Health is the foundation for a ready and fighting force. The Army is committed to ensuring optimal health and fitness of its soldiers, families, and communities. According to recent survey data, 17% of Army soldiers are obese, 62% do not get at least seven hours of sleep, 60% do not meet recommended fruit and vegetable intake, and 23% use tobacco products. These health behavior challenges are not unique to Army populations, although soldiers may experience unique risk and protective factors associated with positive health behaviors. Therefore, the Army is coordinating efforts to reduce health behavior challenges through a systematic and synchronized approach to health promotion with a goal of improving the readiness of the nation’s fighting force. Current strategic efforts move beyond the health education aspects of health promotion into those that are designed to create healthy installation environments where soldiers live, learn, eat, and work. This coordinated approach includes building wellness centers, creating and optimizing local community coalitions, assessing the built environment using standardized tools, and incorporating principles of healthy living by design into the standardized installation master planning process. The U.S. Army Public Health Center assesses the effectiveness of each of these efforts in promoting health behavior changes. This session will provide the audience with an overview of soldier health behavior challenges, a summary of how health promotion is operationalized within the Army organizationally, a description of how Army health promotion compares to civilian health promotion activities, and an orientation to the remaining presentations within the session.

background: The Army Public Health Center (APHC) has implemented a standardized, evidence-informed wellness model that is delivered to Soldiers via a network of community-based facilities – known as Army Wellness Centers (AWCs) – that are physically located outside of Military Treatment Facilities. Currently operating on 34 Army installations, AWCs provide a robust suite of community-based health education services designed to help Soldiers obtain and maintain military readiness. They are centrally managed by the APHC to ensure the services provided are in alignment with U.S. Community Preventive Services Task Force recommendations. Program evaluations of AWC effectiveness have provided promising evidence of an association between participation in AWC services and outcomes related to military readiness.

methods: Data collected from two cohorts of clients participating in AWC services –one in fiscal year 2014-2015 (n=5,703) and the other in fiscal years 2015-2017 (n=40,386)– were analyzed using a pretest/posttest outcome evaluation design to examine whether those engaging in AWC services experienced goal-moderated improvements in multiple physiological and anthropometric outcomes.

results: Clients with at least one follow-up outcome assessment experienced significant improvements (p<.05) in physiological and anthropometric measurements, including body mass index, body fat percentage, estimated VO₂ maximum, and blood pressure.

conclusions: Army community members’ participation in AWC services is associated with improvements in multiple physiological and anthropometric measurements, suggesting the AWC’s community-based approach to health education holds promise for improving the health and readiness of military members.

Background: Army installations, similar to communities in the civilian sector, are comprised of interdisciplinary, complex elements that impact Army Family health. The Army developed Commander’s Ready and Resilient Councils (CR2C) to mitigate the natural stovepipes occurring within separate chains of command, and to more effectively synchronize health promotion programs and services on Army installations. As part of a larger evaluation strategy, leadership sought to determine the extent to which an Army council was achieving collaborative and integrated decision-making related to outcomes.

Methods: A social network analysis was conducted at one Army installation as a case study. Thirty-one council members completed the Program to Analyze, Record, and Track Networks to Enhance Relationships (PARTNER) Tool and data were analyzed with UCINET software. Key measures of social network functioning included density, connectedness, centrality, and integration.

Results: Council members reported about half (45.9%) of all possible relationships within the council. The social network map indicated that the council was not dominated by a single member; members participated in the council as a collective whole. The greatest proportion of council members (44.6%) reported involvement in integrated activities.

Conclusions: Findings indicate council performance is not driven by a senior ranking military officer, and instead is influenced by membership integration and partnerships. The relatively high level of integration further suggests that separate chains of command on the Army installation collaborate and equally participate in the council. Study implications may be extended to the civilian sector to demonstrate the importance of examining member relationships within community health coalitions.

Background: Healthy Army Communities (HAC) is a coordinated Army-wide effort to encourage healthy lifestyles by reshaping Army communities to support healthier places to live, learn, eat, and work. Army Installation Management Command (IMCOM) is leading key food stakeholders at the headquarters level who are committed to providing healthier food choices at local Army installations. Part of the HAC efforts is to objectively assess the Army’s food environment and help create action plans to improve the nutrition environment.

Methods: The Military Nutrition Environment Assessment Tool (m-NEAT) includes questions regarding the policy, availability, and behavioral design of food facilities on Army installations. At each of the five HAC installations, Registered Dietitians completed a pilot of the m-NEAT at four types of food facilities (cafeteria-style dining facilities, restaurants, convenience stores, and grocery stores).

Results: Dietitians completed 155 m-NEAT assessments (17 dining facilities, 105 restaurants, 25 convenience stores, and 8 grocery stores) total. Grocery stores had the highest availability of healthy food options, followed by dining facilities, convenience stores, and restaurants. Restaurants consisted mostly (70%) of fast food types and had the largest variability in providing healthy foods followed by convenience stores, dining facilities, and grocery stores. Dietitians offered suggestions for tool improvement.

Conclusions: Installation food facilities varied in the healthy food options available to soldiers. The HAC stakeholders used m-NEAT findings to identify opportunities for improvement to inform policy and healthy food availability at local installations. The tool is currently being revised to improve its relevance based on users' feedback.

Background: The Army is moving towards redesigning its installations to facilitate active living and mitigate readiness threats resulting from soldiers’ sedentary behaviors. As part of its standardized master planning process, the Army completes Area Development Planning (ADP) charrettes that engage community members in visioning how installation areas can be thoughtfully developed. The Military Promoting Active Communities (m-PAC) tool assesses how well an area supports and promotes active living. This case study at two Army installations examined the feasibility of completing the m-PAC during the ADP charrette and if the tool’s use could help installations prioritize public health concepts into their master plans.

Methods: Evaluators systematically observed attempts to complete and use findings from the m-PAC during ADP charrettes at two installations, quantifying the discussion instances related to healthy community planning and how m-PAC concepts facilitated discussions and project prioritization. Evaluators conducted a master plan document review to determine how many proposed ADP projects promoted health and active living.

Results: Completing the full m-PAC tool within the ADP charrettes was not feasible. However, utilizing a checklist based on m-PAC concepts was helpful in facilitating discussions on healthy community planning principles. Across the two installations, 48 of 73 proposed projects (66%) incorporated principles of healthy community planning.

Conclusions: The ADP charrettes are an appropriate Army platform to encourage future healthy community planning. The m-PAC could be used as a monitoring tool to ensure the installation adheres to its master plan and completes projects that prioritize health and active living.