Page 54 - JSOM Summer 2024

Continuous Assessment of Active-Duty Army Special Operations
and Reconnaissance Marines Using Digital Devices and Custom Software

The Digital Comprehensive Operator Readiness Assessment (DcORA) Study

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

ABSTRACT
Background: Continuous exposure to extreme and chronic rendering SOF members vulnerable to mental health problems
stress from uncontrollable events has been linked to increased and suicide. These exacerbating conditions have prompted a
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psychological and physiological reactivity. Prolonged, frequent change toward emphasis on measuring the holistic health of
deployments may test coping skills over time, ultimately ren- Servicemembers.
dering Servicemembers vulnerable to mental health problems
and suicide. This study develops a methodology for accurately The Preservation of the Force and Family program (POTFF)
collecting holistic health measures from Servicemembers us- was established by the U.S. Special Operations Command to
ing digital tools, including custom-built phone software and support the readiness and resilience of Special Forces members
body-worn sensors. Methods: The secure research platform and their families. The program is organized across the holistic
and mobile app continuously collect multiple health measures health domains of Psychological, Physical, Cognitive, Spiritual,
and, after data analysis, deliver continuously updated sum- and Social and Family care. More recent large-scale programs
mary data back to the Servicemember. This system provides include the Army’s Holistic Health and Fitness (H2F), which
novel insights into the relationships between the measures addresses the physical and non-physical aspects of Servicemem-
while helping individuals track their progress toward self- ber health to optimize and advance readiness, recovery, and ef-
established goals. Participants were given an iPhone (including fectiveness. It is challenging to resource these programs with
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the study app) and an Apple Watch. Participants tracked their equipment and experts to support health needs across multiple
data for more than 6 months and responded to baseline, daily, holistic health domains and to assure access to each component
and weekly questions and assessments. Physiologic, psycho- for every Servicemember. It is also difficult to assess the success
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logic, and cognitive assessment data across the Preservation of these programs in each program location and in aggregate
of the Force and Family program (POTFF) domains were col- because outcome measures have not been established, and stan-
lected, displayed to the individual, and analyzed in aggregate. dardized data are not being uniformly collected. 5–7
Results: When coupled with custom-built software, this hard-
ware can be elevated from a fitness tracker to a user-facing The ability to engage an individual in health and human per-
health monitoring, educational, and delivery system. Conclu- formance optimization practices in real time is vital for early
sion: This wearable system measured vital factors associated preservation before physical or mental injury. Sleep hygiene,
with the health and human performance of Servicemembers. for example, cannot be considered an isolated issue, particu-
In real time, it engaged Servicemembers in health and human larly in active-duty military personnel. Lack of sleep in these
performance optimization practices to achieve a goal of pre- populations is related to a myriad of performance degradations
vention of physical or mental injury. and is directly associated with the exacerbation of conditions
like traumatic brain injury, depression, and post-traumatic
Keywords: mobile applications; military personnel; digital stress disorder (PTSD). 8,9
technology; wearable electronic devices; fitness trackers;
outcome assessment; health behavior; healthcare This study develops a digital methodology for accurately col-
lecting holistic health measures from active-duty Servicemem-
bers (on land and in water) using custom-built software and
body-worn sensors. 10–12 The engagement and measurement
Introduction
of a Servicemember using a smartphone and smart watch sen-
Continuous exposure to extreme and chronic stress from un- sors delivers diverse information, education, and insights con-
controllable events has been linked to increased psychologi- tinuously. The data collected are more inclusive of the totality
cal and physiological reactivity. Over the past 20 years, U.S. of the mental and physical loads experienced by the individual
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Special Operations Forces (SOF) have experienced multiple and, therefore, has the potential to reflect overall health more
deployments with minimal downtime. Such prolonged, fre- accurately. This digital research platform was tested in the
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quent deployments may test coping skills over time, ultimately re- deployment of Army Special Operations warfighters (3rd
*Correspondence to Leslie Saxon, USC Center for Body Computing, 12015 E. Waterfront Dr., Playa Vista, CA 90094 or saxon@usc.edu
1 Dr. Leslie A. Saxon is a Professor and Clinical Scholar at the University of Southern California Institute for Creative Technologies Center for
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Body Computing, Playa Vista, CA. MSG (Ret.) Robert Faulk is a a former human performance researcher at the University of Southern Califor-
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nia Institute for Creative Technologies Center for Body Computing, Playa Vista, CA. Dr. Jill Boberg is a Research Lead at the University of South-
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ern California Institute for Creative Technologies Center for Body Computing, Playa Vista, CA. Dr. Trevor J. Barrett is Lead Data Scientist at
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the University of Southern California Institute for Creative Technologies Center for Body Computing, Playa Vista, CA. Steve McLelland is Lead
Software Developer at the University of Southern California Institute for Creative Technologies Center for Body Computing, Playa Vista, CA.
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