Health assessment for loved ones: Development and validation of a new instrument to measure well-being in military spouses

Christi Ann Duette Luby, University of Texas at El Paso


Since 2001, over 2.7 million US troops have deployed in support of the ongoing conflicts in the Middle East. Combat stress and deployments affect Service members, and consequently affect their spouses/intimate partners. In addition, these spouses often act as the social support system to other spouses experiencing traumatic events, such as death, injury, or illness of their deployed soldier. These indirect exposures to trauma may make spouses vulnerable; yet little research has focused on how the lived experiences of spouses of deployed and returning US Service members have affected their well-being. The purpose of this three-part study was to develop and validate a new instrument to assess the well-being of civilian spouses and partners of active and Veteran US Service members who have been indirectly exposed to combat trauma stress. The three phases of the study included a total of 410 civilian spouses and partners of OEF/OIF/OND active and Veteran US Service members. Study participants were recruited from non-Department of Defense-affiliated online public and private support groups or web pages for civilian spouses and partners. They were almost all (99%) female and ranged in age from 19-60 years. In Phase One (n=22), the Health Assessment for Loved Ones (HALO) pilot instrument was developed by adapting relevant items from constructs found in existing instruments and the literature, and by generating new items using the perspectives of military spouses gathered during individual interviews. During Phase Two (n=182), participants completed an anonymous, online pilot instrument and psychometric properties were assessed. Following factor analysis, 21 items were retained, loading on four specific constructs associated with their unique experiences. The results of this phase of the study provided empirical evidence of the measurement properties of the HALO, including estimates of internal consistency, test-retest reliability and construct validity of the total instrument and subscales. The overall 21-item instrument showed a strong estimate of internal consistency (α= .905, .863, .779, .822) and test-retest reliability (ICC=.967, .982, .945, .971) respectively. During Phase Three (n=206), participants completed an anonymous, online survey that included the 21-item HALO instrument and two well-established criterion measures, the RAND 36-Item Health Survey 1.0 Questionnaire and the Social Support Survey (MOS-SSS) . Spearman's bivariate correlations, computed between the HALO total and subscale scores and the subscale scores of the two criterion measures, ranged from -.434 to -.776. All Spearman's correlations were significant at the 0.01 level (2-tailed). The results of this assessment of concurrent validity suggest the items within the HALO subscales accurately and adequately reflect the newly constructed domains, and that the four subscales are associated with a wide range of valid, theoretically similar and relevant emotional health and social support variables. This study provides evidence that the HALO is a reliable and valid instrument to measure the unique experiences that may affect the well-being of military spouses.

Subject Area

Individual & family studies|Military studies|Health care management

Recommended Citation

Luby, Christi Ann Duette, "Health assessment for loved ones: Development and validation of a new instrument to measure well-being in military spouses" (2015). ETD Collection for University of Texas, El Paso. AAI3708552.