Manual and Fitbit Flex
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Performance Triad Class
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JOINT BASE LEWIS-MCCHORD, Wash. (Army News Service, Sept. 9, 2013) -- The first pilot course for the Army's Performance Triad began with some squad leaders beginning their training at Joint Base Lewis-McChord, Wash., Sept. 9.

Performance Triad focuses on improving Soldiers' health through proper sleep, activity and nutrition. It is a key component of the Army's Ready & Resilient Campaign Plan, according to the Army's surgeon general.

The goal of Performance Triad is "to increase Soldiers' health literacy, because I believe that if people's knowledge is increased, they'll make the right decisions that will optimize their performance and their ability to perform their mission," said Lt. Gen. Patricia D. Horoho, during an interview three days before the launch of the pilot.

Eleven squad leaders from 3rd Squadron, 38th Cavalry Regiment, 7th Infantry Division, are receiving two weeks of training from health and medical professionals. Following their training, they will be responsible for imparting their knowledge and mentoring their Soldiers over the course of 24 weeks.

Data analysis and program evaluation follows the 24-week period, according to Barbara Ryan, a registered nurse with the Army surgeon general's office and the lead for Performance Triad training, education and communications.

Two other pilots are planned using the same schedule and instruction: one at Fort Bliss, Texas, involving Soldiers of 4th Battalion, 6th Infantry, beginning Sept. 30; and the other at Fort Bragg, N.C., with Soldiers of the 189th Combat Sustainment Support Battalion, starting Oct. 28. U.S. Army Forces Command selected all of the battalions participating.

Once all the data and feedback is collected and reviewed, consolidated program recommendations for Army-wide implementation of Performance Triad will be delivered to the Army chief of staff and vice chief of staff in the fourth quarter of fiscal year 2014, according to Ryan.


The approach to the training is that small-unit leaders will be responsible for motivating their Soldiers with the Performance Triad health information. This empowers the squad leader in the overall health and wellness of their Soldiers. It is critical for the squad leaders and Soldiers to be supported by the chain-of-command to be successful, but it is not a top-driven program, Ryan said.

"The squad leader is the one who knows their Soldiers best," said Horoho. "They can have the most impact on their Soldiers' mental, physical, emotional and spiritual health.

In addition to Performance Triad training, squad leaders will receive a guidebook that can fit in their pockets, "Performance Triad: A Leader's Guide and Planner." The guidebook not only explains the importance of activity, sleep and nutrition for performance, it also provides tips for how squad leaders can get their Soldiers motivated and on board with the training. It also includes a calendar and activity log, goals, and links to useful videos and websites.

Soldiers receiving training from their squad leaders will also get a guidebook: "Soldier's Guide: Tools for the Tactical Athlete." It contains similar information, minus the leadership tips portion.

"We wanted to make the books and the training as user-friendly as possible and make it appealing to a younger demographic, which most of these Soldiers are," said Ryan. She added that all of the training materials and instruction are "steeped in research," meaning that all of the latest medical and performance findings are incorporated.

To help Soldiers measure their performance and hoped-for improvements, all will be issued a "personal readiness device." The personal readiness device measures activity, nutrition, and sleep and provides real-time feedback to the user through data that can be viewed daily, weekly, or monthly to track progress over time. The data is uploaded and stored to the user's account via Bluetooth connection between the device and the user's personal computer or smartphone.

Government computers currently allow access to the user's data via the Internet, however this access does not require software to be loaded on a government computer. Non-networked laptops with a wireless card will be provided at each company in the pilot battalion and Soldiers will upload their data by walking by the non-networked laptop on a weekly basis. These computers can be used to check their personal readiness device data and charge their personal readiness devices and do not compromise the DOD network, officials said.

"The team at Telemedicine and Advanced Technology Research Center led the effort and a market analysis was completed. Twenty-five commercial off-the-shelf devices were reviewed on 57 variables of interest. The only device on the market that met the minimum criteria holistically for the pilot was the Fitbit Flex," Ryan said


Once the pilots are completed and assuming Army-wide implementation at a future date, effectiveness of Performance Triad will be measured in a number of ways, Ryan said, including the Global Assessment Tool, a survey taken by all Soldiers at regular intervals.

She said there will also be a seven-year-long longitudinal study that Soldiers can volunteer to participate in.

U.S. Army Training and Doctrine Command will get involved at some point in the packaging and delivery requirements when the program is approved and ready to be rolled out Army-wide.

The effectiveness of Performance Triad is critical to Army mission success for a variety of reasons, Ryan said, citing some sobering statistics:

"Last year, 2,300 Soldiers were discharged due to being overweight, at a cost of $61 million. Soldiers with musculoskeletal injuries make up 45 percent of the medically not-ready force. And, Soldiers who get five hours of sleep or less lose 20 percent of their cognitive performance."

Soldiers can take some easy and simple steps to lower their risk for injuries and illnesses and to elevate their performance, Ryan said, citing examples such as walking around more during the day, eating more fruits and vegetables and getting adequate sleep if the mission allows.

Horoho stressed that the Performance Triad will be an Army initiative, not an Army Medicine initiative.

The surgeon general said she hopes that eventually all "Soldiers will see (Performance Triad) as embedded in the DNA of our Army" similar to what the "Profession of Arms" and "Army Ethos" is.

"Over the last 12 years, we've learned that you need to train not just our Soldiers but their families as well, and ensure that they're healthy mentally, physically, emotionally and spiritually," Horoho continued. "By improving health, I absolutely believe we're improving the readiness of the force."

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Related Links:

Army News Service

Keeping Soldiers active first prong on Performance Triad

Eating for health, performance second prong of Performance Triad

Restful sleep third prong of Performance Triad Health News Ready and Resilient

STAND-TO!: Performance Triad: Nutrition

STAND-TO!: Performance TRIAD Sleep

STAND-TO!: Performance Triad: Activity

STAND-TO!: Performance Triad Pilot Program

Army Medical Command

Performance Triad: A Leader's Guide and Planner (PDF)

Soldier's Guide: Tools for the Tactical Athlete (PDF)

Performance Triad

Soldiers Update video news on Lt. Gen. Patricia Horoho and Performance Triad

Soldiers Update: Performance Triad gives resources to improve health