The Impact of Team-Based and Individual Practitioner Characteristics on Musculoskeletal Injury Outcomes (H2F)

MSKI (e.g., stress fractures, non-specific low back pain) are one of the largest issues facing the U.S. DoD, accounting for two million medical encounters and over $400 million in direct care costs each year. In an attempt to prevent MSKI and their negative consequences (e.g., lost training/duty days, early-career discharge from service), Services have embedded human performance teams (HPT) with musculoskeletal (MSK) practitioners (HPT-MSK), often consisting of Athletic Trainers, PTs, and Strength and Conditioning Coaches, into operational units. The goal of these teams (e.g., Army Holistic Health and Fitness [H2F] teams): reduce the burden of MSKI on medical and operational readiness by improving prevention, early recognition, and treatment of these injuries.

HPT-MSK are typically staffed by selecting and hiring individual HPT-MSK practitioners based on the professional expertise needed to achieve specific goals (e.g., improving physical fitness, treating MSKI). However, HPT-MSK impact may depend on more than practitioners having the basic knowledge and education requirements to fulfill their jobs. HPT-MSK impact may also depend on: (1) team-based characteristics, such as the ability for practitioners to collaborate and communicate effectively with other practitioners; and/or (2) individual practitioner characteristics, such as the ability to connect with service members to gain trust.

Team-based and individual practitioner characteristics are underpinnings of effective patient-centered care in the civilian sector, which has been associated with improved patient outcomes and treatment satisfaction. Little is known about how team-based or individual practitioner characteristics may impact the quality-of-care HPT-MSK are able to provide service members for MSKI. Therefore, the overall goal of this project is to determine whether HPT-MSK team-based and individual practitioner characteristics impact MSKI outcomes among service members. Results from this project will inform strategies for improving how HPT-MSK can effectively mitigate risk of MSKI injury and re-injury, as well as improve treatment outcomes among service members, such as training or education to improve team-based and individual practitioner characteristics. Results will also inform guidelines for selecting individual practitioners to serve on HPT-MSK, to optimize team composition.