Psychological Health, Coping Strategies and Preferences of Military COVID-19 Deployers

NCT04646642 | Completed

• 1 other identifier: FWH20200203E
• Study Type: observational
• Target: 21
• Locations: 1 country
• Sites: 1

Brief Summary

The proposed research study aims to better understand COVID deployer needs. The study, informally referred to as Project COPE, asks David Grant U.S. Air Force Medical Center (DGMC) members who deployed in support of COVID-19 operations to complete a needs assessment questionnaire. The purpose of this study is to understand the stressful experiences of our COVID Theater Hospital (CTH) deployers, the typical coping strategies used and recommended preferences for support so that the investigators can provide the best evidence-based resources for post-deployment and to aid future CTH deployers.

Conditions

Coping Skills; Healthcare Workers; Covid19

Outcome Measures

Primary Outcomes (14)

• Positive Patient Health Questionnaire-2 (PHQ-2)

  Describe the frequencies of positive screen for depression based on total score \>/= 3 on PHQ-2. The PHQ-2 is a 2-item screening tool for depression that uses first 2 items from PHQ-9. Scale 0 (not at all) to 3 (nearly every day), 0 is better and 3 worse. Total scores exceeding 2 suggest a positive depression screening. This tool provides a brief, practical, valid, and reliable screening instrument.

  1-2 months

• Positive PHQ-2 + High risk COVID physical condition

  Describe the frequencies and percentages of positive screened PHQ-2 individuals who also responded YES for self-reported high-risk COVID physical conditions on demographic questionnaire. The PHQ-2 is a 2-item screening tool for depression that uses first 2 items from PHQ-9. Scale 0 (not at all) to 3 (nearly every day), 0 is better and 3 worse. Total scores exceeding 2 suggest a positive depression screening. This tool provides a brief, practical, valid, and reliable screening instrument. The demographic questionnaire consist of 10 questions, one is COVID-19 risk status. A YES response to "Do you have any underlying physical health conditions that place you in a high-risk COVID category would be included in this measure.

  1-2 months

• Positive PHQ-2 + pre-existing mental health conditions

  Describe the frequencies and percentages of positive screened PHQ-2 individuals who also responded YES for self-reported pre-existing mental health conditions on demographic questionnaire. The PHQ-2 is a 2-item screening tool for depression that uses first 2 items from PHQ-9. Scale 0 (not at all) to 3 (nearly every day), 0 is better and 3 worse. Total scores exceeding 2 suggest a positive depression screening. This tool provides a brief, practical, valid, and reliable screening instrument. The demographic questionnaire consist of 10 questions, one is mental health risk status. A YES response to "Do you have any underlying mental health concerns (anxiety, depression, difficulty sleeping, etc.), or have you visited a mental health professional in the past 6 months?" would be included in this measure.

  1-2 months

• Positive Generalized Anxiety Disorder-2 (GAD-2)

  Describe the frequencies of positive screen for depression based on total score \>/= 3 on GAD-2. The GAD-2 is a 2-item screening tool for Generalized Anxiety Disorder. Scale 0 (not at all) to 3 (nearly every day), 0 is better and 3 worse. A total score of 3 points or greater identifies a positive screen and warrants further diagnostic evaluation with GAD-7 for Generalized Anxiety Disorder criteria. This tool provides a brief, practical, valid, and reliable screening instrument.

  1-2 months

• Positive GAD-2 + High risk COVID physical condition

  Describe the frequencies and percentages of positive screened GAD-2 individuals who also responded YES for self-reported high-risk COVID physical conditions on demographic questionnaire. The GAD-2 is a 2-item screening tool for Generalized Anxiety Disorder. Scale 0 (not at all) to 3 (nearly every day), 0 is better and 3 worse. A total score of 3 points or greater identifies a positive screen and warrants further diagnostic evaluation with GAD-7 for Generalized Anxiety Disorder criteria. This tool provides a brief, practical, valid, and reliable screening instrument. The demographic questionnaire consist of 10 questions, one is COVID-19 risk status. A YES response to "Do you have any underlying physical health conditions that place you in a high-risk COVID category would be included in this measure.

  1-2 months

• Positive GAD-2 + pre-existing mental health conditions

  Describe the frequencies and percentages of positive screened GAD-2 individuals who also responded YES for self-reported pre-existing mental health conditions on demographic questionnaire. The GAD-2 is a 2-item screening tool for Generalized Anxiety Disorder. Scale 0 (not at all) to 3 (nearly every day), 0 is better and 3 worse. A total score of 3 points or greater identifies a positive screen and warrants further diagnostic evaluation with GAD-7 for Generalized Anxiety Disorder criteria. This tool provides a brief, practical, valid, and reliable screening instrument. The demographic questionnaire consist of 10 questions, one is mental health risk status. A YES response to "Do you have any underlying mental health concerns (anxiety, depression, difficulty sleeping, etc.), or have you visited a mental health professional in the past 6 months?" would be included in this measure.

  1-2 months

• Positive Pittsburgh Sleep Quality Index-Addendum for PTSD (PSQI-A)

  Describe the frequencies of positive screen for depression based on total score \> 4 on PSQI-A. The PSQI-A is a 7-item questionnaire used to examine disruptive nocturnal behaviors common in adults with PTSD. Response items are endorsed for frequency. Scale 0 (not during the past month) to 4 (3 or more times a week), 0 is better and 4 worse. The PSQI-A is a valid instrument for PTSD applicable to both clinical and research settings.

  1-2 months

• Positive PSQI-A + High risk COVID physical condition

  Describe the frequencies and percentages of positive screened PSQI-A individuals who also responded YES for self-reported high-risk COVID physical conditions on demographic questionnaire. The PSQI-A is a 7-item questionnaire used to examine disruptive nocturnal behaviors common in adults with PTSD. Response items are endorsed for frequency. Scale 0 (not during the past month) to 4 (3 or more times a week), 0 is better and 4 worse. The PSQI-A is a valid instrument for PTSD applicable to both clinical and research settings. The demographic questionnaire consist of 10 questions, one is COVID-19 risk status. A YES response to "Do you have any underlying physical health conditions that place you in a high-risk COVID category would be included in this measure.

  1-2 months

• Positive PSQI-A + pre-existing mental health conditions

  Describe the frequencies and percentages of positive screened PSQI-A individuals who also responded YES for self-reported pre-existing mental health conditions on demographic questionnaire. The PSQI-A is a 7-item questionnaire used to examine disruptive nocturnal behaviors common in adults with PTSD by frequency. Scale 0 (not during the past month) to 4 (3 or more times a week), 0 is better and 4 worse. The demographic questionnaire consist of 10 questions, one is mental health risk status. A YES response to "Do you have any underlying mental health concerns (anxiety, depression, difficulty sleeping, etc.), or have you visited a mental health professional in the past 6 months?" would be included in this measure.

  1-2 months

• Deployer Identified COVID-19 Stressors

  Describe the severity of deployer identified COVID-19 stressors. A tool that requests deployers to list top 3 stressors experienced during deployment. Participants rated listed items as: 1-no distress, 2-mildly distressing, 3-distressing, 4- very distressing, and 5-extremely distressing. Scale 0 (no distress) to 5 (extremely distressing), 0 is better and 5 worse.

  1-2 months

• Positive Brief Coping Orientation to Problems Experienced (Brief COPE)

  Describe the prevalence of positive coping strategies by percentage based on scores \>/= 3 (3-I've been doing this medium amount; 4-I've been doing this a lot) for items targeting: humor, positive reframing, acceptance, active coping, planning, emotional support, instrumental support, religion. The Brief COPE is a 28-item multidimensional measure of 14 strategies (those above, as well as, behavioral disengagement, self-distraction, substance use, denial, self-blame, venting) used for coping or regulating cognitions in response to stressors. This abbreviated inventory (based on the complete 60-item COPE Inventory) is comprised of items that assess the frequency with which a person uses different coping strategies rated on a scale from 0-"I haven't been doing this at all" to 4-"I've been doing this a lot." (Amoyal et al., 2011). 4 is better and 0 worse. Two items related to drugs and alcohol were eliminated to maintain the eligibility of exempt protocol status

  1-2 months

• Negative Brief Coping Orientation to Problems Experienced (Brief COPE)

  Describe the prevalence of negative coping strategies by percentage based on scores \>/= 3 (3-I've been doing this medium amount; 4-I've been doing this a lot) for items targeting: behavioral disengagement, self-distraction, substance use, denial, self-blame, venting. The Brief COPE is a 28-item multidimensional measure of 14 strategies (those above, as well as, humor, positive reframing, acceptance, active coping, planning, emotional support, instrumental support, religion) used for coping or regulating cognitions in response to stressors. This abbreviated inventory (based on the complete 60-item COPE Inventory) is comprised of items that assess the frequency with which a person uses different coping strategies rated on a scale from 0-"I haven't been doing this at all" to 4-"I've been doing this a lot." (Amoyal et al., 2011). 0 is better and 4 worse. Two items related to drugs and alcohol were eliminated to maintain the eligibility of exempt protocol status

  1-2 months

• COVID-19 Coping Strategy and Resource Inventory

  Describe the frequency of preferred coping resources using the COVID-19 Coping Strategy and Resource Inventory. This is an 18-item resource inventory developed by our DGMC research team to assess preferred strategic resources to manage COVID-19-related stressors. The inventory includes 5 categories of coping resources: 1) interactive \[exercise, spiritual, social, mental health visit\], 2) self-help videos/webinars, 3) mobile applications, 4) electronic toolkits, 5) podcasts

  1-2 months

• Demographic questionnaire

  Describe the demographic characteristics of the respondents using the demographic questionnaire. These are 10 questions regarding individual deployer sex, COVID-19 risk status, mental health risk status, COVID-19 risk status of any family members at home, years of experience in current occupation and specific healthcare role, typical work setting at DGMC, any recent deployments.

  1-2 months

Eligibility Criteria

• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Active duty healthcare workers assigned to David Grant U.S. Air Force Medical Center (DGMC) who deployed in July 2020, under the command of Col Justin Nast and the COVID Theater Hospital (CTH), in support of 8 civilian California hospitals.

You may qualify if:

• The eligible participant group includes David Grant United States Air Force (USAF) Medical Center Active Duty personnel:
• Medical technicians (4N)
• Liaison officers (LNO's)
• Nurses
• Physician assistants
• Advanced practice nurses
• Respiratory therapists
• Psychologists
• Social workers
• Chaplains
• Physicians
• Deployed in July 2020, under the command of Col Justin Nast and the COVID Theater Hospital (CTH) in support of the following civilian facilities:
• Adventist Health Lodi Memorial Hospital, Lodi, CA
• Eisenhower Medical Center, Rancho Mirage, CA
• Community Regional Medical Center, Fresno, CA

You may not qualify if:

• Activated guard, reserve, or civilian healthcare deployers in support of COVID-19

Sponsors & Collaborators

• David Grant U.S. Air Force Medical Center: lead

Study Sites (1)

David Grant Medical Center (DGMC)

Travis Air Force Base, California, 94535, United States

Location

Related Publications (29)

• Amoyal NR, Mason ST, Gould NF, Corry N, Mahfouz S, Barkey A, Fauerbach JA. Measuring coping behavior in patients with major burn injuries: a psychometric evaluation of the BCOPE. J Burn Care Res. 2011 May-Jun;32(3):392-8. doi: 10.1097/BCR.0b013e318217f97a.

  PMID: 21562462 BACKGROUND

• Braquehais MD, Vargas-Caceres S, Gomez-Duran E, Nieva G, Valero S, Casas M, Bruguera E. The impact of the COVID-19 pandemic on the mental health of healthcare professionals. QJM. 2020 Jun 22:hcaa207. doi: 10.1093/qjmed/hcaa207. Online ahead of print.

  PMID: 32569374 BACKGROUND

• Cacioppo JT, Reis HT, Zautra AJ. Social resilience: the value of social fitness with an application to the military. Am Psychol. 2011 Jan;66(1):43-51. doi: 10.1037/a0021419.

  PMID: 21219047 BACKGROUND

• Cullen W, Gulati G, Kelly BD. Mental health in the COVID-19 pandemic. QJM. 2020 May 1;113(5):311-312. doi: 10.1093/qjmed/hcaa110. No abstract available.

  PMID: 32227218 BACKGROUND

• The Depressed Project: Living Systematic Review of Mental Health in COVID-19 Retrieved August 27, 2020, https://www.depressd.ca/covid-19-mental-health

  BACKGROUND

• Folkman S. Personal control and stress and coping processes: a theoretical analysis. J Pers Soc Psychol. 1984 Apr;46(4):839-52. doi: 10.1037//0022-3514.46.4.839.

  PMID: 6737195 BACKGROUND

• Greenberg N. Mental health of health-care workers in the COVID-19 era. Nat Rev Nephrol. 2020 Aug;16(8):425-426. doi: 10.1038/s41581-020-0314-5.

  PMID: 32561871 BACKGROUND

• Hawkley LC, Thisted RA, Masi CM, Cacioppo JT. Loneliness predicts increased blood pressure: 5-year cross-lagged analyses in middle-aged and older adults. Psychol Aging. 2010 Mar;25(1):132-41. doi: 10.1037/a0017805.

  PMID: 20230134 BACKGROUND

• Hawkley L, Preacher K, Cacioppo J. As We Said, Loneliness (Not Living Alone) Explains Individual Differences in Sleep Quality: Reply. Health Psychol. 2011 Mar;30(2):136. doi: 10.1037/a0022366. No abstract available.

  PMID: 25067871 BACKGROUND

• Hobfoll, S. E. (1998). The Plenum series on stress and coping.Stress, culture, and community: The psychology and philosophy of stress. Plenum Press. https://doi.org/10.1007/978-1-4899- 0115-6

  BACKGROUND

• Holmes EA, O'Connor RC, Perry VH, Tracey I, Wessely S, Arseneault L, Ballard C, Christensen H, Cohen Silver R, Everall I, Ford T, John A, Kabir T, King K, Madan I, Michie S, Przybylski AK, Shafran R, Sweeney A, Worthman CM, Yardley L, Cowan K, Cope C, Hotopf M, Bullmore E. Multidisciplinary research priorities for the COVID-19 pandemic: a call for action for mental health science. Lancet Psychiatry. 2020 Jun;7(6):547-560. doi: 10.1016/S2215-0366(20)30168-1. Epub 2020 Apr 15.

  PMID: 32304649 BACKGROUND

• Hulley, S. B., Cummings, S. R., Browner, W. S., Grady, D., Hearst, N., & Newman, T. B. (2007). Designing clinical research. Philadelphia.

  BACKGROUND

• Insana SP, Hall M, Buysse DJ, Germain A. Validation of the Pittsburgh Sleep Quality Index Addendum for posttraumatic stress disorder (PSQI-A) in U.S. male military veterans. J Trauma Stress. 2013 Apr;26(2):192-200. doi: 10.1002/jts.21793. Epub 2013 Mar 19.

  PMID: 23512653 BACKGROUND

• Jansoon, M., & Rello, J. (2020). Mental Health in Healthcare Workers and the Covid-19 Pandemic Era: Novel Challenge for Critical Care Abstract. Journal of Intensive and Critical Care, 6(26), 1-3. https://doi.org/10.36648/2471-8505.6.2.6

  BACKGROUND

• Lazarus, R. S., & Folkman, S. (1984). Stress, appraisal, and coping. Springer publishing company.

  BACKGROUND

• Kroenke K, Spitzer RL, Williams JB. The Patient Health Questionnaire-2: validity of a two-item depression screener. Med Care. 2003 Nov;41(11):1284-92. doi: 10.1097/01.MLR.0000093487.78664.3C.

  PMID: 14583691 BACKGROUND

• Kroenke K, Spitzer RL, Williams JB, Monahan PO, Lowe B. Anxiety disorders in primary care: prevalence, impairment, comorbidity, and detection. Ann Intern Med. 2007 Mar 6;146(5):317-25. doi: 10.7326/0003-4819-146-5-200703060-00004.

  PMID: 17339617 BACKGROUND

• Kurina LM, Knutson KL, Hawkley LC, Cacioppo JT, Lauderdale DS, Ober C. Loneliness is associated with sleep fragmentation in a communal society. Sleep. 2011 Nov 1;34(11):1519-26. doi: 10.5665/sleep.1390.

  PMID: 22043123 BACKGROUND

• Muller AE, Hafstad EV, Himmels JPW, Smedslund G, Flottorp S, Stensland SO, Stroobants S, Van de Velde S, Vist GE. The mental health impact of the covid-19 pandemic on healthcare workers, and interventions to help them: A rapid systematic review. Psychiatry Res. 2020 Nov;293:113441. doi: 10.1016/j.psychres.2020.113441. Epub 2020 Sep 1.

  PMID: 32898840 BACKGROUND

• Pfefferbaum B, North CS. Mental Health and the Covid-19 Pandemic. N Engl J Med. 2020 Aug 6;383(6):510-512. doi: 10.1056/NEJMp2008017. Epub 2020 Apr 13. No abstract available.

  PMID: 32283003 BACKGROUND

• Poonian J, Walsham N, Kilner T, Bradbury E, Brooks K, West E. Managing healthcare worker well-being in an Australian emergency department during the COVID-19 pandemic. Emerg Med Australas. 2020 Aug;32(4):700-702. doi: 10.1111/1742-6723.13547. Epub 2020 Jun 25.

  PMID: 32386263 BACKGROUND

• Rajkumar RP. COVID-19 and mental health: A review of the existing literature. Asian J Psychiatr. 2020 Aug;52:102066. doi: 10.1016/j.ajp.2020.102066. Epub 2020 Apr 10.

  PMID: 32302935 BACKGROUND

• Rossi R, Socci V, Pacitti F, Di Lorenzo G, Di Marco A, Siracusano A, Rossi A. Mental Health Outcomes Among Frontline and Second-Line Health Care Workers During the Coronavirus Disease 2019 (COVID-19) Pandemic in Italy. JAMA Netw Open. 2020 May 1;3(5):e2010185. doi: 10.1001/jamanetworkopen.2020.10185.

  PMID: 32463467 BACKGROUND

• Shah K, Kamrai D, Mekala H, Mann B, Desai K, Patel RS. Focus on Mental Health During the Coronavirus (COVID-19) Pandemic: Applying Learnings from the Past Outbreaks. Cureus. 2020 Mar 25;12(3):e7405. doi: 10.7759/cureus.7405.

  PMID: 32337131 BACKGROUND

• Shaukat N, Ali DM, Razzak J. Physical and mental health impacts of COVID-19 on healthcare workers: a scoping review. Int J Emerg Med. 2020 Jul 20;13(1):40. doi: 10.1186/s12245-020-00299-5.

  PMID: 32689925 BACKGROUND

• Shechter A, Diaz F, Moise N, Anstey DE, Ye S, Agarwal S, Birk JL, Brodie D, Cannone DE, Chang B, Claassen J, Cornelius T, Derby L, Dong M, Givens RC, Hochman B, Homma S, Kronish IM, Lee SAJ, Manzano W, Mayer LES, McMurry CL, Moitra V, Pham P, Rabbani L, Rivera RR, Schwartz A, Schwartz JE, Shapiro PA, Shaw K, Sullivan AM, Vose C, Wasson L, Edmondson D, Abdalla M. Psychological distress, coping behaviors, and preferences for support among New York healthcare workers during the COVID-19 pandemic. Gen Hosp Psychiatry. 2020 Sep-Oct;66:1-8. doi: 10.1016/j.genhosppsych.2020.06.007. Epub 2020 Jun 16.

  PMID: 32590254 BACKGROUND

• Skinner EA, Zimmer-Gembeck MJ. The development of coping. Annu Rev Psychol. 2007;58:119-44. doi: 10.1146/annurev.psych.58.110405.085705.

  PMID: 16903804 BACKGROUND

• Spoorthy MS, Pratapa SK, Mahant S. Mental health problems faced by healthcare workers due to the COVID-19 pandemic-A review. Asian J Psychiatr. 2020 Jun;51:102119. doi: 10.1016/j.ajp.2020.102119. Epub 2020 Apr 22.

  PMID: 32339895 BACKGROUND

• Worldometer. (n.d.). Coronavirus Cases. Retrieved August 22, 2020, https://www.worldometers.info /coronavirus/.

  BACKGROUND

MeSH Terms

Conditions

COVID-19

Condition Hierarchy (Ancestors)

Pneumonia, Viral; Pneumonia; Respiratory Tract Infections; Infections; Virus Diseases; Coronavirus Infections; Coronaviridae Infections; Nidovirales Infections; RNA Virus Infections; Lung Diseases; Respiratory Tract Diseases

Study Officials

• Amanda A Fox, MSN

  David Grant Medical Center, Travis Air Force Base

  PRINCIPAL INVESTIGATOR

• Laurie A Migliore, PhD

  David Grant Medical Center, Travis Air Force Base

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: FED
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Clinical Inquiry in Nursing Readiness Fellow

Study Record Dates

• First Submitted: November 25, 2020
• First Posted: November 30, 2020
• Study Start: December 14, 2020
• Primary Completion: February 1, 2021
• Study Completion: February 1, 2021
• Last Updated: April 2, 2021

Record last verified: 2021-04

Locations

US (1)