scholarly journals Lessons Learned From Implementing an App-Based Resilience Training Program in a Naval Operational Setting

Iproceedings ◽  
10.2196/14935 ◽  
2019 ◽  
Vol 5 (1) ◽  
pp. e14935
Author(s):  
Cynthia Simon-Arndt ◽  
Suzanne Hurtado ◽  
Casey Kohen ◽  
Michael Hunter ◽  
Sandra Sanchez

Background Enhancing resilience and reducing stress are critical to increasing the readiness and performance of military personnel in operational settings. Stress and resilience programs can improve service members’ ability to manage their stress during both normal and extreme operational conditions, and have the potential to enhance safety at sea. Implementing an efficient and effective application-based training program in a military setting has unique challenges, including minimizing intrusion on the command’s training time and technological considerations (eg, Wi-Fi and Bluetooth technology restrictions). Objective An enhanced version of a training program called the Stress Resilience Training System (SRTS) was implemented into the operating environment of a naval vessel. The system contains an in-person workshop, regular mentoring in resilience-building techniques, and an iPad-based app used for biofeedback of heart rate variability coherence and training support. This work describes the lessons learned from the implementation process of the app component of the program, based on responses from active duty service members. Methods Crew members aboard a Navy vessel (N=92) volunteered to participate in the evaluation of the 10-week program. All ship personnel were provided with an initial 2.5-hour workshop, mentorship, and iPads containing the SRTS app to use for the duration of the 10-week program. Participants rated different components of the training, and their app usage during the course of the study was recorded. Results Participants somewhat agreed that the app was appropriate for military service members (mean 2.51, SD 1.14; response options 0=strongly disagree to 4=strongly agree for all ratings) and were somewhat likely to recommend the app to fellow service members (mean 2.53, SD 1.03). Ratings of the workshop’s relevance to military readiness (mean 2.68, SD 0.95) and of the instructors’ credibility (mean 3.22, SD 0.92) were higher than ratings of the app. Additionally, usage of the app was low and highly variable (mean 42.26, SD 60.53; range 0 to 312.54 minutes). Anecdotal evidence provided by crewmembers suggested that using the app on an iPad was cumbersome and that the Wi-Fi was often inaccessible, making the iPad a less valuable tool overall. Conclusions This implementation of the app component of SRTS raised questions regarding the suitability of the technological format for this operational setting. User ratings and participant comments suggested that the technology was not the most successful component of the program. The implementation in the iPad format was not conducive to the operational setting and the inconvenience of this format may have deterred participants from using it in settings where a personal or more compact device may have been more appropriate. Recommendations going forward include making the app component available for use on smartphones operating on both iOS and Android platforms to make it user friendly, accessible, and more engaging, which, in turn, is expected to increase usage and uptake of the program’s techniques. Furthermore, incorporating more engaging content, gamification, and tracking and reporting user progress into the overall app may enhance motivation to use more components of the app and increase usage, ultimately enhancing its impact on resilience.

2020 ◽  
Vol 4 (s1) ◽  
pp. 67-67
Author(s):  
Stephanie A. Freel ◽  
Katherine Barrett ◽  
Jillian Hurst ◽  
Rasheed Gbadegesin ◽  
Sallie Permar

OBJECTIVES/GOALS: To ameliorate the leaky pipeline of physician-scientists, we must address the factors that cause medical trainees to disengage from research. Here we describe the development of standardized Physician-Scientist Training Program guidelines that may be implemented across disciplines to address these challenges. METHODS/STUDY POPULATION: Maintenance of a robust pool of physician-scientists is critical to meet the rapidly growing need for novel therapeutics. A variety of factors contribute to the decline of this pool. Key among these are a lengthy training period that segregates research from clinical training, thus impeding research progress and milestones that allow for a successful research career. Through engagement of residency program directors and Vice Chairs of Research, we have created a series of guidelines that promote residency research tracks and enable better integration of research and clinical training time. Guidelines have been piloted in the Departments of Pediatrics, Medicine and Surgery in the context of 2 new R38-supported programs. RESULTS/ANTICIPATED RESULTS: Our physician-Scientist Training Program (PSTP) guidelines were developed by our central Office of Physician-Scientist Development (OPSD) after a successful pilot of an integrated research residency program in the Department of Pediatrics [Duke Pediatric Research Scholars (DPRS); Hurst, et al, 2019], which has included 36 resident and fellow scholars over 3 years. To date, eight clinical departments have adopted our PSTP guidelines as part of their R38-supported or pending programs. The OPSD has recently created a tracking database for scholar metrics, which will further promote PSTP development by enabling centralized reporting on scholar success to individual programs. DISCUSSION/SIGNIFICANCE OF IMPACT: PSTP guidelines enable effective implementation of new programs by sharing best practices and lessons learned, standardizing expectations, and defining metrics of success. By promoting proven strategies for integrated clinical and research training, PSTP guidelines may aid in retaining trainees pursuing research careers.


2019 ◽  
pp. 271-287
Author(s):  
◽  
Andrew Lewandowski ◽  
Lindell K. Weaver ◽  
◽  
◽  
...  

Purpose: Military service members often report both affective and vestibular complaints after mild traumatic brain injury (mTBI), but associations between symptoms and vestibular deficits can be subtle and inconsistent. Methods: From two complementary studies, one of military service members with persistent post-concussive symptoms after mTBI (NCT01611194) and the other of adult volunteers with no history of brain injury (NCT01925963), affective symptoms were compared to postural control, gait, otolith and visuospatial function. Results: The studies enrolled 71 participants with mTBI and 75 normative controls. Participants with mTBI had significantly reduced postural equilibrium on the sensory organization test (SOT), and more so in those with high anxiety or post-traumatic stress. Cervical and ocular vestibular evoked myogenic potentials (cVEMP; oVEMP) showed prolonged latencies in mTBI participants compared to controls; oVEMPs were significantly delayed in mTBI participants with high anxiety, post-traumatic stress or depression. A subset of the mTBI group had abnormal tandem gait and high anxiety. Anxiety, posttraumatic stress, and depression did not correlate with performance on the 6-Minute Walk Test, visuospatial neuropsychological measures, and the Satisfaction with Life Scale in the mTBI group. Conclusions: In this study military service members with mTBI reported affective symptoms, concurrently with vestibular-balance concerns. Worse scores on affective measures were associated with abnormal findings on measures of postural control, gait and otolith function.


2020 ◽  
pp. 088626052097031
Author(s):  
Cary Leonard Klemmer ◽  
Ashley C. Schuyler ◽  
Mary Rose Mamey ◽  
Sheree M. Schrager ◽  
Carl Andrew Castro ◽  
...  

Prior research among military personnel has indicated that sexual harassment, stalking, and sexual assault during military service are related to negative health sequelae. However, research specific to LGBT U.S. service members is limited. The current study aimed to explore the health, service utilization, and service-related impact of stalking and sexual victimization experiences in a sample of active-duty LGBT U.S. service members ( N = 248). Respondent-driven sampling was used to recruit study participants. U.S. service members were eligible to participate if they were 18 years or older and active-duty members of the U.S. Army, U.S. Navy, U.S. Marine Corps, or U.S. Air Force. This study included a sizeable portion of transgender service members ( N = 58, 23.4%). Sociodemographic characteristics, characteristics of military service, health, and sexual and stalking victimization in the military were assessed. Regression was used to examine relationships between health and service outcomes and sexual and stalking victimization during military service. Final adjusted models showed that experiencing multiple forms of victimization in the military increased the odds of visiting a mental health clinician and having elevated somatic symptoms, posttraumatic stress disorder symptomatology, anxiety, and suicidality. Sexual and stalking victimization during U.S. military service was statistically significantly related to the mental and physical health of LGBT U.S. service members. Interventions to reduce victimization experiences and support LGBT U.S. service members who experience these types of violence are indicated. Research that examines the role of LGBT individuals’ experiences and organizational and peer factors, including social support, leadership characteristics, and institutional policies in the United States military is needed.


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