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Purpose The US Military recently added the Vestibular/Ocular Motor Screening (VOMS) to the Military Acute Concussion Evaluation-2 (MACE-2). However, there are no published data on the VOMS in US military personnel. The purpose of this study was to examine the reliability of the VOMS and factors associated with false positives in healthy US Army Special Operations (USASOC) personnel. Methods 206 healthy USASOC military personnel aged 18–40 completed VOMS between March 2018 – January 2019. Analyses included internal consistency, false-positive rates, intraclass correlation coefficients (ICC), chi-square analyses with odds ratios (OR), and independent samples t-tests. VOMS clinical cut-off scores (2+ on any symptom, >5cm for NPC) were used to determine false positives. Results Reliability for the VOMS symptom items (Cronbach alpha=.98, ICC=.90) and NPC distance (Cronbach’s alpha=.98, ICC=.93) were high. False positive rates ranged from 10.2% (smooth pursuits) to 16.9% (NPC distance). Concussion history was associated with a 2.5 fold increase for one or more VOMS items above cut-offs (p=.01). Participants with at least one VOMS item above cut-offs were deployed nearly 6 months longer on average than those without (p=.04). Conclusion The findings indicate that VOMS is reliable in US military personnel with few false positives. False positives were associated with concussion history and longer deployment history, which should be considered by military medical providers when administering and interpreting VOMS in this population. Moving forward, researchers should examine the stability of VOMS and its ability to identify mTBI in this population.

Introduction The Department of Defense spends more than $3 billion annually on medical costs of lifestyle-related morbidity. Military service members and veterans engage in unhealthy behaviors at a higher rate than the civilian population. Lifestyle medicine may mitigate lifestyle-related chronic diseases and increase medical readiness in the U.S. Military. However, patients’ perspectives in a military community regarding a lifestyle medicine–based approach to health care have not been studied. The purpose of this study was to assess the knowledge and attitudes of and interest in lifestyle medicine–based care within a military community. Materials and Methods Following exempt study determination from the Madigan Army Medical Center Human Protections Office (Reference No. 220092), a prospective, cross-sectional, mixed-methods survey study was conducted from September 2020 to January 2021. Volunteer subjects, including active duty service members, National Guard/Reserves service members, and military dependents, were recruited to complete the anonymous survey while seeking care at five military clinics on Joint Base Lewis-McChord, Washington. The study’s outcome measures were the overall level of awareness of lifestyle medicine, ranked level of importance of seven core lifestyle domains, the level of interest in seeking care from a lifestyle medicine practitioner, and the preferred lifestyle medicine care delivery setting. Kruskal–Wallis analyses of variance were conducted for categorical outcome variables. Mean composite scores were calculated for lifestyle domain rankings. Results A total of 623 respondents completed the survey with a 62.3% response rate. The majority of respondents (89.7%) lacked definitive knowledge of the field of lifestyle medicine. Food/nutrition and sleep were ranked the highest of all lifestyle domains to include in a healthcare approach in the overall sample and across all subgroups. Quitting smoking and alcohol use were ranked the lowest of importance overall and across all subgroups. The majority of respondents (65.7%) reported it was extremely or very important that lifestyle is part of the healthcare discussion with their provider. Of 614 responses, 77.6% of respondents expressed interest in a lifestyle medicine–based approach to health care, with 40.1% indicating they were extremely or very interested in this approach. A direct correlation was noted between education levels and level of interest in lifestyle medicine. Many respondents selected their primary care provider (34.6%) or a lifestyle medicine practitioner embedded in their primary care clinic (26.1%) as their preferred method of lifestyle medicine provision. A higher smoking rate was demonstrated in service members in combat arms occupational specialties. Conclusions Despite an overall low level of awareness of lifestyle medicine, most respondents expressed interest in a lifestyle medicine approach to health care, with food/nutrition and sleep ranked as the most important domains. Lower levels of education may be a potential barrier to patient willingness to engage in lifestyle medicine care. Service members in combat arms occupational specialties may represent a potential target population for smoking cessation interventions. Further research with a larger sample more proportionately inclusive of all military service branches is needed.