Rangers, Special Forces) justify the continuation and improvement of data collection from distinct dietary supplement use surveys from military personnel for the following reasons: (1) the higher physical fitness demands of some military subpopulations (e.g., Rangers, Special Forces) compared to those of the general population, (2) the lower proportion of women in these subpopulations, (3) the differences in motivation for using dietary supplements (e.g., meeting military weight standards and improving performance), and (4) differences in military culture and behavior patterns. As an example, the military imposes serious consequences for weight gain and substandard performance, which likely lead to supplement use in the military that differs from that of the civilian population. Data from civilian populations may also not provide an accurate description of the prevalence, patterns of use, and key issues of certain military populations (e.g., Rangers, Special Forces).

In general, survey research uses questionnaires or interviews in relatively large groups of people and, if appropriately planned and conducted, gathers reliable and valid data on various characteristics of the population of interest. The use of survey methodology can be effective to investigate and monitor supplement use in the military. Since it is not feasible to survey everyone, survey data can be collected from a well-defined sample of individuals and, from this, generalized to an entire group (e.g., all military personnel or all Rangers). Challenges in performing surveys include ensuring high response rates, comprehensive data collection, and the validity of the individual responses. The validity of the data from these surveys may be compromised by several factors: incorrect sample selection, unclear terminology (common usage terms versus scientifically defined terms), or survey respondents’ lack of knowledge of and inability to determine total dose of or exposure to supplements or inability to remember their supplement use accurately. A low response rate can lead to a biased sample that does not represent the supplement use of the targeted military population.

The benefits of survey use include having data on the extent of the use of dietary supplement products, changes in patterns of use, and insights on specific health behaviors (e.g., reasons for use, degree of consultation with physician, views on dietary supplements). As also recommended in Chapter 5, an important application of survey data on changes in patterns of use is their utilization as a trigger to initiate a safety review of a specific dietary supplement when there is an initial signal for concern (e.g., because it chemically resembles a hazardous product or there are adverse events associated with its consumption). The outcome of this safety review should be the basis for policy-making decisions by military leadership. A systematic evaluation of patterns of use can therefore be used to develop effective educational messages for military personnel and to formulate health policy. If survey data are representative of the targeted military subpopulation, then

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