Mindfulness-Based Resilience Training for Aggression, Health, and Stress Among Law Enforcement Officers

NCT ID: NCT03784846

Last Updated: 2023-07-03

Study Results

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Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

109 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-10-01

Study Completion Date

2022-06-30

Brief Summary

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Law enforcement officers (LEOs) are exposed to significant stressors, elevating their risk for aggression and excessive use of force, as well as mental health consequences, including post-traumatic stress disorder, burnout, alcohol misuse, depression, and suicide. The proposed study will identify, optimize and refine best clinical and research practices across two sites to ensure success in a future multisite efficacy trial assessing preventative effects of Mindfulness-Based Resilience Training on physiological, behavioral, and psychological outcomes.

Detailed Description

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Law enforcement officers (LEOs) are exposed to significant stressors, elevating their risk for aggression and excessive use of force. Such dysfunctional stress reactivity can lead to devastating consequences for their community, including unjustified shootings, severe beatings, and fatal chokings. It can also lead to serious consequences for the LEOs, including elevated incidence of post-traumatic stress disorder, burnout, alcohol misuse, depression, and suicide. A recent meta-analysis of LEO stress reduction programs found little evidence to demonstrate that such approaches are effective, highlighting the urgent need for preventive interventions targeting the stress inherent to policing. Mindfulness training is a promising approach with high-stress populations that has been shown effective in reducing stress and increasing resilience. In a recent pilot feasibility study (R21AT008854), the study team established initial feasibility, acceptability, and adherence to procedures in a single-site RCT assessing Mindfulness-Based Resilience Training (MBRT), a preventive intervention designed to improve LEO mental health and resilience, and reduce aggression and excessive use of force. The R21 data suggest physiological mechanisms and potential clinical benefit in a sample of LEOs. Relative to waitlist control, MBRT participants showed improvements in stress reactivity, aggression, burnout, occupational stress, sleep disturbance, and psychological flexibility. Implemented at two sites, the proposed study is designed to establish optimal protocols and procedures for a future full-scale, multi-site trial assessing effects of MBRT versus an attention control (Stress Management Education) and a no-intervention control, on physiological, behavioral, and psychological outcomes. To prepare for this future clinical trial, this study will: a) enhance efficiency of recruitment, engagement and retention; b) optimize lab, assessment, and data management procedures; c) optimize intervention training and ensure fidelity to intervention protocols; and d) assess participant experience and optimize outcome measures across sites. The long-term objective of this line of research is to develop an intervention that will reduce violence and increase resilience among LEOs, as well as yield significant benefits for communities and residents they serve.

Conditions

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Stress, Psychological Aggression

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Individually-Randomized Group Treatment
Primary Study Purpose

PREVENTION

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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Mindfulness-Based Resilience Training

MBRT is an 8-week program combining training in standardized mindfulness practices targeting factors that facilitate resilience, cognitive behavioral therapy (CBT), and psychoeducation. It contains experiential and didactic exercises including body scan, sitting and walking meditation, mindful movement and discussions.

Group Type EXPERIMENTAL

Mindfulness-Based Resilience Training

Intervention Type BEHAVIORAL

MBRT is an 8-week program combining training in standardized mindfulness practices targeting factors that facilitate resilience, CBT, and psychoeducation. It contains experiential and didactic exercises including body scan, sitting and walking meditation, mindful movement and discussions.

Stress Management Education

SME was designed as an active control condition for other mindfulness-based intervention trials. SME uses a group-based didactic approach with modules on physiological and dietary effects of stress, time management, sleep physiology and insomnia, nutrition, exercise, stress hardiness, and factors mitigating impacts of stress.

Group Type ACTIVE_COMPARATOR

Stress Management Education

Intervention Type BEHAVIORAL

SME was designed as an active control condition for other Mindfulness-Based Intervention trials. SME uses a group-based didactic approach with modules on physiological and dietary effects of stress, time management, sleep physiology and insomnia, nutrition, exercise, stress hardiness, and factors mitigating impacts of stress.

No Intervention Control

No contact control condition (other than baseline, post, and follow-up assessments)

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Mindfulness-Based Resilience Training

MBRT is an 8-week program combining training in standardized mindfulness practices targeting factors that facilitate resilience, CBT, and psychoeducation. It contains experiential and didactic exercises including body scan, sitting and walking meditation, mindful movement and discussions.

Intervention Type BEHAVIORAL

Stress Management Education

SME was designed as an active control condition for other Mindfulness-Based Intervention trials. SME uses a group-based didactic approach with modules on physiological and dietary effects of stress, time management, sleep physiology and insomnia, nutrition, exercise, stress hardiness, and factors mitigating impacts of stress.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* be 21-65 years old (age limitations for both police departments),
* demonstrate English fluency,
* be a sworn, full-time, active status law enforcement officer,
* agree to random assignment to condition, and
* be willing to complete assessments at multiple time points and attend intervention groups

Exclusion Criteria

* previous participation in MBSR, MBRT or a similar mindfulness course,
* score in the severe range on brief screening measures of depression, suicidal ideation, alcohol use, or PTSD, or
* unable or unwilling to give written informed consent.
Minimum Eligible Age

21 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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National Institutes of Health (NIH)

NIH

Sponsor Role collaborator

National Center for Complementary and Integrative Health (NCCIH)

NIH

Sponsor Role collaborator

Pacific University

OTHER

Sponsor Role lead

Responsible Party

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Michael Christopher, PhD

Multiple Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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University of New Mexico

Albuquerque, New Mexico, United States

Site Status

Pacific University

Forest Grove, Oregon, United States

Site Status

Countries

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United States

References

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Christopher M, Bowen S, Witkiewitz K. Mindfulness-based resilience training for aggression, stress and health in law enforcement officers: study protocol for a multisite, randomized, single-blind clinical feasibility trial. Trials. 2020 Feb 28;21(1):236. doi: 10.1186/s13063-020-4165-y.

Reference Type RESULT
PMID: 32111233 (View on PubMed)

Christopher M, Bowen S, Witkiewitz K, Grupe D, Goerling R, Hunsinger M, Oken B, Korecki T, Rosenbaum N. A multisite feasibility randomized clinical trial of mindfulness-based resilience training for aggression, stress, and health in law enforcement officers. BMC Complement Med Ther. 2024 Apr 4;24(1):142. doi: 10.1186/s12906-024-04452-y.

Reference Type DERIVED
PMID: 38575888 (View on PubMed)

Christopher M, Ferry M, Simmons A, Vasquez A, Reynolds B, Grupe D. Psychometric properties of the Buss-Perry Aggression Questionnaire-short form among law enforcement officers. Aggress Behav. 2024 Mar;50(2):e22145. doi: 10.1002/ab.22145.

Reference Type DERIVED
PMID: 38477412 (View on PubMed)

Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan: pre-COVID

View Document

Document Type: Study Protocol and Statistical Analysis Plan: post-COVID

View Document

Document Type: Informed Consent Form

View Document

Other Identifiers

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U01AT009841

Identifier Type: NIH

Identifier Source: secondary_id

View Link

1295787-14

Identifier Type: -

Identifier Source: org_study_id

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