ERGOGENIC NUTRITIONAL SUPPLEMENT USE: A MARKER FOR HIGH-RISK BEHAVIORS Mark B. Stephens, MD MS; Cara Olsen, MS, USUHS-Departments of Family Medicine and Biostatistics, Bethesda, MD 20814

Objective: To determine the extent to which ergogenic supplement use is associated with personal high-risk behaviors.

Design: Cross-sectional survey.

Setting: Recruit processing centers: Parris Island, SC and Lackland AFB, TX.

Study Populations: 550 new USAF and USMC recruits.

Interventions: A modified CDC Youth Risk Behavior Survey was administered to all participants.

Main Outcome Measures: 1) Ergogenic supplement use. 2) High-risk personal behaviors.

Statistical Tests Used: Descriptive statistics for categorical variables. Chi-square test of contingency for non-parametric group comparisons.

Results: The response rate was 91%. Forty two percent of recruits had used ergogenic supplements. Creatine was the most popular supplement. Individuals who used ergogenic supplements were 60% more likely to carry a personal weapon (OR 1.8; 95% CI 1.1-3.0; p < 0.02); 78% more likely to ride a motorcycle without a helmet (OR 1.9; 95% CI 1.0-3.7; p<0.05); 18% more likely to drink (OR 1.8; 95% CI 1.2-2.9; p<0.01); 45% more likely to drink heavily (OR 2.3; 95% CI 1.5-3.5; p < 0.001); 58% more likely to ride in a vehicle with someone who had been drinking (OR 2.0; 95% CI 1.3-3.0; p < 0.001) and more than twice as likely to drive after drinking (OR 2.6; 95% CI 1.5-4.4; p<0.001), compared to those who had never used supplements. There were no differences in patterns of supplement use according to age or body-mass index. Men were more likely to use supplements than women (p< 0.0001).

Conclusions: Our study indicates an association between individuals who use ergogenic nutritional supplements and specific health risk behaviors. This represents an important opportunity for preventive counseling, particularly in the adolescent population.

MENTAL HEALTH STIGMA AND THE WILLINGNESS TO REPORT SELF- HARM BEHAVIORS IN THE ACTIVE DUTY SOLDIER: Sebastian Robert Schnellbacher, DO, MAJ, MC, USA, 101st Airborne Division (Air Assault), Bagram, Afghanistan 09354; Charles W. Hoge, MD, Division of Psychiatry and Neuroscience, Walter Reed Army Institute of Research, U.S. Army Medical Research and Materiel Command, Silver Spring, MD 20910

Objective: The primary purpose of this study is to ascertain the factors associated with the willingness of Soldiers to seek help if they would want to hurt themselves including behavioral health stigma.

Design: An anonymous, voluntary survey that asked demographics, measured levels of stigma, and questioned Soldiers about their willingness to seek help if they would want to hurt themselves.

Setting: The study was done in September 2008 at Schofield Barracks, a FORSCOM Army installation.

Study Populations: Volunteer sample of active duty Soldiers, primarily in the 25th infantry division, 3rd Brigade who were undergoing a pre-deployment SRP. 2600 Soldiers were surveyed and 1944 responses were returned.

Interventions: No interventions were made.

Main Outcome Measures: The primary outcome measure was the response to the statement “I would go to a mental health provider if I wanted to hurt myself” measured on a 7-point Likert scale (from strongly disagree to strongly agree).

Statistical Tests Used: Chi-square and logistic regression analysis.

Results: 58.2% of Soldiers agreed that they would seek out a mental health provider if they wanted hurt themselves. Stigma was strongly related to a Soldiers’ willingness to seek help if they wanted to hurt themselves. The medium stigma group was more likely to seek help than the high stigma group (p 0.01, OR 1.565, 95% CI of 1.111-2.206) and the low stigma group was even more likely to seek help (p <0.001, OR 2.178, 95% CI of 1.595-2.972). Soldiers who had received Battlemind training were also more likely to seek help. (P <0.034, OR 1.34, 95% CI of 1.02-1.75).

Conclusions: Behavioral health stigma could be an important factor in the recent increase in suicide rates. Focus on correcting the stigmatous perceptions present in our subpopulation with education and training could significantly help this problem.


Objective: To determine the impact of Home Sleep Testing (HST) on CPAP compliance.

Design: Observational cohort study.

Setting: AASM accredited, academic sleep laboratory; Family Medicine residency clinic.

Study Populations: 210 OSA patients were classified into three equal groups. Group 1 underwent traditional, attended, in-laboratory, level I diagnostic and CPAP titration studies; Group 2 underwent in-lab diagnostic and un-attended home auto-adjustable positive airway pressure (APAP) titrations; and Group 3 underwent un-attended home diagnostic and home APAP titration studies.

Interventions: Groups 1 and 2 were evaluated in an academic sleep center and received extensive education and follow-up. Group 3 was evaluated in an academic community hospital and received limited education and follow-up. All groups received the same PAP device.

Main Outcome Measures: Objective measures of PAP compliance. We compared mean hours of nightly PAP use and percentage of nights PAP was used between the three Groups. Rate of “regular use,” defined as >4 hours per night for >70% of nights was also compared.

Statistical Tests Used: Continuous variables were compared between each of the three Groups using analysis of variance. When appropriate, Pearson bivariate correlations were used to analyze the relationships between each of the measured variables.

Results: Location of the study and degree of education did not impair PAP use. PAP was used for 73%, 72% and 70% of nights in Groups 1, 2 and 3, respectively (p=0.68). Mean hours of nightly use (4.7±1.5, 4.6±1.5, and 4.4±2.0 hours, p=0.58) was also similar between groups. Regular use of PAP was observed in 53%, 53% and 57% of subjects (p=0.90).

Conclusions: Despite less contact and education, there was no significant difference in PAP usage among those undergoing HST versus in-lab studies. HST offers an accessible and cost-effective alternative for the diagnosis and initiation of therapy in patients with OSA without compromising therapeutic adherence.