Meta analysis oct 17 2005 v3

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Army training attrition

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Meta analysis oct 17 2005 v3

  1. 1. The Attrition Gordian Knot: A Meta-Analysis Arthur Schopenhauer's Arthur Schopenhauer's three stages of truth: three stages of truth: "First, it is considered "First, it is considered absurd and ignored or absurd and ignored or ridiculed. ridiculed. Next, it is considered Next, it is considered dangerous to the status dangerous to the status quo and viciously attacked. quo and viciously attacked. Lastly, it is considered Lastly, it is considered wholesome, indeed, selfwholesome, indeed, selfevident." evident." Unofficial The presentation represents the author’s views and do not represent DA or DOD Policy. “Training for warfighting is our number one priority in peace and in war. Warfighting readiness is derived from tactical and technical competence and confidence. Competence relates to the ability to fight our doctrine through tactical and technical execution. Confidence is the individual and collective belief that we can do all things better than the adversary and the unit possesses the trust and will to accomplish the mission.” FM 7-0, Training the Force 1
  2. 2. FY05 IET AC-USAR-NG Discharge % 30 12 MRA Rate By Component 25 Where Discharges Occur by Volume AIT 1,554 16% % 20 14.8 15 MP 31B 230 2% 12.6 10.5 10 8.3 Total AC-RC AC Only USAR Only NG Only 12.6 14.8 10.5 NG male 1,597 12% USAR male 910 7% AC female 2,759 20% Knox 145 1% FLW ** 1,191 12% 8.3 FY05 Discharge % USAR female 615 5% Ja cks on** 1,632 17% Eng 21B 207 2% Che m 74D 146 1% 5 0 R ECB N 987 10% NG female 634 5% Discharges By Gender & Component By Volume AC Male 7,101 51% Arm 19K 622 6% Sill 262 3% Inf 11X 1,934 21% Be nning 332 3% Art 13X 603 6% AC RECBN, BCT, OSUT, and AIT Allocation of Discharges by ATC, MOS, and Function (RECBN/AIT) • 84% of IET discharge attrition volume is in BCT & OSUT. • 41+% of IET discharge attrition volume is at 2 sites, even though rates are “good”. • 30% of AC-RC IET discharges are women. 2
  3. 3. Regular Army IET Attrition Risk Profile Recruit Domain Organizational Bonus Behavioral Law Waiver Never thought about quitting High School Current smoker Physical Fitness High Initial Fitness Demographic African American Hispanic -30% Ever suspended Hx fainting /expelled Hx chest pain Preaccession Injury Health -80% Combat Arms MOS Low BMI Entry Pay ChildGrade ren High BMI Hx depression Hx backpain Old >26 years Young <19 years 20% Hx shortness of breath Not AFQT Tier I IIIB 70% Female 120% 170% % Change in Risk of IET Attrition • Base-case IET attrition risk is 15% • Further left or right of the center line means increased risk (or less risk) of attrition. • Bubble size is relative size of RA accessions that are associated with that factor. 20% female bubble is about 1/2 the size of the 33% TSC IIIB bubble. • Not Tier 1 (10%) • Female (20%) • AFQT IIIB (30%) 3
  4. 4. Objectives 1. Meet the Army’s mission, manpower and quality objectives. 2. Soldier graduates who can “mobilize, deploy, fight, sustain, and win any conflict” as units with Warrior Ethos and Values. 3. Soldier graduates who are physically healthy, taskrelevant physically fit, mentally resilient, and deployable. 4
  5. 5. BLUF • Highest quality force in history. • Accessions processes are a complex system (Six Sigma). • Important progress in ‘fighting & winning’ in last 2 years. • Reducing ‘Preventable attrition’ requires ‘actionable intelligence’ across the processes. • High-value target is reducing and/or treating injuries, especially among women. 5
  6. 6. We have the best Soldiers Facts: Highest Quality Accessions In Army History 1979-2002 100 FY79 FY02 90 80 70 60 50 40 30 Our Soldiers: • Intelligent • Educated • Diverse • Representative cross-section 20 10 0 ec A y lit ua ge le ol Q V m er t-T rs Fi m So h ig H I at IA -II G I at SD C C H iti ttr Yet, first-term attrition remains relatively stable 6
  7. 7. MEPCOM (DOD) • School ASVAB Plus ‘Interest Finder’ P&P • Possible dedicated CATASVAB tablet • Web ASVAB Plus ‘Interest Finder’ • Automate all screening tests • METS CATASVAB Plus ‘Interest Finder’ • DL sites • POS contract sites (within 1-2 hours) UNIT OF ASSIGNMENT RECBN USAREC (Station) (Office, School, or Mobile) • POS: Sells MOS • Police check • Determine quals • Waivers • Submit EPSQ Programs • College First • VOTEC • ACASP Plus • STARR Plus • Hispanic ESL Plus • SMART Plus • Recruiter Incentives MEPCOM (DOD) • POS Physical Forward (contract) (within 1-2 hrs of most stations) • ‘Functional’ Physical • Security Background Check (electronic fingerprint/TECH check) • Improved medical screens (R&D) • Physical Fitness Screen USAREC (Station) • Contract • Waivers • Personnel records Self-Paced Training (DL/P&P) • Prepare for Success • BCT preview module (mandatory) • Success Profiler (SP) • Wellness/Success modules (based on SP & time) (JROTC / CHPPM) • Fitness modules (based on time) (JROTC/USAPFS) • YMCA/YWCA MWR ‘partnership’ MEPCOM (DOD) (MEPS MINUS) MTMC (DOD EA) RECEPTION CENTER • Med inspect • Enlistment Oath • Travel (ticket(s)/airport) • E-Packet (medical/ contract) • QC • RON Lodge/meals • Transport • Lodge • Meals • E-Packet - Records • Shots • Issue uniforms • Holding • RECBAS/SIDPERS / ATRRS • TR 350-6 Appdx. replaces AR 601212 USAREC GC • Quality & Status Check • E-Packet (Personnel records) USAREC LNO • MOS renegotiations AOT OSUT TRAINING Policy • OSUT emphasis • Mini-OSUT for VOTEC grad • Combat survival (more trng pts) • Prepare for AIT (as needed) • Prepare for UOA • TR 350-70 aligned with FM 7.0 • BCT Redesign: Individual & Collective design & tasks integrated • ENDEX is respective squad ARTEP or ARTEP slice. • Ranges designed as Perimeter slice. Programs • “You Can Make It” • Combat Chaplain Values Sessions • Injury CM • Disease CM • Victory Diet • Standardized APFT • Dual Track BCT tracks or Ability Group units Six Sigma: Accessions is a complex7system
  8. 8. IET Review Task Force Core Warrior Tasks 9 Week Improved POI ~40 Warrior Tasks Every Soldier … Move (7-8 Tasks) Shoot (16-17 Tasks) • Qualify w/ assigned weapon • Correct malfunctions w/ assigned weapon • Engage targets with M240B MG • Engage targets with M60 or M249 MG • Engage targets with M2 Cal. 50 MG • Engage targets with MK-19 MG • Correct malfunctions of a MG (M2, M240B, M249, MK-19) • Engage targets with weapon using a night vision sight (AN/PVS-4, AN/PAS-13, AN/TVS-5) • Engage targets using an aiming light (AN/PEQ-2A, AN/PAQ-4) • Employ mines and hand grenades • Determine location on ground (terrain association, map, & GPS) • Navigate from one point to another (dismounted & mounted) • Move over, through, or around obstacles (except minefields) • Prepare/operate a vehicle in a convoy Fight (15 Tasks) • Move under direct fire • React to indirect fire (dismounted & mounted) • React to direct fire (dismounted & mounted) • React to unexploded ordnance hazard • React to man-to-man contact (Combatives) • React to chemical or biological attack/hazard • Decontaminate yourself & individual equipment using chemical decontaminating kits • Maintain equipment • Evaluate a casualty • Perform first aid for open wound (abdominal, chest, & head) • Perform first aid for bleeding of extremity • ‘Fighting and Winning’ Training Has Improved Communicate (4-5 Tasks) • Perform voice communications (SITREP, SPOTREP, Call for Fire, & MEDEVAC) • Use visual signaling techniques Joint Urban Operations (3 Tasks) • Perform movements techniques during an urban operation • Engage targets during an urban operation • Enter a building during an urban Red untrained Amber familiarized Green proficient 8
  9. 9. Attrition Variables Cadre Attitudes & Training Medical Screening & Treatment Training POI IET/IMT Soldier/Leader Success Soldier Health & Nutrition Resources/ Facilities Policies Processes • No “smoking gun” in attrition studies. • No “silver bullet” solution. • Determining variance is key to future interventions. 9
  10. 10. Cadre Attitudes & Training Medical Screening & Treatment Training POI IET/IMT Soldier/Leader Success Soldier Health & Nutrition Applicant Qualifying Events Resources/ Facilities Policies Processes • • • • • • • • • Aptitude (ASVAB) Education Physical exam Background check AIM (opt)(TTAS) ‘Gold Standard’ is balancing absolute risk and manpower supply. Relative Risk models distort actual group performance. Bio-data variables have low predictive validity and are not causal. Caution: Type I & II error rates: 1% of 400k = 4k 10
  11. 11. Cadre Attitudes & Training Medical Screening & Treatment IET/IMT Soldier/Leader Success Soldier Health & Nutrition Key issues: Training POI Resources/ Facilities Policies Processes • • • • Can we identify who will succeed? Screen out or develop in? Etiology: Them or us? Are “standards” valid? 1. 2. Less applied fitness and experience (CHPPM). Less group shower experience (TRAC) (demise of fitness in schools). Privacy big issue for adolescents. 3. Poorer nutrition (NAHANES)(less milk drinking, fast foods in HS cafeterias, etc.). 4. High rate of entry mild anemias (females)(USARIEM). 5. Osteopenia (varies by race & gender)(Navy). 6. Adverse Childhood Experiences (ACE) (Navy, VA, USMC, CDC) (high rates of associated high-risk behaviors). 7. Quad-ham imbalances (Sportsmetrics) leading to knee/lower limb injuries (females). 8. Smoking (linked to attrition, poor bone remodeling, and injuries). 9. “Emotional Intelligence” (adaptive skill sets)(vary by education) 10. High % “overfat,” especially minorities and females. 11. 10% will have Chlamydia. 11
  12. 12. Cadre Attitudes & Training Medical Screening & Treatment Adverse Childhood Experiences (ACE) Training POI IET/IMT Soldier/Leader Success Soldier Health & Nutrition Table shows 2 factors. Probably getting a skewed population. Having 3 factors does increase risk somewhat, but does not automatically mean all are ruined. Resources/ Facilities Policies Processes USMC Sample National Samples Men Women Men Women Child physical 26.7 38.3 3.2 4.8 Child sexual 14.7 51.0 3-16 12-27 1. More ACE factors increase risk. 2. Associated high-risk behaviors (sex, drugs, smoking,, etc.) 3. Associated impacts (health, disease, poor job performance, depression, etc.) 4. Diminished brain development. 5. Treatable. 12 Wolfe, J. (1996-2000). Adaptation to First-Term Enlistment Among Women in the Marine Corps. DAMD 17-95-1-5047.
  13. 13. Cadre Attitudes & Training Medical Screening & Treatment Training POI IET/IMT Soldier/Leader Success Soldier Health & Nutrition I Resources/ Facilities Policies Processes 8% II 28% IIIA 17% IIIB 17% IV Recruiting Policies & Processes 21% 1. Marketing de-emphasizes incentives. 2. Army MOS needs drive contracts and incentives. 3. ASVAB Interest Inventory not used to align applicant to MOS. 4. DA PAM 611-21 MOS descriptions not ‘fully accurate.’ 5. MOS entry standards may not be fully validated. 6. Medical exam relies on self-reported history. 7. Recruiting shortfalls lead to short-term Cat IV surges. 8. Ringers. 9. Tattoo standards. 10. BF standards. 11. Recruiter incentive system (ceiling effect). 13
  14. 14. Cadre Attitudes & Training Medical Screening & Treatment Training POI IET/IMT Soldier/Leader Success Soldier Health & Nutrition Body Fat Standards Have Significant Impact Resources/ Facilities Policies Processes 60 56 55 50 40 36 % 30 20 20 Male Female 24 19 10 0 Caucasion Black Hispanic % 17-20 y/o Who Do Not Meet Army Accession Weight Standards Source: Nolte et al, “U.S. Military Weight Standards: What Percentage of U.S. Adults Meet the Current Standards?” The American Journal of Medicine, Vol 113, Oct 15, 2002 14
  15. 15. Cadre Attitudes & Training Medical Screening & Treatment Training POI Attrition Is Not the Only Criteria IET/IMT Soldier/Leader Success Soldier Health & Nutrition Resources/ Facilities Policies Processes I 8% II IIIA 28% 17% High Cat IIIB? IIIB IV 17% 21% Strategy Questions: 1. Where do you want to make-up shortfalls from? 2. What MOS are affected? 15 Cat IV?
  16. 16. Cadre Attitudes & Training Medical Screening & Treatment Training POI IET/IMT Soldier/Leader Success Soldier Health & Nutrition Resources/ Facilities Training Policies & Processes Policies Processes 1. Commanders’ and NCOs’ attitudes are important. 2. Challenging POI. 3. Attrition and TTHS reduction mutually exclusive. 4. Treatment programs can be highly effective. 16
  17. 17. The Dark Side 1. G1 Insist-Assist Study showed leaders’ attitudes affected attrition rates. a. “High Attrition Leaders” believe they were ‘gate guarders.’ b. “Low Attrition Leaders” believed they were developing Soldiers. 2. Emotional Events (‘high fear events,’ ‘food deprivation’, ‘sleep deprivation,’ ‘extreme PT,’ etc.) may be mis-perceived as preparing Soldiers for war, or strengthening them to cope with stress. 17
  18. 18. A Dark Side Example: Body Hardening (Sept-Oct 04) Recruit A Recruit C Recruit D NOT the Army 18
  19. 19. “The discipline which makes the soldiers of a free country reliable in battle is not to be gained by harsh or tyrannical treatment. On the contrary, such treatment is far more likely to destroy then to make an Army. It is possible to impart instruction and to give commands in such a manner and such a tone of voice as to inspire in the soldier no feeling, but an intense desire to obey, while the opposite manner and tone of voice cannot fail to excite strong resentment and a desire to disobey. The one mode or the other of dealing with subordinates springs from a corresponding spirit in the breast of the commander. He who feels the respect which is due to others cannot fail to inspire in them regard for himself while he who feels and hence manifest disrespect towards others, especially his inferiors, cannot fail to inspire in them hatred for himself.” 19
  20. 20. USMA Peak Performance Model Managing the Moment Attention Control Concentration amidst distraction” “ Setting the Goal “ ye on the prize” E Positive/Effective Thinking “ Becoming what we think about most ” Visualization Imagery “What you see is what you get” Winning Performance Stress Management Excellence under pressure” “ • Dr. Scott Graham, ARI – Infantry Forces Research Unit, found time management, command of the basics, skill mastery, combat focus, visualization, repetition, and the use of job aids to be the most critical training that prepared Soldiers for efficient and effective task accomplishment under life-threatening, fastpaced, and stressful conditions (ARI Newsletter – Volume 13, Number 3). • In 1998, the United States Olympic Committee summarized the survey results from 296 Olympic team athletes and 46 Olympic team coaches and found concrete confirmation that human performance at elite levels is heavily dependent upon intangible, mental factors, i.e. confidence despite setbacks, concentration amidst distractions, and composure during times of stress. • Bottomline: High fidelity task repetition to standard prepares Soldiers for combat success. It is why the Combat Training Centers (CTC) and training devices like MILES, paint balls, etc. are worth the multi-billion dollar investment. 20
  21. 21. Cadre Attitudes & Training Medical Screening & Treatment Training POI IET/IMT Soldier/Leader Success Soldier Health & Nutrition Trend: BCT Hours Per Day Trend: BCT Hours Per Day Resources/ Facilities Policies Processes 26 22 18 Personal Meals Sleep POI 14 10 6 2 -2 1980 1981 1983 1987 1990 1993 1997 2005 BCT POI growth (notional data for 2005) affects both Cadre and Soldiers. Source: MAJ Moten study 21
  22. 22. Sleep 1. Teens need 8.5-9.25 hours of sleep each night. By mid 20s: 8 hrs. 2. Natural biological sleep period 11 pm – 8 am (Melatonin secretion). 3. 0400-0600 is peak time for subjective sleepiness. Inadequate sleep: Adequate sleep: • Decreased: • Improved: – Vigilance – Cognitive performance • Inconsistent logical reasoning skills • Reduced short-term memory • Slower learning rate – Grades – Negative mood (depressive symptoms) – Immunity (more disease) – – – – Test scores Retention of knowledge Disease resistance Morale • Decrease in: – Discipline problems – Depression – Attrits • Increased risk re: – Stimulant use – Injury and death – Stress hormone levels Degrading sleep degrades learning, mood, and health. Prof Mary Carskadon, Brown University http://www.sleepfoundation.org/hottopics/index.php?secid=18 22
  23. 23. CHPPM No-PCU and USMA Experimental PCU-X BCT Injury Rates 25 25 20 % BCT Discharge Rates 20 15 15 % 10 5 0 10 5 111 Pass BCT 111 Fail PCU 111 Fail PCUX 111 Fail No PCU 0 111 Pass BCT 111 Fail PCU 111 Fail PCUX 111 Fail No PCU 1. BLUF: The FTU PCU lowers overall discharge attrition by 500-800+ Soldiers (0.4-0.8+%), as well as lowers course attrition and injury rates. 2. 4%-7% of men and 10%-24% of women fail the RECBN 1-1-1 assessment historically. 50-75% of the PCU at GIT sites will be women. 3. PCU Results: a. Lower course attrition: In the “1-1-1 Fail No PCU” group, men are 2.5 times and women are 1.5 times more likely to attrit from BCT. b. Lower discharge attrition: In the “1-1-1 Fail No PCU” group, men are 3.0 times and women are 1.9 times more likely to be discharged from BCT. c. Lower injury rates. d. The USMA experimental PCU-X vice the traditional PCU improved female outcomes, but male outcomes were worse (but still better than no PCU). Recommendation is that USAPFS design a new PCU PT POI. 23 4. The optimum solution would be a 12 week BCT PCU company to maximize program flexibility, maintain bonding, provide non-PT training, etc.
  24. 24. Cadre Attitudes & Training Medical Screening & Treatment IET/IMT Soldier/Leader Success Soldier Health & Nutrition • • • • Admiral Nelson 11 March 1804 to Dr. Mosely: Training POI “The greatest thing in all military service is health; and you will agree with me that it is easier for an officer to keep men healthy than it is for a physician to cure them”. Resources/ Facilities Policies Processes BCT (Ft. Jackson)(CHPPM) – Males: 19-37% are injured in a 9-wk cycle – Females: 42-67% are injured in a 9-wk cycle Most injuries are overuse, compared to traumatic – Males: 75% – Females: 78% Most injuries involve the lower extremity (low back, pelvis, hip and leg)* – Males: 83% – Females: 87% Activities associated with injuries in BCT – Weight bearing activity; predominantly running, marching, walking 24
  25. 25. Femoral Neck Fracture 1. Established a Clinical Practice Guideline for Hip Pain 2. Early effective management 3. 75% Increase in FNFF detection Source: CPT Short, MAH 1. Even though small numbers, high costs. 2. 100% medical board. 3. Lifetime of treatment. 16 14 12 10 8 Pre CPG (56) 6 CPG (98) 4 2 0 MAY JUN JUL AUG SEP OCT NOV DEC JAN FEB MAR APR 25
  26. 26. USAPFS Standardized PT Program Cadre Attitudes & Training Medical Screening & Treatment Injury Rates Soldier Health & Nutrition Training POI IET/IMT Soldier/Leader Success Resources/ Facilities Policies Processes Good design lowers injury rates Control Group 33% decrease Standardized PT Program Injury Control Week 1 Week 3 Time (in weeks) Week 5 Week 9 26
  27. 27. Operation Aegis Injury Control • • • BCT grads arrived at AIT with high injury rates. Epidemiological research identified PT running as the primary cause of musculoskeletal injuries Changing the running program – Reduced Clinic Visits - 36.5% – Reduced Profiles - 48.6% – No difference in APFT Scores – Reduced APFT retakes - 50% – Saved 612 limited duty days/week/BN If implemented at all IET/AIT sites: $9M/yr & 1.5M limited duty days/yr Potential Savings 27
  28. 28. USMC Athletic Trainer Initiative • Treat Marines forward as Warrior Athletes. • Sports Medicine Physicians. • Certified Athletic Trainers (ATC’s) – Contracted civilians who work for USMC commands. – GREEN ASSETS (NCAA model) – aligned with SMART rehab clinic operations – clinically supervised by Navy Sports Med MDs when dealing with injuries – emphasis on prevention, education, and treatment – Collect/enter injury data into TIMS (injury database) RESULTS – Increased Paris Island grad rate (female 68.3% to • 3 trainers for Parris Island (GIT)/1 ATC for San Diego. 74.7%) SOIW Discharges Due to • 3 Athletic Training Room Musculoskeletal Injury FY-03 v. FY-04 Island (ATRs) for Parris 140 115 120 44.3% Decrease in FY-04 100 89 39.3% Decrease in FY-04 Discharge # 80 64 60 54 61.5% decrease in FY-04 40 26 20 FY-03 FY-04 – Increase in BCT Return to Full Duty (RTFD) rates (male 55.5% to 64.3%; female 37.5% to 52.2%) from rehab. – Increase in BCT recycle grad rates (female 63.5% to 75%). – Decrease in BCT rehab discharge rates (male 13%; female 24%) – Decreased musculo/skeletal discharges at Infantry School (see chart at left). – Decreased attrition at OCS (male 8.7% to 3.8%; female 18.1% to 5.9%) – Greater cadre knowledge – Critical feedback on sources of injuries leading to fixes. – Conservative estimate of $3.5M in cost avoidance and $2.9M in Return on Investment in FY04 v. FY03. 10 0 Pre-Existing Occurred in Training Total 28
  29. 29. USMC Athletic Trainer Initiative NPQ ATTRITION (POST INDUCTION) AT SUMMER OCS CLASSES 2002-2004 20.0% 18.1% 18.0% 16.0% NPQ ATTRITION 14.0% 12.0% 12.0% 10.0% MALE 8.7% FEMALE 8.0% 6.0% 5.9% 5.7% 3.8% 4.0% 2.0% 97 22 109 31 ATC BEGAN JULY 03 69 11 0.0% 2002 2003 YEAR 2004 29
  30. 30. USMC Athletic Trainer Initiative Cadre Attitudes & Training Medical Screening & Treatment Training POI IET/IMT Soldier/Leader Success •250 •235 Resources/ Facilities Policies Processes •192 •200 •150 •# Soldier Health & Nutrition •SOI-E MUSCULOSKELETAL DISCHARGES •100 •65 •50 •THROUGH JUN 05 •ATC ARRIVES NOV 04 •0 •2003 •2004 •YEAR •2005 30
  31. 31. Cadre Attitudes & Training Medical Screening & Treatment Defence Injury Prevention Program (DIPP) Training POI IET/IMT Soldier/Leader Success AUSTRALIAN DEPARTMENT OF DEFENCE Soldier Health & Nutrition Resources/ Facilities Policies Processes • Effective, reduced injury rates by 20-70%. • Gives CDRs the tools; harnesses local personnel’s knowledge and skills working together to address their own injury problems. • Reflects world best-practice from leading injury prevention experts. • Consistent with Defence policy and approaches to risk management and injury prevention 31
  32. 32. Defence Injury Prevention Program (DIPP) AUSTRALIAN DEPARTMENT OF DEFENCE Results for Army Basic Training: Injury 100% Results for Army Basic Training: Attrition 80% 100% Uninjured 60% 80% 40% 20% Injured 60% 1,834 Injuries Prevented Training Successes 40% 0% 1994 1995 1996 1997 1998 1999 20% 0% 1,260 Discharges Prevented Discharged 1994 1995 1996 1997 1998 1. 95% reduction in rates of pelvic stress fracture in female recruits. 2. Elimination of serious knee injuries in recruits negotiating obstacle course 3. 70% reduction over 4 years in rates of injury and attrition 4. 60% reduction in compensation paid per recruit enlisted 32 1999
  33. 33. Pre-training Cadre Attitudes & Training Medical Screening & Treatment 1. Soldier Health & Nutrition 2. 3. Post-training Training POI IET/IMT Soldier/Leader Success Females at risk for knee injuries Neuromuscular testing & training is an effective preventative treatment for serious knee injuries in female athletes. Reduces knee injuries by 80%. Resources/ Facilities Policies Processes 0.5 0.43 0.4 0.3 0.2 0.116 0.094 0.1 0 Results:All Sports; All Knee Injuries per 1,000 Athlete 33
  34. 34. What To Do? 34
  35. 35. Hypothesis: Preventable Discharge Attrition Can be Reduced 1. Female discharge attrition rates generally runs almost 2x male attrition rates and are 29.4% of all AC-RC discharges by volume. 46.7% of all AC BCT discharges. 2. Female rates vary by component from AC at 24.5% to USAR at 8.4% to NG at 13.4%. 3. Females enter the FTU PCU and PTRP at higher rates than males and have 3-5x higher injury rates than men. FY05 IET AC-USAR-NG Discharge Male-Female % 4. Contributing factors are: a. Leg muscle imbalances 30 b. Mild anemia 25 c. Soft bones 20 d. Lower fitness levels at entry 15 24.5 20.3 % 16.7 10.8 10 e. Smoking hx 8.4 7.2 5 5. Female attrition can be reduced by: a. Restarting & Improving the FTU PCU and PTRP at GIT sites. b. Implementing injury control measures. 13.4 12.8 0 FY05 Discharge % AC-RC AC Male Male 10.8 12.8 USAR AC-RC AC NG Male Male Female Female 8.4 7.2 20.3 c. Researching application of bone screening. d. Improving the IET diet (Surgeon study underway in fall). 6. Fixing female preventable attrition also fixes male preventable attrition. 35 24.5 USAR Female NG Female 16.7 13.4
  36. 36. BU 36
  37. 37. “Fit To Win:” Health and Wellness • Nutrition - Increase health Reduce Anemia from 85% to 10% Authorize vitamins Authorize protein drinks Authorize electrolyte beverages Interactive elements – ex. sleep affects stress, disease, and injuries • Injury Countermeasures - Reduce injuries by 50% (milestones TBD) - Standardized PT (first phase)(move to group tailoring next) -(DEP, FTU, DSS, PTRP, etc. POIs) - Marching SOP - SOP - Heat Injury prevention & treatment (Cdr Mission TSP: Safety Ctr) - New Active Profile Form • Disease Countermeasures - Reduce disease by 50% (milestones TBD) New vaccination program SCT Program Handwashing (retrofit sinks, etc.) Building design standards (02/contamination, etc.) • Stress Countermeasures (FM 22-51 re Combat Stress) - Sleep standards - Homesickness countermeasures - Link to “You Can Make-It” Program 37
  38. 38. “You Can M ake It” Program 1. Positive Command Climate 2. See a BCT graduation early 3. Combat Stress countermeasures (FM 22-51) 4. Positive Jody/Cadence Calls (TR 350-6)(already changed) 5. Combat Chaplain revival-style ‘values’ sessions 6. BCT & DSS POI redesign 38
  39. 39. Warrior Ethos and Values 1. Redesign BCT POI around Future Soldier Warfighting Skills • • • Flexible and adaptable Resilient Warfighting Collective tasks (ex. Squad defensive perimeter) 2. Redesign supporting elements: • • • • Ranges (multiple tasks & collective slice) Targets (reactive and shoot-back) Combat PT test/program (STO underway) System changes • • • • • • • • TR 350-70 (TD policies & standards) SMCT CTT AR 350-1 NCOES OES EER/OER? Transition Plan: Upgrade Army-wide skills by FY09 39
  40. 40. USARIEM BCT Study USARIEM BCT Study •• 1993 study of 174 women in an all-female 8-week BCT company at 1993 study of 174 women in an all-female 8-week BCT company at Fort Jackson, SC (158 graduated). Fort Jackson, SC (158 graduated). •• Serum ferritin (body iron stores) were low pre-BCT (56% females Serum ferritin (body iron stores) were low pre-BCT (56% females at less than 20 ng/ml iron) and decreased further by graduation at less than 20 ng/ml iron) and decreased further by graduation (84%)(pg.109). (84%)(pg.109). •• Anemia was correlated with poor PT performance (pg. 111) Anemia was correlated with poor PT performance (pg. 111) •• Serum folate levels were low normal pre-BCT and “decreased Serum folate levels were low normal pre-BCT and “decreased significantly over BCT.” (pg. 2) significantly over BCT.” (pg. 2) •• Maternal low folate intake and blood levels have been "associated Maternal low folate intake and blood levels have been "associated with (fetal) neural tube defects“ (pg. 39) (note: neural tube defects with (fetal) neural tube defects“ (pg. 39) (note: neural tube defects can be fatal for the fetus). can be fatal for the fetus). •• Menu was adequate in energy, but inadequate in B6, folic acid, Menu was adequate in energy, but inadequate in B6, folic acid, calcium, magnesium, iron, and zinc. calcium, magnesium, iron, and zinc. •• Source: “Health, Performance, and Nutritional Status of U.S. Source: “Health, Performance, and Nutritional Status of U.S. Army Women during Basic Combat Training,” (1995)(ADA302042) Army Women during Basic Combat Training,” (1995)(ADA302042) •• NOTE: Study BCT menu governed by the 1985 AR 40-25 NOTE: Study BCT menu governed by the 1985 AR 40-25 40

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