Effectiveness Trial of Wingman-Connect Implemented Across Career Phases

Wingman-Connect 跨职业阶段实施的有效性试验

• 批准号: 10723587
• 负责人: Peter A Wyman
• 金额: $ 176.14万
• 依托单位: UNIVERSITY OF ROCHESTER
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-08-16 至 2028-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10723587
• 关键词: Address; Air; Air Force Personnel; Climate; Communication; Data; Diffusion; Effectiveness; Exposure to; Funding; Health; Human Resources; Individual; Intervention; Leadership; Mediating; Mediation; Mediator; Mental Depression; Military Personnel; Morale; Occupational; Outcome; Patient Self-Report; Periodicals; Phase; Population; Prevention approach; Prevention program; Process; Randomized; Records; Reporting; Research Personnel; Severities; Social Network; Suicide; Suicide attempt; Suicide prevention; Surveys; Techniques; Testing; Training; Vision; Work; active control; base; career; cohesion; computerized; coping; design; digital; effectiveness study; effectiveness testing; effectiveness trial; effectiveness/implementation trial; experience; follow-up; implementation determinants; implementation measures; implementation outcomes; programs; reducing suicide; remediation; scale up; secondary analysis; skills; social attachment; suicidal behavior; suicidal individual; suicidal morbidity; suicidal risk; suicide rate; theories; therapy development; translational pipeline; universal prevention; usability

ABSTRACT Military suicide rates increased 61% from 2008 – 2019 and rates have increased faster in the U.S. Air Force (USAF) compared to other branches. Currently, the predominant military suicide prevention approach is to try to remediate suicide risk after suicidal individuals are identified. No RCT-validated universal programs shown to reduce vulnerability to suicide are in wide use. To fill this gap, the Wingman-Connect Program is a group-based intervention that strengthens protective relationship networks and skills for managing career and personal challenges, to reduce vulnerability to suicide across the broad USAF population. This proposed Hybrid Effectiveness-Implementation trial tests the effectiveness of the Wingman-Connect Program on individual suicide risk and on base-level suicide attempts. We will examine theory-driven mediators and moderators and implementation of the program as delivered by US Air Force (not research) personnel under real world conditions across 2 sequential early career phases. This effectiveness study is the critical next stage in the translational pipeline toward large-scale roll-out to prevent suicide deaths. To rigorously test effectiveness, we co-developed with USAF partners a 2-stage randomized design. (1) The first stage of randomization will be at Initial Technical Training, in which 396 classes of USAF personnel will be randomized to Wingman-Connect or to an active control (N=2,970 Airmen) and followed for one year. These classes send a high proportion of graduates to 8 operational bases. (2) The second stage of randomization will occur among these 8 operational bases, which will be randomized in pairs to start implementing WC at 4- month intervals (stepped wedge design). Once WC has been initiated at each base, all entering first-term Airmen will receive WC, with ~17,400 total Airmen trained across all bases. This 2-stage design will yield robust, multi-level effectiveness findings. Aim 1: Test effectiveness of WC on reducing (a) self-reported suicide risk and (b) base-level rates of suicide attempts. We will evaluate (a) individual level outcomes of suicide risk, depression, and occupational problems up to 1 yr; and (b) base-level administrative records of suicide attempts. Aim 2: Evaluate theory-proposed network health mediators and moderators. WC is expected to increase Airmen's positive social bonds, group cohesion, morale, and healthy coping norms in their social networks; those changes will contribute to reduced suicide risk, depression and occupational problems. Aim 3: Examine implementation determinants and mechanisms, and refine Implementation Package. Key implementation outcomes will be USAF implementers' fidelity delivering WC (n=24-30) and engagement in training/technical support. Implementer fidelity and engagement is expected to be predicted by base implementation climate and WC embeddedness into base communications and support activities.

抽象的 与2008年至2019年相比，军事自杀率增加了61％，美国航空的利率提高了 与其他分支相比，力量（USAF）。目前，预防军事自杀的方法是 在确定自杀个体后，试图解决自杀风险。没有RCT验证的通用程序 显示以减少自杀的脆弱性已广泛使用。为了填补这一空白，边锋连接程序是一个 基于团体的干预措施，可以保护关系网络和技能，以管理职业和 个人挑战，以减少整个USAF人口中自杀的脆弱性。这提出了 混合有效性实施试验测试Wingman-Connect计划在 个人自杀风险和基础自杀企图。我们将研究以理论驱动的调解人和 主持人和美国空军（不是研究）人员提供的计划的实施 在两个顺序的早期职业阶段的现实世界条件。这项有效性研究是下一阶段的关键 在转化的管道中，大规模推出以防止自杀死亡。严格测试 有效性，我们与USAF合作伙伴共同开发了两阶段的随机设计。 （1）第一阶段 随机化将接受最初的技术培训，其中396班将是USAF人员 随机分配给Wingman-Connect或主动控制（n = 2,970名飞行员），然后进行一年。这些 课程将很大比例的毕业生发送到8个运营基地。 （2）随机化的第二阶段将 在这8个操作基础中发生，将成对随机分组以开始在4-- 月间隔（阶梯楔设计）。一旦在每个基础上启动WC，所有人都将进入第一学 飞行员将接收WC，所有基地的飞行员总训练有17,400名。这个2阶段的设计将产生 强大的多层次有效性发现。 目标1：WC对减少（a）自杀风险和（b）基础级别的测试有效性 自杀企图的发生率。我们将评估（a）自杀风险，抑郁和 占据1年的问题； （b）自杀企图的基础行政记录。 AIM 2：评估理论传统的网络健康调解人和主持人。 WC有望 增加飞行员的积极社会纽带，群体凝聚力，士气和健康的应对规范 网络；这些变化将导致自杀风险，抑郁和占领问题的减少。 目标3：检查实施确定和机制，并完善实施 包裹。关键实施结果将是USAF实施者的保真度，以交付WC（n = 24-30）和 参与培训/技术支持。实施者的保真度和参与度有望由 基础实施气候和WC嵌入基础通信和支持活动中。