Center for Military Psychiatry and Neuroscience, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA.
TechWerks, LLC., San Antonio, TX 78209, USA.
Mil Med. 2024 Aug 19;189(Suppl 3):276-283. doi: 10.1093/milmed/usae091.
Blast overpressure and accelerative impact can produce concussive-like symptoms in service members serving both garrison and deployed environments. In an effort to measure, document, and improve the response to these overpressure and impact events, the U.S. Army Medical Material Development Activity is evaluating body-worn sensors for use by the Joint Conventional Force. In support, the WRAIR completed a qualitative end-user evaluation with service members from high-risk mission occupational specialties to determine the potential needs, benefits, and challenges associated with adopting body-worn sensors into their job duties.
WRAIR staff led hour-long semi-structured focus groups with 156 Army, Navy, and Marine Corps participants, primarily representing infantry, combat engineer, explosive ordnance disposal, artillery, mortar, and armor job specialties. Topics included their sensor needs, concepts of operations, and recommended design features for implementing sensors into the force. Dialogue from each focus group was audio recorded and resulting transcripts were coded for thematic qualitative analysis using NVivo software.
Users recommended a single, unobtrusive, rugged, multi-directional sensor that could be securely mounted to the helmet and powered by a battery type (such as rechargeable lithium or disposable alkaline batteries) that was best suited for their garrison and field/deployed environments. The sensors should accurately measure low-level (∼1.0 pounds per square inch) blasts and maintain a record of cumulative exposures for each service member. Discussions supported the need for immediate, actionable feedback from the sensor with the option to view detailed blast or impact data on a computer. There were, however, divergent opinions on security issues regarding wireless versus wired data transfer methods. Participants also expressed a need for the exposure data to integrate with their medical records and were also willing to have their data shared with leadership, although opinions differed on the level of echelon and if the data should be identifiable. Regarding accountability, users did not want to be held fiscally liable for the sensors and recommended having the unit be responsible for maintenance and distribution. Concerns about being held fiscally liable, being overly burdened, and having one's career negatively impacted were listed as factors that could decrease usage. Finally, participants highlighted the importance of understanding the purpose and function of the sensors and supported a corresponding training module.
Participating service members were generally willing to adopt body-worn sensors into their garrison and deployed activities. To maximize adoption of the devices, they should be convenient to use and should not interfere with service members' job tasks. Providing a clear understanding of the benefits (such as incorporating exposure data into medical records) and the function of sensors will be critical for encouraging buy-in among users and leaders. Incorporating end-user requirements and considering the benefits and challenges highlighted by end users are important for the design and implementation of body-worn sensors to mitigate the risks of blast overpressure and accelerative impact on service members' health.
爆炸超压和加速冲击会使驻守和部署环境中的军人产生类似震荡的症状。为了测量、记录和改善对这些超压和冲击事件的反应，美国陆军医疗器材发展活动正在评估供联合常规部队使用的身体佩戴式传感器。作为支持，WRAIR 对来自高风险任务职业专业的军人进行了定性的最终用户评估，以确定采用身体佩戴式传感器纳入其工作职责的潜在需求、益处和挑战。
WRAIR 工作人员与 156 名陆军、海军和海军陆战队的参与者进行了长达一小时的半结构化焦点小组讨论，主要代表步兵、战斗工兵、爆炸物处理、炮兵、迫击炮和装甲作业专业。主题包括他们的传感器需求、作战概念以及将传感器纳入部队的建议设计特点。每个焦点小组的对话都进行了录音，并使用 NVivo 软件对生成的抄本进行了主题定性分析编码。
用户建议使用一种单一的、不引人注目的、坚固耐用的、多方向的传感器，可以安全地安装在头盔上，并由最适合其驻守和野外/部署环境的电池类型（如可充电锂电池或一次性碱性电池）供电。传感器应能准确测量低水平（约 1.0 磅/平方英寸）的爆炸，并为每个军人记录累积暴露量。讨论支持了从传感器获得即时、可操作反馈的需求，并可以选择在计算机上查看详细的爆炸或冲击数据。然而，对于无线与有线数据传输方法的安全性问题存在不同意见。参与者还表示需要将暴露数据与他们的医疗记录集成，并愿意与领导层共享数据，尽管对数据应在哪个级别进行识别以及数据是否可识别存在不同意见。关于问责制，用户不希望对传感器承担财务责任，并建议由单位负责维护和分发。用户认为可能会降低使用率的因素包括对承担财务责任、过度负担和职业受到负面影响的担忧。最后，参与者强调了了解传感器的目的和功能的重要性，并支持相应的培训模块。
参与的军人普遍愿意将身体佩戴式传感器纳入其驻守和部署活动。为了最大限度地采用这些设备，它们应该便于使用，并且不应干扰军人的工作任务。为了鼓励用户和领导的认可，提供对益处（例如将暴露数据纳入医疗记录）和传感器功能的清晰理解将是至关重要的。纳入最终用户的要求并考虑最终用户强调的益处和挑战对于设计和实施身体佩戴式传感器以减轻爆炸超压和加速冲击对军人健康的风险至关重要。
