Military Settings Strategy

Military Settings

STRATEGY 1 – Leadership

TACTICS 1:

The DoD and VA should identify a functional lead to drive organizational change and transform current strategy and doctrine into actionable policies, systems, and/or environmental changes, prioritizing physical activity as a fundamental component of Total Force Fitness (TFF) and Whole Health (WH).

Objectives:

In 2023 the DoD-VA Joint Executive Committee (JEC) should review the NPAP Military Sector and identify where physical activity can become a unified JEC priority within the Joint Strategic Plan.
In 2023 the DoD-VA JEC should consider establishing a separately chartered Physical Activity Team, similar to the Suicide Prevention Team, to assess and align interagency physical activity coordination efforts.
In 2023 the Under Secretary of Defense for Personnel and Readiness (USDP&R) should consider establishing a Federal Office for Physical Activity and Health, similar to the Suicide Prevention Office, to advance holistic, data-driven health-readiness metrics through policy, oversight, and engagement to positively impact individual behaviors and beliefs, as well as instill systemic cultural change.
By 2024 the Federal Office for Physical Activity and Health should establish an annual forum to solicit feedback on the implementation of physical activity initiatives, encourage organizational engagement, maintain momentum, and create a positive enviroment for future development.
By 2024 the Federal Office for Physical Activity and Health should work with the Office of Personnel Management and DoD Military Decorations and Awards Program to enact policy through which leaders receive formal recognition and reward for implementation of policy, systems and/or environmental changes that enhance physical activity literacy, TFF and WH.
By 2024 the Federal Office for Physical Activity and Health should work with the Secretary of Defense for Public Affairs on public communication and community engagement stories that promote the importance of physical activity as it relates to military readiness and national security.

STRATEGY 2 – Education and Employment of Qualified Personnel

TACTICS 1:

Identify existing personnel within the DoD and VA workforce with requisite subject matter expertise in physical activity and health, physical fitness, and/or tactical strength conditioning, who can be immediately leveraged as subject matter experts within their organizations. [Aligns with NPAP Public Health Sector Strategy 1]

Objectives:

In 2023, the DoD and VA should determine the physical activity and health credentials and/or qualifications that can be effectively leveraged for subject matter expertise, and conduct a systems record review to identify existing personnel, (e.g. Army Wellness Centers) that may be utilized in support of physical activity initiatives.
In 2023, the VA and/or Veteran-based organizations (e.g. the Student Veterans Association) should develop and disseminate a list of institutions of higher education with an active Office of the Student Veterans Association that offer degree programs in the areas of exercise science, strength and conditioning, or tactical strength and conditioning.
In 2023, the DoD should leverage existing resources (e.g. DOD Credentialing Opportunities Online) to identify credentialing and/or qualifying opportunities for existing personnel in the areas of physical activity, health promotion, physical fitness, and/or tactical strength and conditioning.
In 2023, the DoD should establish a method of identifying Reserve Officers’ Training Corps students majoring in an exercise-related field (e.g. Exercise Science, Kinesiology, Strength and Conditioning, Physical Education) in order to recognize their potential capacity to provide subject matter expertise within their assigned unit and to priorititize their continuung education.

TACTICS 2:

Collaborate with government agencies, industry, and academia to identify existing, or to develop new, progressive levels of subject matter expertise through internal mechanisms, external professional credentialing bodies, and institutions of higher education, to support and sustain physical fitness, performance, and readiness of personnel, that can then be evaluated (e.g., U.S. Air Force and American College of Lifestyle Medicine’s Lifestyle & Performance Medicine Working Group Charter).

Objectives:

By 2023, the VA should adapt or adopt an existing curriculum for physical activity and health (e.g. the American College of Sports Medicine (ACSM) Physical Activity in Public Health Specialist) to establish a Certificate Program focused specifically on Physical Activity and Health in order to create workplace champions.
In 2023, Veterans should be prioritized for educational opportunities to become qualified and/or credentialed physical activity and health, physical fitness, or tactical strength and conditioning experts.
By 2023, the VA and/or Veteran-based organizations should partner with professional certifying bodies (e.g. ACSM, National Strength and Conditioning Association (NSCA), National Academy of Sports Medicine (NASM), American Council on Exercise (ACE)) and/or institutions of higher education for developing, implementing,and having a plan to evaluate programs for Veterans that lead to professional certifications or academic degrees in support of Whole Health and Let’s Move!
In 2023, the DoD should establish a method of identifying Reserve Officers’ Training Corps students majoring in an exercise-related field (e.g. Exercise Science, Kinesiology, Strength and Conditioning, Physical Education) in order to recognize their potential capacity to provide subject matter expertise within their assigned unit and to priorititize their continuung education.
By 2024, each branch of the U.S. Armed Forces should establish and/or optimize existing internal schools (e.g. U.S. Army Master Fitness Trainer, U.S. Marine Corps High Intensity Tactical Training), and/or career pathways (e.g. U.S. Army Voluntary Transfer Incentive Program) in support of the Physical Fitness dimension of TFF to develop entry-level tactical strength and conditioning subject matter experts.
By 2024, each branch of the U.S. Armed Forces, and all uniformed services should establish and/or optimize existing internal programs and facilities and/or external professional certifying bodies (e.g. ACSM, NSCA, NASM, ACE) in support of the Physical Fitness domain of TFF to develop entry-level physical and health promotion experts.

TACTICS 3:

Use credentialed and/or qualified subject matter experts to drive individual- and population-level programs to improve physical activity, health, and readiness of personnel.

Objectives:

In 2022, the DoD should consider reviewing designated physical activity providers that exist within the North Atlantic Treaty Organization (NATO) and Five Eyes (FVEY) partner nations to assist in the establishment and sustainment of physical activity career pathways within the U.S. military.
In 2023, the VA should develop and deliver a standardized, baseline education module on physical activity and health for delivery to every employee, contractor, health profession trainee, volunteer, veteran, and beneficiary of the VA.
In 2023, all components and branches of the U.S. Armed Forces should consider presenting courses of action for establishing a military occupational specialty (MOS), with progressive levels of qualification/education/promotion relevant to tactical strength and conditioning.
In 2024, the DoD and the nation’s senior military colleges should formalize and implement a scholarship program to train future health and human performance leaders for the U.S. Armed Forces similar to its Cyber Scholarship Program (CySP).
In 2024, the DoD and VA should collaborate with the newly-established Federal Office for Physical Activity and Health to provide incentives for completion of physical activity and health education that leads to a professional certification and/or qualification in health, physical fitness, or tactical strength and conditioning training.

TACTICS 4:

Collaborate with government agencies, academia, and/or industry leaders with expertise in program evaluation to develop and implement process, impact, and outcome measures to assess the efficacy and effectiveness of educating and employing credentialed and/or qualified personnel. [Aligns with NPAP Public Health Sector Strategy 4]

Objectives:

In 2022, the DoD and VA should convene a panel of experts in program evaluation to identify the most salient process, impact, and outcome measures, and the costs associated with conducting thorough evaluation, building on established models (e.g. Army Wellness Centers).
In 2023, the DoD should collaborate with government agencies, industry, and/or academia to conduct evaluations of tactical strength and conditioning programs across all branches and components, and to report process, impact, and outcomes findings.
In 2023, the VA and/or Veteran-based organizations should identify meaningful outcomes for assessing the efficacy of educational programs aimed at helping Veterans achieve professional certifications or degrees and subsequent employment as a qualified professional.
In 2024, the DoD and VA should establish a forum for consolidating evidence of best practice for development and training of qualified personnel.
In 2025, the DoD and VA should implement best practices and lessons learned from findings.

STRATEGY 3 – Surveillance and Technology

TACTICS 1:

Develop a plan to integrate physical activity as a vital sign into electronic health records, such that physical activity can be monitored from the point of accession into the military through the lifespan of a Veteran. [Aligns with NPAP Healthcare Sector Strategy 1, and National Academies of Medicine Healthcare Workgroup]

Objectives:

In 2023, the DoD and VA should formalize the common data elements across DoD and VA systems to ensure longitudinal connections from recruitment through the lifespan of Service Members and Veterans.
In 2023, the DoD and VA should establish policy, procedures and practices to strengthen physical activity monitoring and reporting, such that the effect on health behaviors, and benefit of targeted prevention programs, can be justly recognized.
In 2024, the DoD and VA should develop predictive models and tracking tools to determine optimal physical training metrics, and relative interventions, across the lifespan of Service Members and Veterans.

TACTICS 2:

Ensure that electronic health records systems are capable of supporting routine health surveillance functions to monitor incidence and prevalence of physical activity-related injuries and illnesses.

Objectives:

By 2023 the DoD should routinely monitor, in a standardized manner across the military services, health conditions that have been demonstrated to be associated with low levels of physical activity and fitness, such as overuse musculoskeletal injuries, heat illnesses and obesity.
By 2023 DoD and VA health records systems should have standard medical record code sets for physical activity-related conditions including not just injuries and obesity, but also stress, anxiety, depression, Post Traumatic Stress Disorder, heart disease, stroke, diabetes, and certain other conditions that should be routinely monitored and reported

TACTICS 3:

Conduct periodic worksite-based health screenings and/or telehealth visits that measure physical activity and fitness levels of DoD/VA workers. [Aligns with NPAP Healthcare Sector Strategy 1, NPAP Business & Industry Sector Strategy 1, and National Academies of Medicine Workplaces Workgroup]

Objectives:

Use standardized population health measurements to capture longitudinal information on employees to track effective interventions.
Evaluate, prescribe, and monitor physical activity for efficacy in the employee population.

TACTICS 4:

Develop, implement, evaluate, and fund strategies to effectively integrate objective measures of physical activity derived from wearable devices, smartphones, tablets, and applications into workplace and healthcare settings.

Objectives:

In 2023, the DoD should consider expanding upon, and effectively communicating, the VA’s encrypted and protected Apple Health Records capability to include physical activity tracking.
In 2023, the DoD should consider expanding upon the use of mobile health technologies and patient-generated data, as demonstrated by the VA’s Office of Connected Care, to enable the development of tailored physical activity programs across broad demographics.
In 2023, the DoD and VA should consolidate and publicize key initiatives (e.g. the VA’s Fitbit pilot, and the mobile health technologies within the DoD’s Building Healthy Military Communities initiative) that demonstrate potential for enhanced physical activity amongst at-risk population groups, and enable the DoD and VA to quickly assess effectiveness.

TACTICS 5:

Replace lagging indicators of health and performance with leading Key Performance Indicators (KPIs) of human movement (e.g., force plate technology, movement screens, isometric assessments) to enhance measurement of physical fitness and performance.

Objectives:

In 2023, the DoD should invest in developing a secure, unified data-management system capable of integrating disparate and disaggregated data into synthesized reporting.
In 2024, the DoD should integrate training and assessment outcomes with leading KPIs to effectively engage the holistic health team (clinician, leadership, end-user) with enhanced physical fitness and performance measures.

STRATEGY 4 – Physical Activity and Physical Training Programs

TACTICS 1:

Develop and implement comprehensive and immersive physical activity and physical training prescriptions for the U.S. Armed Forces to ensure the delivery of safe and effective training and subsequent assessments of the Physical Fitness Dimension of TFF.

Objectives:

In 2022, the DoD should review the Physical Fitness and Body Fat Program Directive, and any associated policy, procedures, and practices with a view to better enabling an enterprise-approach to physical training progression across the U.S. Armed Forces.
In 2022, as part of the Physical Fitness and Body Fat Program Directive review, the DoD should consider developing physical training policy, procedures, and practices that effectively address pre-accession fitness training, recruit conditioning, and periodized sustainment training, with a focus on injury prevention.
In 2022, as part of the Physical Fitness and Body Fat Program Directive review, the DoD should consider incorporating mandated periods of instruction/allocated time for all pre-accession, recruitment, and sustainment physical training as a means of prioritizing the importance of individual- and population-level program delivery.
By 2023, the U.S. Armed Forces should apply best practices and technologies observed and/or validated from NATO, FVEY, Special Operations Command, and sport communities to optimize warfighter readiness and performance.
By 2024, the DoD should be in a position to comprehensively assess the physical activity and physical fitness of Service Members, as a foundation for safe and effective physical training.

TACTICS 2:

Adequately fund physical training and education programs to ensure optimal readiness from recruitment through the lifespan of Service Members and Veterans.

Objectives:

In 2023, the DoD-VA JEC should consider utilizing a separately chartered Physical Activity Team to identify and assess existing pre-accession, recruitment and sustainment programs that have evidence to support efficacy for improving physical fitness (e.g. the U.S. Army National Guard Recruitment Sustainment Program, the U.S. Army Holistic Health and Fitness).
In 2023, the Physical Activity Team should make known to the USDP&R the resources required to employ evidence-based pre-accession, recruitment, and sustainment programs, with particular emphasis in states and localities shown to have the highest number of personnel with the lowest fitness levels and/or largest number of musculoskeletal injuries.
In 2024, the National Defense Authorization Act should include an allocation of resources for evidence-based pre-accession, recruitment and sustainment physical training programs.

TACTICS 3:

Establish a Tri-Service Component Center of Excellence aimed at optimizing the Physical Domain of TFF by providing training and education, and sharing evidence of best practices specific to DoD physical activity, physical fitness, and performance.

Objectives:

In 2022 the Reserve Component should convene a Joint Task Force, including representation from academia and industry, to share evidence of current best practices, needs, and concerns as they relate to the Physical Domain of TFF.
By 2023, the Reserve Component should Identify and utilize an established training site with the capacity to provide equipment, classroom space, lodging, and infrastructure in order to provide training to all Reserve Component Soldiers, Sailors, Airmen, and Marines on how to increase physical activity, physical fitness, and overall performance.
In 2023, Subject Matter Experts from across the Tri-Services should be stationed at the COE to provide Branch Specific training and education, while also coordinating and sharing best practices with other Branch Subject Matter experts
In 2024, MOUs/MOAs should be established, as necessary, in order for the COE to serve as a testing and evaluation arm for DoD Research Labs in order to validate and provide feedback on the latest equipment, technology, training, and services.
In 2024, the Reserve Component should retain properly educated and qualified professionals at state- and local-levels to implement established best practices for the TFF Physical Domain.
In 2025, the Reserve Component should host an annual meeting and publish a Joint Annual Report on evidence-based best practices for physical activity and physical fitness programs. That meeting should also be used as a platform for a Reserve Component Awards program (see NPAP Military Sector Strategy 1, Tactic 1, Objective 5).
In 2025, the DoD should consider establishing regional COEs based upon best practices and lessons learned from having established the initial COE.

TACTICS 4:

Provide resources and training necessary to support Veterans and VA employees in adopting and maintaining physical activity behaviors, including providing access to relevant expertise, evidence-based behavioral change programs, and qualified fitness and behavior change professionals.

Objectives:

In 2023, the VA should ensure employees, veterans and veteran’s families are connected with the VA’s Fitbit pilot and other ongoing activities to enable the VA to quickly assess cost-benefit effectiveness
In 2023, the VA should adapt existing Wellness in the Workplace programming and expand existing Veterans Health Administration Employee Health Promotion Disease Prevention Program to include physical activity incentives
In 2023, the VA should promote and encourage every employee to participate in VA’s Whole Health programming in order to create role models and champions for the program, and support participation in the employee satisfaction models to promote rewards for adoption.
In 2023, the VA should collaborate with the National Academies Physical Activity and Health Innovation Collaborative to promote and monitor physical activity and encourage uniformity of best governmental and public health practices

STRATEGY 5 – Partnerships

TACTICS 1:

Establish an interagency advisory committee on physical activity within the National Physical Activity Plan Alliance (NPAPA), with representation from all NPAP Sectors, to enable effective multi-sectoral collaboration.

Objectives:

In 2022, the NPAPA should identify key representatives from all NPAP Sectors to establish an interagency NPAP Advisory Committee.
In 2023, the NPAPA Advisory Committee should have established an effective framework for the management of multi-sectoral partnerships at the federal/national level, including the means by which they will review and evaluate the effectiveness of collaborative, multi-agency implementation of physical activity based initiatives.
In 2023, the NPAPA Advisory Committee should disseminate a progress report on the physical activity-based initiatives selected for multi-agency implementation at the federal/national level.
In 2024, the NPAP Advisory Committee should disseminate a report on best practices and lessons learned for multi-agency implementation of physical activity-based initiatives at the federal/national level.
In 2025, the NPAP Advisory Committee should identify additional federal/national level physical activity-based initiatives for prioritization upon review of the 2026 NPAP

TACTICS 2:

Provide key DoD and VA leadership to the NPAP Advisory Committee to represent the Military Sector’s priorities and ensure engagement with federal and national functional leads responsible for enhancing physical activity.

Objectives:

By 2023, the DoD and VA NPAP Advisory Committee representatives should have established a formal feedback loop with the DoD-VA JEC.
In 2023 and 2024, the DoD and VA NPAP Advisory Committee representatives should work in an advisory role to inform any newly established USDP&R Physical
In 2023 and 2024, the DoD and VA NPAP Advisory Committee representatives should make recommendations to functional leads within the Military Sector on physical activity-based initiatives that enhance multi-sectoral partnerships and raise the profile of the DoD and VA as a leader in the improvement of physical activity

TACTICS 3:

Ensure collaboration between the DoD Education Activity (DoDEA) and NPAP’s Education Sector and Sport Sector to identify opportunities to advance existing recommendations from those Sectors, and to identify new opportunities to increase physical activity and fitness in DoDEA schools and among military-connected students.

Objectives:

In 2022, leadership from DoDEA and the NPAP’s Education Sector should convene to identify and report on existing Strategies and Tactics from the Education Sector that are currently being implemented in DoDEA Schools and among military-connected students.
In 2022, leadership from DoDEA and the NPAP’s Sport Sector should convene to identify and report on existing Strategies and Tactics from the Sport Sector that are currently being implemented in DoDEA Schools and among military-connected students.
In 2023, leadership from the NPAP’s Education Sector and Sport Sector should collaborate with the DoDEA and industry to pilot test a national martial arts initiative in DoDEA schools and among military-connected students.
In 2024, leadership from DoDEA and the NPAP’s Education Sector should disseminate evidence of best practices for implementation and evaluation of existing Strategies and Tactics from the Education Sector
In 2024, leadership from DoDEA and the NPAP’s Sport Sector should disseminate evidence of best practices for implementation and evaluation of existing Strategies and Tactics from the Sport Sector.

TACTICS 4:

Use the DoD’s United Facilities Criteria (UFC)—Installation Master Planning document and its Building Healthy Military Communities (BHMC) initiative, perhaps in collaboration with the NPAP’s Transportation, Land Use, and Community Design Sector and/or the NPAP’s Community Recreation, Fitness and Parks Sector, to implement and evaluate their physical activity-related recommendations (e.g., “Healthy Community Planning,” “Connected Transportation Networks,” and “Horizontal and Vertical Mixed Use” within the UFC, and State Coordinators for the BHMC)

STRATEGY 6 – Communication

TACTICS 1:

Invest in efforts to understand what motivates military members, veterans, civilian DoD and VA employees, and military families to establish physically active lifestyles and identify strategically compelling physical activity messaging.

Objectives:

By 2023, the DoD and VA should establish a formal collaboration with the FrameWorks Institute, as part of the larger, multi-method project sponsored by the NPAPA and the Centers for Disease Control (CDC), to study better ways to frame physical activity amongst sub-populations within the Military Sector
In 2023, the DoD and VA should develop and test communication narratives that ensure sub-populations within the Military Sector understand the various types of physical activity and behavior strategies needed to create lasting cultural change.
In 2024, the DoD and VA should engage in cross-sectoral partnerships to ensure marketing campaigns effectively target all demographics and disparities within the Military Sector

TACTICS 2:

Work with other public stakeholders to invest in developing, implementing, and evaluating physical activity communication campaigns that are effective in increasing individual-level physical activity.

Objectives:

In 2023 the newly established Federal Office for Physical Activity and Health should work with the Secretary of Defense for Public Affairs to develop an evidence informed strategic communication plan focused on improving physical activity amongst sub-populations within the Military Sector.
In 2024, the Federal Office for Physical Activity and Health, in collaboration with the Secretary of Defense for Public Affairs, should identify federal funding lines to effectively resource physical activity communication and marketing campaigns for the Military Sector.

TACTICS 3:

Incorporate DoD and VA physical activity marketing campaigns into policy, procedures, and practices.

Objectives:

By 2024, the DoD and VA should introduce physical activity messaging into annual and biennial guidance documents.
By 2025, the DoD and VA, in collaboration with relevant constituents, should lead efforts to promote and share best practices and lessons learned from incorporating physical activity messaging into guidance documents.
By 2025, the DoD and VA should ensure full awareness and education is provided to the Military Sector through dissemination of tools and resources important for promoting physical activity to improve health, prevent disease and disability, and enhance quality of life.

TACTICS 4:

Partner with broadcasting agencies to highlight Military Physical accomplishments, such as Best Ranger Competition, or Best Sapper Competition, to bring positive attention to the physical aspect of the military.