title: Health-related quality of life among veterans in addictions treatment: identifying behavioral targets for future intervention.
abstract: US veterans report lower health-related quality of life (HRQoL) relative to the general population. Identifying behavioral factors related to HRQoL that are malleable to change may inform interventions to improve well-being in this vulnerable group.
  
  
  
  The current study sought to characterize HRQoL in a largely male sample of veterans in addictions treatment, both in relation to US norms and in association with five recommended health behavior practices: regularly exercising, managing stress, having good sleep hygiene, consuming fruits and vegetables, and being tobacco free.
  
  
  
  We assessed HRQoL with 250 veterans in addictions treatment (96 % male, mean age 53, range 24-77) using scales from four validated measures. Data reduction methods identified two principal components reflecting physical and mental HRQoL. Model testing of HRQoL associations with health behaviors adjusted for relevant demographic and treatment-related covariates.
  
  
  
  Compared to US norms, the sample had lower HRQoL scores. Better psychological HRQoL was associated with higher subjective social standing, absence of pain or trauma, lower alcohol severity, and monotonically with the sum of health behaviors (all p < 0.05). Specifically, psychological HRQoL was associated with regular exercise, stress management, and sleep hygiene. Regular exercise also related to better physical HRQoL. The models explained >40 % of the variance in HRQoL.
  
  
  
  Exercise, sleep hygiene, and stress management are strongly associated with HRQoL among veterans in addictions treatment. Future research is needed to test the effect of interventions for improving well-being in this high-risk group.
authors.affiliation: Department of Medicine, Stanford Prevention Research Center, Stanford University, Medical School Office Building, X316, 1265 Welch Road, Stanford, CA, 94305-5411, USA.
authors.forename: Marily A
authors.initials: MA
authors.lastname: Oppezzo
authors.affiliation: Department of Medicine, Stanford Prevention Research Center, Stanford University, Medical School Office Building, X316, 1265 Welch Road, Stanford, CA, 94305-5411, USA.
authors.forename: Anne K
authors.initials: AK
authors.lastname: Michalek
authors.affiliation: Department of Psychiatry, University of California, San Francisco, CA, USA.
authors.forename: Kevin
authors.initials: K
authors.lastname: Delucchi
authors.affiliation: Department of Medicine, Stanford Prevention Research Center, Stanford University, Medical School Office Building, X316, 1265 Welch Road, Stanford, CA, 94305-5411, USA.
authors.forename: Michael T M
authors.initials: MT
authors.lastname: Baiocchi
authors.affiliation: Department of Psychiatry, University of California, San Francisco, CA, USA.|Health Economics Resource Center, Veterans Affairs Palo Alto Health Care System, Livermore, CA, USA.
authors.forename: Paul G
authors.initials: PG
authors.lastname: Barnett
authors.affiliation: Department of Medicine, Stanford Prevention Research Center, Stanford University, Medical School Office Building, X316, 1265 Welch Road, Stanford, CA, 94305-5411, USA. jpro@stanford.edu.
authors.forename: Judith J
authors.initials: JJ
authors.lastname: Prochaska
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D015438:Health Behavior / Q000187:drug effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018434:Sickness Impact Profile; D019966:Substance-Related Disorders / Q000523:psychology*; D014728:Veterans / Q000523:psychology*
keywords: Health behaviors; Health-related quality of life; Substance abuse; Veterans