Study Results
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.
TERMINATED
NA
46 participants
INTERVENTIONAL
2023-10-01
2025-07-31
Brief Summary
Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.
The main questions it aims to answer are:
1. When delivered in real-world conditions, to what extent does SMART increase levels of resiliency and decrease levels of stress in a sample of active component U.S. Air Force personnel?
2. Does SMART have a sustained effectiveness from baseline to 12, 24 and 36-weeks after training completion in a sample of active component U.S. Air Force personnel?
3. Does SMART provided via an in-person/video-teleconference (VTC) or Computer-Based Training (CBT) modality demonstrate equivalent effectiveness in increasing resilience and decreasing stress in active component Air Force personnel?
Participants will be asked to complete a pre-intervention survey, complete the assigned modality of SMART ( in-person/VTC or CBT), and complete follow-up measurements at 12-, 24-, and 36-weeks post-intervention completion.
Researchers will compare in-person/VTC and CBT groups' measurements to see if a difference in self-reported resilience, stress, anxiety, or quality of life is present pre-intervention. Researchers will compare in-person/VTC and CBT groups' measurements to see if a difference in self-reported resilience, stress, anxiety, or quality of life is present post-intervention.
Related Clinical Trials
Explore similar clinical trials based on study characteristics and research focus.
Improving Resiliency in Air Force Personnel
NCT05460663
Stress Management and Resiliency Training (SMART) for Family Medicine Residents at Eglin AFB
NCT03936114
Stress Management Training for School Staff
NCT02366078
Mindfulness-Based Resilience Training for Aggression, Health, and Stress Among Law Enforcement Officers
NCT03784846
Managing Minds at Work: A Feasibility Pilot Trial
NCT05154019
Detailed Description
Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.
Four study sites have been identified for the study (Joint Base Andrews, Joint Base San Antonio-Lackland, Nellis Air Force Base, and Wright-Patterson Air Force Base). Simple randomization will be used to assign 2 sites to the randomization arm (Arm 1) and 2 sites to the self-selection arm (Arm 2). Arm randomization will be accomplished in Year1, Month 1. Initial recruitment and randomization will be completed during Month 2 of Year 1 through Month 5 of year 2 of the study.
Arm 1: Randomization: At two study site locations, the investigators will use a ratio of 2:1 to randomly assign participants to the VTC/in-person or CBT training modalities. Therefore, the investigators anticipate 84 participants (42 per site) will be assigned to the CBT modality and 168 (84 per site) will be assigned to the VTC/in-person modality. Randomization will be stratified with respect to military grade and sex to reduce potential confounding due to baseline differences. There may be important differences based upon military grade between the 5 categories of military grade or two categories of participants may select. Under stratification, 1 in every 3 participants will be assigned to complete CBT and the other two participants will be assigned to VTC/in-person training to maintain a balanced distribution between groups.
Arm 2: Self-selection: At two study site locations, the investigators aim to recruit 250 participants in the self-selection arm. Participants will be able to self-select their preferred method of SMART completion (VTC/in-person or CBT training modality).
In order to assure consistent delivery of the intervention, the study PI and the Site AIs will meet to discuss course delivery, make notations, and jointly agree to incorporate recommendations for improving training delivery. At the end of the course, participants will be offered a copy of a Resilience Journal. This book will serve as a review of the resiliency practices and allow participants to track their use of these practices for improving gratitude, mindful presence, kindness, and developing a resilient mindset.
The Site PIs and PI will work with identified local points of contact to develop a schedule to assure the maximum number of participants can receive SMART during a variety of times. After informed consent is obtained and prior to the delivery of the intervention, a survey will be administered to collect demographic information and baseline measurements of resilience, stress, anxiety, and quality of life. Participants will be provided a link to access the initial survey via the research data capture survey system (REDCap; DHHS/NIH/NCRR #8UL1TR000041) to provide demographic data, e-mail contact information, and responses to survey instruments.
REDCap is a secure and encrypted, web-based platform licensed to and managed by the University of New Mexico Health Sciences Center Clinical and Translational Science Center (UNM HSC CTSC). REDCap includes research tools for project management, survey administration, encrypted database storage and retrieval, and reporting. REDCap will be utilized to administer follow-up surveys at week 12, 24, and 36 (if applicable) after participants complete SMART. The investigators propose to collect the 36-week follow-up survey responses in order to conduct an analysis to assess the longevity of the effect of SMART on resilience and stress.
Participants' e-mail contact information will be used be utilized to send follow-up surveys through REDCap. Each survey will take approximately 10 to 15 minutes for participants to complete. If the participant does not respond to the initial REDCap invitation, a maximum of three e-mail reminders (one reminder per week after the initial e-mail is sent) will be sent to complete the survey. If the participant still has not responded, no further attempt to contact the participant will be made until the next scheduled interval (e.g. at 24 and 36 weeks). Because participants' demographic information will be associated with an individual's contact information in REDCap™, demographic information will not be requested as part of the surveys at weeks 12, 24, or 36. All data will be de-identified when it is exported from REDCap for the data analysis.
IBM SPSS Statistics (version 28 or later) and R (survey package, version 4.1.2) will be used for the statistical analysis. Initial analysis will include descriptive statistics, including means or medians, frequencies and percentages, as appropriate, to characterize demographic status, military grade, duty location, military occupation, and previous deployment status. Cronbach's α will be calculated for each multi-item scale.
The objectives of our analysis include testing and estimating the effectiveness of the intervention by comparing pre-post intervention changes (improvements) in the outcome measurements of interest at each follow-up. Analyses will be reported as point estimates with 95% confidence intervals and appropriate estimates of effect size. In this analysis, both the VTC and CBT groups will be analyzed separately and scores will also be pooled together to test for overall intervention effects as well as difference between the modalities.
Post-intervention improvements in resilience, stress, anxiety, and quality of life will be assessed by separately analyzing changes from baseline to each follow-up time (e.g. week 12, week 24, and week 36). A joint analysis of the longitudinal trend over the study period will be conducted as well. The investigators will also consider a joint analysis of resilience, stress, anxiety, or QOL, as well as, analysis for subscales of any specific domain of interest. To better understand factors that can impact the intervention effects, our regression models on the post intervention improvements over time incorporate changing time-slopes and between-subject random effects. The investigators will control for demographic characteristics, AFSC, and previous deployment. The investigators will also use random effects to take into consideration potential clustering effects among the participants from the same organizational unit.
With the two-arm randomization scheme, the results of the "self-selection" group provide a window into "potential" outcomes in real-world settings.
Comparison of the outcomes from the "self-selection" arm with the results from the "randomized assignment" (per-protocol) will enable us to conduct causal inference and use the real difference between VTC and CBT to inform scale-up implementation of SMART.
Conditions
See the medical conditions and disease areas that this research is targeting or investigating.
Study Design
Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.
RANDOMIZED
PARALLEL
SUPPORTIVE_CARE
NONE
Study Groups
Review each arm or cohort in the study, along with the interventions and objectives associated with them.
Randomization
At two study sites, we will randomly assign participants to the VTC/in-person group or CBT group using a ratio of 2:1 to assign participants to the VTC/in-person or CBT training modalities. We anticipate 84 participants (42 per site) will be assigned to the CBT modality and 168 (84 per site) will be assigned to the VTC/in-person modality.
Stress Management and Resilience Training
The Stress Management and Resilience Training (SMART) program focuses on improving the practices of gratitude, mindful presence, kindness, and developing a resilient mindset. In this proposed study, SMART will be provided via either a two-hour, video teleconference (VTC) or in-person training or by completion of a self-paced, on-line version completed over a period of four to eight weeks. The modalities VTC and in-person are the two intervention conditions.
Self-selection
At two study sites, participants will be able to self-select which SMART training modality they will complete (VTC/in-person or CBT).We aim to recruit 250 participants in the self-selection arm.
Stress Management and Resilience Training
The Stress Management and Resilience Training (SMART) program focuses on improving the practices of gratitude, mindful presence, kindness, and developing a resilient mindset. In this proposed study, SMART will be provided via either a two-hour, video teleconference (VTC) or in-person training or by completion of a self-paced, on-line version completed over a period of four to eight weeks. The modalities VTC and in-person are the two intervention conditions.
Interventions
Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.
Stress Management and Resilience Training
The Stress Management and Resilience Training (SMART) program focuses on improving the practices of gratitude, mindful presence, kindness, and developing a resilient mindset. In this proposed study, SMART will be provided via either a two-hour, video teleconference (VTC) or in-person training or by completion of a self-paced, on-line version completed over a period of four to eight weeks. The modalities VTC and in-person are the two intervention conditions.
Eligibility Criteria
Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.
Inclusion Criteria
* 59th Medical Wing, including the 59th Medical Operations Group, 59th Medical Support Group, 559th MDG, 959th MDG, 59th Training Group, and 59th Dental Group (Joint Base San Antonio-Lackland, TX \[JBSA-L\])
* 316th Medical Group (Joint Base Andrews, MD \[JBA\])
* 99th Medical Group (Nellis AFB, NV)
* 711th Human Performance Wing (HPW), including the U.S. Air Force School of Aerospace Medicine (USAFSAM), and the 88th Medical Group (MDG) at Wright-Patterson Air Force Base, OH (WPAFB)
* Able to provide informed consent
* ≥ 18 years of age
Exclusion Criteria
* Unable to provide informed consent
* Basic Military Trainees (BMTs)
* \< 18 years of age
* Prisoners
18 Years
ALL
Yes
Sponsors
Meet the organizations funding or collaborating on the study and learn about their roles.
University of Nevada, Las Vegas
OTHER
Johns Hopkins University
OTHER
University of New Mexico
OTHER
Responsible Party
Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.
Principal Investigators
Learn about the lead researchers overseeing the trial and their institutional affiliations.
Stephen Hernandez, PhD
Role: PRINCIPAL_INVESTIGATOR
University of New Mexico
Locations
Explore where the study is taking place and check the recruitment status at each participating site.
Mountain Home Air Force Base
Mountain Home, Idaho, United States
Johns Hopkins University, School of Nursing (Joint Base Andrews)
Baltimore, Maryland, United States
University of Nevada Las Vegas, School of Nursing (Nellis Air Force Base)
Las Vegas, Nevada, United States
Wright-Patterson Air Force Base
Dayton, Ohio, United States
Joint Base San Antonio-Lackland
San Antonio, Texas, United States
Countries
Review the countries where the study has at least one active or historical site.
References
Explore related publications, articles, or registry entries linked to this study.
Meredith LS, Sherbourne CD, Gaillot SJ, Hansell L, Ritschard HV, Parker AM, Wrenn G. Promoting Psychological Resilience in the U.S. Military. Rand Health Q. 2011 Jun 1;1(2):2. eCollection 2011 Summer.
Thompson SR, Dobbins S. The Applicability of Resilience Training to the Mitigation of Trauma-Related Mental Illness in Military Personnel [Formula: see text]. J Am Psychiatr Nurses Assoc. 2018 Jan/Feb;24(1):23-34. doi: 10.1177/1078390317739957. Epub 2017 Nov 15.
Rocklein Kemplin K, Paun O, Godbee DC, Brandon JW. Resilience and Suicide in Special Operations Forces: State of the Science via Integrative Review. J Spec Oper Med. 2019 Summer;19(2):57-66. doi: 10.55460/BQES-AM8H.
Committee on the Assessment of Resiliency and Prevention Programs for Mental and Behavioral Health in Service Members and Their Families; Board on the Health of Select Populations; Institute of Medicine; Denning LA, Meisnere M, Warner KE, editors. Preventing Psychological Disorders in Service Members and Their Families: An Assessment of Programs. Washington (DC): National Academies Press (US); 2014 Feb 11. Available from http://www.ncbi.nlm.nih.gov/books/NBK222170/
Connor KM, Davidson JR. Development of a new resilience scale: the Connor-Davidson Resilience Scale (CD-RISC). Depress Anxiety. 2003;18(2):76-82. doi: 10.1002/da.10113.
Sood A, Prasad K, Schroeder D, Varkey P. Stress management and resilience training among Department of Medicine faculty: a pilot randomized clinical trial. J Gen Intern Med. 2011 Aug;26(8):858-61. doi: 10.1007/s11606-011-1640-x. Epub 2011 Jan 29.
Chesak SS, Bhagra A, Schroeder DR, Foy DA, Cutshall SM, Sood A. Enhancing resilience among new nurses: feasibility and efficacy of a pilot intervention. Ochsner J. 2015 Spring;15(1):38-44.
Campbell-Sills L, Stein MB. Psychometric analysis and refinement of the Connor-davidson Resilience Scale (CD-RISC): Validation of a 10-item measure of resilience. J Trauma Stress. 2007 Dec;20(6):1019-28. doi: 10.1002/jts.20271.
Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG. Research electronic data capture (REDCap)--a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform. 2009 Apr;42(2):377-81. doi: 10.1016/j.jbi.2008.08.010. Epub 2008 Sep 30.
Cohen, S., & Williamson, G. (1988). Perecived stress in a probablility sample of the United States. In S. Spacapan & S. Oskamp (Eds.), The social psychology of health (pp. 31-67). Newbury Park, CA: Sage.
Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. J Health Soc Behav. 1983 Dec;24(4):385-96. No abstract available.
Spitzer RL, Kroenke K, Williams JB, Lowe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006 May 22;166(10):1092-7. doi: 10.1001/archinte.166.10.1092.
Locke DE, Decker PA, Sloan JA, Brown PD, Malec JF, Clark MM, Rummans TA, Ballman KV, Schaefer PL, Buckner JC. Validation of single-item linear analog scale assessment of quality of life in neuro-oncology patients. J Pain Symptom Manage. 2007 Dec;34(6):628-38. doi: 10.1016/j.jpainsymman.2007.01.016. Epub 2007 Aug 20.
Campbell-Sills L, Flynn PJ, Choi KW, Ng THH, Aliaga PA, Broshek C, Jain S, Kessler RC, Stein MB, Ursano RJ, Bliese PD. Unit cohesion during deployment and post-deployment mental health: is cohesion an individual- or unit-level buffer for combat-exposed soldiers? Psychol Med. 2022 Jan;52(1):121-131. doi: 10.1017/S0033291720001786. Epub 2020 Jun 10.
Rubin, D.B., Causal inference using potential outcomes. Journal of the American Statistical Association, 2005. 100(469): p. 322-331.
Provided Documents
Download supplemental materials such as informed consent forms, study protocols, or participant manuals.
Document Type: Informed Consent Form
Other Identifiers
Review additional registry numbers or institutional identifiers associated with this trial.
UNM HRRC 22-317
Identifier Type: -
Identifier Source: org_study_id
More Related Trials
Additional clinical trials that may be relevant based on similarity analysis.