Cost-effectiveness analysis of the U.S. Army Assessment of Recruit Motivation and Strength (ARMS) program

The Assessment of Recruit Motivation and Strength (ARMS) Study was conducted at six Military Entrance Processing Sites during 2005-2006. The objectives were to compare morbidity and attrition of Army accessions who exceeded body fat (EBF) accession standards compared to weight for height or body fat qualified (WQ) and to compare among the WQ subset, those who were physically fit as measured by a 5-minute step test compared to unfit. We performed a cost-effectiveness analysis to address both objectives. Analysis was performed by gender with the primary outcomes of musculoskeletal injury and attrition. Results were expressed in terms of cost per year of military service. Sensitivity analysis was performed on probability cost estimates. We found WQ female recruits were $5,141 less expensive per year than EBF female recruits. WQ males were $2,785 less expensive per year of military service than EBF male recruits. Among WQ recruits, fit females were $3,638 and fit males were $10,381 less expensive per year of service than their unfit counterparts. The ARMS step test is a cost-effective method to identify physically fit EBF applicants for accession in weak recruiting environments. It also offers a cost-effective method to reduce poor physical fitness associated morbidity and attrition.