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, and food and nutrition. SettingThree Veterans Affairs Polytrauma Rehabilitation Centers. ParticipantsVeterans who served in the United States military on or after September 11th, 2001, and whose medical diagnoses met the criteria for polytrauma; at least one mild traumatic brain injury, and at least one associated comorbidity (e.g., post-traumatic stress disorder, chronic musculoskeletal pain, vestibular disturbances). InterventionNone Main Outcome MeasuresThemes from survey responses and semi-structured interview data were pooled into core constructs, and influencing factors. Results37 veterans completed all surveys and participated in recorded interviews. Based on qualitative and quantitative data, veterans’ relation to food and nutrition (i.e., 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, relationships, and current beliefs and behaviors. ConclusionsNutritional functioning (food background, nutrition knowledge, meal aptitude, resource navigation, and navigation to/of food spaces) among injured veterans is complex, and shaped by multiple physical, psychosocial, economic, and cultural factors.