Factors influencing health behaviors among active duty Air Force personnel.

BACKGROUND: Individual health behaviors affect whether U.S. Air Force (USAF) service members are fit and ready to deploy. PURPOSE: The purpose of this study was to understand health behaviors of USAF members to guide future interventions to reduce cardiovascular risks. METHODS: A qualitative descriptive study was conducted with a purposive sample of 24 active duty USAF participants. Conventional content analysis was used to derive data-driven themes that were compared with the Health Promotion Model (HPM). DISCUSSION: Participants defined health in a multifactorial way that covered physical, emotional, and spiritual dimensions. The three themes that contributed to participants' health behaviors addressed: "who I am," "what works for me," and the USAF culture. There was a poor fit between findings as expressed by these participants and the HPM. CONCLUSION: Although these findings were derived from a sample of USAF participants, the findings have implications for members of other military services. The findings also have relevance for nurses and other providers within the civilian work environments who can promote health and wellness by integrating a client's personal history into a plan for developing and sustaining a healthy lifestyle.

Indicators of sequential fitness assessment failures for Travis Air Force Base airmen who attend the Be Well Course.

PURPOSE: This retrospective community intervention trial evaluated the Be Well course--a mandatory lifestyle intervention course for airmen who fail the U.S. Air Force fitness assessment (FA)--at Travis Air Force Base from November 1, 2010 to February 1, 2011. METHODS: Pre-existing data (N = 276) were analyzed for change in FA scores and for predictors of future outcomes. RESULTS: On the subsequent FA after completing Be Well, males and females scored significantly higher on total points, aerobic fitness, push-ups, and sit-ups (p < 0.001 for all), and males had lower body mass indices (BMI; p = 0.005) and smaller abdominal circumferences (AC; p < 0.001), as compared to their initial FA. As opposed to those who passed the subsequent FA, those who failed consecutively had significantly higher BMIs (p < 0.001), larger ACs (p < 0.001), and lower total scores (p < 0.0001) at the time of the initial failure. CONCLUSIONS: The Be Well course is an effective tool and should remain a component of remedial training for airmen who fail the Air Force FA. Stratification of failure should be considered at the policy level, with special consideration given to the risk factors of high BMI, large AC, and low total FA score.

Effectiveness of Lifestyle Interventions in an Active Duty Air Force Population.

PURPOSE: To examine the effectiveness of 3 lifestyle intervention programs in an active duty military population. DESIGN: Experimental design with stratified random assignment to 1 of 3 intervention groups. Measures were taken at baseline, 3 months and 6 months. SETTING: A Military Treatment Facility in the western U.S. SUBJECTS/INTERVENTION: 122 active duty service members were enrolled and randomly assigned to 1 of 3 lifestyle intervention programs: the Diabetes Prevention Program-Group Lifestyle Balance (DPP-GLB), the Better Body Better Life (BBBL) program or the Fitness Improvement Program (FIP). MEASURES: weight, abdominal circumference, lipid and HbA1c levels, physical activity, and well-being as measured by the RAND SF-36 questionnaire. ANALYSIS: Statistical analyses were performed to assess changes over time. RESULTS: 83 participants completed the study (BBBL N = 23, FIP N = 30, DPP-GLB N = 30). The DPP-GLB participants had statistically significant decreases in weight (-3.1 pounds, p = .01) and abdominal circumference (-0.9 inches; p = .01) over time. HbA1c was also significantly lower in this group at 6 months compared to baseline (p = .036). There were no statistically significant changes in weight, abdominal circumference, or HbA1c in the FIP or BBBL groups. No significant changes were observed in lipids in any of the groups. CONCLUSION: Results from this study indicate that the DPP-GLB program may be effective in reducing weight, abdominal circumference, and HbA1c in an active duty U.S. military population.

Preparing for the usual, preparing for the unusual: ethics in routine and emergency public health practice.

A tremendous amount of resources is being poured into public health agencies for the purpose of planning to prevent, respond to, and/or recover from all manner of emergencies. As planning and practice drills have progressed, many of the shortcomings of our current public health system are being recognized. Many gray areas, particularly legal and ethical, are coming into focus. There are many questions about whether the standards of medical care and public health practice will necessarily remain constant during emergencies. This article examines whether the same might be true of the ethical standards of public health practice. Will they or should they be the same regardless of whether we are working in "usual" times or "unusual" times?

An intervention to reduce excess body weight in adults with or at risk for type 2 diabetes.

Overweight and obesity increase risk for type 2 diabetes, which, in turn, increases the risk of cardiovascular disease (CVD); therefore, effective interventions to control body weight have the potential to prevent many cases of diabetes and CVD in the United States. However, few randomized controlled trials have shown that behavioral interventions can control body weight in persons with diabetes or at risk for diabetes. Therefore, the authors conducted a clinic-based randomized controlled trial, testing whether a comprehensive behavioral intervention could reduce weight, total cholesterol, and blood pressure (BP) in persons with two or more risk factors for diabetes and/or CVD. Approximately 50% of the participants had diabetes at baseline. Intervention participants had significantly greater reductions in weight and systolic BP than control participants, who received usual care. Among participants with nonelevated baseline values of total cholesterol and diastolic BP, intervention participants also had significantly greater reductions in these risk factors.

Physical activity determinants of military health care recipients.

This study describes physical activity determinants (motivation, self-efficacy, benefits/barriers, and stage of change) of 71 healthy, military-affiliated volunteers, 28 men and 43 women (mean age, 31 +/- 7 years) from a military primary care setting. The physical activity determinants were measured with investigator-administered questionnaires at three time points over 8 months. The Kruskal-Wallis analysis of variance indicated that there were significant differences (p < 0.0001) among factors determining self-efficacy, motivation, and benefits/barriers. The subjects reported being most confident that they could be physically active even if they had to do it by themselves. The chief benefit reported was an improvement in physical performance, whereas the leading barrier to physical activity was the physical exertion involved. The biggest motivator was the positive health effect gained. Most subjects considered themselves to be in the "maintenance" stage of change. This study provides a platform for the development of an effective physical activity intervention in this population.