Understanding risk and protective factors of injuries: Insights from Canadian recruits during basic military training

LAY SUMMARY Injuries are a common occurrence during basic military training. These injuries have the potential to influence recruits' health and performance throughout their military careers. This study examined various factors that can influence the health of Canadian recruits during basic training and their chances of experiencing an injury. Open-ended survey responses were collected at the end of basic military training from 1,540 recruits. Several factors - including poor nutrition, aspects of physical training (frequency, intensity), apprehension regarding obtaining medical attention, and not enough rest - may be important considerations when developing injury prevention strategies for this population. Introduction: Musculoskeletal (MSK) injuries are common among recruits undergoing basic military training. They have the potential to influence performance, mission effectiveness, and overall retention throughout a military career. Timely information on physical health and injury risk and on protective factors is needed to help tailor and prioritize prevention efforts. The goal of this study was to explore the experience of Canadian Armed Forces (CAF) recruits pertaining to various factors that may be associated with health and injury during basic training. Methods: Qualitative analyses of data from Project Horizon, a longitudinal study of early career retention in the CAF, were conducted. Responses to six questions administered at the end of Basic Military (Officer) Qualification were searched, filtered, and examined for spontaneously generated content relevant to the context of injuries, health, and safety. Recruit feedback was analyzed across common themes, and a concept map was developed. Results: Responses from 1,540 recruits (82.1% men) were analyzed. Feedback suggested that injuries may be traced to recruits' physical condition, as influenced by nutritional intake, physical training (PT), and disease or illness. Other recurrent themes included inadequate rest and recovery and the prevailing culture and stigma surrounding injuries and treatment-seeking behaviour. Although some recruits described instructors as mindful of their well-being, others cited recovery issues and pressures to endure pain. Discussion: This study's findings reveal potential avenues for injury prevention efforts and areas requiring further empirical attention, including the distribution and intensity of PT, recovery practices and attitudes, and the holistic health and lifestyle of recruits.