Running head: AIMING HIGHER 1

Aiming Higher: Encouraging Healthy Lifestyle Behaviors Among U.S. Airmen

Scott Koeckritz and Michael Meridith

George Mason University

May 6, 2009

Authors’ Note

The authors are members of the United States Air Force, and this activity is written to

fulfill the partial requirements of Intercultural Risk and Health Communication (COMM 705),

taught at George Mason University. The opinions within are solely the authors’, and are not

intended to reflect or represent the positions of the United States Air Force or George Mason

University.

AIMING HIGHER 2

Abstract

Objective: To highlight the beliefs and attitudes U.S. Air Force Airmen have about healthy

lifestyle behaviors and how an understanding of these beliefs and attitudes, aligned with a

theoretical framework addressing both individual and organizational factors, can be used to

develop effective communicative intervention strategies for promoting positive change.

Methods: Interviews were conducted with 8 Airmen of diverse backgrounds in order to identify

and understand the variability of attitudes and beliefs about healthy lifestyle behaviors,

perceptions of the Air Force’s actual and idealized roles in promoting health, and individual

ideas of what would constitute the most effective communicative intervention strategies to

promote healthy lifestyles.

Results: Three main themes were identified in the participants’ narratives: (1) the dialectic

between individual conceptualizations of healthy lifestyles and past Air Force programmatic,

policy and communicative emphasis; (2) the relationship between interpersonal communication,

source credibility, and effective media channels; and (3) responsibility and quality of life as

effective messages promoting the adoption of healthy lifestyle behaviors.

Conclusion/Implication: Organizational and individual factors interact to affect Airmen’s

attitudes and beliefs about healthy lifestyle behaviors, and as such, intervention strategies

designed to promote these behaviors should address both sets of factors.

AIMING HIGHER 3

Aiming Higher: Encouraging Healthy Lifestyle Behaviors Among U.S. Airmen

Concerns about the overall health of Airmen have recently spurred Air Force leaders to

institute significant programmatic and policy changes (Harris, 2009). While these changes have

created more stringent physical fitness standards and monitoring mechanisms, they do not

encourage lifelong sustainment of healthy lifestyles. As a result, Airmen who leave the service

are at risk of lapsing into unhealthy behaviors, which can in turn place increased strain on

medical systems.

Communicative intervention strategies designed to address both individual and

organizational factors and spur, reinforce and maintain change, hold the potential for affecting

long-term healthy behaviors among Airmen. As such, this study explores Airmen’s beliefs and

attitudes toward healthy lifestyle behaviors as well as effective strategies to encourage and

sustain those behaviors. Specifically, we use both individual and organizational communication

theories and models as well as an analysis of key themes articulated by Airmen as a means of

developing potentially effective intervention strategies. Finally, we suggest a means of

evaluating the effectiveness of these strategies and discuss possible directions for future study.

The Issue

“An Air Force-wide audit found the service’s fitness program is failing to keep Airmen

fit year-round,” read an Air Force Times story published in early 2009 (Hoffman). The story

referenced several findings made during a 2007-2008 Air Force Audit Agency review of

physical fitness programs across the service. Specifically, the audit found that more than one

third of Airmen participating in the reviewed programs “gained a significant amount of weight”

after their annual physical fitness test (PFT) and that PFT standards were generally administered

and enforced in an inconsistent fashion (Air Force Audit Agency, 2008, p. i). However, perhaps

AIMING HIGHER 4

the most significant finding of the review was that the programs were “not effectively

promot[ing] a healthy lifestyle” (Air Force Audit Agency, 2008, p. i).

Healthy Lifestyles

The importance of healthy lifestyles for Airmen has been repeatedly highlighted by Air

Force leadership, particularly in relation to the stressors created by an increasing operations

tempo and the challenges of operating in deployed, wartime environments (McKinley, 2008;

Seals, 2008).

More than merely physical activity, Air Force leadership conceptualizes a healthy, or “fit

to fight” lifestyle as a proper diet (including both the content and amount of food consumed),

abstinence from tobacco use, responsible consumption of alcohol and effective stress

management (McKinley, 2008). In practice, however, Air Force programs and policies have

traditionally focused on just the physical dimensions of health, particularly weight, endurance

and strength (Air Force Instruction 2010; Roshetko, 2008). This may be in large part due to the

practical ease of assessing these particular dimensions rather than measuring a more

comprehensive, multidimensional construct. Development of new PFT standards in the wake of

the audit is a significant example of the focus on a limited number of health dimensions (Air

Force Instruction, 2010; Harris, 2009).

Programs and policies represent superficial responses to a broader issue impacting the Air

Force’s ability to encourage Airmen to adopt long-term healthy lifestyles: effective, audience-

centered communication. In particular, the service’s communicative efforts have routinely

focused on specific components of health (or combinations of them) rather than a unified, multi-

dimensional construct (Roshetko, 2008). Additionally, communication has been generally

indiscriminate with regard to variation among audiences and unconcerned with the differing

AIMING HIGHER 5

beliefs Airmen have about health issues (Ververka et al., 2003). While programmatic and policy

changes can mandate some degree of compliance among active duty Airmen, they do not build

the individual and organizational consensus needed for the establishment and maintenance of

long-term healthy lifestyles. As a result, retirees may suffer steep declines in health, placing

greater burdens on overtaxed health systems (Berger et al., 2005).

Objectives

Airmen, although embedded in a shared Air Force culture, hold a variety of attitudes and

beliefs about healthy lifestyle behaviors that are influenced by individual acculturation

experiences. Tailored communicative intervention strategies can be effective, particularly since

tailored messages can focus on the specific factors that impact an individual’s readiness to

change (Ververka et al., 2003).

However, while tailored strategies can address individual obstacles to the adoption of

healthy lifestyles, they do not address broader, institutional concerns. The Air Force’s

continuing cultural shift, built around adoption of a “warrior ethos” (Gettle, 2007), may have

created a collective space of resentment among some Airmen. Within an organizational context,

this space may reflect the dialectical tension between traditional and emerging Air Force roles,

missions, and performance expectations, suggesting that effective interventions should also have

organizationally-centered components.

Because of the duality of this issue, our research seeks to highlight Airmen’s beliefs and

attitudes about healthy lifestyle behaviors and how an understanding of them can be applied

toward the development of both individual and organizational communicative intervention

strategies.

AIMING HIGHER 6

Literature Review

A review of the literature on individual and organizational communicative interventions

encouraging behavioral change – particularly the importance of inherent source credibility, the

effectiveness of interpersonal vs. computer-mediated communication, and the Kotter

organization change step model – was used to provide the theoretical framework for this

research.

Inherent Source Credibility

Perception of risk is both socially constructed and dependent on individual beliefs,

attitudes, expectations, and the context in which an individual is immersed when evaluating risk

(Sjoberg, 2000). Risk perception is also mediated by interpersonal networks, especially friends,

family, peers and supervisors (Cozma, 2005) whose inherent credibility is bolstered by an

individual’s previous, positive experiences with them (Slater & Rouner, 1996). Related to

Airmen’s adoption and maintenance of healthy lifestyles, this suggests that message strategies

that leverage the inherent credibility of interpersonal networks can be effective.

Interpersonal Communication Effectiveness

The explosive growth of social media and computer-mediated communication (CMC) has

often been dogged by the critique that such media constrains the full “richness” of human

communication, hampering the effectiveness of persuasive approaches by limiting nonverbal

cues (Wilson, 2003). While Airmen have acknowledged the utility of receiving “Air Force-

related information” via e-mail, they have also indicated that interpersonal communication

channels are highly valued (Pope, 2007). The perceived value of these channels does not negate

the effectiveness of CMC; rather it implies that interpersonal communication is complementary.

This echoes survey findings that Airmen “rely on receiving a message via multiple channels for

AIMING HIGHER 7

it to register as important” (Pope, 2007). Additionally, interpersonal approaches are by their

nature better suited to tailored communicative strategies. These findings, coupled with our own

analysis suggest that current communicative approaches using CMC (i.e. e-mail, websites,

articles, etc.) should be complemented with strategies that leverage the appeal and richness of

interpersonal communication.

Kotter Organization Change Step Model

While previous research provides support for the effectiveness of tailored communicative

interventions (Wilson, 2003), such support does not indicate that generalized approaches are

inherently ineffective. On the contrary, the difference between the effects of tailored and general

interventions appears to be minimal when there is less variability within a specific population

(Bull et al., 1999). Additionally, availability of communication resources and the practicality of

audience segmentation can often constrain action in favor of generalized communication

strategies, even if there is a desire to use tailored ones.

General approaches have been routinely used in Air Force health communication

(Ververka et al., 2003). However, relatively few interventions have addressed the dialectical

tension produced by the Air Force’s traditional roles and missions and its adoption of an

expeditionary-ready, warrior ethos, described by the Air Force Manpower and Personnel

Directorate as:

…a mindset that provides [Airmen] the mental and moral stamina to overcome the

stresses and hardship of combat, pressures of deployed operational requirements, and

demands of activities at their home station with valor, courage and sacrifice (Long, M.,

personal communication, February, 24, 2010).

AIMING HIGHER 8

That tension saw its initial expression in 2003, with the unveiling of more stringent PFT

standards and the then-Air Force Chief of Staff’s declaration that “the amount of energy we

devote to our fitness programs is not consistent with the growing demands of our warrior culture.

It’s time to change that,” (Dougherty, 2009, p. 14). These “growing demands” stem from

increasing requirements for Airmen to participate in non-traditional frontline combat and combat

support missions once dominated by the land services. These missions include convoy

operations and enemy detention, host nation training and advisory missions, and innumerable

activities “outside the wire” (Bates, 2007).

The Air Force’s self-described warrior ethos represents a significant cultural shift for the

service. In addition to the aforementioned participation in non-traditional missions, Air Force

culture has been historically “stovepiped” around functional specialties, inhibiting a common

identity in favor of one where “fliers are fliers, and maintenance, maintenance and never the

twain shall meet” (Matthews, 1997, p. 2). In as much as we credit the idea that culture is socially

constructed, largely through discourse, the creation of a new unifying cultural identity for the Air

Force is a challenging, multi-faced communicative effort that occurs at both the interpersonal

and organizational levels.

John Kotter, Konosuke Harvard Business School’s Matsushita Professor of Leadership,

Emeritus, has proposed an 8-step framework that describes organizational change as an

incremental process that moves through several discrete points (1995; 1998). In particular, these

points are the following:

(1) establishing a sense of urgency [emphasis added] by relating external environmental

realities to real and potential crises and opportunities facing an organization, (2) forming

a powerful coalition of individuals who embrace the need for change and who can rally

AIMING HIGHER 9

others to support the effort; (3) creating a vision to accomplish the desired end-result; (4)

communicating the vision through numerous communication channels; (5) empowering

others to act on the vision by changing structures, systems, policies, and procedures in

ways that will facilitate implementation; (6) planning for and creating short-term wins by

publicizing success, thereby building momentum for continued change; (7) consolidating

improvements and changing other structures, systems, procedures, and policies that aren’t

consistent with the vision; and (8) institutionalizing the new approaches by publicizing

the connection between the change effort and organizational success (Armenakis &

Bedeian, 1999, pp. 301-302).

The Kotter Model offers complementary utility to interpersonal, tailored approaches in

that it is well suited to offer “insights for monitoring and minimizing the likelihood of

unfavorable employee reactions to [specific] change interventions” (Armenakis & Bedeian,

1999, p. 308). In addition, the Kotter Model is conceptually similar to social learning theory’s

idea of enactive mastery, in that both extol the value of incremental, process-guided change.

Specifically, the concept of enactive mastery posits that “the gradual accumulation of

successively more complex skills maximizes feelings of self-efficacy and minimizes stress

resulting from the realization that established (automatic) responses are no longer effective in a

new setting” (Armenakis & Bedeian, 1999, p. 312). This concept is applicable to the current

issue in that of healthy lifestyle behaviors (i.e. accumulation of new skills) can potentially

maximize self-efficacy and minimize stress in the new setting (i.e. the warrior ethos culture).

AIMING HIGHER 10

Theoretical Framework

The adoption of long-term healthy lifestyle behaviors among Airmen is dependent on the

mitigation of a number of change-related affective and cognitive barriers. These barriers are

characterized by both individual factors (i.e. varying attitudes and beliefs about healthy lifestyle

behaviors) and organizational factors (i.e. differing ideas as to the appropriate nature of

organizational culture). Effective interventions must be based on a theoretical framework that

addresses both sets of factors in a synergistic fashion. The complementary natures of

interpersonal communication approaches and the Kotter model (which addresses organizational

factors) suggests they may be linked together as a conceptual foundation for the development of

effective communicative interventions within the Air Force context.

AIMING HIGHER 11

Methods

Overall Design

Eight Airmen of diverse backgrounds were interviewed in effort to identify and

understand the variability of attitudes and beliefs about healthy lifestyle behaviors, perceptions

of the Air Force’s actual and idealized roles in promoting health, and individual ideas of what

would constitute the most effective communicative interventions to promote healthy lifestyles.

Participants

Half of the participants were identified and recruited with the assistance of public affairs

officers at one domestic Air Force Base (Andrews Air Force Base, Md.) and one overseas Air

Base (Bagram Air Base, Afghanistan) while the other half consisted of a convenience sample

recruited through one author’s interpersonal networks. Seven participants were active duty Air

Force members while one was a reservist working in a full-time capacity for the Air Force.

The age of participants ranged from 23 to 46 years old and the median duration of Air

Force service was 12.4 years. The participants were divided equally with respect to sex and 25%

identified themselves as African-American with the remaining self-identifying as white or

Caucasian. The rank of participants ranged from Staff Sergeant (E-5) to Major (0-4) and a

variety of job specialties were identified, including a navigator, training instructor, paralegal,

public administration specialist, photojournalist, chaplain, and two pilots. The participants’

locations included Air Force installations across the U.S. and a deployed location in Afghanistan.

All participants identified themselves as being in good to very good health and voluntarily

provided information to the researchers with no compensation. Table 1 provides a general

description of the participants and Table 3 offers a snapshot of Air Force demographics at large.

AIMING HIGHER 12

Procedures

Open-ended interview questions were used to elicit information relating to several

categories, including participants’ perceptions of what constitutes a healthy lifestyle, the

effectiveness of Air Force policies and programs, individual barriers to adoption of a healthy

lifestyle, and preferred communication channels/messages to promote adoption of healthy

lifestyle behaviors. Due to the sensitivity of physical fitness standards and its link to career

advancement in the Air Force, every effort was made to ensure anonymity in order to provide the

subjects an environment for open and truthful discussion about the subject. Interviews were

conducted face-to-face, by telephone, and via e-mail and ranged from 30 to 60 minutes in

duration. Two participants responded via e-mail due to constraints on availability. Interview

notes were transcribed, personal identification information was removed, and the results were

combined for analysis.

We conducted thematic analysis of the interview data within a framework of three

factors; individual, organizational, and perceptual. This multi-factored analysis was driven by

our belief that a study of communication surrounding this issue should not be restricted to merely

dyads or the organization. Instead, we felt that this issue was better understood by examining the

perceived communication flow permeating the entirety of the environment that surrounds the

individual, the organization, and perceptions of both.

Analysis of individualistic factors revealed each participant’s ideological position

(Prochaska & DiClemente, 1986) toward healthy lifestyle related issues. Analysis of

organizational factors captured participants’ thoughts and beliefs about the effectiveness

(Armenakis & Bedeian, 1999) of Air Force programs and policies. Perceptual factors illustrated

AIMING HIGHER 13

individuals’ perceptions of effective communication channels and messages. Table 2 captures

the general results of our analysis.

AIMING HIGHER 14

Results

Analysis of participants’ responses using the framework of individual, organizational and

perceptual factors revealed three primary themes within Airmen’s narratives: (1) the dialectic

between individual conceptualizations of healthy lifestyle and Air Force programmatic and

policy emphasis; (2) the relationship between interpersonal communication, source credibility,

and effective communication channels; and (3) responsibility and quality of life as effective

messages promoting the adoption of healthy lifestyle behaviors. Collectively, these themes

suggest the effectiveness of a theoretical framework for communicative interventions that

integrates interpersonal/tailored and organizational change strategies.

Theme One: Dialectic of the Multidimensionality of Health

The dialectic between Air Force rhetoric about the multidimensionality of a healthy

lifestyle and the perceived unidimensionality of programmatic and policy efforts (i.e.

emphasizing PFT-oriented measures) was a key theme reflected in many of the participants’

responses. This theme engaged all three primary dimensions of the analytical framework (i.e.

individual definitions of healthy lifestyles, organizational emphasis, and perceptions of the gaps

between the two). Participants defined healthy lifestyles in a variety of ways, but a commonly-

expressed belief was that health is constituted by a variety of separate, but related concepts. In

particular, one participant described healthy lifestyles as having social, spiritual, emotional and

physical dimensions:

You have to be … taking care of that social aspect of your life because [it] … can

definitely affect the way the rest of your body functions. And then of course you have to

take care of that spiritual aspect of yourself, making sure that you have something bigger

to grab on to than just you because life is hard … The emotional side kind of plays on the

AIMING HIGHER 15

other three. If you’re allowing yourself to become depressed and anxious about

everything then your body just starts to shut down … Taking care of your body – which

includes rest, relaxation, physical fitness and your diet – with all of that together you can

function – Participant M1.

Other participants also recognized the multidimensionality of healthy lifestyles, citing the

importance of attending to emotional and psychological factors, specifically by reducing stress.

In addition, limited use – or avoidance altogether – of tobacco and alcohol was considered an

important factor by several participants. When asked about their perceptions of the effectiveness

of Air Force programs and policies, many noted the gap between their definitions and what they

perceived the Air Force as emphasizing:

I feel the Air Force stresses exercise more – go run around the track! – Participant K1.

I don’t think it [new Air Force PFT standard] will encourage a healthy lifestyle, I think it

will encourage a better physical component. Some people say that when you work out

you feel better emotionally and mentally, but that’s just for the duration of the workout –

Participant M2.

They encourage you to look healthy rather than be healthy—focused on the waist

measurement rather than a healthy lifestyle – Participant K3.

While some participants noted that a multidimensional construct would be difficult

measure, most indicated that closing the gap between organizational rhetoric, programs and the

policies they represent would have beneficial effects for encouraging Airmen to adopt and

maintain healthy lifestyles.

AIMING HIGHER 16

Theme Two: Interpersonal Communication

Source credibility. Participants’ ideas about the effectiveness of interpersonal

communication represented a second key theme and related to both the individual and perceptual

factors of the analytical framework (individual attributions of source credibility and perceptions

of the effectiveness of intepersonal communication channels). Participants described the

effectiveness of communication as being based on both the credibility of the message source as

well as that of the channel itself. Most participants appeared to attribute the greatest amount of

source credibility to members of their interpersonal networks; particularly friends, family, peers,

and leaders/supervisors.

The attribution of source credibility was made with little or no reference or consideration

of individuals’ expertise on healthy lifestyle issues (i.e. few participants mentioned

professionally-trained health and fitness experts), echoing Slater and Rouner’s claim that

“credibility judgments based on prior beliefs concerning, and prior affective responses to, the

source are likely to be powerful in shaping message impact” (1996, p. 975).

People listen more to the people they think can relate to them – Participant M1.

Friends and family have the most impact, then medical – Participant M2.

My preference [of message source] would be to have conversations with my friends that

are physically fit or attempting to be fit – Participant M3.

Source credibility was only part of the overall theme of communication effectiveness

articulated by participants. It was complemented by the perception that the communication

channel was a critical and complementary determinant for overall effectiveness.

AIMING HIGHER 17

Effective Channels. The inherent effectiveness of specific communication channels was

reflected in a variety of participant responses. Most notably, generalized approaches were

typically subordinated to the value of tailored, interpersonal communication.

Word of mouth is good…definitely not forced or by e-mail – Participant K3.

It’s got to come from the people around you. Nobody cares what you can write in an e-

mail. People want to see the effects. It’s like TV infomercials. Nobody’s going to buy

something unless you show them what it can do – Participant M1.

These responses parallel Vance’s study of the perceived effectiveness of interpersonal

persuasion strategies in CMC, which suggested that face to face communication (FTFC) was

generally more effective than CMC and that people “naturally tend to gravitate toward FTFC

when dealing with issues that emphasize interpersonal persuasion, such as dealing with problems

and sensitive issues in the workplace” (2003, p. 549).

Theme Three: Effective Messages

Participants’ ideas about effective healthy lifestyle messages centered around two ideas:

responsibility and quality of life. While responsibility was mostly relevant to the organizational

factor of the analytical framework (i.e. it dealt with individual responsibility to the organization),

the quality of life theme was concerned with both individual and perceptual factors (i.e. long-

term well-being for individuals as well as a concern with how others would perceive them).

Responsibility. The idea of responsibility conceptualized a healthy lifestyle as an

individual’s obligation to the Air Force – a condition of employment – with the suggestion that

messages highlighting this obligation (and the negative consequences of non-adherence) would

be the most effective. Messages proposed by participants echoing this idea included the

following:

AIMING HIGHER 18

It’s up to you. Make them understand that it is their personal responsibility in the matter

– Participant K1.

Get healthy or get kicked out—PT [physical training] affects your retainability, job and

career – Participant K2.

My message would be: This is your job, I’m paying you to stay in shape—do it! If you

can’t, get out of the Air Force! – Participant K4.

This concept of responsibility seemed to extend beyond just individuals’ obligations to

the organization and also included the idea of responsibility to others:

“Do you want the people that are closest to you that you care about to emulate what you

are? People pick up smoking and their kids start smoking. Do you want your kid to die

of emphysema? Because that’s basically what you’re telling them.” – Participant M1.

Quality of life. Another message theme identified by participants was quality of life.

This theme addressed individuals’ long-term well-being, their ability to maintain independence

after separation or retirement from the Air Force, physical appearance, and a variety of

individualistic factors. While the idea of responsibility inductively referenced the Air Force core

values of “service” and “excellence”, the quality of life theme was primarily concerned with

individualistic concerns, and as such seemed well aligned to the idea of long-term (including

post-service) lifestyle maintenance.

First, think about the long term implications of it. People like cars, they like houses.

You wouldn’t fill your house with horse manure and you wouldn’t fill your car with sand

so are you more important than your material possessions? If the answer is yes then you

should take care of yourself at least as well, if not better, than what you own – Participant

M1.

AIMING HIGHER 19

I am 46 years old and I am in very good shape, younger men are trying to go out with me

all the time – Participant M3.

Communicate the importance of investing in your body, the earlier the better for long-

term health benefits – Participant K1.

Considered collectively, the themes articulated by participants suggest that the integration

of interpersonal/tailored and organizational change approaches into cohesive communicative

intervention strategies can be effective at encouraging sustainable healthy lifestyles.

AIMING HIGHER 20

Strategies

One of the Air Force Manpower and Personnel Directorate’s “desired effects” for the

introduction of new Air Force PFT standards in 2010 was the creation of “an understanding that

being physically fit is consistent with the Air Force Core Values and mission” (Long, 2010).

This effect is based on the idea of the immediate responsibility that Airmen owe to the Air Force

as a condition of service. However, this effect fails to consider the broader societal desirability

for Airmen to have a lifelong commitment to healthy lifestyle behaviors. Thematic analysis of

the interviews with a diverse group of eight Airmen and applied against a theoretic framework of

communication that addresses both individual and organizational behavioral change, suggests

strategies with the potential to encourage this commitment both while serving in the Air Force

and afterward (Appendix A).

Individual Strategy

Past research has suggested some merit to tailored communication interventions seeking

to encourage behavioral change (Noar et al., 2007; Ververka, 2003). Placed within the context

of Airmen’s adoption and maintenance of healthy lifestyles, as well as the previously-discussed

thematic analysis of interviews with Airmen, this suggests effective communicative intervention

strategies should leverage an Airmen’s interpersonal networks.

The use of interpersonal communication strategies provides potential benefits beyond

just the inherent credibility of a particular message source or the richness of a communication

medium. Specifically, interpersonal approaches are better suited for tailoring communication to

individual needs. In particular, family, friends, peers and supervisors must understand the value

of this approach in order to merge information and influence in a fashion that can effectively

encourage behavioral impacts for a specific individual.

AIMING HIGHER 21

We suggest an interpersonal communication strategy incorporating the full spectrum of

voices of healthy lifestyle professionals within an organization. These voices can provide

accurate information about the multidimensional constituents of healthy lifestyles and their

impact on quality of life to a variety of interpersonal sources with high levels of source

credibility for Airmen. These healthy lifestyles professionals would include the Health and

Wellness Center and Fitness Center staffs as well as military medical professionals.

Interpersonal sources with high credibility can include military families (through Airman and

Family Readiness Center Programs, base Youth Programs, and informal family support

programs like spouses groups); Airmen’s parents through commanders (i.e. by weaving

appropriate themes into letters about Airman or unit accomplishments); peer and mentorship

networks (through organizations such as the Top 3, Airman’s Councils, Company Grade

Officer’s Councils, and formal and informal mentorship programs). In sum, we suggest a

partnership between organizational experts and interpersonal sources—leveraging source

credibility and familiarity with Airmen’s communication needs and preferences—as an effective

strategy to encourage adoption and maintenance of healthy lifestyle behaviors.

Organizational Strategy

While a strategy leveraging interpersonal networks has the potential to tailor

communication to an individual’s beliefs, attitudes and specific context, such an approach does

little to address broader cultural issues. Although the Air Force’s adoption of a warrior ethos has

individual implications, it has been more often conceptualized as a cultural change with

implications for the entire organization (Gettle, 2007; Matthews, 1997; Roshetko, 2008). Seen

as such, organizational communication approaches such as the Kotter Model provide

complementary utility to tailored communicative intervention strategies.

AIMING HIGHER 22

The Kotter Model suggests that the first step in effective organizational change is to

“examine market and competitive realities” and to “identify and discuss crises, potential crises,

or major opportunities” as a means of creating an organizational sense of urgency for embracing

change (Kotter, 1998). This idea relates to the Air Force Audit Agency’s examination of the

fitness program, but also suggests that further action should include a wider survey to examine

Airmen’s knowledge, attitudes, and beliefs about healthy lifestyle behaviors.

At an organization’s macro-level, the Kotter Model also argues for the creation of a

group “with enough power to lead the change effort” (Kotter, 1998). Such change has begun in

the Air Force, led communicatively by the service’s senior leaders (Gettle, 2007; Roshetko,

2008). However, this principle also suggests that change should occur at micro-levels as well –

with the creation and articulation of a vision for change. This idea speaks to unit-level leaders

directly addressing their Airmen’s responsibility to maintain a multidimensional standard of

health and to encourage others to do so as well.

Another key facet of the Kotter Model involves the idea of removing obstacles by

changing “systems or structures that seriously undermine the vision” (Kotter, 1998). Among the

obstacles to healthy lifestyle behaviors cited most frequently by interview participants were

inconsistent work schedules and long hours; lack of healthy food choices on base; and the

“say/do” dissonance between leaders who call for fitness, but appear unfit themselves:

Another barrier, and it’s more of a psychological barrier, is looking around at the people

that are preaching fitness and taking care of your self are the ones that are neglecting it.

I’ve heard some commanders described as if I was walking behind them they’d look like

a ‘fat little Airman out of basic training’ – Participant M1.

AIMING HIGHER 23

Work hours are long—my office has 12-14 hour days plus there is nothing healthy to eat

on base – Participant K2.

In any kind of stressful career field, if you’re hungry you grab the closest thing that’s

available to you and you don’t really have time to make something healthy. It’s a

Snickers bar, some string cheese or something. You do what you can with what you have

– Participant M1.

The military preaches a healthy lifestyle then bombards us with fast food, clubs and

alcohol. I do not believe there is a correlation between healthy lifestyles and fast food

chains – Participant M3.

Dismantling of healthy lifestyle barriers may require “risky” approaches such as

reconsidering fast food concessions on Air Force bases; and the conceptualization of certain

healthy lifestyle behaviors (such as regular physical fitness) as “mission-essential training”, with

the creation of unit-level structures to monitor performance more aggressively than the twice-

per-year PFT. The removal of barriers may also require a more comprehensive examination of

correlations between unit missions, Airmen healthy lifestyle behaviors, and readiness. Such an

examination, particularly at unit levels, could provide commanders with a clearer picture of the

real “cost” of operations tempo. This view could illuminate personnel, procedural, and

procurement decisions related to specific missions.

Finally, the Kotter Model calls for planning and creating short-term “wins”, and

consolidation and institutionalization of those wins (Kotter, 1998). Recognition programs, a

mainstay of Air Force culture, represent a potentially effective mechanism for this process. By

publicly highlighting individuals who embody healthy lifestyles through formal or informal

recognition programs, they not only serve as role models, but are also able to exert positive

AIMING HIGHER 24

influence through their interpersonal networks. Over time, this influence can serve to create a

behavioral norm, complementary to the norms codified in policy, for the adoption of healthy

lifestyle behaviors.

Ultimately, no strategy can anticipate every potential mitigating factor, a notion

exemplified in the military adage that “no plan survives first contact with the enemy.” Success

requires incremental adjustment, which must be based on regular measurement and evaluation.

AIMING HIGHER 25

Evaluation

Evaluation of the success of strategies to encourage Airmen to adopt and sustain healthy

lifestyles will require Air Force leaders to measure awareness, acceptance, and behavior. In

particular, such evaluation must first recognize that healthy lifestyles include a host of

dimensions (i.e. stress management, responsible alcohol use, limited or no use of tobacco and a

healthy diet, etc.) and that these lifestyles should be long-term in nature in order to maintain

quality of life. In particular, we suggest a survey-like mechanism to measure the following:

Awareness and acceptance

o Existing Airmen beliefs, attitudes and understandings about

Constituents of a healthy lifestyle

Long-term consequences of healthy/unhealthy lifestyle (i.e. quality

of life impacts)

Responsibility to the Air Force to live a healthy lifestyle

Behavior

o Individual health practices

Physical fitness

Stressors and stress management techniques

Diet and nutrition

Alcohol and tobacco use

o Barriers to healthy lifestyle practices

Structural

Procedural

Programmatic

AIMING HIGHER 26

Policy

Personal

Such a survey should be conducted at the local level to reflect unique contextual

elements. Additionally, because individual lifestyle and organizational cultural change requires

long-term effort, evaluation must be continual. In other words, the survey should be

administered regularly, ideally every six months, concurrent with the PFT. In this fashion,

leaders at local levels have the foundation on which to “course correct” their efforts on an

incremental basis, rather than having to introduce wholesale changes late into the process.

Success within evaluation efforts also implies more than just acceptance and awareness –

it also requires understanding behavior. Through questions that examine individual behaviors—

in addition to beliefs and attitudes—a survey instrument can offer insight into the practical

results of applied intervention strategies. The expertise of local military health professionals will

be critical in this endeavor, as they can provide the interpretive framework for determining a

realistic change goal for each incremental measurement.

AIMING HIGHER 27

Discussion

Although the validity of this study is challenged by a relatively small and convenient

sample, our research does suggest some strategic directions and evaluation methods to encourage

the adoption and maintenance of multidimensional healthy lifestyle behaviors among Airmen. In

particular, our analysis suggests the importance of considering both individual and organizational

factors in the design of communicative intervention strategies.

At the individual level, strategies leveraging the inherent source credibility of

constituents of Airmen’s interpersonal networks hold the promise of tailored effectiveness. This

means that interpersonal communication can be shaped by a source’s knowledge of how an

Airman understands and interprets particular messages in order to increase communication

effectiveness. Interpersonal approaches also capitalize on a broad consensus among Airmen as

to the value of this communication channel. Organizational strategies, such as those proposed by

the Kotter Model, complement interpersonal efforts by addressing the need for broader, cultural

change. These strategies not only work to help forge a new organizational identity, but identify

structural and process-oriented actions that can remove barriers and encourage larger-scale

change. In addition, future studies on this issue may find benefit in using larger sample sizes,

controlling for individual cultural characteristics independent from the Air Force culture, and

collecting longitudinal data to determine the impact of a continually evolving Air Force culture

on individual beliefs and attitudes about healthy lifestyles.

Air Force leadership has taken important steps to encourage Airmen to adopt and sustain

healthy lifestyles. They have recognized and articulated the issue and called for action to move

the service in the appropriate direction. The next steps forward will entail responsibility for the

organization as a whole, but will also demand much of individual Airmen. Success will be

AIMING HIGHER 28

measured over time, in both the external trappings of a new culture and within the hearts and

minds of Airmen themselves.

AIMING HIGHER 29

References

Air Force Audit Agency. (2008). Air Force fitness program: Audit report (F2009-0004-

FD4000). Washington, DC: Air Force Audit Agency.

Air Force Instruction 36-2905, Fitness Program. (2010). Retrieved from http://www.e-

publishing.af.mil/shared/media/epubs/AFI%2036-2905.pdf

Air Force Personnel Center. (2010). Military demographics. Retrieved from

http://www.afpc.randolph.af.mil/library/airforcepersonnelstatistics.asp

Armenakis, A. A. & Bedeian, A. G. (1999). Organizational change: A review of theory and

research in the 1990s. Journal of Management, 25(3), 293-315.

Bates, M. (2007, February 6). Chief of staff: Warrior Airmen new culture of Air Force. Air

Force News Agency. Retrieved from http://www.af.mil/news/story.asp?id=123040010

Berger, U., Der, G., Mutrie, N., & Hannah, M. K. (2005). The impact of retirement on physical

activity. Ageing and society, 25, 181-195.

Bull, F. C., Krueter, M. W., & Scharff, D. P. (1999). Effects of tailored, personalized and general

health messages on physical activity. Patient Education and Counseling, 36(2), 181-192.

Cozma, R. (2005). Risk reporting and source credibility: Trying to make the readers interested.

(Master’s thesis, University of Bucharest). Retrieved from http://etd.lsu.edu/docs/

available/etd-04132005-115008/unrestricted/Cozma_thesis.pdf

Dougherty, R. J. (2009). Fit to fight: Admin or ethos? Retrieved from Air University Research

Information Management System: https://www.afresearch.org/skins/rims/q_mod

_be0e99f3-fc56-4ccb-8dfe-670c0822a153/q_act_downloadpaper/q_obj_d6329c64-7a55-

4439-b6c2-f6169ef1202f/display.aspx?rs=enginespage

AIMING HIGHER 30

Gettle, M. (2007, March 21). Air Force fosters "warrior ethos" in all Airmen. Air Force News

Agency. Retrieved from http://www.af.mil/news/story.asp?id=123045702

Harris, K. (2009, September 15). A look at the Air Force's new physical fitness standards. Stars

and Stripes. Retrieved from http://www.stripes.com/article.asp?section=104

&article=64781

Hoffman, M. (2009, January 5). PT program needs fixing, audit finds. Air Force Times.

Retrieved from http://www.airforcetimes.com/news/2009/01/airforce_PT_audit_

010209w/

Kotter, J. (1995). Leading change: Why transformation efforts fail. Harvard Business Review,

73(2), 59-67.

Kotter, J. P. (1998). Winning at change. Leader to Leader, 10(4), 27-33.

Matthews, M. T. (1997). A search for warriors: The effects of technology on the Air Force

ethos. Retrieved from Defense Technical Information Center: http://www.dtic.mil/cgi-

bin/GetTRDoc?AD=ADA424693&Location=U2&doc=GetTRDoc.pdf

McKinley, R. (2008, March 31). Maintaining a healthy lifestyle. Air Force Surgeon

General News. Retrieved from http://www.sg.af.mil/news/story.asp?id

=123092276

Noar, S., Benac, C., & Harris, M. (2007). Does tailoring matter? Meta-analytic review of

tailored print health behavior change interventions. Psychological Bulletin, 133(4), 673-

693.

Pope, R. (2007). Where Airmen get information. Retrieved from the online Air Force Public

Affairs Community of Practice.

AIMING HIGHER 31

Prochaska, J. O. & DiClemente, C. C. (1986). Toward a comprehensive model of change. In

Miller, W. R. & Heather, N. (Eds), Addictive behaviors: Processes of change (pp. 3-27).

New York, NY: Plenum Press.

Roshetko, T. F. (2008). Air Force fitness culture: Are we there yet? Retrieved from Air

University Research Information Management System: https://www.afresearch.org/

skins/rims/q_mod_be0e99f3-fc56-4ccb-8dfe670c0822a153/q_act_downloadpaper/q_obj_

a01b27e9-20a0-4c06-be3e-9a141f8010d5/display.aspx?rs=enginespage

Seals, C. (2008, December 12). 'Perspective' highlights healthy lifestyles. Air Force news

Agency. Retrieved from http://www.afsoc.af.mil/news/story.asp?id=123127809

Sjoberg, L. (2000). Specifying factors in radiation risk perception. Scandinavian Journal

of Psychology, 41, 169-174.

Slater, M., & Rouner, D. (1996). How message evaluation and source attributes may influence

credibility assessment and belief change. Journalism & Mass Communication Quarterly,

73(4), 974-991.

Wilson, E. V. (2003). Perceived effectiveness of interpersonal persuasion strategies in computer-

mediated communication. Computers in Human Behavior, 19(5), 537-552.

Ververka, D. V., Anderson, J., Auld, G. W., Coulter, G. R., Kennedy, C., & Chapman, P. L.

(2003). Use of the stages of change model in improving nutrition and exercise habits in

enlisted Air Force men. Military Medicine, 168(5), 373-379.

AIMING HIGHER 32

Table 1

Participant Characteristics

Measure M1 M2 M3 M4 K1 K2 K3 K4 Age 24 23 46 37 35 32 38 33Sex M F F M F M M FRace* CA AA AA CA CA CA CA CARank** E5 E5 E8 E6 O3 O4 O4 O4Current level of health*** G VG VG G VG G VG GCurrent level of stress**** H L M M M M M HMost recent fitness test category***** S E E S G S G ENumber of years of service 6.5 5 26 18 12 10 12 10

Notes. *Race was self-identified by participants and includes the following responses: caucasian or white (CA) and African-American (AA).**Air Force ranks include enlisted personnel (E1 through E9) and commissioned officers (O1-O10). ***Level of health was self-identified by participants using the following four categories: very good (VG), good (G), fair (F), and poor (P).**** Level of stress was self-identified by participants using the following four categories: low (L), medium (M), and high (H).*****Fitness level was also self-identified including the categories of excellent (E), satisfactory (S), unsatisfactory (U), pass (P - under some conditions Airmen may take a partial or modified test that only indicates pass or fail), fail (F), or exempt (E)

AIMING HIGHER 33

Table 2

Participants’ Major Themes

Healthy lifestyles - Healthy lifestyles encompass social, spiritual, emotional and physical dimensions- Eating right and working out, reducing stress are key to healthy lifestyles- Regular exercise, healthy diet, and alcohol & tobacco avoidance are important to living a

healthy lifestyle- Healthy lifestyles include cardio, strength, appropriate BMI (body-mass index), healthy

eating, flexibility & stress management

Programs & Policies - Air Force programs and policies focus on physical dimensions- Air Force fitness programs encourage you to look healthy rather than actually be healthy

Communication Channels - Friends, leadership (when it “looks the part”), supervisors, and peers - Chain of command - Self-motivation and personal concerns about public image- Wife

Messages - It is your responsibility – practice healthy lifestyle behaviors or get out of the Air Force- Healthy behaviors are necessary for long-term well-being, independence, and quality of

life- Don’t pollute your body (with unhealthy behaviors)- Be an example to others- A healthy lifestyle makes you look and feel better- Failure to live a healthy lifestyle can hurt your career- Life is better when you are healthy- This is your job and you are being paid to do it

Notes. The themes above reflect the results of open-ended interview questions used to elicit information relating to four specific categories:

(a) Participants’ perceptions of what constitutes a heathy lifestyle (Lifestyle), (b) Perceived focus of Air Force fitness policy and programs (Policy/Programs)(c) Preferred communication channels to promote adoption of healthy lifestyle behaviors (Channels)(d) Perceived effective messages to promote adoption of healthy lifestyle behaviors (Messages)

AIMING HIGHER 34

Table 3

Air Force Demographics

Data as of March 31, 2010 Total Airmen on Active Duty 331,486

Total Officers 65,349Total Enlisted Personnel 266,137

Average Age Officers 35Enlisted 29

SexFemale 19.4% Male 80.6%

Average Number of Years of ServiceOfficers 11Enlisted Personnel 8

Race (self-reported)White 73.4%Black or African American 14.6%Declined to Respond 5.5% Asian 2.6% Other 2.3%Native Hawaiian or Other Pacific Islander 1%

American Indian/Alaska Native 0.6%

Note. Information above is adapted from the Air Force Personnel Center (2010).

AIMING HIGHER 35

Appendix A

Healthy Lifestyle Strategy

General Themes for Message Development:- Responsibility (Organizational Message): A healthy lifestyle, including physical fitness, nutritional diet, responsible drinking, and effective stress management is your obligation to the Air Force. The Air Force can help you learn how to do it, but in the end you must be the one who makes it happen.

- Quality of Life (Individual Message): A healthy lifestyle, including physical fitness, nutritional diet, responsible drinking, and effective stress management will help you live a longer, more independent life for your own sake, and for the sake of your family, friends and community.

Sources and ChannelsHealth and Wellness Center, Fitness Center, and military medical professionals provide accurate information about multidimensional constituents of healthy lifestyle and impact on quality of life to groups and organizations mentioned below:

- Military families through Airman and Family Readiness Center Programs, base Youth Programs, and informal family support programs (i.e. spouses groups). - Parents through commander’s communication (i.e. woven into letters about Airman or unit accomplishments)- Peer and mentorship networks through engagement with organizations such as Top 3, Airman’s Councils, Company Grade Officer’s Councils, formal and informal mentorship programs- Local development networks (i.e. First Term Airman’s Centers, Airman Leadership Schools, etc.)- Supervisors (mandatory “roll call” discussions)- Leadership (Commanders, Chief Master Sergeants and First Sergeants)

AIMING HIGHER 36

Additional Organizational Change Strategies- Unit-level leaders address Airmen’s responsibility to maintain a multidimensionalstandard of health within themselves and also address Airmen’s responsibility to encourage others to do so - Address organizational barriers/obstacles to healthy lifestyle behaviors (i.e. inconsistent work schedules and long hours; lack of healthy food choices on base; and the “say/do” dissonance between leaders who call for fitness, but appear unfit themselves)

-- Reconsidering fast food concessions on Air Force bases-- Conceptualization of certain healthy lifestyle behaviors (such as regular physical fitness) as “mission-essential”, with creation of unit-level structures to monitor performance aggressively (e.g. more than the twice-per-year PFT)-- Examination of correlations between unit missions, Airmen healthy lifestyle behaviors, and readiness. Provides clearer picture of “cost” of OPSTEMPO, and aids in personnel and procedural decisions related to specific missions.-- Publicly highlight individuals who embody healthy lifestyles through forma/informal recognition programs. Individuals serve as role models and can exert positive influence through their networks.

Evaluation:-Survey-like mechanism (twice per year, concurrent with PFT) to measure:

-- Airmen beliefs, attitudes and understandings about the constituents of a healthy lifestyle -- Airmen beliefs about structural, procedural, programmatic, policy, or individual barriers to those lifestyles -- Individual health practices.

-- Conducted at the local level (identifies unique contextual factors)-- Uses expertise of local military health professionals to provide interpretive framework for realistic change goal