This report is one of a series designed to support Air Force leaders in promoting resilience among Airmen, its civilian employees, and Air Force family members. The research sponsors requested that RAND assess the current resilience-related constructs and measures in the scientific literature and report any evidence of initiatives that promote resilience across a number of domains. We did not limit our search to research conducted in military settings or with military personnel, as Air Force leaders sought the potential opportunity to apply the results of these studies to a population that had not yet been addressed (i.e., Airmen). Further,...

The conference that resulted in the August 2010 special issue ofMilitary Medicinecollectively defined the eight domains of fitness we address in this report. “Behavioral fitness” was defined in the following way:

Behavioral health refers to the relationship between one’s behaviors and their positive or negative health outcomes. Although there is some overlap between behavioral health and psychological health (indeed, many health behaviors share a relationship with mental health outcomes), this fitness domain incorporates health-related behaviors rather than underlying psychological factors (Bray et al., 2010b).

Behavioral health emphasizes individual responsibility to engage in behaviors and activities that facilitate the...

It is interesting to note that researchers have not been able to clearly establish the purpose of sleep (Friedl and Penetar, 2008). Nonetheless, sleep is absolutely necessary (Rechtschaffen, 1998) and decrements in sleep are strongly linked to a wide range of negative outcomes including reduced physical health outcomes and obesity, poor mental health, and decreased job-related performance (Orasanu and Backer, 1996; Friedl and Penetar, 2008; Killgore et al., 2008; Patel and Hu, 2008; Koffel and Watson, 2009). Other reviews of research suggest that sleep is particularly important in cognition and promotes brain plasticity, which supports learning and memory by forming...

Many technical terms are found within the scientific literature to describe problematic drinking and drug use. In this chapter, we define the difference between light, moderate, and heavy drinking when discussing research on alcohol use. For research using terms that have a specific clinical definition (e.g., drug abuse, dependence, alcoholism), we use the term drug and alcohol use disorders. Although it is important to differentiate between these clinical terms when making a diagnosis or when selecting a specific intervention, the goal of our report was to provide a broad overview of research associated with all types of alcohol use, misuse,...

The adverse effects of tobacco use are well known, and prevalence rates in the United States continue to decline. Recent survey results¹⁵estimated the prevalence of smoking at 31 percent in 2008 across all services, which steadily decreased from 1980 to 2002 and remained relatively stable from 2002 to 2008. However, there are significant differences in tobacco use among service members, with the lowest prevalence among Air Force personnel (23 percent). The HRB results also show that approximately 14 percent began smoking since joining the Air Force. Although the Air Force has compared favorably against the other services, tobacco use...

Extensive research has examined programs and interventions for the prevention and treatment of tobacco, alcohol, and drug abuse. Somewhat less research has been conducted on interventions for sleep. In the next section, we will provide a broad overview of the interventions and programs shown to be most effective in effecting health behavior change in general and then more specifically for each behavioral issue. Although the focus of our discussion emphasizes quantitative and systematic reviews to provide an overview of effective interventions, we provide a limited review of efforts specific to the military and the Air Force. Additionally, distinctions are made...

This report has focused on the behavioral domain of the TFF concept. This domain focuses on specific components of behavioral health that emphasize an individual’s responsibility to engage in behaviors and activities that facilitate the maintenance of health or prevent disease or dysfunction (Matarazzo, 1980). The report focuses on sleep, drug and alcohol use, and smoking.¹⁶Failure to appropriately manage these behaviors can lead one to be more susceptible to the negative effects of stress. Although we include research conducted with military populations, much of the research and conclusions were drawn from research with civilians. Additional research may be needed...