Page 80 - JSOM Winter 2022

A Novel Digital Research Methodology for
Continuous Health Assessment of the
Special Operations Warfighter

The Digital cORA Study

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Leslie A. Saxon, MD *; Robert Faulk, DPT ;
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Trevor Barrett, PhD ; Steve McLelland ; Jill Boberg, PhD 5

ABSTRACT
The role of US Special Operations Forces (SOF) globally has assessment, and better results. They also provide the ability to
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expanded greatly in the past 20 years, leaving SOF serving facilitate increased warfighter engagement in their own health
multiple deployments with little time or ability to recover optimization, all in real time.
in between. Currently, assessments of the health and human
performance capabilities of these individuals are episodic, pre- In this paper we describe the digital research methodology de-
cluding an accurate assessment of physical and mental load veloped to support continuous SOF holistic health surveillance
over time, and leading to high rates of acute and chronic injury that is supporting the ongoing digital comprehensive Opera-
to the mind and body. The collection of personal health-re- tor Readiness Assessment (cORA) study. The University of
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lated continuous datasets has recently been made feasible with Southern California Center for Body Computing (USC CBC)
the advancement of digital technologies. These comprehensive has developed a unique and configurable research platform
data allow for improved assessment, and consequently better that allows continuous collection of both passive and actively
results, partly due to the warfighters’ real-time access to their collected data using commercially available and medically reg-
data. Such information allows Soldiers to engage in their own ulated digitally-enabled sensors and software. The design of the
health optimization. This article describes a research platform platform has several novel features that include the ability to
that allows for collection of data via a custom-made secure collect, organize, and report structured and unstructured data
mobile application that extends the type, scope, and frequency from body-worn sensors or curated video. The integration of
of data collection beyond what is feasible during an in-person individual schedules allows researchers to detect relationships
encounter. By digitizing existing assessments and by incorpo- between military tasks and well-being. Surveys can easily be
rating additional physical, neurocognitive, psychological, and administered using our customized iOS mobile software ap-
lifestyle assessments, the platform provides individuals with plication (app) that can be delivered via the app or the Apple
the ability to better understand their mental and physical load, Watch. The app allows researchers to contact users, add ques-
as well as reserve. The results of this interactive exchange may tions, or collect additional data. Based on individual input, the
help to preserve the health of users as well as the stability and platform can learn the goals and habits of the individual and
readiness of units. respond in-app with customized support assets. Continuous
data collection and analysis can provide insights for the user
Keywords: mobile applications; military personnel; digital tech- that detect early physical and mental optimization or degra-
nology; data visualization; wearable electronic devices; health dation. The platform also incorporates state of the art privacy
behavior; computer security and cybersecurity practices. The holistic nature of the health
assessment and the ability to deliver individual customization
features privately were designed to help to drive app adherence.
Introduction
The research platform can be configured and tailored to gain
Over the past 20 years, prolonged conflicts in the Middle deeper insights and understanding into SOF health status in a
East and other global events have put unprecedented strain wide variety of uses. It can also provide individuals with the
on US SOF, with multiple deployments and little downtime ability to archive their status over time and better understand
in between. Episodic assessments of the health and human their mental and physical load and reserve. The results of this
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performance capabilities of these individuals provides only a real-time interactive health information exchange may help to
snapshot in time, rather than an accurate assessment of phys- preserve the health of users, as well as the stability and readi-
ical and mental load over time. The limitations of the current ness of units.
model of care include high rates of acute and chronic injury
to the mind and body. Recent advances in digital technol- Optimizing the health and human performance of the mod-
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ogies allow accurate collection of continuous and simultane- ern warfighter requires a care model methodology that can
ous datasets, providing more comprehensive data, improved accurately measure status over time. This care model must also
*Correspondence to saxon@ict.usc.edu
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1 Dr Leslie A. Saxon is a physician and MSG (Ret) Robert Faulk is a physical therapist affiliated with the University of Southern California
Institute for Creative Technologies Center for Body Computing, Los Angeles, CA. Dr Trevor Barrett and Dr Jill Boberg are scientists affiliated
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the University of Southern California Institute for Creative Technologies Center for Body Computing, Los Angeles, CA. Steve McLelland is an
independent contractor.
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