these materials will remind and encourage the service member to contact the user’s primary physician or emergency room in the event that adverse effects are experienced, even if they do not require medical intervention.

Actively pursue outreach activities Service members and their commanders must be educated so that they recognize both the potential adverse effects and the benefits from the use of a given dietary supplement, and the importance of reporting any adverse events to health care providers. This may be achieved through the following approaches:

• Include information about dietary supplements in routine commanders’ calls and communication regarding force protection/performance enhancement and health promotion, to reinforce the concept that some dietary supplements should be used with care and the importance for force protection of reporting adverse effects. Military commanders will be made aware of issues surrounding dietary supplement use as part of their formal education and routinely rely on their medical staff for input. There will also be direct communication with the designated oversight committee or via summary tables and monographs, produced by the review panel, or other educational materials that are provided both to medical staff and commanders.

• Consider modifying current contracts for sale of dietary supplements to include requirements to allow placement of outreach and educational materials about dietary supplements at point of sale on military installations (e.g., AAFES/NEX outlets and fitness centers).

Provide appropriate training and continuing education for health care personnel Health care personnel (e.g., emergency room staff, flight surgeons, medics, dietitians, pharmacists, and health promotion personnel) should improve their abilities to evaluate dietary supplement use, to inform military members, and to appropriately report adverse events. Education should be included in existing programs (e.g., Uniformed Services University of Health Sciences, internships and residencies, aerospace medicine training, independent duty medical technician training, and mandatory continuing education at medical staff meetings).

Education and training should emphasize the following objectives:

• Enhance health care personnel’s awareness of and ability to pose relevant questions and provide information to patients about the use of dietary supplements. Identify and direct their patients to credible sources of information (e.g., NIH Office of Dietary Supplements).

• Provide guidelines on how to effectively report adverse events. Training should address the following topics: (1) identification of adverse