Exploration of a Pre-Deployment Health Intervention in the British Military: A Mixed Methods Research Approach.

Willoughby, Kirsty-Marie (2026) Exploration of a Pre-Deployment Health Intervention in the British Military: A Mixed Methods Research Approach. Doctoral thesis, Birmingham City University.

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Abstract

Introduction: In an increasingly volatile and unpredictable world, safeguarding the health of British military personnel so they can protect the security of the UK, and our allies has never been more critical. British military personnel are often deployed to austere environments around the world with a heightened risk of Disease Non-Battle Injury (DNBI). DNBI not only has detrimental effects on individual health but also reduces the unit workforce, impairing a commander’s ability to achieve mission objectives. Pre-deployment health briefs aim to equip military personnel with the knowledge needed to adopt good health practices whilst overseas. This research investigates the effectiveness of the health brief in influencing behaviour change, focusing on attitudes towards the health brief, its delivery, risk-taking tendencies and illness prevalence within this cohort.

Methods: A Mixed Methods Research (MMR) Explanatory Sequential design was employed, combining quantitative data using a cross-sectional survey (n=295) and qualitative data using three focus groups (6 military personnel in each) conducted with three British infantry units who returned from six-month operational tours in Iraq (code name: Operation SHADER). The findings from the studies were analysed separately and integrated using an explanatory sequential analysis approach.

Results: The findings reveal critical limitations in the health brief’s efficacy. While 76.9% of participants acknowledged the necessity of health briefs, only 37.3% reported adopting a behavioural change as a result of the intervention. Focus group participants criticised the brief for its lack of specificity and utility, reinforcing the quantitative finding that much of the advice was perceived as “common sense”. Although 92% of participants believed they knew how to protect themselves from illness or injury, this awareness appeared to stem from prior knowledge rather than the brief itself. Alarmingly, 26.4% of participants admitted to knowingly engaging in health-risk behaviours during deployment, highlighting a significant gap between awareness and practice. The prevalence of DNBI, self-reported at 22.7%, underscores the clinical importance of addressing risk-taking behaviours more effectively.

Conclusion
The findings suggest that while the concept of health briefs is widely supported, their current design and delivery fail to achieve meaningful behaviour change. High baseline awareness of health risks among participants indicates that the brief contributes minimally to existing knowledge. The prevalence of risk-taking behaviours despite this awareness points to deficiencies in the health brief’s ability to translate knowledge into action. This misalignment emphasises the need for health interventions underpinned by behavioural science to address underlying factors influencing health decisions.

To enhance the effectiveness of health briefs, it is recommended that military health interventions integrate behavioural science frameworks such as the Capability, Opportunity, Motivation - Behaviour (COM-B) model within the Behaviour Change Wheel (BCW). These tools provide a structured approach to designing interventions that address psychological, social, and environmental determinants of behaviour.

This research offers a critical perspective on the limitations of pre-deployment health briefs and provides actionable recommendations for their improvement. By incorporating behavioural science principles, future health interventions can better equip military personnel when required to deploy to high-risk environments.

Item Type:	Thesis (Doctoral)
Dates:	Date Event 3 August 2026 Accepted
Uncontrolled Keywords:	health intervention, health brief, Pre-deployment training, behaviour, behaviour change, British Military.
Subjects:	CAH02 - subjects allied to medicine > CAH02-05 - medical sciences > CAH02-05-02 - healthcare science (non-specific) CAH02 - subjects allied to medicine > CAH02-06 - allied health > CAH02-06-01 - health sciences (non-specific)
Divisions:	Doctoral Research College > Doctoral Theses Collection Life and Health Sciences > Health and Social Care Professions > Health Care
Depositing User:	Louise Muldowney
Date Deposited:	07 Oct 2026 11:32
Last Modified:	07 Oct 2026 11:32
URI:	https://www.open-access.bcu.ac.uk/id/eprint/17264

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