth A. Goldstein, Wolf E. Mehling, Thomas J. Metzler, et al., Journal of Affective Disorders, Volume 227, pp.345-352, (February 2018). We developed a group-based Integrative Exercise (IE) program combining aerobic and resistance exercise, which is familiar to veterans, with mindfulness-based practices suited to veterans with PTSD. This study aimed to evaluate the effects of IE on PTSD symptom severity and quality of life, as well as assess the feasibility and acceptability of IE. Veterans (N = 47) were randomized to either IE or waitlist control (WL). Veterans in IE were asked to attend three 1-h group exercise sessions for 12 weeks. This initial study suggests that IE is an innovative approach to treating veterans with symptoms of PTSD that reduces symptoms of posttraumatic stress and improves psychological quality of life. This approach to recovery may expand the reach of PTSD treatment into non-traditional settings and to veterans who may prefer a familiar activity, such as exercise, over medication or psychotherapy.
- Effects of therapeutic horseback riding on post-traumatic stress disorder in military veterans, Rebecca A. Johnson, David L. Albright, James R. Marzolf, et al., Military Medical Research, Volume 5, Article 3, (January 2018). Fifty-seven participants were recruited and 29 enrolled in the randomized trial. They were randomly assigned to either the horse riding group (n = 15) or a wait-list control group (n = 14). The wait-list control group experienced a 6-week waiting period, while the horse riding group began THR. The wait-list control group began riding after 6 weeks of participating in the control group. Participants had a statistically significant decrease in PTSD scores after 3 weeks of THR as well as a statistically and clinically significant decrease after 6 weeks of THR. Logistic regression showed that participants had a 66.7% likelihood of having lower PTSD scores at 3 weeks and 87.5% likelihood at 6 weeks. Under the generalized linear model, our ANOVA findings for the coping self-efficacy, emotion regulation, and social and emotional loneliness did not reach statistical significance. The results for coping self-efficacy and emotion regulation trended in the predicted direction. Results for emotional loneliness were opposite the predicted direction. Logistic regression provided validation that outcome effects were caused by riding longer.
- Kripalu Yoga for Military Veterans With PTSD: A Randomized Trial, Kristen M. Reinhardt, Jessica J. Noggle Taylor, Jennifer Johnston, et al., Journal of Clinical Psychology, Volume 74(1), pp.93-108, (January 2018). Fifty-one participants were randomized into yoga or no-treatment assessment-only control groups. Primary outcome measures included questionnaires and the Clinician Administered PTSD Scale. Both yoga (n = 9) and control (n = 6) participants showed significant decreases in reexperiencing symptoms, with no significant between-group differences. Secondary within-group analyses of a self-selected wait-list yoga group (n = 7) showed significant reductions in PTSD symptoms after yoga participation, in contrast to their control group participation. Consistent with current literature regarding high rates of PTSD treatment dropout for veterans, this study faced challenges retaining participants across conditions. These results are consistent with recent literature indicating that yoga may have potential as a PTSD therapy in a veteran or military population. However, additional larger sample size trials are necessary to confirm this conclusion.
- Association Between Adaptive Sports Programs and Quality of Life Among Amputee Veterans [thesis], Seay, Sean V., Walden Dissertations and Doctoral Studies, 4755, (2018). Adaptive sports programs (ASPs) are important for enhancing the physical, psychological, and social aspects of life for amputee combat veterans while reducing the risk of depression and anger. Although the role of ASPs in improving quality of life (QoL) has been researched in relation to amputee combat veterans of World War II, the Korean War, and the Vietnam War, there has been limited examination of the role of ASPs in improving QoL among veterans of Operation Enduring Freedom (OEF), Operation Iraqi Freedom (OIF), and Operation Noble Eagle (OND). Therefore, the purpose of this study was to assess the effects of ASPs on the QoL of amputee veterans of OEF, OIF, and OND using logistic regression as well as 3 surveys assessing QoL and life satisfaction in combat veterans who suffered traumatic amputations between 2003 and 2013. The dependent and independent variables included psychosocial and behavioral factors for those amputees who participated in an ASP versus those amputees who did not. There was a statistically significant association between gender and perception of overall health. Likewise, there was a statistically significant association between enjoying life and having a meaningful life and participation in an ASP. The findings indicate that participation in ASPs may help improve QoL and overall health for amputee veterans. Public health programs and policies aimed at improving the overall health and wellbeing of amputee veterans should consider ASPs as essential therapeutic interventions for promoting health in amputee veteran populations.
- Exploring strategies used to deliver physical activity experiences to Veterans with a physical disability, Celina Shirazipour, Alice Aiken, Amy Latimer-Cheung, Disability and Rehabilitation, Volume 40(26), pp.3198-3205, (2018). Physical activity is an important method of rehabilitation used to promote positive physical and psychosocial outcomes among military personnel, including Veterans, with a physical disability. However, minimal research has explored physical activity program implementation strategies, particularly how these strategies may foster positive rehabilitation outcomes, and quality participation experiences among Veterans post-injury. The purpose of the current study is to document strategies used to deliver physical activity programs to Veterans with a physical disability. Semi-structured interviews were conducted with program staff from three Veteran physical activity programs, and program documentation was collected. Data were analyzed using a thematic analysis. Four themes were identified representing strategies used for delivering physical activity programming: (1) foster social connections; (2) challenge participants; (3) tailor programs and outcomes to match participant needs; and (4) include knowledgeable coaches/instructors.
- The Effects of the Warrior Transition Unit’s Physical Activity Program on Affect of Wounded Military Personnel, Gwan Yon Hwang; Davis, Ron; Driver, Simon, Palaestra, Volume 32(1), pp.9-14, (2018). Warrior Transition Units (WTU) were created to successfully transition soldiers who are considered wounded, ill, or injured through comprehensive medical and adaptive reconditioning care, including sport and recreational activities. Entry-level sports engagement in WTU may transition from noncompetitive to competitive which may impact the soldier’s physical and emotional well-being status. The purpose of this study was to compare the differences in physical activity affect between two groups of wounded military personnel (N = 22) with WTU experience. Group 1 (NonCompWTU, n=11) engaged in on and off campus noncompetitive activities (e.g., rock wall climbing, community golf driving range) and Group 2 (CompWTU, n=11) competed in a wheelchair basketball tournament. Physical activity affect was measured using the physical activity affect scale ([PAAS], Lox et al., 2000) pre and post activities. The PAAS is a 12-item tool that measures 4 subscales (Positive Affect [PA], Negative Affect [NA], Tranquility [TR], and Fatigue [FA]). Independent and paired t-tests were used to determine differences across groups and pre-post activities (p <.05). Cohen’s D effect size (ES) was also reported. Results reported no statistical differences in PA, NA, TR, and FA across groups at the beginning of the activities; however, PA was significantly different across groups following the activities. The noncompetitive activities significantly increased PA and TR, while reducing NA from pre to post within Group 1. However, a significant increase between pre and post activities existed for FA within each group. While further study is needed to investigate the impact of the noncompetitive and competitive physical activity participation on affect of wounded military personnel, APA professionals should consider this challenge to improve the well-being of this population.
- The Impact of Ocean Therapy on Veterans with Posttraumatic Stress Disorder: Final Technical Report and Summary, Russell Crawford, for Operation Surf, (2018). The purpose of this quantitative study was to determine the effect of nature-based therapy, an alternative form of treatment that focuses on the interaction of the individual and the environment, on combat veterans with PTSD. The focus was to determine if the therapy reduced PTSD symptoms, decreased depression and increased self-efficacy among veterans. Participants in Amazing Surf Adventure’s Operation Surf program were eligible to participate. Both men and women between the ages of 20 and 55 participated in this study. All participants were military combat veterans. A total of 113 subjects were contacted for participation, and 95 subjects responded to the survey. Their PTSD, depression and self-efficacy were measured using online surveys prior to the commencement of the therapy. The same veterans were surveyed using the same surveys at the end of the program and also 30 days after the program. This chapter firsts presents summary statistics of the collected data at each time point and then repeated-measures ANOVAs to answer the research questions and hypotheses. The chapter is concluded with a summary. Participants experienced an average 36% decrease in PTSD symptoms, a 47% decrease in depression, a 68% increase in self-efficacy.
- The health and wellbeing needs of veterans: a rapid review, Candice Oster, Andrea Morello, Anthony Venning, et al., BMC Psychiatry, Volume 17, article 414, (December 2017). The current paper reports on the findings of a rapid review of the literature on the health and wellbeing needs of veterans, commissioned by the Australian Department of Veterans’ Affairs to inform future programs and services. A total of 21 systematic reviews were included. The reviews reported on a range of mental, physical and social health problems affecting veterans. While there was limited information on prevalence rates of physical, mental and social health problems in veterans compared to civilian populations, the reviews demonstrated the interconnection between these domains and the effect of demographic and military service factors. A key finding of the review is the interconnection of the mental, physical, and social health of veterans, highlighting the importance that an integrated approach to veterans’ wellbeing is adopted. It is suggested that understanding key factors, such as demographic factors and factors relating to military service, can support improved service provision for veterans.
- This is your new normal: A qualitative study of barriers and facilitators to physical activity in Veterans with lower extremity loss, Alyson Littman, Erin Bouldin, Jodie Haselkorn, Disability and Health Journal, Volume 10(4), pp.600-606, (October 2017). Semi-structured interviews were conducted with male Veterans with a lower extremity amputation (LEA). Two raters analyzed interview transcripts using a qualitative descriptive approach, involving both a priori and emergent themes. Among the 27 male Veterans (mean age = 54 years) interviewed, facilitators to PA included acceptance of their limb loss, confidence (to try new activities or adapt activities), creating a daily routine involving PA, resources, supportive others, perceived benefit, and having a history of being physically active. Barriers to PA were illnesses/injuries, poorly-fitting prostheses, low self-efficacy, insufficient resources, unsupportive others, and hassle.
- Investigation of the Impact of Sports, Exercise and Recreation (ser) Participation on Psychosocial Outcomes in a Population of Veterans with Disabilities Using the Sports Outcome Research Tool and Comprehensive Uniform Survey (Sportacus). A Longitudinal Study, Justin Laferrier, Emily Teodorski, Nathan Sprunger, et al., Journal of Novel Physiotherapies, Volume 7, (September 2017). A convenience sample of 163 individuals (91 sports-participants and 72 non-participants) matched on disability type with a variety of disabilities took part in this longitudinal study. Variables of interest were: SER participation vs. non-participation, years of SER participation since onset of disability (less than one year, one to five years, five to ten years, and more than ten years), the type of activity they engaged in (individual activities or a combination of team and individual activities) and time (pre-event, immediately post-event, one month post-event, and three months post-event). Main outcome measures were self-esteem, depression, posttraumatic growth and QOL. SER participants had significantly higher self-esteem, posttraumatic growth and QOL, and significantly lower depression scores than non-participants. There were also significant differences found between the independent variables of: time, number of years participating in SER since onset of disability and type of activity engaged in and various outcome measures studied.
- Quality participation experiences in the physical activity domain: Perspectives of veterans with a physical disability, Celina Shirazipour, M. Blair Evans, Nick Caddick, et al., Psychology of Sport and Exercise, Volume 29, pp.40-50, (March 2017). Eighteen veterans (15 men, 3 women) with a physical disability were recruited using maximum variation sampling to take part in interviews. The interviews explored their PA experiences, with a focus on exploring participants' perspective of a quality PA experience. Data were analyzed using thematic analysis. Two overarching themes, elements of a quality experience and conditions enabling access to a quality experience, were identified. Within the overarching theme of elements of a quality experience, four key themes were identified: group cohesion, challenge, having a role, and independence and choice. A further three key themes (the physical and social environments, and program structure) were identified within the overarching theme of conditions for accessing the quality experience.
- An Analysis of BBC Television Coverage of the 2014 Invictus Games, Shirazipour, Celina; Meehan, Madelaine; Latimer-Cheung, Amy, Adapted Physical Activity Quarterly, Volume 34(1), pp.33-54, (2017). The Invictus Games are a parasport competition for service members and veterans with illnesses and injuries. The 2014 Games were aired by the BBC, for a total of 12 hr of coverage. This study aimed to investigate what messages were conveyed regarding parasport for veterans during the BBC's Invictus Games broadcast. A content analysis was conducted. Five qualitative themes were identified: sport as rehabilitation, the promotion of ability over disability, the social environment, key outcomes of participation, and the importance of competition. Quantitative results indicated that 2 segment types accounted for the majority of the broadcast: sport coverage (50.57%) and athlete experiences (12.56%). Around half of the coverage focused on participants with a physical disability (51.62%). The findings demonstrate key similarities to and differences from previous explorations of parasport media coverage, with the needs of the event and athlete population potentially influencing the broadcast.
- Exercise and Post-Traumatic Stress Disorder in Military Veterans: A Systematic Review, James W. Whitworth, Joseph T. Ciccolo, Military Medicine, Volume 181(9), pp.953-960, (September 2016). The purpose of this review was to (1) provide the rationale for the use of exercise in the treatment of veterans with PTSD and (2) systematically review studies examining the relationship between exercise and PTSD in military veterans. A search of electronic databases (PubMed, PsycINFO, and Web of Science) for relevant studies published in print or online from January 1980 to September 2015 produced 204 unique articles and 13 relevant studies (9 observational studies, 2 experimental, and 2 qualitative). Results of these initial studies are promising and suggest that regular exercise is inversely correlated with PTSD and its symptoms in military veterans. However, the longitudinal effect of exercise on PTSD in military veterans remains unclear because the current research lacks a common focus and suffers from several methodological limitations.
- Female Veterans' Involvement in Outdoor Sports and Recreation: A Theoretical Sample of Recreation Opportunity Structures, Neil Lundberg, Stacy Taniguchi, Rachel McGovern, et al., Journal of Leisure Research, Volume 48(5), pp.413-430, (2016). Previous research has recognized the need to better understand the experience of female veterans and their adjustment upon returning home, especially considering that a growing number of veterans are women. Their stories, particularly as they relate to combat and the associated wounds of war, largely remain untold. Therefore, the purpose of this project was to employ a theoretical sample from Grounded Theory methodology to determine if similar recreation opportunity structure patterns existed in the use of outdoor sports and recreation for a sample of female veterans, as had been found in previous research with individuals with physical disabilities. The investigation revealed findings that substantiated the way in which recreation opportunity structures provide novel environments where physical skills and emotional capacities could be developed through (a) establishing social networks and bonding, (b) facilitating a sense of freedom from constraints, and (c) by providing opportunities to redefine or recapture their identity.
- Physical and social factors determining quality of life for veterans with lower-limb amputation(s): a systematic review, Jan Christensen, Thomas Ipsen, Patrick Doherty, et al., Disability and Rehabilitation, Volume 38(24), pp.2345-2353, (2016). The literature search identified 2073 citations, leading to the inclusion of 10 studies in the systematic review. Physical activity level, sport participation, level of amputation, back pain, years of education, as well as duration and severity of phantom pain were found to be determining factors for HRQoL among veterans with lower-limb amputation. Conclusions: The identified physical and social determinants were similar to those found in civilian traumatic amputees. More high quality research designs, interventions and complex statistical analyses are warranted to identify the physical and social factors that influence the HRQoL of veteran amputees.
- Values-Based Sport Programs and Their Impact on Team Success: The Competitive Sport Model at the United States Military Academy, Ralph Pim, International Sport Coaching Journal, Volume 3(3), pp.307-315, (2016). The purpose of this paper is to examine the values-based competitive sport program at the United States Military Academy (West Point), and to determine if the components of character and leadership development were associated with team success. Strategies employed at West Point to develop cultures that produced leaders of character and teams of significance were reviewed. Major points of emphasis in the competitive sport program included (i) teaching values through sport, (ii) identifying and defining core values, (iii) developing warrior athletes of character, (iv) building teams and cultures of significance, (v) reinforcing values through recognition, and (vi) assessing character and leader development of athletes and teams. Characteristics and specific behaviors of great leaders and teams were identified. A rubric for assessing character and leader development in sport and a survey evaluating the competitive sport experience on the desired learning outcomes of the West Point Cadet Leader Development System were presented. Results indicated that competitive sports programs built on values encouraged and developed behaviors that produced success both on and off the field. Subsequent investigations are recommended to identify how character and leadership development can be integrated into the coaching process and applied in civilian secondary schools and institutions of higher learning.
- Changes in Meeting Physical Activity Guidelines After Discharge From the Military, Alyson Littman, Isabel Jacobson, Edward Boyko, et al., Journal of Physical Activity and Health, Volume 12(5), pp.666-674, (2015). Using data from 28,866 Millennium Cohort Study participants (n = 3782 of whom were discharged during the years between assessments), we 1) investigated changes in meeting federal PA guidelines for moderate-to-vigorous activity (MVPA) following military discharge and 2) determined predictors of meeting these guidelines after discharge. MVPA declined more in those who were discharged than in those who were not (−17.8 percentage points vs. −2.7 percentage points), with greater declines in former active-duty personnel, those who had deployed with combat exposures, had 14 to 25 years of service, and had been discharged more recently (>2 years prior). In those who were discharged, being normal or overweight (vs. obese), and a nonsmoker or former smoker (vs. current smoker) were positively associated with meeting MVPA Guidelines at follow-up, while meeting MVPA Guidelines at baseline and depression were inversely associated. Reductions in MVPA were substantial and unexpected. Increased understanding of transitional periods that may benefit from interventions to mitigate declines in PA will help prevent excess weight gain and physical inactivity-associated health consequences.
- Investigation of the Impact of Sports, Exercise, and Recreation Participation on Psychosocial Outcomes in a Population of Veterans with Disabilities: A Cross-sectional Study, Laferrier, Justin; Teodorski, Emily; Cooper, Rory A., American Journal of Physical Medicine and Rehabilitation, Volume 94(12), pp.1026-1034, (December 2015). Two hundred twenty service members/veterans with disabilities who were participants in one of three annual adaptive sporting events took part in this cross-sectional study. Variables of interest were years of sport, exercise, and recreation participation since the onset of disability as well as the type of activity they engaged in. Main outcome measures were self-esteem and quality-of-life. A positive relationship was found between participant quality-of-life and the number of years spent participating in sports, exercise, and recreation since the onset of their disability. A significant difference was found between pre-event and postevent self-esteem scores. A significant difference was also found in self-esteem scores between the levels of years of participation in sports, exercise, and recreation when averaged across activity type. Finally, there were significant differences found on self-esteem scores between the levels of type of activity averaged across years of participation. Our results indicate that participation in sports, exercise, and recreation has a positive influence on self-esteem and quality-of-life in individuals with disabilities.
- The Effects of Surfing and the Natural Environment on the Well-Being of Combat Veterans, Nick Caddick, Brett Smith, Cassandra Phoenix, Qualitative Health Research, Volume 25(1), pp.76-86, (2015). Although researchers have identified the benefits of physical activity on well-being, there is little evidence concerning the effects of nature-based physical activity. We investigated the effect of one nature-based activity—surfing—on the well-being of combat veterans experiencing posttraumatic stress disorder (PTSD). We conducted interviews and participant observations with a group of combat veterans belonging to a United Kingdom-based veterans’ surfing charity. Our primary analytical approach was dialogical narrative analysis. Based on our rigorous analysis and findings, we suggest that surfing facilitated a sense of respite from PTSD. Respite was a fully embodied feeling of release from suffering that was cultivated through surfing and shaped by the stories veterans told of their experiences. We significantly extend previous knowledge on physical activity, combat veterans, and PTSD by highlighting how nature-based physical activity, encapsulated in the conceptual notion of the “blue gym,” can promote well-being among combat veterans.
- The Effects of Surfing and the Natural Environment on the Well-Being of Combat Veterans, Nick Caddick, Brett Smith, Cassandra Phoenix, Qualitative Health Research, Volume 25(1), (2015). Although researchers have identified the benefits of physical activity on well-being, there is little evidence concerning the effects of nature-based physical activity. We investigated the effect of one nature-based activity—surfing—on the well-being of combat veterans experiencing posttraumatic stress disorder (PTSD). We conducted interviews and participant observations with a group of combat veterans belonging to a United Kingdom-based veterans’ surfing charity. Our primary analytical approach was dialogical narrative analysis. Based on our rigorous analysis and findings, we suggest that surfing facilitated a sense of respite from PTSD. Respite was a fully embodied feeling of release from suffering that was cultivated through surfing and shaped by the stories veterans told of their experiences. We significantly extend previous knowledge on physical activity, combat veterans, and PTSD by highlighting how nature-based physical activity, encapsulated in the conceptual notion of the “blue gym,” can promote well-being among combat veterans.
- Understanding contextual influences of community reintegration among injured servicemembers, Brent Hawkins, Francis McGuire, Sandra Linder, et al., Journal of Rehabilitation Research and Development, Volume 52(5), pp.527-542, (2015). This study presents the second phase of a larger explanatory sequential mixed-methods study that sought to understand the influence of contextual factors on community reintegration (CR) among injured, community-dwelling servicemembers. Factors that had an indirect but important influence on CR, including adapted sports, recreation, and other social programs; rehabilitation programs and therapists; school, work, and volunteering; and organizations and policies in developing social supports and personal factors. Comparisons between servicemembers indicated that participants with low CR described many more contextual barriers and far fewer contextual facilitators to reintegration than those with high CR. Those with moderate CR were unique in that they described many facilitators and barriers to reintegration. Adapted sports, recreation, and other social programs were discussed very frequently and with high regard as facilitators of CR. These programs were examples of participation in community activities, yet these events and programs served a larger purpose than mere participation. Programs were the vehicle for CR through which development of social supports, self-efficacy, and other personal factors were gained. They helped establish connections with other people (e.g., other servicemembers, injured civilians) and provided participants with opportunities to push personal boundaries and realize their own potential. Participants who discussed frequent participation in these events discussed these psychosocial benefits. Specific to adapted sports, some participants described participation as highly influential to CR.
- Addressing Posttraumatic Stress Among Iraq and Afghanistan Veterans and Significant Others: An Intervention Utilizing Sport and Recreation, Bennett, Jessie L; Lundberg, Neil R; Zabriskie, Ramon, et al., Therapeutic Recreation Journal, Volume 48(1), pp.74-93, (2014). The purpose of the study was to evaluate the effectiveness of an existing "couples" adaptive sport and recreation program called Higher Ground developed by Sun Valley Adaptive Sports to reduce symptoms of PTSD, facilitate posttraumatic growth, and enhance marital satisfaction for veterans with PTSD and their significant others. The sample consisted of two experimental groups (Group A five couples, Group B six couples) and a control group (six couples). This study identified important findings suggesting that couples' sports and recreation programs can be used to reduce PTSD symptoms and increase marital adjustment and satisfaction. More specifically, the findings suggest that the combination of processing themes through discussion and journaling, learning a recreational activity that requires focus, and having a trained staff that can provide a positive recreational experience may help to address the PTSD symptoms of re-experiencing, hyperarousal, and avoidance/ emotional numbing. A recreation experience's ability to distract, aid in the development of meaningful relationships, produce positive emotions, and enhance perceptions of competence (Kleiber, et al., 2002), appears to be relevant to the sport and recreation participation of veterans and their significant others.
- Enhancing the well-being of veterans using extended group-based nature recreation experiences, Jason Duvall, Rachel Kaplan, Journal of Rehabilitation Research and Development, Volume 51(5), pp.685-696, (2014). Physical and mental health issues associated with military service persist as challenges for many veterans. This study draws on existing research showing the value of engaging in nature-based recreation to examine the effects of such experiences on veterans specifically. Four organizations, offering 12 different programs each lasting 4–7 d, were included in the study. Examples of included activities were fishing, kayaking, whitewater rafting, backpacking, hiking, mountain biking, paddle boarding, canoeing. Ninety-eight veterans were recruited and surveyed 1 wk before, 1 wk after, and approximately 1 mo after participating in these extended group-based outdoor experiences. In addition to background information, the survey instrument assessed changes in psychological well-being, social functioning, and life outlook. The results showed significant improvements in each of these domains 1 wk after the outdoor experience. Some improvements persisted over the next month, but to a lesser degree. The positive changes were particularly strong for veterans who initially reported more severe ongoing health issues. Overall, the findings suggest that extended group-based nature recreation experiences that bring veterans together can have significant positive effects on veterans struggling with serious health problems.
- The impact of sport and physical activity on the well-being of combat veterans: A systematic review, Nick Caddick, Brett Smith, Psychology of Sport and Exercise, Volume 15(1), pp.9-18, (January 2014). A systematic review was conducted. The question guiding this review was ‘what is the impact of sport and physical activity on the well-being of combat veterans?’ 11 studies were identified as relevant for inclusion. Data from these studies were extracted by means of a directed content analysis, the results of which were reported in a narrative synthesis. Sport and physical activity enhances subjective well-being in veterans through active coping and doing things again, PTSD symptom reduction, positive affective experience, activity in nature/ecotherapy, and quality of life. Impact on psychological well-being includes determination and inner strength, focus on ability and broadening of horizons, identity and self-concept, activity in nature/ecotherapy, sense of achievement/accomplishment, and social well-being. Participating in sport and/or physical activity can also enhance motivation for living.
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Last updated: 05 February 2025
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