Objective:To explore the perceptions of soldiers participating in a US Army Office of The Surgeon General’s worksite health promotion programme (WHPP) on the local food environment within their campus-style workplace.Design:Focus groups were conducted to evaluate the perceived effectiveness of the WHPP implementation. Further exploration of focus group data through thematic analysis focused on perceived contributions of the military campus-style food environment to soldiers’ nutrition behaviours.Setting:Three US Army installations located in the continental USA.Participants:Active duty soldiers (n 366) participating in one of the fifty-eight focus groups.Results:Soldiers shared a common belief of self-discipline and personal responsibility as the foothold to nutrition behaviour change. Soldiers described aspects of the military campus-style food environment as factors impeding achievement of optimal nutrition. Collectively, soldiers perceived the proximity and density of fast-food restaurants, lack of healthy alternatives on the installation and the cost of healthy food as inhibitors to choosing healthy foods. Overwhelmingly, soldiers also perceived time constraints as a factor contributing to unhealthy food choices.Conclusions:Although nutrition behaviour is individually driven, soldiers perceived the military campus-style food environment inhibits healthy decision making. Nutrition programming in military WHPP must integrate food environment changes to improve soldiers’ nutrition behaviour outcomes. Applicable to the military, food choice behaviour studies suggest environmental changes must be appealing to young adults. Considerations for environmental changes should include an increased portion size for healthy options, broadened use of soldiers’ daily food allowances on local produce and increased availability of grab-and-go options.

Background Previous studies have documented the impact of domain-specific leadership behaviors on targeted health outcomes in employees. The goal of the present study was to determine the association between specific leadership behaviors addressing COVID-19 and US soldiers’ mental health and adherence to COVID-19 public health guidelines. Methods An electronic, anonymous survey was administered to US Army soldiers across three major commands (N = 7,829) from December 2020 to January 2021. The primary predictor of interest was soldiers’ ratings of their immediate supervisors’ behaviors related to COVID-19. The outcomes were soldiers’ mental health (i.e., depression and generalized anxiety) and adherence to COVID-19 public health guidelines. Covariates were rank, gender, ratings of immediate supervisors’ general leadership, level of COVID-19 concerns, and COVID-19 status (e.g., tested positive, became seriously ill). Logistic regressions were used to model the unique association of COVID-19 leadership behaviors with outcomes after adjusting for covariates. Results High levels of COVID-19 leadership behaviors were associated with lesser likelihood of soldiers’ screening positive for depression (AOR = 0.46; 95% CI [0.39, 0.54]) and anxiety (AOR = 0.54; 95% CI [0.45, 0.64]), and greater likelihood of frequent adherence to preventive health guidelines (AORs = 1.58; 95% CI [1.39, 1.80] to 2.50; 95% CI [2.01, 3.11]). Conclusion Higher levels of COVID-19 leadership behaviors may support soldiers’ mental health and encourage their adherence to COVID-19 public health guidelines. Given the link between these leader behaviors and soldier adaptation to the pandemic over and above general leadership, training for supervisors should focus on targeting specific health-promoting behaviors. Results can inform leader training for the military and other high-risk occupations.

Objective: Fitness trackers are appealing in public health intervention programmes aimed at promoting physical activity, but it is unclear whether tracker use leads to health behaviour change in soldiers. This programme evaluation investigated the effects of fitness tracker usage on goal-setting, self-monitoring and physical activity behaviours in soldiers participating in a 6-month pilot health promotion programme focused on improving sleep, activity and nutrition behaviours. Design: Participants in this programme ( n = 4,418) were assigned to a health education, an education plus fitness tracker or a comparison (i.e. no intervention) condition. Data were collected at baseline, 3 and 6 months. Setting: Soldiers in five brigades participated in one of the three conditions, with health education integrated into daily operations. Method: Participants in the health education and education plus fitness tracker conditions were exposed to materials distributed via health educators and through leader interaction. Participants in the education plus fitness tracker condition were also assigned a fitness tracker for use. Results: Self-monitoring increased in all conditions over time; however, there was a significant interaction of group by time, such that individuals in the fitness tracker condition reported significantly greater increases in self-monitoring over time, compared with the other groups. Conversely, self-reported physical activity decreased in all conditions over time, with no significant interaction, indicating no effect of group membership. Conclusion: Although fitness trackers are popular in the health and fitness industry, they may have limited utility as a public health intervention aimed at increasing physical activity in soldiers participating in this programme.

IntroductionThe objective of this study is to characterize the associations between demographic, attitudinal, and leadership factors with COVID-19 vaccination rates, vaccination intentions among those not vaccinated, and attitudes about vaccination safety, effectiveness, and importance. Methods A serial cross-sectional anonymous online survey was administered to soldiers at two large U.S. Army Divisions located in the Southwestern region of the U.S. at two different time points (April-May 2021 [Time 1; T1] N = 24,629; July-August 2021 [Time 2; T2] N = 21,116). Binary logistic regressions were used to assess demographic and attitudinal predictors of vaccination receipt and vaccination intent. Multinomial logistic regressions were used to assess demographic and leadership predictors of endorsement of three vaccination attitudes concerning effectiveness, safety, and importance. Results Approximately 43% of soldiers reported that they received a COVID-19 vaccine at T1, increasing to 67% at T2. Soldiers who agreed with three separate statements on vaccination effectiveness, safety, or importance were more likely to indicate that they intended to get the vaccination at both time points. Soldiers who reported that their immediate supervisor encouraged soldiers to get a COVID-19 vaccine were more likely to indicate that the vaccination was effective, safe, or important at both time points. Discussion Negative attitudes about COVID-19 vaccines were prevalent and correlated with less intention to get a vaccination. However, prioritizing leadership engagement around the importance of vaccinations may be a simple but widely effective intervention point to increase future vaccine uptake following the development of novel vaccines to future COVID-19 variants.

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