Increasing Resiliency in U.S. Air Force Personnel: A Multi-Site Trial Protocol

The purpose of this study is to examine the efficacy of the Stress Management and Resilience Training (SMART) in increasing the resilience of U.S. Air Force personnel. We aim to recruit up to 500 active component Air Force personnel and provide a two-arm randomization modality to make SMART more acc...

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Main Authors: Stephen H.A. Hernandez, Jacqueline Killian, Mark B. Parshall, Tonya Y. White, Enesha J. Hicks, Victoria Hughes, Theresa A. Bedford, Yiliang Zhu
Format: Article
Language:English
Published: Elsevier 2025-08-01
Series:Contemporary Clinical Trials Communications
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Online Access:http://www.sciencedirect.com/science/article/pii/S245186542500081X
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author Stephen H.A. Hernandez
Jacqueline Killian
Mark B. Parshall
Tonya Y. White
Enesha J. Hicks
Victoria Hughes
Theresa A. Bedford
Yiliang Zhu
author_facet Stephen H.A. Hernandez
Jacqueline Killian
Mark B. Parshall
Tonya Y. White
Enesha J. Hicks
Victoria Hughes
Theresa A. Bedford
Yiliang Zhu
author_sort Stephen H.A. Hernandez
collection DOAJ
description The purpose of this study is to examine the efficacy of the Stress Management and Resilience Training (SMART) in increasing the resilience of U.S. Air Force personnel. We aim to recruit up to 500 active component Air Force personnel and provide a two-arm randomization modality to make SMART more accessible and adaptive to the personnel's schedules. Two-arm randomization will be used to assign three sites for participants to choose in-person or computer-based training (CBT) and two sites where participants are randomized into their training type (in-person or CBT). The use of two-arm randomization will enable the examination of the difference between real-world settings within the framework of causal inference, as well as, differences based upon self-selection and a randomized control trial. We propose to examine the intervention effects at 12, 24 and 36-weeks post-intervention. Initial analysis will include descriptive statistics to characterize demographic status, military grade, duty location, and military occupation. The objectives of our analyses will include testing and estimating the intervention effects by comparing pre-post intervention changes in resilience, stress, anxiety, and QoL at each follow-up. Scores will also be pooled to test for overall intervention effects over time. Intervention effectiveness will be reported by comparing mean or median effects using 95 % confidence intervals and effect size estimates. An analysis of the longitudinal trend over the study period will be conducted by simultaneously examining data from all follow-ups using mixed-effects models in which random effects will be used to characterize between and within-subject variations.
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spelling doaj-art-e936c39ff5c541ab9f887c378ff338932025-08-20T03:51:08ZengElsevierContemporary Clinical Trials Communications2451-86542025-08-014610150710.1016/j.conctc.2025.101507Increasing Resiliency in U.S. Air Force Personnel: A Multi-Site Trial ProtocolStephen H.A. Hernandez0Jacqueline Killian1Mark B. Parshall2Tonya Y. White3Enesha J. Hicks4Victoria Hughes5Theresa A. Bedford6Yiliang Zhu7University of New Mexico, College of Nursing, MSC07 4380, Box 9, 1 University of New Mexico, Albuquerque, NM 87102, USA; Corresponding author.School of Nursing, University of Nevada, Las Vegas, Mail Stop: 3018, 4505 S. Maryland Pkwy. Las Vegas, NV 89154, USAUniversity of New Mexico, College of Nursing, MSC07 4380, Box 9, 1 University of New Mexico, Albuquerque, NM 87102, USA59 Medical Wing, Sciences and Technology, 1632 Nellis St., Bldg. 5406, JBSA-Lackland TX, 78236, USA59 Medical Wing, Sciences and Technology, 1632 Nellis St., Bldg. 5406, JBSA-Lackland TX, 78236, USAJohns Hopkins University, School of Nursing, 5525 N. Wolfe St., Room S419, Baltimore MD 21205, USA88th Medical Group, Clinical Investigations, 4881 Sugar Maple Dr, Wright-Patterson AFB, Dayton, OH 45433, USAUniversity of New Mexico, School of Medicine, MSC10 5550, 1 University of New Mexico, Albuquerque, NM 87102, USAThe purpose of this study is to examine the efficacy of the Stress Management and Resilience Training (SMART) in increasing the resilience of U.S. Air Force personnel. We aim to recruit up to 500 active component Air Force personnel and provide a two-arm randomization modality to make SMART more accessible and adaptive to the personnel's schedules. Two-arm randomization will be used to assign three sites for participants to choose in-person or computer-based training (CBT) and two sites where participants are randomized into their training type (in-person or CBT). The use of two-arm randomization will enable the examination of the difference between real-world settings within the framework of causal inference, as well as, differences based upon self-selection and a randomized control trial. We propose to examine the intervention effects at 12, 24 and 36-weeks post-intervention. Initial analysis will include descriptive statistics to characterize demographic status, military grade, duty location, and military occupation. The objectives of our analyses will include testing and estimating the intervention effects by comparing pre-post intervention changes in resilience, stress, anxiety, and QoL at each follow-up. Scores will also be pooled to test for overall intervention effects over time. Intervention effectiveness will be reported by comparing mean or median effects using 95 % confidence intervals and effect size estimates. An analysis of the longitudinal trend over the study period will be conducted by simultaneously examining data from all follow-ups using mixed-effects models in which random effects will be used to characterize between and within-subject variations.http://www.sciencedirect.com/science/article/pii/S245186542500081XAir forceMilitaryResilienceStress
spellingShingle Stephen H.A. Hernandez
Jacqueline Killian
Mark B. Parshall
Tonya Y. White
Enesha J. Hicks
Victoria Hughes
Theresa A. Bedford
Yiliang Zhu
Increasing Resiliency in U.S. Air Force Personnel: A Multi-Site Trial Protocol
Contemporary Clinical Trials Communications
Air force
Military
Resilience
Stress
title Increasing Resiliency in U.S. Air Force Personnel: A Multi-Site Trial Protocol
title_full Increasing Resiliency in U.S. Air Force Personnel: A Multi-Site Trial Protocol
title_fullStr Increasing Resiliency in U.S. Air Force Personnel: A Multi-Site Trial Protocol
title_full_unstemmed Increasing Resiliency in U.S. Air Force Personnel: A Multi-Site Trial Protocol
title_short Increasing Resiliency in U.S. Air Force Personnel: A Multi-Site Trial Protocol
title_sort increasing resiliency in u s air force personnel a multi site trial protocol
topic Air force
Military
Resilience
Stress
url http://www.sciencedirect.com/science/article/pii/S245186542500081X
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