142nd APHA Annual Meeting and Exposition

Annual Meeting Recordings are now available for purchase

Evaluation of an Injury Prevention Program in a Deploying Army Unit

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Tuesday, November 18, 2014 : 11:15 AM - 11:30 AM

Michelle Canham-Chervak, PhD, MPH , Injury Prevention Program, US Army Institute of Public Health, Aberdeen Proving Ground, MD
Tyson Grier, MS , Injury Prevention Program, U.S. Army Institute of Public Health, Aberdeen Proving Ground, MD
Esther Dada, MPH , Injury Prevention Program, U.S. Army Institute of Public Health, APG, MD
Bruce H. Jones, MD, MPH , Injury Prevention Program, U.S. Army Institute of Public Health, Aberdeen Proving Ground, MD
Background: To reduce injuries and improve Soldiers’ deployment readiness, an injury prevention program was implemented in an infantry brigade.  The program included the addition of physical therapy and athletic training staff and implementation of physical training (PT) activities emphasizing cross-training and lower running mileage. 

Methods:  Demographics, physical fitness, and PT activities were obtained from surveys administered to Soldiers upon program implementation and 7 months later.  Medical records captured injury-related encounters for 7 months before and 7 months after implementation.  Pre- and post-implementation changes were assessed using chi-square for person-time rates (injury) and Wilcoxon Signed Rank test (fitness, PT).  Army and brigade injury rates were compared using linear regression.

Results: Both surveys and medical data were available for 1,250 Soldiers; data on matched males (n=1,183) were analyzed.  Injury incidence pre- and post-implementation did not differ (55 vs. 57/1,000 Soldiers/month, p=0.64) and no difference between Army and brigade trends was observed (p=0.72).  Fitness improved, as measured by Army Physical Fitness Test total scores (251 vs. 255 points, p<0.01). The proportion of Soldiers running ≥10 miles/week with their unit decreased (36% vs. 26%, p<0.01) and the proportion cross-training with their unit ≥1 time/week increased (66% vs. 75%, p<0.01).

Discussion: While injury rates did not change with this program, fitness improved, running mileage decreased, and cross-training increased as intended.  Improved access to care may have increased injury identification, thereby masking reductions resulting from PT modifications.  A longer period of study is needed to fully assess program effects.  

Learning Areas:

Implementation of health education strategies, interventions and programs
Occupational health and safety
Program planning
Public health or related public policy
Public health or related research

Learning Objectives:
Describe the elements of an injury prevention initiative implemented in a deploying Army unit. Explain the intended and observed effects of this program. Define how this evaluation adds to the scientific knowledge base on training-related injury prevention.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: As an injury epidemiologist at the U.S. Army Public Health Command for the past 18 years, I have been responsible for the execution of public health activities, including program and policy evaluations. In the past 3 years, have lead 7 program evaluations of Army injury prevention programs and policies. Educational training includes a MPH from Yale University and a PhD from Johns Hopkins Bloomberg School of Public Health.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.