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Medical Fitness and Resilience

Medical Fitness and Resilience: A Review of Relevant Constructs, Measures, and Links to Well-Being

Regina A. Shih
Sarah O. Meadows
Margret T. Martin
Copyright Date: 2013
Published by: RAND Corporation
Pages: 88
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  • Book Info
    Medical Fitness and Resilience
    Book Description:

    This report is one of a series designed to support Air Force leaders in promoting resilience among its Airmen, civilian employees, and Air Force families. It examines the relationship between medical fitness and resilience, using key constructs found in the scientific literature, which address preventive care, the presence and management of injuries and chronic conditions, and facilitators and barriers to access of appropriate health care.

    eISBN: 978-0-8330-7900-8
    Subjects: Health Sciences, Management & Organizational Behavior, Population Studies

Table of Contents

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  1. Front Matter
    (pp. i-ii)
  2. Preface
    (pp. iii-vi)
  3. Table of Contents
    (pp. vii-viii)
  4. Figures
    (pp. ix-x)
  5. Summary
    (pp. xi-xii)
  6. Acknowledgments
    (pp. xiii-xiv)
  7. Abbreviations
    (pp. xv-xvi)
  8. 1. The Context of This Report
    (pp. 1-4)

    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,...

  9. 2. Introduction
    (pp. 5-8)

    Medical fitness, along with the physical, nutritional, and environmental fitness domains, reflects overall body fitness and complements the spiritual, psychological, social, and behavioral components of fitness of the mind. Using the definition in the special issue ofMilitary Medicineon Total Force Fitness, medical fitness for Airmen, their families, and Air Force civilians entails being free of any medical condition or predisposition and being medically ready (where readiness is capability of being able to accomplish a task [Mullen, 2010]) to perform duties under all conditions without excessive loss of quality of life, excessive loss of duty time or separation from...

  10. 3. Preventive Screenings
    (pp. 9-16)

    Prevention of diseases or injuries is one way to improve medical fitness. Preventive medicine has three levels: primary, secondary, and tertiary. Primary preventive medicine’s goal is to avoid the development of disease and includes all population-based health promotion activities (e.g., daily exercise, anti-smoking campaigns). Secondary preventive care involves detecting disease in its early stages to avoid further progression. An example of secondary prevention would be detection campaigns for certain types of cancer (e.g., colon, breast). Tertiary prevention attempts to reduce, reverse, or delay the progression of the disease and disease-related complications (Starfield et al., 2008). This chapter focuses on secondary...

  11. 4. Facilitators and Barriers to Accessing Appropriate Quality Health Care
    (pp. 17-20)

    Barriers to appropriate, adequate, high-quality health care are factors that prevent individuals either from accessing the care they need or from receiving the level of care that is needed in terms of its quality. In contrast, facilitators to accessing care are those factors associated with adequate consumption of either the appropriate amount or quality of care. The literature on facilitators and barriers to health care is massive. In this chapter, we highlight some of the most-researched factors that can be used as metrics of medical fitness and focus primarily on the facilitator and barrier factors that the Air Force may...

  12. 5. The Presence and Management of Chronic Conditions
    (pp. 21-28)

    Some chronic health conditions can interfere with job performance, readiness, and quality of life. This chapter discusses the presence and management of chronic conditions as metrics of medical fitness and the scientific evidence on how the presence and management of specific conditions directly influence well-being or contribute to resilience and how the negative effects of stress influence physical and psychological well-being. Among the most common chronic health conditions for Americans under age 40 are diabetes, hyperlipidemia (e.g., high cholesterol), hypertension, cardiovascular conditions, and asthma (Stagnitti, 2010). In this chapter, we focus on overweight/obesity, diabetes, and asthma, given that they are...

  13. 6. The Presence and Management of Injuries
    (pp. 29-36)

    Injuries are another possible aggravating factor should Airmen, civilians, or families be exposed to stress or strain. The presence and management of injuries can be thought of as metrics of medical fitness in that they affect well-being and may exacerbate or buffer the effects that exposure to stress has on well-being. Injuries are defined as the physical damage resulting from exposure of the human body to sudden intolerable levels of energy (Sommers, 2006).¹ They are most commonly classified by intent (intentional or unintentional), mechanism of injury (penetrating or blunt), and the temporal pattern (acute or chronic) of the injury (Sommers,...

  14. 7. Interventions to Promote Medical Fitness
    (pp. 37-44)

    Many programs, policies, and interventions may be able to bolster medical fitness through disease prevention, detection, and management. These programs can be implemented at individual, family, community, and clinical levels. Programs are often tailored to each medical condition, such as early screening for diabetes and management of TBI, and interventions that improve treatment adherence for certain chronic conditions, such as diabetes and asthma. Some interventions seek to reduce stigma to seek health care, to remove physical and social barriers to care, or to bolster social support to improve health care access and care-seeking. The realm of these programs, policies, and...

  15. 8. Conclusion
    (pp. 45-46)

    The goal of this report was to review and highlight the relevant constructs and measures of medical fitness as well as initiatives designed to improve medical fitness. This fitness domain is not mutually exclusive from the other domains, as the measures reviewed herein are often related to metrics used to measure other fitness domains. Likewise, the interventions we reviewed also relate to interventions of relevance to the behavioral, psychological, and nutritional fitness domains. These findings provide the foundation against which the larger study on Total Force Fitness assessed current Air Force metrics, policies, and programs.¹

    We focused on four main...

  16. Bibliography
    (pp. 47-72)