Health characteristics and self-identified health promotion needs of army personnel in Perth Western Australia

Australian Defence Force (ADF) personnel require high levels of health and fitness to cope with the inherently stressful situations that occur as part of military life. However, several health and lifestyle issues among ADF personnel have been identified relating to mental health and alcohol use1, tobacco smoking in deployed personnel2 and increased body mass index (BMI).3 Mental disorders among service personnel have been of increasing concern,1,4 and recent recognition of issues around alcohol use has led to a focus for ADF culture change.5,6 While cardiovascular risk factors such as smoking have long been associated with the military, and ongoing efforts to reduce smoking are required,2,7 overweight and obesity have become more prevalent8,9 and costly10 in recent years. This is despite such diseases historically being reported at lower rates than in civilian populations, probably due to a ‘healthy worker effect’.3 This effect has been attributed to ADF applicant screening processes whereby individuals with specified health problems are declined entry, resulting in a healthier workforce.3 It has been suggested the increasing prevalence of overweight and obesity among service personnel may in part be related to changes made to ADF entry restrictions in 2005, which allow acceptance of applicants with a BMI of up to 33kg/m2, in the absence of hypertension, elevated blood cholesterol, or evidence of cardiovascular or other metabolic disease.3,10 At local levels, an important step in addressing many of these identified health risk factors is collaboration with personnel and identification of their health promotion needs. This preliminary study sought to identify baseline cardiovascular and mental health characteristics of a cohort of Army personnel in Perth Western Australia, along with their self-identified needs related to health promotion activities, with a view to guiding future workplace health promotion initiatives. Through the application of needs assessment principles, stakeholder voices were incorporated to identify direction in program planning,11 and to foster the community ownership and action required for successful health promotion.12 In this study, the workplace provides an opportune setting, and engagement with the target group early in the health promotion evaluation cycle can encourage empowerment, self-help, social support and participation, which are essential requirements for health behaviour change.13