Predictors of injury in U.S. Army basic training and in the first 2 years of military service

Injury during military service is a potentially life-compromising outcome for young recruits, as attrition from military service or even permanent disability can result. Injury incidence during 9-week Army Basic Training (BT) ranges from 19% to 37% and 42% to 67% for men and women, respectively. Injury risk is higher for smokers (>20 cigarettes/day) than non-smokers (relative risk = 2.4 and 1.6, men and women respectively). Between 2002 and 2003, 22,156 Army recruits completed the self-administered Recruit Assessment Program questionnaire with measures of childhood and adult exposures (including secondhand smoke), physical and mental functioning, health-compromising behaviors (including tobacco and alcohol use), and potential social support. These questionnaires were matched with personnel and medical data containing demographic (education, ethnicity, marital status, dependents), career (deployment and attrition information), and injury information. A theory-based conceptual model will be used to guide separate analyses of predictors of injury in BT and the first 2 years of Army service. Analyses will also be conducted separately by gender and component (Guard and Reserve vs. Active Duty). Structural equation and logistic regression modeling will be used to identify individual factors and combinations of factors that best predict injury. Based on results of previous analyses of BT injury using a subset of these data, tobacco use, low physical activity, risky dieting practices, and risky sexual behaviors are expected to be associated with injury. While level of alcohol use was not a significant predictor of BT injury, past research suggest this may be associated with injury subsequent to BT.