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Creating A Culture of Healthy Eating

A Military Nurse's Research Journey

Military nurse scientists significantly contribute to mission readiness by generating new knowledge in areas ranging from health promotion to combat casualty care. In this article, I describe my research journey, from a concerned and curious clinician to a novice nurse scientist dedicated to improving the nutrition of warfighters. I aim to inspire nurses to consider a career as a nurse scientist and encourage military leaders to create a culture of healthy eating in the military.

Finding My Way to Research

I was not always interested in research. Professional satisfaction came when I directly cared for patients or teaching hospital corpsmen. Because I thrive on seeing quick and tangible wins, I expected to be happiest if I avoided research and policy. Thankfully, incredible researchers and mentors challenged my limiting beliefs and nudged me into my current passions––research and policy.

A family nurse practitioner and nurse scientist who studied obesity and was intimately familiar with the military sparked my interest in research. I reached out to her to discuss some of the common yet undertreated, diet-related health conditions I saw while caring for Marines and Sailors at Marine Recruit Depot (MCRD) Parris Island. She showed me research was needed to understand better my patients’ health conditions and the myriad of factors influencing their poor health outcomes. The culmination of witnessing painful patient experiences, a lack of evidence to advocate for positive change, and the call to make a difference in a new way led me to begin the journey of earning a PhD and become a nurse scientist.

Growing Through the Process of Becoming a Scientist

A PhD program teaches you to think differently, question assumptions, systematically gather and evaluate evidence, rigorously analyze data, and disseminate research findings to diverse audiences. Up to this point, earning my PhD was my most challenging accomplishment. I learned, and am still learning, how to make peace with cognitive strain, think like a scientist, welcome critique, and communicate research problems, methods, and findings to the scientific community, military decision-makers, clinicians, and the public.

Mentorship, networking, and collaboration were critical components of the journey. I learned about the art and nuances of research by mixing and mingling with scientists from different disciplines. The requisite coursework gave me the essential knowledge and skills to conduct independent research and successfully defend my dissertation. Members of my dissertation committee introduced me to scholars with similar research interests and championed my work at high levels within Navy Medicine, the Military Health System, and the Department of Defense (DoD). The TriService Nursing Research Program provided direct support and encouragement through educational conferences, Grant Camp, and grant funding. Lastly, my peers who also conducted fantastic research inspired me, and we discussed opportunities for future collaboration.

Collecting Evidence That Matters

My patients and the junior Sailors working alongside me at MCDR Parris Island were my why and my starting point. After a few years of reading the scientific and grey literature on obesity, weight cycling, nutrition, and eating behaviors, I identified a research problem: Despite current military policies, programs, and initiatives encouraging healthy eating behaviors, a significant number of Service members have unhealthy eating behaviors. Eating behaviors refer to the actions related to food consumption, such as food preferences, food intake (quality and quantity), and feeding patterns. There was little scientific evidence on determinants of eating behaviors within the military population. To my knowledge, there was no published literature on factors influencing eating behaviors among young, junior enlisted Sailors, a population at risk for gaining excess weight and developing unhealthy eating habits. There was a critical knowledge gap and narrowing that gap could provide researchers and military leaders with salient and culturally relevant data to address barriers and facilitators to eating a healthy and nutritious diet.

The purpose of my dissertation study was to explore intrapersonal, social, and environmental factors influencing eating behaviors of junior enlisted Sailors in non-deployed settings within the context of Navy and military culture. I also aimed to identify prominent eating behaviors among this group, the influence of cyclical physical readiness testing on eating behaviors, and perceived facilitators and barriers to healthy eating behaviors. It was a monumental lift, but it was personally meaningfully and operationally relevant.

I conducted a qualitative research study using a focused ethnographic design to better understand the cultural perspective of the problem. The research design included collecting multiple forms of evidence (e.g., observations, formal and informal interviews, policy documents, etc.). With the help of the methodology expert on my committee, I conducted deductive and inductive data analysis in parallel with data collection. In simple terms, I spent a lot of time reading, rereading, organizing, categorizing, and interpreting the data by using qualitative and quantitative data analysis methods to yield results aligned with my research purpose and aims.

The study showed participants’ eating behaviors were influenced by many modifiable factors at the individual, social, environmental, and cultural levels. Participants acknowledged a cultural expectation to eat healthily, but they had to overcome numerous barriers to do so. For many junior enlisted Sailors, unhealthy eating behaviors were the default due, in part, to sociocultural norms, life in barracks, and food environments that influenced them to choose cheap, quick, and easy foods. To eat healthily, junior Sailors had to opt-out of social norms and have access to healthy foods, a kitchen, prudent management of resources (i.e., time and money), and nutrition and culinary literacy. Research findings indicated a need for leaders to model healthy eating behaviors and proactively engage with junior Sailors to make healthy choices, the easy and preferred choices.

Disseminating the Evidence

I was privileged to discuss ideas and disseminate my work through several venues throughout my journey. Doing so helped me grow a network of collaborators and mentors, refine my work, and maintain enthusiasm along the way. I learned about the DoD Food, Nutrition, Dietary Supplement Subcommittees’ efforts to improve the military nutrition environment and reduce food insecurity among military families, and how my work could help inform their efforts. Similarly, I worked with Navy dietitians and the Navy Fitness Advisory Council to conduct future research that addresses unhealthy eating behaviors in the Navy. Learning from others and sharing ideas kept me inspired and reminded me that my work is necessary.

Now that I have successfully defended my research, it is time for the next phase of the research journey. One of the many first steps is to publish my work in peer-reviewed journals, ensuring the evidence is available to a broader audience. There is also the matter of communicating findings to military leaders and other stakeholders who may not read scientific literature but are in key positions to create and implement policy. I look forward to this next phase of the journey, learning from experts and collaborating with military nurses and scientists to improve the nutrition of warfighters, ensuring a fit and ready force.


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