What does the physical domain refer to

In our last Friday Field Notes, we discussed how experts from the operational, scientific and educational communities came together to integrate the components of health and fitness under the title “Total Force Fitness for the 21st Century.” In 2020, the TFF concept was updated to reflect the current health and performance issues of service members. Today we will unpack these components.

The concept of Total Force Fitness encompasses eight domains:

MIND

Psychological
Financial
Ideological & Spiritual
Social

BODY

Physical
Medical and Dental Preventative Care
Nutritional
Environmental

Total Force Fitness involves seamlessly integrating fitness of the mind, body and spirit. Achieving total fitness is a state in which service members, their families and the family’s unit/organization can sustain optimal well-being and performance even, under difficult conditions. Total Force Fitness is critical to Military Family Readiness and Lethality.

The Consortium for Health and Military Performance (CHAMP) at the Uniformed Services University of the Health Sciences is the Department of Defense center of excellence in TFF and human performance optimization. CHAMP’s mission is to research and educate service members about TFF, to optimize service member performance. More information about their work can be found at their website for service members: Human Performance Resources by CHAMP (HPRC).

Physical Fitness: Training Year-Round Boosts Resilience

In the military community, physical fitness involves service members and their families’ ability to physically handle all aspects of a mission, while at the same time remaining healthy and uninjured to meet the criteria for retention and continued military service. Year-round exercise can help build and maintain warrior and military family lethality and psychological health and resilience, and some studies have shown that it may improve mood and attitude.

The latest military fitness guidance emphasizes the need to focus on “mission and job task-oriented fitness.” This involves having a well-rounded approach to fitness routines that reflects the various types of conditions that your service member might experience. Physical fitness assessments (link is external) can provide important tools to measure whether your service member’s fitness efforts effectively complement mission duties, but they can also be a great way for military family members to stay connected with their service member and to maintain their own psychological health and resilience.

At HPRC, you’ll find science-based TFF information for service members about injury prevention and training and performance.

Psychological Fitness: Keeping Your Mind Fit

Coping with the stressors and realities of deployment takes a fit mind, not just a fit body. Psychological fitness is about strengthening performance and resilience. It involves the way one:

• Thinks and processes information
• Feels about themself, others and the environment
• Act in response to thoughts and feelings

Understanding what makes up psychological fitness and how to develop a healthier mental state can improve military family readiness to confront the challenges of life – both in the military and in civilian life. Learning stress management tips to build coping skills is important part of strengthening  psychological health.

Keeping fit can also require getting help to address psychological health concerns. Reach out to line leaders, doctors or chaplains for appropriate care right away if military family members:

• Can’t shake feeling down or worried
• Have thoughts that repeatedly cause anxiety
• Have sleep problems
• Have thoughts about hurting themself

For more information, visit the mental fitness section of HPRC. Here you’ll find information on performance psychology, mental health, sleep & stress, and substance use.

And, other resources are available and they work. Contact the Psychological Health Resource Center 24/7 by calling 1-866-966-1020 for answers to questions.

Financial Fitness

Being financially fit means managing your money effectively to benefit your military family health. There are three primary components of this domain, including:

• Debt management, such as paying down credit cards
• Insurance and emergency planning, like having life and home insurance in place, as well as a will
• Investment wealth strategies, such as contributing to your retirement account on a regular basis

Money management has implications for your fitness in other domains. Financial struggles are associated with strife in couple relationships and higher stress levels in individuals. Rather than engaging in financial decisions and behaviors that may lead down an unstable path, be proactive about managing your finances and utilize the resources available to you.

MilitaryOneSource has a range of money management resources, including financial wellness counseling. HPRC also has articles on how finances can impact your relationships and your performance.

Ideological & Spiritual Fitness

For many, ideology and spirituality may be a relationship with God and certain religious practices. For others, it plays out in non-religious ways, such as through a focus on family or nature. However expressed, spirituality can promote healthy connections with others, healthy lifestyle choices and the strength to endure hard times.

Spirituality can:

• Help cope with multiple deployments, combat stress or injury
• Encourage a supportive environment and foster military family cohesion
• Help cope with “moral injuries,” which can occur from either awareness of, participating in or witnessing certain acts that may conflict with deeply held moral beliefs and expectations

As military families and members of civilian communities, spirituality can play a key role in a family’s well-being. Research has linked spirituality to increased optimism, less anxiety and depression, fewer suicides and greater marital stability.

Learn more at about spiritual fitness by visiting the spiritual fitness section of HPRC. You’ll find evidence-based spiritual fitness resources focused on using core beliefs, values, and spiritual practices to help navigate life’s challenges and optimize performance.

Medical and Dental Preventive Care

The medical and dental fitness domain involves multiple evaluation tools to determine whether service members and their families are medically fit for mission duties and deployment. Military medical fitness specifically establishes that one is:

• Free of contagious diseases that would likely endanger the health of other personnel
• Free of medical conditions or physical defects that would require excessive lost duty time for treatments or hospitalization or would likely result in separation from service for medical unfitness
• Free of medical conditions or physical defects that would require excessive lost duty time for treatments or hospitalization or would likely result in separation from service for Medically incapable of satisfactorily completing any and all required training
• Free of medical conditions or physical defects that would require excessive lost duty time for treatments or hospitalization or would likely result in separation from service for Medically capable of performing duties without aggravation of existing physical defects or medical conditions

Determining medical fitness involves evaluation tools, including DNA, immunizations, periodic health assessments, hearing and vision assessments, dental health, and a behavioral health assessment.

Sleep is also an important aspect of medical fitness, as it provides improved judgment, reduced obesity, inflammation, and cardiovascular disease, improved resilience, and more rapid recovery from behavioral health problems, injury and illness.

Medical and dental preventative care information is available in various sections of the HPRC website, including the pain management section and the Rehab, Refit, Return to duty (Rx3) program.

Environmental Fitness

Military families and their service members that are environmentally fit are able to perform or support duties well in any environment, such as in high altitudes or contaminated areas, and withstand multiple stressors associated with some military missions. Combating the stresses associated with challenging environments involves the following two sets of tools:

• Biomedical (i.e., nutrition, hydration)
• Mission-related (i.e., the equipment and clothing available to service members)

Adapting to challenging environments involves acclimating to the particular conditions (e.g., cold temperatures, high altitudes, etc.), building up service-member tolerance while exposed to certain environmental stresses and cross-tolerance, when they adapt to environment stresses prior to any exposure. Leaders should ensure that appropriate risk assessments are conducted prior to entering and extreme climate. Additionally, routine risk assessments for all conditions should include an environmental component. Prior to deploying to a different environment, proper equipment for that climate should be issued and leaders should monitor for appropriate utilization. While deployed to difficult environments, service-members can often take steps to assist in adapting, such as use of proper vision and hearing protection, DoD insect repellent system and water purification techniques. Military family members can provide helpful assistance and accountability checks in this domain.

Additional information about environmental fitness can be found in the environmental extremes section of HPRC.

Nutritional Fitness

Nutritional fitness includes providing and consuming all types of foods in quantities, quality, and proportions sufficient to preserve mission performance and to protect against disease or injury.

Healthy foods are fuel for the body. This fuel is important to  physical and mental performance, and helps maintain emotional control during field operations. or while family members are deployed. Beyond performance, nutrition also plays an important role in protecting overall health throughout a lifetime. A diet rich in whole grains, lean protein, fruits, vegetables and low-fat dairy products helps lower the risk of certain diseases such as diabetes.

Nutritional needs are not universally the same. Daily fluid and food requirements depend on body mass, physical activity and the environment in which the work is performed. While military nutrition efforts have traditionally focused on making sure service members are eating enough, the concern today is about eating too much. Consuming more calories than you need leads to excess weight. Being overweight can impact the success of missions, and the military family’s ability to support missions, as well as raise the risk for heart disease, certain cancers, diabetes and more.

HPRC has information about performance nutrition, fighting weight strategies, eating environments, and unique nutrition needs. Here you’ll also find the Combat Rations Database, the Warfighter Nutrition Guide, and information about the Go4Green DoD program.

Social Fitness

Social fitness involves building and maintaining healthy relationships with others.  It also plays a role in supporting optimal performance and resilience. Social fitness is multi-dimensional and includes not only friends and family, but also recreation, religion and hobbies, as well as bosses and peers. Social activity can help relieve stress, build connections with others, and ease the strain of missing family and friends.

Unit cohesion is an important component within social fitness. When service members, their fellow unit members, and their families exhibit healthy social connections and behaviors, the unit thrives and enhances community capacity. The stronger the unit is socially, the more resilient it is. Having a clear understanding of service values, the mission and its meaning is key in supporting healthy social networks and healthy military families.

To learn more about optimizing your social fitness in your family, within couple or intimate relationship, or within teams or as a leader, visit HPRC-online.org.

Sources

MAJ Tonja C. Roy and others. “Total Force Fitness for the 21st Century – A New Paradigm (link is external),” [PDF 17.54MB] Military Medicine: Supplement to Military Medicine – Volume 175. Published August 2010.

Total Fitness for the 21st Century: Conference Report [PDF 550KB], Institute for Alternative Futures, Uniformed Services University of the Health Sciences. Published December 30, 2009.