JOINT BASE LEWIS-MCCHORD, Wash. (Army News Service, Sept. 16, 2013) -- The Performance Triad is an exciting initiative that could go far in improving the health of the force, said Col. John O'Brien, a medical doctor, and chief of Operational Medicine and Deployment Health at Madigan Army Medical Center here.

The Performance Triad targets better performance through improvements in sleep, activity and nutrition.

The first pilot course for Performance Triad started here, Sept. 9, with squad leaders and Soldiers from 3rd Squadron, 38th Cavalry Regiment, 7th Infantry Division, participating in two weeks of training led by health and medical professionals from the Office of the Army Surgeon General.

Following their training, the squad leaders will be responsible for imparting their knowledge and mentoring their Soldiers over the course of 24 weeks.

Two other pilots are planned using the same schedule and instruction. The first kicks off Sept. 30, at Fort Bliss, Texas. Soldiers from the 4th Battalion, 6th Infantry, will participate. The second kicks off Oct. 28, at Fort Bragg, N.C. There, it will be Soldiers with the 189th Combat Sustainment Support Battalion, who participate.

Once the team from the Office of the Army Surgeon General leaves next week, O'Brien's medical team of Performance Triad-trained professionals will be the go-to persons for Soldiers participating in the pilot.

O'Brien said he anticipates a lot of questions from squad leaders.

"I graduated from medical school about 20 years ago, and even I have trouble keeping up with all the latest research on diet, exercise and nutritional supplement findings," he continued.

He cautioned that there are a lot of unregulated "health promotion products" like supplements that don't get pulled from the shelves unless problems arise. Some of those products have bad side effects. Others, while not harmful, might not have much in the way of benefits.

Soldiers in the pilot all have Performance Triad guidebooks with URLs to websites and videos that O'Brien said provides information steeped in the latest science, research and medical findings and are safe to rely on. The pilots will reveal if new material needs to be incorporated in the guidebooks.

However, Soldiers will still have many questions, he said, which he and his team are prepared to answer via phone, email or visits.

The team has at its disposal access to the Natural Medicines Comprehensive database on products and nutritional supplements, he said. Information changes all the time and the database is constantly updated with new findings.

O'Brien attended the pilot classes and was peppered with questions from squad leaders, wanting to know such things as the effectiveness of the "Caveman Power Diet," herbal medicines and different types of extreme exercise programs.

His team will be tracking the volume and type of questions they get over the course of the pilot to better gauge the support Soldiers will be requiring once the program kicks off Army-wide. Answering questions from one squadron is one thing, but Joint Base Lewis-McChord, or JBLM, has some 40,000 Soldiers, he said.

Rather than wait for the pilot to end, O'Brien said he's already casting about for ideas he'd like to implement in support of Performance Triad.

Besides tracking calls, he's looking at the types of questions that will be asked. From these, he'd like to create an FAQ page on a Performance Triad website. He'd also like to share the data and compare notes with his counterparts at Fort Bragg and Fort Bliss, where the other pilots will be held.

Another idea he's exploring is enlisting the help of Soldier Centered Medical Homes to assist Soldiers going through Performance Triad training with questions if his staff becomes saturated. He said the homes have the medical expertise in Performance Triad areas and would be able to field some of the questions and even assist with therapy.

JBLM already has one such home and three others are planned to open soon. He described the home as an enhanced primary care clinic augmented with physical therapy, behavioral health and nutrition providers. The homes are being located close to where the Soldiers live and work so access will be easy, he said.

"(The homes) might be one way to implement this Army-wide, as they mesh well with Performance Triad," he said, adding that Army Wellness Centers also have personnel trained in aspects of the Performance Triad. JBLM's Wellness Center has just brought on board their full complement of staff.

"For (the Performance Triad) to work, there needs to be an integration of effort between these various components," he said.

O'Brien is confident that the Performance Triad's outcomes will be rigorously evaluated. He said his staff will utilize some of the tests and surveys used to measure the program's effectiveness as some of the data could point to Soldiers who might need some assistance.

For example, the new Global Assessment Tool survey, or GAT, which includes aspects of Performance Triad, "might reveal outlier results indicating that a Soldier is on a weird diet" and might need some nutritional guidance. Another survey might indicate "strange sleeping patterns. We'd like to invite those Soldiers in for some helpful suggestions."

As part of participation in the Performance Triad pilot program, Soldiers receive a "Fitbit" activity monitoring wristband. O'Brien said he's already benefited from wearing the wristband, which calculates such things as sleep patterns, calories consumed and steps walked every day.

Five weeks ago when he first put the wristband on, O'Brien said he weighed 228 pounds. He's tall, so the weight isn't noticeable and he's fit, having entered multiple triathlons. However, he said for 10 years he's wanted to get down to his dream weight of 210.

The Fitbit system calculated the number of calories he needed to consume to lose weight at a reasonable rate, and O'Brien said he's on a gentle glide-slope to achieving his long-sought goal. He's lost a pound a week since putting it on and is now weighs 217 pounds, well on his way to 210 pounds.

"I feel more energetic now and positive about myself," he said. Besides lowering his caloric intake, he said he's increased his walking and other activity. Just the other day he said he went on a 90-minute bike ride with his wife and son.

The Performance Triad really works, he said. "It helps you set goals and then achieve them."

O'Brien is such a big believer in the program that he sees it someday being a model for America's health system, where prevention is the primary goal and where the incidence of chronic diseases like obesity and diabetes are lowered. "This could be a real game-changer."

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