Concussion Knowledge and Attitudes in Reserve Officers’ Training Corps Cadets

ABSTRACT Introduction Military members’ knowledge of concussion signs and symptoms may be critical to appropriate concussion identification and health-seeking behavior, particularly for those in leadership roles. The current study aimed to characterize concussion knowledge and attitudes among future military officers undergoing U.S.-based Reserve Officers’ Training Corps (ROTC) training. Materials and Methods Army and Air Force ROTC cadets at 2 large, public universities were utilized for a survey-based observational study. The study was approved by the institutional review board at both university research sites. Cadets completed a modified Rosenbaum Concussion Knowledge and Attitude Survey to obtain cadets’ Concussion Knowledge Index and Concussion Attitude Index, where higher scores are preferable. Cadets’ concussion knowledge and attitudes were characterized via descriptive statistics. Results Cadets (n = 110) had a mean Concussion Knowledge Index of 18.8 ± 3.2 (range = 9–23, out of 25). Potentially detrimental misconceptions included: belief that typically concussion symptoms no longer persist after 10 days (79.1%) and brain imaging shows visible physical damage following concussion (74.5%). Mean Concussion Attitude Index was 60.6 ± 7.4 (range = 46–75, out of 75). In general, cadets reported higher agreement with safe concussion behavior than what they believe peers would report. Conclusions Cadets were found to have a high concussion knowledge, yet common misconceptions remained. Cadets consistently reported safe choices but were less sure that peers felt similarly; future investigations should evaluate ROTC concussion social norms and education should note peers’ beliefs supporting safe concussion attitudes.

Access to Care, Reporting Behaviors, and Quality of Athletic Training Service Interactions for Reserve Officers' Training Corps cadets

Purpose: Reserve Officers’ Training Corps (ROTC) programs prepare student-civilians to become leaders through strenuous physical and leadership training. Unlike their student-athlete counterparts who have direct access to athletic training services, ROTC cadets may or may not have a healthcare provider available. The purpose of this study was to examine the access to care and reporting behaviors of ROTC cadets with a secondary aim exploring the quality of healthcare service interactions relative to patient-centered care. Methods: An online survey assessed access to care using a self-report tool on the type of medical providers available to the ROTC cadets (n=132, age=20±3 y) dispersed between the Army, Navy, Air Force, and Marines, and their illness/injury history and reporting behaviors. The participants who sought care for an injury/illness also completed the Consultation and Relational Empathy tool to measure the level of patient-centered care by the healthcare provider with follow-up analysis using the Consultation Care Measure tool for all athletic training service interactions. Data were analyzed using descriptive statistics. Results: ROTC cadets reported access to 2±1 healthcare providers including a designated civilian physician (26.5%), athletic trainer (23.5%), and ROTC peer first responder (14.4%). However, 50.8% of respondents stated they were unsure what healthcare providers were available. In total, 22.7% of cadets reported being injured and 26.5% reported being sick/ill while participating in ROTC activities. Of those who stated they had sustained an injury during ROTC, 59.9% seldomly or never reported their injury. The ROTC cadets who sought healthcare expressed they were satisfied with their injury (35.96±10.60) and illness (35.48±13.10) treatment from a patient-centered viewpoint. Conclusions: The ROTC cadets reported a general unfamiliarity with the healthcare providers available to them. Despite the reporting behaviors, the cadets reported being satisfied with the care they received.

Energy-Adjusted Dietary Intakes Are Associated with Perceived Barriers to Healthy Eating but Not Food Insecurity or Sports Nutrition Knowledge in a Pilot Study of ROTC Cadets

Military service is inherently demanding and, due to the nature of these demands, the term “tactical athlete” has been coined to capture the physical requirements of the profession. Reserve Officers’ Training Corps (ROTC) cadets are a unique subset of the military service community, and the complexity of their training and educational pursuits increases their susceptibility to unhealthy eating patterns. The purpose of this pilot study was to explore the relationship between the perceived barriers to healthy eating, food insecurity, sports nutrition knowledge, and dietary patterns among Army ROTC cadets. The usual dietary intake was gathered from (N = 37) cadets using the General Nutrition Assessment Food Frequency Questionnaire. The perceived barriers to healthy eating were measured using a set of scales consisting of social barriers (6 items, α = 0.86), access barriers (2 items, α = 0.95), and personal barriers (2 items, α = 0.67), with higher-scale scores indicating greater perceived barriers. Spearman correlation coefficients were used to measure the association between the energy-adjusted dietary intakes and the scores on the barriers scales. Energy-adjusted intakes of calcium (ρ = −0.47, p ≤ 0.01), fiber (ρ = −0.35, p = 0.03), vitamin A (ρ = −0.46, p ≤ 0.01), vitamin C (ρ = −0.43, p ≤ 0.01), fruit (ρ = −0.34, p = 0.04), and vegetables (ρ = −0.50, p ≤ 0.01) were negatively correlated with the perceived personal barrier scores. The energy-adjusted intakes of fiber (ρ = −0.36, p = 0.03), vitamin C (ρ = −0.37, p = 0.03), and vitamin E (ρ = −0.45, p ≤.01) were negatively correlated with perceived social barriers, while energy-adjusted vitamin C intake was negatively correlated with perceived access barriers (ρ = −0.40, p = 0.01). Although additional research is needed to better understand the dietary patterns of ROTC cadets, among the participants in this study, greater perceived personal, social, and access barriers were associated with less nutrient-dense eating patterns. Interventions aimed at addressing such barriers may prove beneficial for the improvement of diet quality among ROTC cadets.

Sex-related Differences in Functional Movement Screen Scores Among Reserve Officers’ Training Corps Cadets

ABSTRACT Introduction The primary aim of Reserve Officers’ Training Corps (ROTC) programs is to prepare cadets for future military service. To successfully complete one of these programs and perform active duty responsibilities, cadets must be able to complete a variety of physical tasks. Therefore, performing movement screening may be useful for identifying potential movement disparities that could lead to injury. The purpose of this investigation was to determine whether sex-related differences in movement patterns exist on the Functional Movement Screen (FMS). The FMS is a tool that uses seven functional movements to assess movement pattern deficits and asymmetries; deep squat, hurdle step, inline lunge (ILL), shoulder mobility, active straight-leg raise (ASLR), trunk stability pushup (TSPU), and rotary stability. Materials and Methods Archived data for 93 (male, n = 69; female n = 24) ROTC cadets were provided to the primary investigators for analysis. Independent t-tests (P < .05) were conducted to analyze differences in assessments between sexes. Results Significant differences between sexes were observed on the ILL (P = .014), ASLR (P < .001), and TSPU (P < .001). Females scored higher on both the ILL (2.13 ± 0.54) and ASLR (2.04 ± 0.69) compared with males (1.81 ± 0.52 and 1.48 ± 0.58). Males scored significantly higher (P ≤ .001) on the TSPU (2.57 ± .581) compared with females (2.00 ± .417). No significant differences were observed in the deep squat (P = .865), hurdle step (P = .829), shoulder mobility (P = .342), and rotary stability (P = .230) assessments. Conclusions Sex differences in the ILL, ASLR, and TSPU may be because of greater mobility in the ankle and hamstrings and reduced upper-body muscle mass for females compared with males. Males performed better than females on the TSPU test. In conclusion, sex-related differences in FMS performance do exist within the ROTC population. Additionally, these differences should be taken into consideration when designing specific exercise programs for ROTC cadets.

Prevalence of Eating Disorder Risk and Body Image Dissatisfaction among ROTC Cadets

Injury risk is multifactorial including non-modifiable and modifiable factors such as nutrition and mental health. The purpose of this study was to estimate eating disorder risk and body image (BI) dissatisfaction among Reserve Officers Training Corps (ROTC) cadets. A total of 102 (male: n = 75, female: n = 27; age: 20 ± 2 years) ROTC cadets self-reported height, current and ideal weight, and completed the Eating Attitudes Test-26 (EAT-26) and self-perceived BI current and perceived sex-specific figural stimuli. The overall eating disorder risk for ROTC cadets was 32.4%. No significant differences were found when comparing sex, ethnicity, or military branch. Overall risk of pathogenic behaviors included 11.8% who reported binge eating; 8.8% who used laxatives, diuretics, or diet pills; 8.8% who exercised for >60 min to control their weight; and 8.8% who lost 9.1 kg or more within the last 6 months. We identified significant interactions (p ≤ 0.01) between sex of the solider, overall perceptions of male and female soldiers, and BI self-perceptions. The ROTC cadets in this study displayed eating disorder risk and BI dissatisfaction, which is concerning for tactical readiness, long-term behavioral health issues, and injury from pathogenic behaviors. Education and quality healthcare are necessary to mitigate the increased risk of eating and BI dissatisfaction within this population.

Concussion history is associated with increased lower-extremity injury incidence in Reserve Officers’ Training Corps cadets

IntroductionConcussions have been associated with an increased risk of lower-extremity musculoskeletal injury (LE-MSI) in athletes and US Army soldiers, creating an added economic, physical and social burden. Yet, there is a paucity of evidence on this relationship among Reserve Officers’ Training Corps (ROTC) cadets, a group which engages in activities with high-injury risk and will subsequently commission as active duty officers. This study aimed to examine the association between concussions and LE-MSI in ROTC cadets.Methods125 (83 were male) Army and Air Force ROTC cadets (19.8±2.0 years) from two large state universities’ Army and Air Force ROTC programmes participated in this study. Cadets completed a reliable injury history questionnaire to ascertain the following variables of interest: (1) any concussion history, (2) reported concussions, (3) undiagnosed concussions, and (4) potentially unrecognised concussion history and LE-MSI history (eg, ankle sprain, knee sprain or muscle strain). Data were analysed using a χ2 test for association and binary logistic regression to determine ORs.ResultsCadets with any concussion history (n=42) had a significantly (p=0.035) higher association with LE-MSI (OR 2.47, 95% CI 1.05 to 5.83) than those without. Cadets who had a reported concussion (n=33) had a significantly (p=0.026) higher association with LE-MSI (OR 2.95, 95% CI 1.11 to 7.84) compared to cadets without.ConclusionsROTC cadets with a history of diagnosed concussion were more likely to have suffered an LE-MSI than cadets without a concussion history. ROTC cadre should be aware of this relationship and incorporate injury prevention protocols.

Physical Performance Among Air Force ROTC Cadets Following Non-Mandatory Training

INTRODUCTION: Due to the standard collegiate academic calendar (two semesters), U.S. Air Force Reserve Officers Training Corps (ROTC) cadets have an approximate 3-mo break over the summer in which physical training (PT) is neither regulated nor required. The purpose of this investigation was to determine if significant changes in cadet physical fitness assessment (PFA) scores occur after a 3-mo summer break when training is not mandatory.METHODS: Male (N 28) and female (N 10) cadets performed the PFA in April and August. Cadets were split into two groups depending on if they participated in field training over the summer [FT; N 12 (men 6, women 6)] or did not [NFT; N 26 (men 22, women 4)] to determine if engaging in field training had any effect on performance.RESULTS: Cadets performed significantly better on run time (7%), pushups (7.6%), sit-ups (5.8%), and overall composite score (3.6%) before summer break compared to after. Significant time group interactions were observed for abdominal circumference and run time. Abdominal circumference paired samples t-tests indicated that while the FT group did not differ between the spring and fall time points, the NFT did. There was a main effect for time in which cadets had a significantly larger abdominal circumference in the spring compared to the fall semester.CONCLUSION: Nonmandatory physical training over summer break may significantly decrease a cadets performance on the PFA. Additionally, it appears that even the inclusion of field training for some cadets was not enough to prevent the detraining that took place over summer break.Mackey CS, Johnson Q, Dawes JJ, DeFreitas JM. Physical performance among Air Force ROTC cadets following non-mandatory training. Aerosp Med Hum Perform. 2020; 91(10):818823.

Benefits and Barriers Associated with Intention to Participate in Injury Prevention Programs in ROTC Cadets

Background: There is a lack of participation in Exercise-Related Injury Prevention Programs (ERIPPs) within Reserve Officer Training Corps (ROTC) which limits the effectiveness. Identification of factors which may influence participation in ERIPPs within ROTC cadets is an important first step in improving adoption and adherence rates. Therefore, the purpose of the study was to identify factors associated with intention to participate in an ERIPP within ROTC cadets. Methods: The study design was cross-sectional where a paper survey was distributed in spring 2019. Twenty-eight (M/F=23/5; Age=20.68±2.02years; Height=175.78±8.95cm; Mass=75.30±11.10kg) ROTC cadets volunteered to participate in this study. Participants completed the Health Belief Model Scale (HBMS) and Theory of Planned Behavior Scale (TPBS) to assess attitudes towards participation in ERIPPs. A backwards multiple linear regression was used to determine if associations between attitudes towards ERIPP participation and intention to participate existed. Partial eta squared was calculated for each significant variable to determine the strength of the association and alpha was set at P≤0.05 for all analyses.Results: Perceived benefits (B=4.364, ƞ2=0.68, p<0.001) had a positive and large association with intention to participate while perceived barriers (B=-2.43, ƞ2=0.40, p<0.001) had a negative and large association with intention to participate. There were no other statistically significant associations (p>0.05).Conclusion: Perceived benefits and barriers were significantly associated with intention to participate in ERIPPs within ROTC cadets. Implementation strategies for ERIPPs may need to focus on the benefits and barriers of participating in an ERIPP to increase adoption and adherence.