Total quality leadership in the US navy: Effective for health promotion activities?

Background. Although the U.S. Navy mandated Total Quality Leadership (TQL) as a management strategy throughout its medical department in the early 199 0s, it was unknown to what extent it was being used for health promotion ac tivities and, if so, how effectively. Methods. A brief mail sun ey of 204 Navy commands supplemented by 97 teleph one interviews to TQL-for-health-promotion-using commands and nonusing cont rols provided worksite information on TQL implementation. Responses from a Navywide health and fitness survey provided perceptions and health behavior attitudes from the individuals at commands. Results. A total of 32% of commands surveyed had used TQL specifically for improving health- and fitness-related processes and outcomes between 1991 a nd 1995. Participants at commands that had used TQL for health- and fitness -related processes reported a higher importance of good health (P < 0.05) a nd were more certain that they would reach and or maintain their ideal weig ht (P < 0.05) than participants at non-TQL commands. However, there were no significant differences in perceptions of command support for health and f itness between TQL and non-TQL commands. Conclusions. Several factors and organizational arrangements that were pert inent to the development and practice of TQL in the Navy were identified. T he use of TQL specifically for health promotion was not consistently relate d to health-related perceptions or health behavior attitudes.