Nutrition and Food Security Among Veterans: Operationalizing Nutritional Functioning

Abstract

ObjectiveTo assess injured military veterans’ experiences, beliefs, and daily physical and psychosocial functioning in relation to food and nutrition. DesignWe used a convergent mixed-methods study design and the International Classification of Functioning, Disability, and Health to operationalize the core constructs and influencing factors related to physical and psychosocial functioning, food, and nutrition. SettingThree Veterans Affairs polytrauma rehabilitation centers. ParticipantsVeterans who served in the United States military on or after September 11, 2001, and whose medical diagnoses met the criteria for polytrauma; at least 1 mild traumatic brain injury and at least 1 associated comorbidity (eg, posttraumatic stress disorder, chronic musculoskeletal pain, vestibular disturbances), for a total N of 43. InterventionsNone. Main Outcome MeasuresThemes from survey responses and semistructured interview data were pooled into core constructs and influencing factors. ResultsThirty-seven veterans completed all surveys and participated in recorded interviews. Based on qualitative and quantitative data, veterans’ relation to food and nutrition (ie, nutritional functioning) was found to be characterized by 5 core constructs, including food background, nutrition knowledge, meal aptitude, resource navigation, and navigation to/of food spaces. Nutritional functioning was found to be shaped by 5 influencing factors, including injuries and health conditions, ideological and cultural exposures, relations, current beliefs, and current behaviors. ConclusionsNutritional functioning (food background, nutrition knowledge, meal aptitude, resource navigation, navigation to/of food spaces) among injured veterans is complex and shaped by multiple physical, psychosocial, economic, and cultural factors.