Fallowfield Joanne L, Drain Jace R, Carins Julia, Kilding Helen, Williams Emma, Fisher Ben, Hayhurst Debra, Gourlay Alysia, Olivotto Simon, Bullock Garrett
Institute of Naval Medicine, Ministry of Defence, Alverstoke, Hampshire, United Kingdom.
Joint Health Command, Department of Defence, Canberra, ACT, Australia.
Front Physiol. 2025 Apr 8;16:1541256. doi: 10.3389/fphys.2025.1541256. eCollection 2025.
The military role and associated occupation-specific training contribute to a high musculoskeletal injury (MSKI) incidence and poor health burden. A fit Force is better prepared for achieving mission success, as well as being more resilient to operational physical and cognitive demands. Conversely, MSKI and ill-health reduce Force readiness. Internationally, militaries have common workforce capacity and capability challenges, where more is being asked of fewer personnel. Unhealthy body composition, low aerobic fitness, poor movement control and poor health behaviours interact to adversely impact human performance. The military workplace-including leadership prioritisation and resource allocation-has generally strategically managed and supported health and performance interventions to maximise people outcomes. Efforts have focused on the individual and capabilities to address ill-health or poor performance. Only through system-based thinking-adopting a Whole System Approach (WSA)-can effective evidence-based interventions to promote health and human performance be: holistically developed; successfully implemented at scale across geographically dispersed organisations to realise meaningful and enduring outcomes; and impacts measured and evaluated. This paper provides a synthesis of scientific and practice-based evidence to operationalise system-thinking in developing integrated WSA workplace interventions for military health and human performance, and measure effect and return on investment. Whilst militaries are recognising the need for a paradigm shift to realise the benefits of effective health and performance interventions, persuasive financial arguments could assist with overcoming large-organisation inertia. Moreover, system-based thinking-addressing individual and organisational factors-could maximise military health and performance, foster resilience and deliver operational effectiveness.
军事角色及相关的特定职业训练导致肌肉骨骼损伤（MSKI）发生率较高且健康负担较重。一支健康的部队能更好地为使命成功做好准备，也能更有韧性地应对作战中的身体和认知需求。相反，MSKI和健康不佳会降低部队的战备状态。在国际上，军队面临着共同的劳动力能力挑战，即要求更少的人员承担更多的任务。不健康的身体成分、低有氧适能、不良的运动控制和不良的健康行为相互作用，对人员表现产生不利影响。军事工作场所——包括领导层的优先事项安排和资源分配——总体上对健康和绩效干预措施进行了战略管理和支持，以最大限度地提高人员成果。相关努力主要集中在个人及解决健康不佳或表现不佳问题的能力上。只有通过基于系统的思维——采用全系统方法（WSA）——才能全面制定促进健康和人员表现的有效循证干预措施；在地域分散的组织中大规模成功实施这些措施，以实现有意义且持久的成果；并对影响进行衡量和评估。本文综合了基于科学和实践的证据，以便在为军事健康和人员表现制定综合的WSA工作场所干预措施时将系统思维付诸实践，并衡量效果和投资回报。虽然军队认识到需要进行范式转变以实现有效健康和绩效干预措施的益处，但有说服力的财务论据有助于克服大型组织的惰性。此外，基于系统的思维——解决个人和组织因素——可以最大限度地提高军事健康和绩效，培养韧性并提高作战效能。
