Date of Conferral



Doctor of Nursing Practice (DNP)




Catherine Garner


Escalating health care costs in the military health system are not sustainable long term. Regular physical activity has been shown to improve health and reduce health care costs. Military members serving in the United States Air Force (USAF) are encouraged to maintain physical fitness year-round and undergo mandatory physical fitness assessments (PFAs) annually. The purpose of this quantitative correlational study was to determine the nature of the relationship between the timing of the PFA and health care utilization (HU) by active duty service members assigned to the United Kingdom's USAF military treatment facility. Donabedian's framework and the logic process model were used to design the study. Archived fitness and health care utilization data were obtained on 361 military members. Findings indicated a strong, positive correlation between the timing of the PFA and HU, which was strongest during the PFA month. Monthly HU 6 months prior to PFA was compared using a 1-way repeated measures ANOVA. Findings indicated a significant difference between T-1 (PFA month), T-2 (1 month prior to PFA), and T-5 (5 months prior to PFA). Paired-samples t tests demonstrated a statistically significant increase in HU from T-5 to T-2. Although findings are not generalizable, they signal a need for further study to evaluate HU variability between populations, to identify at-risk groups, and to inform health and fitness policies that affect the readiness and retention of military members. The DNP project may promote interdisciplinary collaboration between health care providers and senior military leadership, innovation in health care delivery, and evidence-based and cost-conscious policies.