A Web-Based Intervention for Alcohol and Stress Janice M. Brown,* Jason Williams, Laura Strange, Rich Zemonek • RTI International, Research Triangle Park, NC
1. Background ■■
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Combat and Operational Stress Reactions (COSRs) are expected and predictable emotional, intellectual, physical, and/or behavioral reactions.
2. Methods (continued)
3. Results
Marketing Poster
Demographics
An estimated 20% to 30% of U.S. military personnel report significant psychological symptoms (including COSRs).
Your Health H Your Relationships H Your Readiness The SUSTAIN study is being undertaken to learn more about stress reactions among military personnel. • All post-deployment Active Duty and Reserve Component personnel are encouraged to participate. • This installation is one of several that have been selected for this important research study.
Participants will receive a novel web-
Studies with soldiers have found that symptoms increase 3 to 6 months after returning from deployment. Among the National Guard, impediments to seeking health care for combat and operational related stress responses include lack of access to care, stigma, embarrassment, time off from work, and other factors. A web-based intervention provides a private and convenient approach and can facilitate access to care by reducing the stigma and common barriers associated with seeking treatment.
based study that is geared toward enhancing combat effectiveness, health, and overall well-being of warriors and families.
4. Conclusions Change in AUDIT-C Scores at 1-, 3-, and 6-Month Follow-Up
All (272)
Stress Plus (95)
Stress Only (88)
Female
28.68
29.47
31.82
24.72
2.5
Male
71.32
70.53
68.18
75.28
2.0
E1-E3
8.89
10.64
5.75
10.11
All you need to participate is: • Internet access. • A desire to help our fighting force become healthier and stronger.
4.0
Delayed Feedback (89)
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3.5 3.0
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1.5 1.0
E4-E6
59.63
59.57
60.92
58.43
0.5
E7-E9
13.70
11.70
17.24
12.36
0.0
READY? LOG ON AT SUSTAIN.RTI.ORG TO GET STARTED.
For more information about the study, please call 1-800-647-9655 or email
[email protected].
O1-O3
11.85
9.57
13.79
12.36
O4-O6
4.44
6.38
2.30
4.49
Married
49.26
49.47
48.86
49.44
White
Study Design
Black Self-Referral
63.12 23.57
60.44 25.27
62.07 26.44
67.06 18.82
Stress plus Substance Use Baseline
1-Month Follow-Up
Stress Only
The interventions were designed to increase awareness of behavior and consequences, facilitate comparison of oneself to a standard, and encourage the identification of strategies to reduce risks related to high stress levels (e.g., relaxation, exercise, effective communication) and consuming alcohol (e.g., pacing drinks, avoiding heavy drinking).
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We were able to demonstrate that a webbased intervention can have a significant impact on stress and alcohol use.
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These data are vital to understanding additional steps the military might take in addressing issues of behavioral health, such as developing new, more broadly focused treatment and prevention programs.
Delayed Feedback
3-Month Follow-Up
6-Month Follow-Up
Change in Stressors at 1-, 3-, and 6-Month Follow-Up 9 8
Hispanic
7.60
7.69
5.75
9.41
7
Other
5.70
6.59
5.75
4.71
6 5 4
Individual Accesses SUSTAIN Website
3
Baseline Characteristics
2. Methods ■■
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CONSENT for Screen Participant Completes Screener
We conducted a randomized, controlled trial with National Guard personnel comparing two webbased interventions to a wait list control: ●● Stress Only Feedback and Intervention ●● Stress plus Substance Use Feedback and Intervention ●● Delayed Feedback (Stress plus Substance Use Feedback and Intervention) Volunteers were recruited through in-person briefings at National Guard armories.
All (272)
2
Stress Plus Stress Only (95) (88)
Delayed Feedback (89)
1 0
Stress plus Substance Use Baseline
1-Month Follow-Up
Stress Only
Delayed Feedback
3-Month Follow-Up
6-Month Follow-Up
PCL CONSENT for Full Study Participant Completes Baseline if Positive
17-29 30-43 44+
Randomization
34.85 51.89 13.26
35.56 50.00 14.44
33.72 55.81 10.47
Wait List Control
Participants accessed the website, consented to the study, and completed a brief web assessment for alcohol use and current COSRs.
1-Month Follow-Up
The intervention materials were presented immediately upon completion of the baseline assessment.
3-Month Follow-Up
1-Month Follow-Up
Stress plus Substance Use Brief Intervention 1-Month Follow-Up
50.00 14.77
Change in PCL Score from Baseline to 6-Month Follow-Up 35 30
57.72
50.53
60.23
62.92
20
21-40
36.40
37.89
35.23
35.96
15
5.88
11.58
4.55
3-Month Follow-Up
3-Month Follow-Up
COSR (0-20)
4.63 9.70
3.91 10.40
5.19 9.30
This work was supported by U.S. Department of Defense grant award number W81XWH-11-2-0197.
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Points of view are those of the authors and do not necessarily reflect the views of the U.S. Department of Defense.
1.12
*Presenting author: Janice M. Brown, Ph.D 919.541.7125
[email protected]
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RTI International 3040 E. Cornwallis Road Research Triangle Park, NC 27709
5 AUDIT (0-19)
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More Information
25
0-20
41-72
Acknowledgments
35.23
Stressors Stress Only Brief Intervention
Developing individualized alternatives for helping to change behavior
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Conducted by: RTI International Sponsored by: United States Army Medical Research and Materiel Command
The key elements of this approach are consistent with motivational interventions and include: ●● Using a nonconfrontational approach ●● Helping participants perceive a discrepancy between their goals and their current stress level and/or alcohol use
4.82 9.30
0
Stress plus Substance Use (16) Baseline
Stress Only (23)
Delayed Feedback (9)
6-Month Follow-Up
Presented at: the Military Health System Research Symposium, Kissimmee, FL, August 15–18, 2016
www.rti.org 6-Month Follow-Up
6-Month Follow-Up
6-Month Follow-Up
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