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Article History

Received: 27 October 2017

Accepted: 28 June 2018

First Online: 11 July 2018

Ethics approval and consent to participate

: The 2011 HRBS was conducted by ICF International under advisement of the Office of the Assistant Secretary of Defense for Health Affairs, Tricare Management Activity (TMA; now Defense Health Agency), and the USCG []. Primary data collection was approved by the Office of the Assistant Secretary of Defense for Health Affairs/TRICARE Management Activity (OASD(HA)/TMA), Human Research Protection Office. Informed consent was required and obtained at the beginning of the HRBS, and responses were anonymous. For the present secondary data analyses, we obtained a de-identified data file from TMA through a data use agreement. Because the data were previously collected and de-identified, the protocol for the present study was deemed exempt (not human subject research) by both the US Army Research Institute of Environmental Medicine (Natick, MA) and the Office of the Assistant Secretary of Defense for Health Affairs/TRICARE Management Activity (OASD(HA)/TMA), Human Research Protection Office.

: Not applicable (no individual-level data included).

: The authors declare that they have no competing interests.

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