The Association of Health Risk Behaviors and Training-Related Injury Among U.S. Army Basic Trainees

While physiologic risk factors for injury in military training populations have been well-established, knowledge of behavioral risk factors is limited. This study investigated the association of health risk behaviors with injuries sustained by men and women in Army basic training. Self-reported questionnaire data on health risk behaviors collected on entry to training were linked to medical data on injuries occurring during the 9-week training period. Multivariate survival analysis tested the association of training-related injury with a risk-taking index consisting of five individual health risk behaviors (cigarette use, smokeless tobacco use, alcohol use, weight control practices, and diet/lifestyle choices). Analyses were conducted separately for men and women, and models controlled for demographic, physical fitness, and physiologic characteristics. Among this sample of 1,156 young mean and 746 women (median age: 19), cumulative injury incidence was 4.2 trainees/1,000 trainee-days for mean and 9.3 trainees/1,000 trainee-days for women. Males in both the lowest (Hazard ratio (HR)=1.73, 95%CI:1.47,2.05) and highest (HR=1.92, 95%CI:1.57,2.34) risk-taking index categories had greater risk of training-related injury compared to persons within one standard deviation of the mean risk index score. Cigarette use was independently associated with training-related injury; males in the medium risk cigarette use index category had 1.8 times the risk of a training-related injury compared to the low risk category (HR=1.77, 95%CI:1.31 ,2.40). An association between the combined risk-taking index and injury was not seen among females. However, females in the high risk cigarette use category (HR=1.53, 95%CI:1.1 0,2.12) and females in the medium (HR=1.08, 95%CI:1.03, 1.14) and high risk (HR: 1.52, 95%CI:1.21, 1.93) diet/lifestyle categories had higher risk of training-related injury compared to females in low risk categories.
Doctoral dissertation