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Recruit Assessment Program

By collecting pre-service, baseline physical and mental health data from new military recruits, our researchers are working to better understand how different military-specific factors, as well as pre-existing conditions, can impact retention and readiness.

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Background

The enlisted Marine Corps is largely a first-term force with active duty service losses ranging from 40-56% after initial enlistment over the last decade. Additionally, the Marines spend approximately $25,000 to recruit and train an active duty enlistee, with a 12% attrition rate after one year.

A military recruit assessment program was called for by a past Presidential Review Directive, Institute of Medicine reports, and the Armed Forces Epidemiological Board to collect baseline health data for pre-existing health risks, creating a foundation for longitudinal surveillance. The purpose was to increase understanding of how service-related exposures affect health and develop early intervention and prevention programs to protect health and readiness.

To answer this need, the Recruit Assessment Program (RAP) was developed by the Naval Health Research Center (NHRC). The RAP was implemented in June 2001 and by January 2017 approximately 200,000 male recruits completed the RAP survey at Marine Corps Recruit Depot (MCRD), San Diego.

Value

    Baseline health data collected prior to deployments enables military health researchers to better understand how deployments and other military experiences affect health and how pre-service risk factors are associated with health outcomes that develop during or after military service.

    This information might identify Marines who could benefit from targeted, supportive interventions to reduce attrition, potentially saving millions of training dollars annually.

Goals

  • Use pre-service data as a baseline supplemented with routinely captured medical and deployment data to answer future questions about the health risks of operational deployments, military occupational specialties, and general service in the Marine Corps
  • Examine effects of prior military family experiences on service-related outcomes
  • Identify behavioral and psychological characteristics of recruits that may increase understanding of factors associated with attrition or resilience

 

 

 

 

 

 

 

 

 

 

 

 

Methods

  • The RAP questionnaire is administered to consenting recruits at MCRD San Diego during the first week of training
  • The questionnaire was developed using standardized survey instruments and expert input
  • Recruits are given 45 minutes to complete the survey

Key Findings

  • Non-high school graduates and smokers at baseline are at increased risk for completed suicide.
  • Diagnosis with a traumatic brain injury, diagnosis of depression, and counseling for a relationship problem are all independent risks factors for completed suicide.
  • Deployment alone is not a risk factor for completed suicide.
  • Previously deployed Marines, especially those who experienced combat, are at increased risk of several adverse, health-related behaviors postdeployment, including binge drinking, alcohol dependence, initiate smoking, and decreased seatbelt use.
  • Marines exposed to violence prior to entering the Marine Corps are at increased risk for postdeployment PTSD independent of combat exposures. Combat exposures, specifically the threat of death, serious injury, and witnessing injury or death are also significant risk factors for screening positive for postdeployment PTSD among male Marines.
  • The strongest predictors of early attrition due to drug use are being a smoker; African-American race; frequent moves as a child; not having a high school diploma; joining the military to leave problems behind; and having a prior arrest record.