Measuring life skills among Veterans: A systematic review of published instruments

Abstract:Introduction: Supporting the well-being of Canadian Veterans is a key policy objective of Veterans Affairs Canada, which led to the development of a seven-domain well-being construct: employment, finances, health, social integration, housing and physical environment, cultural and social environment, and life skills and preparedness. However, the usefulness of this construct depends on being able to reliably measure and operationalize each domain. This review addresses a gap by evaluating instruments measuring the life skills and preparedness domain, defined as knowledge and skills to navigate civilian life after military service. Methods: We conducted a systematic review of eight bibliographic databases, identifying instruments measuring life skills and preparedness. We used the COSMIN checklist and criteria to assess bias risk and evaluate instrument measurement performance. Veteran partners evaluated the instruments for applicability and clarity. Results: Of 1,472 records screened, 13 publications describing nine instruments were included — five measured life skills and preparedness among Veterans and four in the general community. Internal consistency among instruments was sufficient; however, other measurement properties were inconsistent. Only one, the Community Reintegration for Service Members — Community Adaptive Test, developed with and validated by Veterans, had high-quality evidence, but our partners were conflicted on its clarity and applicability. The Life Skills Development Inventory — College Form may be promising for younger Veterans; however, further validation is required including content validity and applicability to Veterans. Discussion: Further validation of some promising instruments is needed, or de novo creation of an instrument is required to measure life skills and preparedness for Canadian Veterans.