The association between behavioral health risk factors and physical performance among BCT trainees

Engaging in health risk behaviors affects U.S. Army trainees' performance on the Army Physical Fitness Test (APFT) and also poses a challenge to military readiness. While many studies have examined the effects of health risk behaviors, few have examined their effect in a controlled environment.;This cross-sectional study investigates the association between behavioral health risk factors and performance at the beginning and end of basic combat training (BCT) among at cohort of U.S. Army trainees. This study's sample consisted of 1,902 BCT trainees at Fort Jackson, South Carolina who completed the Army Recruit Assessment Program (RAP) Questionnaire. Linear regression analysis was used to determine the association between the prior health risk behaviors of tobacco use, alcohol use, and physical inactivity and the health related fitness measures of cardiovascular endurance and muscle endurance as measured by performance on the APFT.;Smoking every day during the year before entering the Army was statistically significantly associated with lower APFT performance compared to non-smokers even after adjusting for gender, age, race, and alcohol use. Smoking some days was not statistically significantly associated with any of the three APFT sections. Alcohol use was also not statistically significantly associated with push-up and sit-up performance on the initial or final APFT however some trainees who consumed alcohol during the year before entering the military performed better than non-alcohol users on both the initial and final push-up segment of the APFT. Additionally, physical activity in the year prior to Army enlistment was statistically significantly associated with performance on all three components of the initial APFT such that performance improved for each successive category of increasing fitness.;The behavioral health risk factors of smoking and physical inactivity are significantly negatively associated with APFT performance among basic combat trainees. Resources should be prioritized to address those behaviors before trainees enter the military.