Improving Resiliency in Air Force Personnel

NCT05460663 | Completed Results

• 3 other identifiers: FWR20200166EN20A19IRHRRC 20-522
• Study Type: interventional
• Target: 56
• Locations: 1 country
• Sites: 1

Brief Summary

The study purpose is to examine the effectiveness of the Stress Management and Resilience Training (SMART) in increasing resilience in Air Force (AF) healthcare personnel. SMART includes practices that focus on six factors that promote individual-level resilience. A pretest-posttest, randomized control trial will be used to examine the effectiveness of SMART and is guided by the Defense Centers of Excellence Resilience Continuum. After institutional review board approval, the principal investigator (PI) will recruit a sample of AF healthcare personnel assigned to the 88th Medical Group or USAF School of Aerospace Medicine at Wright Patterson AF Base. SMART will be provided via either a two-hour, video teleconference (VTC) or in-person training or a self-paced, on-line version completed over four to eight weeks. VTC or on-line versions will be utilized to prevent transmission of COVID-19. If in-person training is feasible and safe at a future point in time, in-person training will replace VTC training. A baseline survey will include questions regarding age, gender, marital status, race, ethnicity, previous deployment, military rank, and military job duty. The Connor Davidson 10-Item Resilience Scale has demonstrated reliability and validity, and has been used in studies to measure service member resilience. Additional measures include the Perceived Stress Scale, Generalized Anxiety Disorder Scale, and a Quality of Life measure. The CD-10, PSS, GAD-7, and QoL measure will be readministered 12, 18, and 24-weeks after SMART completion. Initial analysis will include descriptive statistics to characterize demographics, military grade, duty location, and previous deployment status. Cronbach's α will be calculated for each scale. Analyses will be reported as point estimates with 95% confidence intervals and estimates of effect size. Both VTC and on-line groups will be analyzed separately and scores will be pooled to test for overall intervention effects. Regression models will be conducted on the pre-post intervention difference while controlling for demographic characteristics and previous deployment. The investigators will consider clustering effects among participants from the same organizational unit using random effects. Changes in resilience, stress, anxiety, and QoL over time will be assessed by analyzing changes from baseline to weeks 12, 18, and 24. The investigators will consider a joint analysis of resilience, stress, anxiety, or QOL.

Conditions

Military Personnel; Health Promotion

Keywords

Air Force; Military; Stress; Resilience

Outcome Measures

Primary Outcomes (1)

• Changes in Connor-Davidson 10-Item Scale (CD-10)

  Resilience was measured using the CD-10, a 10-item scale derived from the original, 25-item Connor Davidson Resilience Scale. Respondents can answer each item using a five-point rating ranging from not true at all (0) to true nearly all the time (4). A total CD-RISC score is calculated by summing the score of all 10 items for a total possible score of 40, with a higher score reflecting a greater level of resilience. The CD-10 has a reported Cronbach's alpha of .85 and has demonstrated construct validity. The scale was administered to each participants at 4 times: baseline, and 12/18/24 weeks after SMART completion.

  Changes in self-reported CD-10 from Baseline at 12, 18, and 24 weeks post-SMART completion

Secondary Outcomes (3)

• Changes in Perceived Stress Scale (PSS)

  Changes in self-reported PSS from Baseline at 12, 18, and 24 weeks post-SMART completion

• Changes in Generalized Anxiety Disorder Scale (GAD-7)

  Changes in self-reported GAD-7 scores from Baseline at 12, 18, and 24 weeks post-SMART completion

• Changes in Quality of Life (QOL)

  Changes in self-reported QOL scores from Baseline at 12, 18, and 24 weeks post-SMART completion

Study Arms (2)

In-person SMART training

EXPERIMENTAL

The two-hour VTC or in-person will be provided SMART synchronously to a maximum of 10 individuals. A study team member will contact participants in the VTC group to provide available dates and times of scheduled classes, and these participants will be scheduled for a class they would like to attend. Participants in the VTC group will be provided a web-link prior to the session, and each session will have a unique password to access the training. Participants in the on-line training group will be provided a code to access the training website. If local conditions permit in-person group meetings (i.e. Health Protection Condition \[HPCON\] Alpha or Bravo), in-person group SMART training in a classroom will be offered as an alternative to VTC sessions. VTC and in-person sessions were provided using the same materials and methods, with the same instructors. Therefore, these are considered to be 'In-Person".

Behavioral: Stress Management and Resilience Training (SMART)

CBT SMART training

EXPERIMENTAL

SMART will be provided via completion of a self-paced, on-line version completed over a period of four to eight weeks.

Behavioral: Stress Management and Resilience Training (SMART)

Interventions

Stress Management and Resilience Training (SMART) BEHAVIORAL

The Stress Management and Resilience Training (SMART) program was developed by Dr. Amit Sood. SMART focuses on improving the practices of gratitude, mindful presence, kindness, and developing a resilient mindset. The SMART program incorporates practices that focus on six individual factors that have been found to promote individual-level resilience: positive coping, positive affect, positive thinking, realism, behavioral control, and altruism. In this proposed study, SMART will be provided via either a two-hour, video teleconference (VTC) and in-person training or by completion of a self-paced, on-line version completed over a period of four to eight weeks.

CBT SMART training; In-person SMART training

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Participants must be active component healthcare personnel (any 4XXX Officer or Enlisted AFSC) serving in the U.S. Air Force, assigned to 88th MDG and USAFA at WPAFB, OH.
• Participants must be ≥ 18 years of age to participate.

You may not qualify if:

• Adults unable or unwilling to provide consent and individuals who are not yet adults will be excluded from this study.
• Active component Air Force service members without a healthcare AFSC will be excluded from the study.

Sponsors & Collaborators

• University of New Mexico: lead

Study Sites (1)

Wright-Patterson Air Force Base

Dayton, Ohio, 45433, United States

Location

Related Publications (32)

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Limitations and Caveats

We cannot preclude self-selection bias. Although invitations to participate and reminder e-mails were sent to participants, there was variable completion rates of follow-up surveys. In-person SMART was conducted via VTC and small face-to-face classes. Although the content of face-to-face delivery of SMART was identical to VTC, we do not know if a difference in teaching effectiveness due to the difference in delivery method was present. We were unable to recruit 90 participants, as planned.

Results Point of Contact

• Title: Stephen H. A. Hernandez, PhD, RN, FAAN
• Organization: University of New Mexico, College of Nursing

shhernandez@salud.unm.edu

505-272-0756

Study Officials

• Stephen Hernandez, PhD, RN

  University of New Mexico College of Nursing

  PRINCIPAL INVESTIGATOR

Publication Agreements

• PI is Sponsor Employee: No
• Restrictive Agreement: No

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: SUPPORTIVE CARE
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Associate Professor

Model Details: Randomized Control Trial

Study Record Dates

• First Submitted: July 7, 2022
• First Posted: July 15, 2022
• Study Start: December 4, 2020
• Primary Completion: February 1, 2022
• Study Completion: May 31, 2022
• Last Updated: October 8, 2024
• Results First Posted: October 8, 2024

Record last verified: 2024-09

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)