Stress Management and Resilience Training for Stress in Air Force Personnel

No longer recruiting at 4 trial locations

Overseen By Yiliang Zhu, PhD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of New Mexico

Disqualifiers: Non-active personnel, BMTs, prisoners, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Approved in 1 Jurisdiction This treatment is already approved in other countries

Compensation: Varies

Number of Visits: 4

Duration: 6-8 weeks

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to test the effectiveness of Stress Management and Resilience Training (SMART) in boosting resilience and reducing stress among U.S. Air Force personnel. It will assess whether the training remains effective up to 36 weeks after completion. Participants will engage in SMART through either in-person/video calls or computer-based training to determine the most effective method. Active duty Air Force personnel at specific bases who can provide consent are suitable candidates for this trial. As an unphased trial, participants can contribute to innovative research that may enhance stress management techniques for military personnel.

Do I need to stop my current medications for this trial?

The trial information does not specify whether you need to stop taking your current medications. It is best to discuss this with the trial coordinators or your healthcare provider.

What prior data suggests that the Stress Management and Resilience Training (SMART) is safe for Air Force personnel?

Research shows that Stress Management and Resilience Training (SMART) is generally easy for people to handle. In past studies, participants in SMART reported feeling less stressed and having better mental health. For instance, one study found that people experienced a noticeable drop in stress and improved overall mental well-being. Another study showed that SMART helps people manage anxiety and stress better, while also increasing their satisfaction and quality of life.

SMART teaches skills for self-care, managing stress, regaining emotional control, and improving life quality. These findings suggest that SMART is a safe and effective way to help people manage stress and build resilience. Research has not reported any major negative effects, making it a promising option for those interested in this type of training. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the Stress Management and Resilience Training (SMART) for Air Force personnel because it offers flexibility and personalization in managing stress. Unlike traditional methods that might focus on in-person cognitive behavioral therapy (CBT), this approach allows for both virtual (VTC) and in-person sessions, catering to different needs and preferences. Additionally, participants can choose their preferred training modality, which empowers them and could enhance engagement and outcomes. By incorporating these adaptable delivery methods, the trial aims to uncover more effective ways to bolster resilience and manage stress in high-pressure environments.

What evidence suggests that Stress Management and Resilience Training is effective for increasing resilience and decreasing stress in Air Force personnel?

Research has shown that the Stress Management and Resilience Training (SMART) program can lower stress and boost mental health. In one study, participants reported feeling less stressed and had better mental health scores. Another study found that SMART increased resilience and happiness while reducing stress and anxiety. These benefits can last for months after completing the program. In this trial, participants will either be randomly assigned to different SMART training modalities or will self-select their preferred modality. This evidence suggests that SMART could effectively manage stress and build resilience over time. ^{1 2 3 6 7}

Who Is on the Research Team?

Stephen Hernandez, PhD

Principal Investigator

University of New Mexico

Are You a Good Fit for This Trial?

This trial is for active U.S. Air Force personnel at specific bases who are over 18 years old and can give informed consent. It's not open to those on temporary duty, civilians at the base, trainees in basic military training, prisoners, or anyone under 18.

Inclusion Criteria

Active Component Air Force personnel assigned or attached to specific medical wings and groups at various Air Force bases

Able to provide informed consent

Exclusion Criteria

Personnel at the specified locations who are not Active Component Air Force personnel (e.g. individuals on temporary duty [TDY] at the location or civilian personnel)

Unable to provide informed consent

Prisoners

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Pre-intervention

Participants complete a pre-intervention survey to collect demographic information and baseline measurements of resilience, stress, anxiety, and quality of life

1 week

1 visit (virtual)

Treatment

Participants complete the assigned modality of SMART (in-person/VTC or CBT)

6-8 weeks

Multiple sessions (in-person/VTC or online)

Follow-up

Participants are monitored for changes in resilience, stress, anxiety, and quality of life at 12, 24, and 36 weeks post-intervention

36 weeks

3 follow-up surveys (virtual)

What Are the Treatments Tested in This Trial?

Interventions

• Stress Management and Resilience Training

Trial Overview The trial tests Stress Management and Resilience Training (SMART) delivered either in-person/video-teleconference or via Computer-Based Training to see if it boosts resilience and reduces stress among participants over time up to 36 weeks post-training.

How Is the Trial Designed?

Group I: Randomization Experimental Treatment 1 Intervention

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.

Group II: Self-selection Active Control 1 Intervention

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 is already approved in United States for the following indications:

Approved in United States as SMART for:

• Increasing resilience in U.S. Air Force personnel
• Decreasing stress in U.S. Air Force personnel

Who Is Running the Clinical Trial?

University of New Mexico

Lead Sponsor

Trials

393

Recruited

3,526,000+

Wright-Patterson Air Force Base

Collaborator

Trials

1

Recruited

500+

Joint Base San Antonio-Lackland

Collaborator

Trials

1

Recruited

500+

Johns Hopkins University

Collaborator

Trials

2,366

Recruited

15,160,000+

University of Nevada, Las Vegas

Collaborator

Trials

81

Recruited

14,700+

Nellis Air Force Base

Collaborator

Trials

1

Recruited

500+

Joint Base Andrews

Collaborator

Trials

1

Recruited

500+

TriService Nursing Research Program (Funder)

Collaborator

Trials

1

Recruited

500+

Published Research Related to This Trial

The article provides guidelines for implementing Critical Incident Stress Debriefing (CISD) interventions specifically tailored for Air Force and aviation personnel after fatal aircraft mishaps, based on experiences with several hundred military members and their families.

Lessons learned from two specific mishaps highlight the importance of structured debriefing to support mental health and recovery in high-stress environments, emphasizing the efficacy of the CISD model in these situations.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Critical incident stress intervention following fatal aircraft mishaps. Cigrang, JA., Pace, JV., Yasuhara, TT.[2004]

The Stress Management and Resilience Training (SMART) program significantly improved resilience and reduced perceived stress among 49 Air Force healthcare personnel, with notable increases in resilience scores and decreases in stress scores observed at 12, 18, and 24 weeks post-training.

Participants showed a 14% to 21% increase in resilience and a 22% to 35% decrease in perceived stress, indicating that SMART can be an effective intervention for enhancing mental well-being in military personnel.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Improving Resiliency in U.S. Air Force Healthcare Personnel: A Randomized Preventive Trial. Hernandez, SHA., Killian, J., Parshall, MB., et al.[2023]

The implementation of the Critical Incident Stress Management (CISM) Program for air traffic controllers in Germany showed that after five years, the program's fiscal benefits exceeded its costs, indicating economic efficiency.

The program significantly improved the safety culture within the German Air Traffic Control Services, with even those who did not use the services recognizing its value as a supportive resource.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Economic evaluation of CISM--a pilot study. Vogt, J., Leonhardt, J., Köper, B., et al.[2019]

The military medical system has seen a 167% increase in costs over the past decade, largely due to behavioral health issues and physical ailments, highlighting the need for improved resilience among medical professionals.

A study of 172 medical professionals who participated in the Provider Resiliency Program showed that nearly all attendees found the training valuable and plan to apply the mind-body resiliency techniques learned, indicating a positive impact on their ability to cope with stress and burnout.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Resiliency training for medical professionals. Adams, S., Camarillo, C., Lewis, S., et al.[2010]

The SMART program, designed to enhance resilience in physicians, did not show statistically significant improvements in resilience, happiness, stress, or anxiety at 3 and 6 months, based on a study of 40 academic physicians.

Despite the lack of statistical significance, the intervention group reported clinically relevant improvements in resilience, stress, and anxiety, suggesting potential benefits that warrant further investigation in larger trials.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The impact of Stress Management and Resailience Training (SMART) on academic physicians during the implementation of a new Health Information System: An exploratory randomized controlled trial. Spilg, EG., Kuk, H., Ananny, L., et al.[2022]

A systematic training program is essential for military personnel to enhance unit-level resilience in preparation for crises, emphasizing the need for structured support.

Mental health professionals in the military, such as nurses and social workers, are crucial in educating personnel about resilience and supporting effective pre-combat training, leveraging their expertise to improve overall mental health outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Enhancing Resilience in Active Duty Military Personnel. Crabtree-Nelson, S., DeYoung, LP.[2017]

A self-directed Stress Management and Resiliency Training (SMART) program using only written materials was effective in improving stress, resilience, mindfulness, anxiety, and quality of life among 37 employees over a 12-week period.

Out of the 37 participants, 34 completed the study, showing that the program can be successfully implemented without in-person training, making it accessible for wider use.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Bibliotherapy to decrease stress and anxiety and increase resilience and mindfulness: a pilot trial. Sharma, V., Sood, A., Prasad, K., et al.[2014]

The pilot-tested resilience skills training program for pediatric residents resulted in 76% of participants rating the skills as important and 60% expressing satisfaction with the training.

Post-training, 82% of residents reported a change in their response to patient-related grief and trauma, indicating increased awareness of stress signs and improved coping strategies.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Adaptation and Evaluation of Military Resilience Skills Training for Pediatric Residents. Bursch, B., Lloyd, J., Mogil, C., et al.[2022]

The Stress Resilience Training System (SRTS) has been shown to effectively engage users in managing stress, reducing stress symptoms, and improving job performance through a series of seven evaluations, including usability studies and controlled experiments.

SRTS provides an individualized training approach that not only mitigates the negative effects of stress but also teaches users to leverage stress positively, making it applicable to various professions such as law enforcement, athletics, and healthcare.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Building resilience with the Stress Resilience Training System: Design validation and applications. de Visser, EJ., Dorfman, A., Chartrand, D., et al.[2019]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC9093702/

Stress Management and Resiliency Training for Healthcare ... Participants experienced a significant reduction in perceived stress (p < 0.001) and significant improvements in global mental health (p = 0.001), physical ...

2. learn.hms.harvard.edu learn.hms.harvard.edu/programs/stress-management-and-resiliency-training-smart

Stress Management and Resiliency Training (SMART) An evidence-based, 8-week interactive course that teaches mind-body techniques and self-care practices to reduce stress through active participation and group ...

3. journals.plos.org journals.plos.org/plosone/article?id=10.1371/journal.pone.0267240

The impact of Stress Management and Resilience Training ... The objective of the current study was to assess the impact of the SMART program on academic physicians' levels of resilience, subjective happiness, stress, ...

4. sciencedirect.com sciencedirect.com/science/article/abs/pii/S1526820911001145

Stress Management and Resilience Training (SMART ... Results. Twenty patients completed the study. A statistically significant improvement in resilience, perceived stress, anxiety, and overall quality of life at ...

5. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC11816901/

The Long-Term Impact of Resilience-Building Interventions ... These data suggest that resilience improvements may become apparent 3 months post intervention, even when no immediate improvement is observed upon program ...

6. sciencedirect.com sciencedirect.com/science/article/abs/pii/S1744388118305942

Stress Management and Resiliency Training for public ... The SMART program showed promising effectiveness for improving anxiety, stress, gratitude, happiness, life satisfaction and QOL.

7. mayo.edu mayo.edu/research/clinical-trials/cls-20315197

A Study to Examine the Stress Management and ... The purpose of this study is to assess the effect of Mayo Clinic's Resilience Training Program among healthcare employees and members of an employee-based ...