Air Force Medical Operation Agency (AFMOA) Mental Health Division Research Project

AIR FORCE MEDICAL OPERATION AGENCY (AFMOA) MENTAL HEALTH DIVISION RESEARCH PROJECT

Sponsoring Institution

National Institute of Food and Agriculture

Project Status

EXTENDED

Funding Source

OTHER GRANTS

Reporting Frequency

Annual

Accession No.

1014449

Grant No.

2017-39574-27342

Project No.

PENW-2017-08861

Proposal No.

2017-08861

Multistate No.

(N/A)

Program Code

MHRP

Project Start Date

Sep 1, 2017

Project End Date

Aug 31, 2019

Grant Year

2018

Project Director
Perkins, D. F.

Recipient Organization
PENNSYLVANIA STATE UNIVERSITY
408 Old Main
UNIVERSITY PARK,PA 16802-1505

Performing Department
Agricultural Economics, Sociol

Non Technical Summary
The current proposal outlines the Clearinghouse for Military Family Readiness at Penn State recommended work for the next two years. Specifically, the proposed approach builds on already existing factors, including: (1) a strong partnership between AFMOA and the Clearinghouse; (2) practical knowledge acquired from six years of prior experiences with AFMOA; (3) familiarity with multiple aspects of AF culture and family life; (5) infrastructure supports for the AFMOA.Although each project within this RFA is different in scope, the Clearinghouse utlizes the following tasks: (1) gathering and interpreting empirical literature; (2) developing, applying, and implementing prevention and behavioral health policy; (3) utilizing research and evaluation to address operations; and (4) providing evidence-informed resources, coordinating best practices, analyzing data, and offering supportfor efficient implementation of evidence-based approaches.For the advisory and consultation task, we propose facilitating the use of subject matter experts to assist AFMOA with ongoing service improvement efforts. The Clearinghouse proposes the support one of AFMOA's key priorities is the translation of evidence-based programs into policy, program development, and practices by extending its already existing assistance with Phase I into Phase II of Air Force Implementation of Zero Suicide Systems Approach and the Creation of Evidence-Based Course of Care Repository projects. Finally, this project will build upon Phase I and Phase II of the Social Norms Initiative. In Phase III, the Clearinghouse will develop an online Social Norms survey with the ultimate goal of establishing an AF-specific Social Norms intervention that targets alcohol overuse and abuse.

Animal Health Component

Research Effort Categories

Basic

Applied

100%

Developmental

(N/A)

Classification

Knowledge Area (KA)	Subject of Investigation (SOI)	Field of Science (FOS)	Percent
802	6010	3070	100%

Knowledge Area
802 - Human Development and Family Well-Being;

Subject Of Investigation
6010 - Individuals;

Field Of Science
3070 - Psychology;

Keywords

Goals / Objectives
Advisory and Consultation. We propose facilitating the use of subject matter experts (SMEs) to assist AFMOA with ongoing service improvement efforts. These SMEs may be internal Clearinghouse scientific staff or other experts in clinical practice, programming, and program evaluation for the prevention and treatment of psychological issues and alcohol/drug abuse problems. This purposeful consultation will serve as a guidepost for initiatives and will help the Clearinghouse staff design and improve the programming for Airmen and their families. This proposed advisory and consultation task enable AFMOA to remain nimble in meeting the ever-changing mission and needs.Phase II of Air Force Implementation of Zero Suicide Systems Approach. During the next two years, the Clearinghouse proposes to work with AFMOA on the development of an implementation plan of ZSSA across the entire AF. The Clearinghouse will employ the use of data and participant feedback from Phase I to improve existing trainings and develop new trainings.Phase III Social Norms Alcohol Misuse/Abuse Prevention Initiative. This project will build upon Phase I and Phase II of the Social Norms Initiative. In Phase III, the Clearinghouse will develop an online Social Norms survey with the ultimate goal of establishing an AF-specific Social Norms intervention that targets alcohol overuse and abuse. The Clearinghouse proposes to do the following: (1) create of an AF version survey; (2) validate the survey's questions and psychometric properties; (3) pilot the survey; and (4) develop AF-specific Social Norms marketing materials.

Project Methods
The proposed approach builds on already existing factors, including the following: (1) a strong partnership between AFMOA and the Clearinghouse; (2) practical knowledge acquired from six years of prior experiences with AFMOA; (3) familiarity with multiple aspects of AF culture and family life; (4) project efforts and deliverables completed, or in progress, by the Clearinghouse; and (5) infrastructure supports for the AF and the professionals who work with Airmen and their families.The Clearinghouse will assisted AFMOA leadership in an advisory and consultation role and in the coordination and administration of Continuing Education Units (CEUs). The Clearinghouse proposes the support of this priority by extending its already existing assistance with Phase I into Phase II of Air Force Implementation of Zero Suicide Systems Approach and the Creation of Evidence-Based Course of Care Repository projects. Building on Phase I of ZSSA. While much has been accomplished in Phase I of the ZSSA implementation, the Clearinghouse proposes several new aspects be developed and implemented to ensure ongoing progress and focus toward broad dissemination of ZSSA. During the next two years, the Clearinghouse proposes to work with AFMOA on the development of an implementation plan of ZSSA across the entire AF. The Clearinghouse will employ the use of data and participant feedback from Phase I to improve existing trainings and develop new trainings.The Clearinghouse proposes the creation of a web-based platform and a course-of-care decision tree to improve the effectiveness and consistency of provider care decisions. To accomplish this goal, the Clearinghouse will work closely with AFMOA to identify the most frequently encountered diagnoses AF providers experience and identify providers' concerns about treating mental health problems. This effort will be done through the examination of de-identified patient health records and in-person and virtual feedback sessions with AF providers. We propose conducting 8 to 10 installation site visits and 15 telephone feedback sessions. The data will be analyzed and results will be written in a report outlining next steps for this project.The Clearinghouse will develop an online Social Norms survey with the ultimate goal of establishing an AF-specific Social Norms intervention that targets alcohol overuse and abuse. The Clearinghouse proposes to do the following: (1) create of an AF version survey; (2) validate the survey's questions and psychometric properties; (3) pilot the survey; and (4) develop AF-specific Social Norms marketing materials. If the pilot is successful, the next phase may involve refinement and evidential rollout of the survey AF-wide and the evaluation of the survey as a prevention tool.

Progress 09/01/17 to 08/31/18

Outputs
Target Audience:The Target audience includes: Airmen, their families, and professionals serving them. Changes/Problems: Nothing Reported What opportunities for training and professional development has the project provided? 14 Training Modules to train Air Force Mental Health Technicians in becoming Certified Alcohol and Drug Counselors Developed three modules to train Military Mental Health Providers in Ethical Issues Developed a Career Field Technical Education and Training Plan (CFETP) manual for U.S. Air Force mental health technicians Trained all mental health providers in the Air Force on using the Columbia Suicide Severity Rating Scale (C-SSRS) to screen and assess for suicide risk Delivered trainings on Safety Planning Protocol for mental health providers at Zero Suicide Systems Approach (ZSSA) pilot sitesProvided CEUs for three Air Force Conferences and 10 individual trainings How have the results been disseminated to communities of interest?All project reports and summary sheets are submitted and reviewed with AFMOA headquarter and local installation providers through face-toface meetings, TCONs, and webinars. What do you plan to do during the next reporting period to accomplish the goals?Continue to collaborate with our partners on the various projects including: rolling out the treatment elemnet of ZSSA, piloting an alcohol prevention project, and developing a care repository.

Impacts
What was accomplished under these goals? This past year of the AFMOA project has seen significant accomplishments and movement related to several projects within the overall effort. The accomplishments are noted below. Beta Test of Brief Cognitive Behavioral Therapy (BCBT) for Suicide Prevention; along with a report of project activities, findings and recommended next steps Beta Test of Prolonged Exposure within Primary Care; along with a report of project activities, findings, and recommended next steps Awareness Campaign for the Air Force's Behavioral Health Optimization Program Beta implementation of the Unified Protocol; along with a report of project activities, findings, and recommended next steps Testing a sustainable Social Norms implementation within the Air Force; along with a report of project activities, findings, and recommended next steps Conducted two time-motion studies within Air Force Mental Health Clinics; along with a report summarizing findings Trained all mental health providers in the Air Force on using the Columbia Suicide Severity Rating Scale (C-SSRS) to screen and assess for suicide risk Developed a Safety Planning Protocol for mental health providers at Zero Suicide Systems Approach (ZSSA) pilot sites Continued to provide implementation support for five pilot sites participating in Zero Suicide Systems Approach (ZSSA) Evaluation plan completed for the Zero Suicide Systems Approach (ZSSA)

Publications

Type: Conference Papers and Presentations Status: Published Year Published: 2018 Citation: Hawkey, K. R., Aronson, K. R., & Perkins, D. F. (May, 2018). Complexities and promise of suicide prevention in the military context: Implementing a Zero Suicide Systems Approach in the Air Force. Paper presentation presented at the 2018 Society for Prevention Research Conference. Washington, DC.
Type: Journal Articles Status: Published Year Published: 2018 Citation: Aronson, K. R., Welsh, J. A., Fedotova, A., Morgan, N. R., Perkins, D. F., & Travis, W. (In press). Treating PTSD in active duty service members using cognitive processing therapy or prolonged exposure therapy: Examining everyday practice at a military outpatient clinic. Military Psychology.
Type: Other Status: Published Year Published: 2018 Citation: Pytel, K. F., Hawkey, K. R., & Perkins, D. F. (2018). Project summary: Brief Cognitive Behavioral Therapy Beta Test. Report submitted to the United States Air Force Medical Operations Agency (AFMOA), July, 2018.
Type: Other Status: Published Year Published: 2018 Citation: Griggs, J. G., Hawkey, K. R., & Perkins, D. F. (2018). Project summary: Beta test of Prolonged Exposure in Primary Care. Report submitted to the United States Air Force Medical Operations Agency (AFMOA), July, 2018.
Type: Other Status: Published Year Published: 2018 Citation: Hamel, M., Hawkey, K. R., Griggs, J. G., Aronson, K. R., & Perkins, D. F. (2018). Air Force Mental Health time-motion study: Clinic-level operational findings from Mental Health Clinics at Tinker and Nellis Air Force Bases. Report submitted to the United States Air Force Medical Operations Agency (AFMOA), July, 2018.
Type: Other Status: Published Year Published: 2018 Citation: White, L. D. & Perkins, D. F. (2018). Report of the beta implementation of the Unified Protocol within the U.S. Air Force. Report submitted to the United States Air Force Medical Operations Agency (AFMOA), March, 2018.
Type: Other Status: Published Year Published: 2018 Citation: White, L. D., Jones, D. E., & Perkins, D. F. (2018). USAF Social Norms Phase II Program for Airmen alcohol abuse prevention: Implementation report. Report submitted to the United States Air Force Medical Operations Agency (AFMOA), January, 2018.