This application is a revision of application R34 MH083494-01 which was reviewed on November 9, 2007 by National Institute of Mental Health Special Emphasis Panel ZMH1 ERB-N (02) (Prevention of Trauma Related Adjustment and Mental Disorders in High-Risk Occupations). The revised application updates the literature review to emphasize pertinent lessons learned, incorporates work of local focus group participants, expands the coping strategy modules to address sleep, optimizes outcome measures, improves the data analysis, enhances human subjects protection, clarifies safety procedures, and increases investigator time. The motivation for the project is unchanged in that spouses of military personnel returned from Iraq or Afghanistan must often deal with consequences of service members'traumatic experiences. Warriors'spouses are at elevated risk for psychological distress, marital dysfunction, and intimate partner violence. However, time constraints, distance, and questions about eligibility for services may preclude spouses from using face-to-face programs. There is growing evidence indicating that the World Wide Web may help address these needs. Computerized video-based systems that include tailored feedback and chat room features could provide essential information to spouses, facilitate acquisition of coping strategies, and increase social support. Moreover, Internet-based programs offer the possibility of reaching the large numbers of at-risk spouses who would be needed to test effectiveness of a preventive intervention. Building on a very recently funded study, the proposed project will refine and pilot test interactive Web-based technologies to address these issues. The interactive Web site will provide education about post-traumatic stress disorder, advise on implementation of coping strategies, facilitate social support, attend to safety concerns, and offer referrals and resource information. The program will include videos showing potential impact of post-traumatic stress disorder on spouses as well as scenes depicting common coping strategies. The proposed project will involve refinement of an existing computer program, collaboration with local focus group members on selection of materials, data gathering from spouses dealing with service members'post-traumatic stress disorder, and pilot testing of the updated Web site. The program will then be improved based on feedback from users. Randomization will be employed to examine impact of the interactive video-based technology versus currently available mainly narrative view-only materials. Outcome measures will address user satisfaction, knowledge about post-traumatic stress disorder, acquisition of coping strategies, social support, family functioning, and psychological distress. - Public Health Relevance The proposed project will refine technology especially beneficial to military families;provide information about the value of Internet-based interventions designed to prevent distress and disorders among people at elevated risk;and set the stage for large scale prevention research employing Internet services.
- Public Health Relevance The proposed project will refine technology especially beneficial to military families;provide information about the value of Internet-based interventions designed to prevent distress and disorders among people at elevated risk;and set the stage for large scale prevention research employing Internet services.
| Lewy, Colleen S; Oliver, Celina M; McFarland, Bentson H (2014) Barriers to mental health treatment for military wives. Psychiatr Serv 65:1170-3 |
