title: Physical fitness and injury reporting among active duty and National Guard/Reserve women: associations with risk and lifestyle factors.
abstract: OBJECTIVE
  As more women enter the military, it is important to understand how different risks and lifestyle factors influence physical fitness and injury among women in both active duty (AD) and National Guard/Reserve (NG/R). Women in military service are less fit and more likely to suffer musculoskeletal injuries during physical training than men. They also use more medical care during deployment than men. Using data from the Comprehensive Soldier and Family Fitness Global Assessment Tool 2.0 (GAT 2.0), self-reported health and lifestyle and behavioral risk factors were analyzed in nondeployed Army personnel, with the goals of examining (1) service-component differences across traditional risk and lifestyle factors, and (2) correlates of physical performance and physical activity-related injury.
  
  
  METHODS
  Self-report GAT 2.0 data included health risk factors (overall perceived health, sleep, diet, tobacco and alcohol use), self-reported health metrics (height, weight, Army Physical Fitness Test (APFT) scores), and history of physical activity-related injury. The GAT 2.0 was completed by 1,322 AD and 1,033 NG/R women, and APFT data were available for a subsample of 605 AD and 582 NG/R women.
  
  
  RESULTS
  Initial analyses of GAT 2.0 data indicated that AD had higher rates of fair/poor perceived health, poor sleep, and unhealthy diet compared to NG/R women. However, AD women had a lower APFT fail rate (8%) than NG (27%) and R (28%). Active duty women were more likely to experience a physical injury in the past 6 months (38%) than NG (19%) and R (22%) women, and more likely to seek medical care than NG/R women. Across all service components, predictive factors for APFT failure included high body mass index (BMI), fair/poor health, and unhealthy diet. Predictive factors for physical injury included high BMI, fair/poor health, and binge drinking.
  
  
  CONCLUSIONS
  Our analyses suggest that AD women Soldiers are more physically fit than NG/R women Soldiers, which is accompanied by a greater prevalence of physical activity-related injuries. As women's roles expand into combat military occupation specialties, a thorough understanding of service component differences will be critical to inform training programs, mitigate physical injury, and enhance force health protection and readiness.
authors.affiliation: Department of Military and Emergency Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD.
authors.forename: Josh B
authors.initials: JB
authors.lastname: Kazman
authors.forename: Sarah
authors.initials: S
authors.lastname: de la Motte
authors.forename: Elizabeth M S
authors.initials: EM
authors.lastname: Bramhall
authors.forename: Dianna L
authors.initials: DL
authors.lastname: Purvis
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Deuster
mesh_terms: D005260:Female; D015438:Health Behavior; D006801:Humans; D008019:Life Style; D008889:Military Personnel / Q000706:statistics & numerical data; D010809:Physical Fitness; D012309:Risk-Taking; D014481:United States; D014947:Wounds and Injuries / Q000453:epidemiology*