Robert DeFraites, MD, MPH

1
Prevention of Injuries DuringInitial Entry
Training

• Robert DeFraites, MD, MPH
• COL, MC

Fort Jackson, SC 19 Oct 1999
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Purpose

• To provide IET Injury Prevention Users Group
  with background information on process and
  progress

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Process Action Team AMEDD CS 29-30 March 99

• Co-hosted by MGs Peake/Van Alstyne
• Two key questions
• How to optimize IET fitness?
• Balance conditioning with injury
• How can Army best benefit from research and
  surveillance efforts?
• Evaluation, implementation, and monitoring for
  effectiveness

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Proceedings

• Information briefs
• Patterns of Injury in IET
• Individualized Physical Training for Profiled
  Soldiers
• DOD Injury Prevention Plan
• Use of Existing Databases for Injury Studies
• Discussion

5
Findings I. Optimal Fitness

• One size fits all regimen problematic
• Preliminary Recommendations
• Pre-entry conditioning program
• More strengthening exercises
• Progressive training for all

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Findings II. Learning from Research

• Effective advocacy by medical community
• Include state-of-art practices into doctrine,
  pubs, and practice
• Engage leaders in variety of forums
• Form IET Injury Prevention Users Group

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DOD Prevention

• Prevention, Safety and Health Promotion Council
  chartered by SECDEF, Chaired by AFSG (2 year
  term)
• Subcommittees
• Alcohol Abuse and Tobacco Use
• Injury/Occupational Illness
• Self-administered Assessment Tools
• Putting Prevention into Practice
• Sexually-transmitted Disease Prevention
• Joint Preventive Medicine Policy Group

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Injury Prevention Plan Goals

• A. Reduce frequency and severity of
  unintentional injury/occupational illness.
• B. Provide quality information to
  decision-makers in support of injury/occupational
  illness prevention.
• C. Implement best practices approaches to
  injury/occupational illness surveillance,
  research, intervention models, and prevention.
• D. Institutionalize continuous support for
  injury/occupational illness prevention

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Definition

• Injury/Occupational Illness damage to the
  body...
• no purposeful intent
• acute or cumulative exposure to energy(thermal,
  mechanical, radiant, electrical, or chemical)or
• from the absence of such essentials as heat or
  oxygen.
• will result in medical treatment or lost duty
  time.
• Department of Health and Human Services Healthy
  People 2010 Draft Definition (modification)

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Goal A Reduce frequency and severity of
unintentional injury/occupational illness

• Reduce impact of injuries
• Duty-related
• Physical training
• Other work related, especially lower back
• Not related to duty
• Leisure (sports, recreation)
• Motor -vehicle related

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Goal C Best practices implementedObjectives

• Promising intervention programs reviewed,
  selected and piloted
• Research and surveillance needs prioritized
• Training materials and manuals reflect advances
  in knowledge

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Goal C Best practicesTasks

• Convene military and civilian experts to review
  existing data and programs
• Select promising intervention programs for pilot
  testing
• Identify and prioritize research requirements to
  close data gaps

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Injury/Occ Illness Plan Focus
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Why a Users Conference?

• Broader Army perspective
• Forum for dialogue and discussion
• Provide model and leadership for IET Injury
  Prevention for DOD

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COL Robert DeFraites MCDir, Epidemiology
Disease SurveillanceU.S. Army CHPPM (410)
436-4655 (DSN 584)Alternate [phone] (DSN
662)bob.defraites_at_amedd.army.mil