Attitude towards Combat Veterans Scale: Implications for Community Practice and Cultural Competence

Background and Purpose: Since the inception of the Global War on Terror, the United States has deployed over 2 million service members to Afghanistan and Iraq. The fact that deployed service members experience significant mental health challenges upon returning is well established. These problems can manifest as acute stress, anger, anxiety, depression, and elevations in suicide rates. Evidence suggests that mental health problems are positively moderated by the buffering effect of social support. Social support is conceptualized as various forms of reinforcement provided by family members, friends, and the civilian community. Positive social support is shown to improve the reintegration experience of veterans. This prompted us to question how we might encourage positive social support for veterans, which led us to the exploration of the attitude-behavioral link. Attitudes are antecedents to behavior. Thus, the purpose of this study was to develop and validate a brief instrument that could identify whether or not an individual had a favorable or unfavorable attitude towards combat veterans which could then impact their ability to offer social support. The development of this scale offers practical implications for civilian community professionals interacting with veterans within a cultural competence framework.

Methods: The initial item pool was generated by conducting two pilot studies that asked participants to identify attributes of combat veterans (first pilot study) and then identify whether each attribute was favorable, unfavorable, or neutral (second pilot study), followed by two rounds of expert review that asked whether or not the attributes were representative of combat veterans. Consistently neutral and non-representative attributes were dropped. The remaining attributes were used to write question stems with six-point Likert-like scale response choices from 1 (completely disagree) to 6 (completely agree). The initial instrument consisted of 22 items. The instrument was piloted on a nonprobability sample of 631 individuals. The data were randomly split into two samples to facilitate both an Exploratory Factor Analysis (EFA) and a Confirmatory Factor Analysis (CFA). We used case-wise deletion for missing data. The data violated multivariate normality assumptions so the WLSMV estimator was employed.

Results: This sample was predominately female (62%) and white (95%) with ages ranging from 18 to 88 years (M=46, SD=16). The final EFA model used the Promax rotation resulting in a RMSEA estimate of .01 and RMSR value of .02; both indicating excellent fit. This model suggested three underlying factors (cognition, affect, and conation) that accounted for the underlying variance of the data. The final CFA model included nine observed variables and three latent constructs. This model resulted in excellent fit indexes: RMSEA = .05, CFI = .99 and the WRMR = .54.

Conclusions and Implications: The Attitude towards Combat Veterans Scale appears promising in its ability to evaluate individual attitudes towards combat veterans. This scale can be applied in a variety of settings including institutions of higher education, workplace and healthcare agencies in order to evaluate and increase socially supportive environments for returning veterans. Additionally, this scale can inform assessment and treatment planning in behavioral health community environments