Wellness Indices of Coast Guard Drill Instructors Toward the Development of a Health Management Program
Eunice M. Aceron
Discipline: health studies
Abstract:
Coast Guard Drill Instructors (CGDIs) play a vital role in shap-ing recruits into disciplined service members. However, the de-manding nature of their profession can impact overall wellness, making it essential to assess and address health concerns to sus-tain both individual performance and organizational effectiveness.
This study examined the wellness indices of CGDIs by evaluat-ing their physical, mental, and emotional health and explored how demographic factors may influence these dimensions. The pri-mary goal was to develop a tailored Health Management Program suited to their specific needs.
A mixed-methods design was employed, integrating quantita-tive surveys with qualitative interviews. Standardized instru-ments—including the International Physical Activity Question-naire (IPAQ), Depression Anxiety Stress Scales (DASS-21), and Emotional Style Questionnaire (ESQ)—were used to assess well-ness levels. ANOVA was conducted to identify significant differ-ences across demographic groups, while interviews with a PCG psychologist and selected military personnel provided richer con-textual insights.
Findings indicated that while the majority of CGDIs maintain stable mental health, a subset exhibited extreme symptoms of de-pression and anxiety, particularly CGDIs who are single, junior in rank and those assigned far distant from the place of residence. Despite the physically demanding nature of their duties, a signifi-cant level of sedentary behavior was reported. Emotional wellness was found to be moderate overall, with differences noted by age, birth order, and RTC assignment.
The study resulted in the development of a comprehensive health program encompassing mental health support, physical ac-tivity, stress management, and spiritual counseling. Key recommendations include a strict implementation of Rotation Policy, es-tablishing mental health screening tools and mandatory post mis-sion debriefing.
References:
- Adoption and promulgation of the code of eth-ics and professional standards for Psy-chology Practitioners in the Philippines. (2017). Philippine Regulatory Board of Psychology Resolution No. 11, series of 2017. Philippine Regulatory Commission. https://www.prc.gov.ph/sites/default/files/PSYCHOLOGY-CodeEthics-201711.pdf
- Adler, A. B., Bliese, P. D., Allard, Y. S., & Sharp, D. (2024). Wellness checks: Piloting a universal intervention for soldiers. Psy-chological Services, 21(2), 337–346. https://doi.org/10.1037/ser0000794
- Ali, A. M., Alkhamees, A. A., Hori, H., Kim, Y., & Kunugi, H. (2021). The Depression Anxie-ty Stress Scale 21: Development and Vali-dation of the Depression Anxiety Stress Scale 8-Item in Psychiatric Patients and the General Public for Easier Mental Health Measurement in a Post COVID-19 World. International Journal of Environ-mental Research and Public Health, 18(19), 10142. https://doi.org/10.3390/ijerph181910142
- Anestis, M. D., & Green, B. A. (2015). The Im-pact of Varying Levels of Confidentiality on Disclosure of Suicidal Thoughts in a Sample of United States National Guard Personnel. Journal of Clinical Psychology, 71(10), 1023–1030. doi:10.1002/jclp.22198
- Almubaddel, Abdulmohsen. (2022). Psycho-metric properties of a Saudi Arabian ver-sion of the Positive Mental Health (PMH) scale. Psicologia: Reflexão e Crítica. 35. 10.1186/s41155-022-00232-0. https://pubmed.ncbi.nlm.nih.gov/36125579/
- Arce, C.R., Bance, L.O. (2017) Construction, Validation And Standardization Of Tem-perament Scale For The Armed Forces. Proceedings Journal of Education, Psy-chology and Social Science Re-search.Vol04:Iss01:Pg58. https://doi.org/10.21016/4.17.5864.112O
- Blasche G, Szabo B, Wagner-Menghin M, Ek-mekcioglu C, Gollner E. Comparison of rest-break interventions during a mental-ly demanding task. Stress Health. 2018 Dec;34(5):629-638. doi: 10.1002/smi.2830. Epub 2018 Aug 16. PMID: 30113771; PMCID: PMC6585675.
- Bogaers, R., Sluik, D., Helmhout, P., & Leijten, F. (2024). A Workplace Health Promotion Program for a Predominantly Military Population: Associations with General Health, Mental Well-Being and Sustaina-ble Employability. International Journal of Environmental Research and Public Health, 21(5), 625. https://doi.org/10.3390/ijerph21050625
- Brownstein, A. (2023) How do you measure health and wellness. Inside Tracker. https://blog.insidetracker.com/how-do-you-measure-health-and-wellness
- Burton WN, Schultz A, Edington DW. (2021) Health and Wealth: The Importance for Lifestyle Medicine. Am J Lifestyle Med. 2021 Apr 3;15(4):407-412. doi: 10.1177/15598276211005348. PMID: 34366738; PMCID: PMC8299921. https://pubmed.ncbi.nlm.nih.gov/34366738/
- Butler, J., & Kern, M. L. (2016) The PERMA-Profiler: A brief multidimensional meas-ure of flourishing. International Journal of Wellbeing, 6(3), 1-48. doi:10.5502/ijw.v6i3.526. https://www.internationaljournalofwellbeing.org/index.php/ijow/article/view/526/579
- Chan, R. Y. (2016). Understanding the purpose of higher education: An analysis of the economic and social benefits for complet-ing a college degree. Journal of Education Policy, Planning and Administration, 6(5), 1-40. https://scholar.harvard.edu/sites/scholar.harvard.edu/files/roychan/files/chan_r._y._2016._understanding_the_purpose_aim_function_of_higher_education._jeppa_65_1-40.pdf
- Cleland, C., Ferguson, S., Ellis, G., & Hunter, R. F. (2018). Validity of the International Physical Activity Questionnaire (IPAQ) for assessing moderate-to-vigorous phys-ical activity and sedentary behaviour of older adults in the United Kingdom. BMC medical research methodology, 18(1), 176. https://doi.org/10.1186/s12874-018-0642-3
- Elliman, T., Schwalb, M., Krauss, S., Mikoski, P., Adler, A., (2021) US Army Drill Sergeants: Stressors, Behavioral Health, and
- Mitigating Factors, Military Medicine, Volume 186, Issue 7-8, July-August 2021, Pages 767–776, https://doi.org/10.1093/milmed/usab002
- Gaetano, A. L. T. A. V. I. L. L. A. (2016). Rela-tionship between physical inactivity and effects on individual health status. Jour-nal of Physical Education and Sport, 16(2), 1069-1074. https://mail.efsupit.ro/images/stories/3%20September2016/art%20170.pdf
- Galderisi, S., Heinz, A., Kastrup, M., Beezhold, J, and Sartorius, N. (2015) Toward a new definition of mental health. World Psy-chiatry. Volume 14, Issue 2, Pages 231-233. https://doi.org/10.1002/wps.20231
- Gomez, F. (2016). A guide to the depression, anxiety and stress scale (DASS 21). Cen-tral and Eastern Sydney primary health networks. https://d1wqtxts1xzle7.cloudfront.net/45493280/Dass21-libre.pdf?1462841918=&response-content-disposi-tion=inline%3B+filename%3DA_Guide_to_the_Depression_Anxiety_and_St.pdf&Expires=1758539785&Signature=JkTr7~FplJ0LUIu47tixaFKr6I3FNWxxhofmnu7D~G2NxaTWW7Yewjz1UtmuO86dP~4rxmtvEkToszp4MAiHX53IWBlKaelUjeOsP-UG33nXXB~vuWptt2ty58AGcPxs5Qi5AfB1Fb87Bppq8bPAeGaSDGdtOs7tMypx8vdxwy8T5A1sIDs0uvlOBR-nJqRDmtiVrrA-zqmlS6M5kq~Nxx00rV3chVP6AmiLnJc5b4hQJ3GsRRrwK3z-8v5K3YTstGuqO-yDsbbhzZV0UhCs6DoXlUSkeTLW-GYEnJKaFt-NlVyBpfH3leKCwbAfywlfe1jzAM9Eihqia79h0OqFrcA__&Key-Pair-Id=APKAJLOHF5GGSLRBV4ZA
- Goodwin, L., Wessely, S., Hotopf, M., Jones, M., Greenberg, N., Rona, R. J., ... & Fear, N. T. (2015). Are common mental disorders more prevalent in the UK serving military compared to the general working popula-tion? Psychological medicine, 45(9), 1881-1891. https://pubmed.ncbi.nlm.nih.gov/25602942/
- Gupta, T. (2019). Personality an essence of the person directs by birth order. age, 1000, 33. Retrieved from: https://www.researchgate.net/profile/Tamanna-Gupta-4/publication/354532813_Personality_an_essence_of_the_person_directs_by_birth_order/links/613d9d74e4419c5e6ec6c637/Personality-an-essence-of-the-person-directs-by-birth-order.pdf
- Hajdari, R., & Jupa, N. (2023). The role of py-ramidal organizational structure in or-ganizational efficiency and effectiveness. ACC Journal, 29(2), 1-?. DOI: 10.2478/acc-2023-0001
- Health information. Emotional Wellness Toolkit. (2022). National Institutes of Health. https://www.nih.gov/health-information/emotional-wellness-toolkit#:~:text=Emotional%20wellness%20is%20the%20ability,to%20change%20and%20difficult%20times
- Hermosilla, S., Forthal, S., Sadowska, K., Magill, E. B., Watson, P., & Pike, K. M. (2023). We need to build the evidence: A systematic review of psychological first aid on mental health and well-being. Journal of Traumatic Stress, 36, 5–16. https://doi.org/10.1002/jts.22888
- Holdsworth, M. (2019) Health, Wellness and Wellbeing. Revue Interventions économiques [Online], 62 | 2019, Online since 28 June 2019, connection on 25 April 2024. URL: http://journals.openedition.org/interventionseconomiques/6322; DOI: https://doi.org/10.4000/interventionseconomiques.6322
- Hull, E. L. (n.d.). Review of military life: The positive and negative consequences of married and single life in the military. Na-tional Healthy Marriage Resource Center, Brigham Young University Hub. Retrieved from https://healthymarriageinfo.org/wp-con-tent/uploads/2017/12/review_mmilitarylife.pdf
- Jiunn Tay, K., Yap, A. U.-J., Wong, J. C. M., Tan, K. B. C., & Allen, F. P. (2018). Associations between Symptoms of Temporomandibu-lar Disorders, Quality of Life and Psycho-logical States in Asian Military Personnel. Journal of Oral Rehabilitation. doi:10.1111/joor.12751. https://pubmed.ncbi.nlm.nih.gov/30478918/
- Kesiber, P., Gasiorowska, A., Goldman, R., Hirshberg, M.J., Davidson, R.J., (2019). Manuscript Version of Emotional Style Questionnaire: A Multidimensional Meas-ure of Healthy Emotionality. American Psychological Association. DOI: https://psycnet.apa.org/manuscript/2019-36357-001.pdf
- Kirkland, A. (2014). What Is Wellness Now? Journal of Health Politics, Policy and Law, 39(5), 957–970. doi:10.1215/03616878-2813647. https://read.dukeupress.edu/jhppl/article/39/5/957/13664/What-Is-Wellness-Now
- Khadka, P. B. (2023). The relevance of psycho-logical testing in the selection of army of-ficers. Unity Journal, 4(1), 227–238. https://doi.org/10.3126/unityj.v4i01.52243
- Kotoulas, A. S., Karamanavis, D., Lambrou, G. Ι, & Karanikas, P. (2021). A pilot study of the depression, anxiety and stress in Greek military personnel during the first year of the COVID-19 pandemic. BMJ Mili-tary Health, bmjmilitary–2021–001874. doi:10.1136/bmjmilitary-2021-001874
- Kovich, M.K., Simpson, V.L., Foli, K.J. et al. Ap-plication of the PERMA Model of Well-being in Undergraduate Students. Int. Journal of Com. WB 6, 1–20 (2023). https://doi.org/10.1007/s42413-022-00184-4
- Lawrence, E. M. (2017). Why do college grad-uates behave more healthfully than those who are less educated?. Journal of health and social behavior, 58(3), 291-306. https://pmc.ncbi.nlm.nih.gov/articles/PMC5570614/pdf/nihms808489.pdf
- Lunau, T., Siegrist, J., Dragano, N., & Wahren-dorf, M. (2015). The association between education and work stress: does the poli-cy context matter?. PloS one, 10(3), e0121573. https://doi.org/10.1371/journal.pone.0121573
- Mangaluz, R. (2024). Women in the army: The changing role of female soldiers in the Philippines. 3Inquirer.net. https://newsinfo.inquirer.net/1918034/fwd-women-in-the-army
- Marck, A., Antero, J., Berthelot, G. C. B., John-son, S., Sedeaud, A., et al. (2019). Age-related upper limits in physical perfor-mances. The Journals of Gerontology: Se-ries A, Biological Sciences and Medical Sciences, 74(5), 591–599. https://doi.org/10.1093/gerona/gly165
- Masciadri, A., Sacchi, M., Comai, S., & Salice, F. (2019). Wellness Indexes to Assess Quali-ty of Life. Proceedings of the 5th EAI In-ternational Conference on Smart Objects and Technologies for Social Good. doi:10.1145/3342428.3342694
- McGuire, A. C. L., Kanesarajah, J., Runge, C. E., Ireland, R., Waller, M., & Dobson, A. J. (2016). Effect of Multiple Deployments on Military Families: A Cross-Sectional Study of Health and Well-Being of Part-ners and Children. Military Medicine, 181(4), 319–327. doi:10.7205/milmed-d-14-00310
- Kiechle, M., (2019). “Health is Wealth”: Valuing Health in the Nineteenth-Century United States, Journal of Social History, Volume 54, Issue 3, Spring 2021, Pages 775–798, https://doi.org/10.1093/jsh/shz104
- Mental health (2022). World Health Organiza-tion. https://www.who.int/news-room/fact-sheets/detail/mental-health-strengthening-our-re-sponse/?gad_source=1&gclid=CjwKCAjwupGyBhBBEi-wA0UcqaN4V47Rb2IuByAQxndH8e34oSJoWW6kiQHUk8zdMyF1SYBSr8yQx3BoC7QQQAvD_BwE
- Molinaro, J. (2017). Why is health and wellness so important? https://medium.com/@judymolinaro/why-is-health-wellness-so-important-ac206766387
- Perma Theory of Wellbeing and Perma Work-shops. Positive Psychology Center. Uni-versity of Pennsylvania. https://ppc.sas.upenn.edu/learn-more/perma-theory-well-being-and-perma-work-shops#:~:text=what%20enables%20it%3F-,Dr.,are%20strategies%20to%20increase%20each.
- Priory Group. (2024). Retrieved from https://www.priorygroup.com/blog/emotional-health-and-wellbeingProfile of the Military Community. (2023) De-partment of Defense. https://download.militaryonesource.mil/12038/MOS/Reports/2023-demographics-report.pdf
- Radhakrishnan, R. (n.d.). What Is Health and Wellness? Retrieved from Medicine Net: https://www.medicinenet.com/what_is_health_and_wellness/article.htm
- Santini, Z. I., Koyanagi, A., Tyrovolas, S., Ma-son, C., & Haro, J. M. (2015). The associa-tion between social relationships and de-pression: A systematic review. Journal of Affective Disorders, 175, 53–65. doi:10.1016/j.jad.2014.12.049
- Scholes S, Bridges S, Ng Fat L, Mindell JS. (2016). Comparison of the Physical Activ-ity and Sedentary Behaviour Assessment Questionnaire and the Short-Form Inter-national Physical Activity Questionnaire: An Analysis of Health Survey for England Data. PLoS ONE 11(3): e0151647. https://doi.org/10.1371/journal.pone.0151647
- Schoonenboom J, Johnson RB. (2017) How to Construct a Mixed Methods Research De-sign. Kolner Z Soz Sozpsychol. 2017;69(Suppl 2):107-131. doi: 10.1007/s11577-017-0454-1. Epub 2017 Jul 5. PMID: 28989188; PMCID: PMC5602001.Seligman, M.
- Scoring protocol for the International Physical Activity Questionnaire (IPAQ) (2005). Score the IPAQ. https://sites.google.com/view/ipaq/score
- Sefidan, S., Pramstaller, M., La Marca, R., Wyss, T., Sadeghi-Bahmani, D., Annen, H., & Brand, S. (2021). Resilience as a Protec-tive Factor in Basic Military Training, a Longitudinal Study of the Swiss Armed Forces. International journal of environ-mental research and public health, 18(11), 6077. https://doi.org/10.3390/ijerph18116077
- Seven dimensions of wellness (2024). Grand Rapids Community College. https://www.grcc.edu/faculty-staff/human-resources/professional-development/employee-wellness/seven-dimensions-well-ness#:~:text=Physical%20wellness%20encom-pass-es%20a%20variety,yourself%20from%20injuries%20and%20harm
- Shaheen, A., Nassar, O., Amre, H. and Hamdan-Mansour, A. (2015) Factors Affecting Health-Promoting Behaviors of Universi-ty Students in Jordan. Health, 7, 1-8. doi: 10.4236/health.2015.71001. https://www.scirp.org/journal/PaperInfor-mation.aspx?PaperID=53021abstract
- Steenkamer, B. M., Drewes, H. W., Heijink, R., Baan, C. A., & Struijs, J. N. (2017). Defin-ing Population Health Management: A Scoping Review of the Literature. Popula-tion Health Management, 20(1), 74–85. doi:10.1089/pop.2015.0149
- Teychenne, M., Abbott, G., Lamb, K. E., Rosen-baum, S., & Ball, K. (2017). Is the link be-tween movement and mental health a two-way street? Prospective associations between physical activity, sedentary be-haviour and depressive symptoms among women living in socioeconomically dis-advantaged neighbourhoods. Preventive Medicine, 102, 72–78. doi:10.1016/j.ypmed.2017.07.005
- Thomas P. A. (2016). The Impact of Relation-ship-Specific Support and Strain on De-pressive Symptoms Across the Life Course. Journal of aging and health, 28(2), 363–382. https://doi.org/10.1177/0898264315591004
- Tuppin, K., Morrison, B. W., & Earl, J. K. (2025). Psychological Assessment for Military Se-lection: Past, Present and Future Applica-tions [Online first]. Journal of Military and Veterans’ Health. https://jmvh.org/article/psychological-assessment-for-military-selection-past-present-and-future-applications/
- U.S. Department of Defense. (2023). 2023 De-mographics: Profile of the military com-munity. https://download.militaryonesource.mil/12038/MOS/Reports/2023-demographics-report.pdf
- Webber, B. J., Flower, A. M., Pathak, S. R., Bur-ganowski, R. P., Pawlak, M. T., Gottfred-son, R. C., … Young, J. A. (2019). Physical and Mental Health of US Air Force Mili-tary Training Instructors. Military Medi-cine. doi:10.1093/milmed/usy418
- What is health promotion? (n.d) University of Georgia College of Public Health. https://publichealth.uga.edu/departments/health-promotion-behavior/what-is-health-promo-tion/#:~:text=Health%20promotion%20is%20a%20behavioral,driven%20voluntary%20behavior%20change%20activities
- What is the difference between mental health and emotional health? (2023). Mindful health solutions. https://mindfulhealthsolutions.com/difference-between-mental-and-emotional-health/#:~:text=Mental%20health%20involves%20your%20overall,handle%20and%20express%20your%20emotions
- What is wellness? (2024). Pfizer Inc. https://www.pfizer.com/und/health-wellness/wellness/what-is-well-ness#:~:text=Wellness%20is%20the%20act%20of,how%20it's%20linked%20to%20health
- Wickramarathne, P. C., Phuoc, J. C., & Albattat, A. R. S. (2020). A review of wellness di-mension models: For the advancement of the society. European Journal of Social Sciences Studies. https://www.researchgate.net/publication/342770547_European_Journal_of_Social_Sciences_Studies_A_REVIEW_OF_WELLNESS_DIMENSION_MODELS_FOR_THE_ADVANCE-MENT_OF_THE_SOCIETY_A_REVIEW_OF_WELL-NESS_DIMENSION_MODELS_FOR_THE_ADVANCEMENT_OF_THE_SOCIETY
- World Health Organization. (2020). WHO guidelines on physical activity and seden-tary behavior. https://iris.who.int/bitstream/handle/10665/336656/9789240015128-eng.pdf?sequence=1
- Vaidya, A., Stevenson, R., Singer, R., Meston, L. (2021) What does it truly mean to be "healthy"? Genesis Medical Associates Inc. https://www.genesismedical.org/location/West-View-Office/blog/what-does-it-truly-mean-to-be-healthy#:~:text=According%20to%20The%20World%20Health,function%20throughout%20their%20everyday%20lives.
- Yadav, A. & Singh, R. (2024). Impact of Birth Order on Emotional Competence. Inter-national Journal of Indian Psychology, 12(4), 2540-2552. DIP:18.01.240.20241204, DOI:10.25215/1204.240 https://ijip.in/wp-con-tent/uploads/2025/01/18.01.240.20241204.pdf
- Zohair N, Javed M, Rahat M, Mumtaz H, Sher A, Raza Z, Qayyum S, Ahmad S, Dimensions of Wellness: A Multidimensional Concept. BMC J Med Sci 2020. 1(2): 39-46 https://www.researchgate.net/publication/386531152_Dimensions_of_Wellness_A_Multidimensional_Concept