Comprehensive Cross-Cutting Prevention Opportunity to Decrease Harmful Behaviors and Increase Service Member Readiness and Performance

U.S. military personnel and their families face many challenges that contribute to decreasing the readiness and resiliency of the force. The goal of this MTEC funding opportunity is to support proposals focused on preventive interventions designed to have an impact on multiple outcomes including:

  • Suicide ideation and behaviors and non-suicidal self-directed injury
  • Sexual violence (sexual harassment and assault)
  • Harassment (e.g., gender and racial discrimination, retaliation)
  • Domestic abuse (intimate partner violence)
  • Alcohol and substance use, misuse, and disorders
  • Psychological health issues

Critical gaps in research remain and must be addressed to improve the application of crosscutting prevention within a military context. Research is needed to identify which programs and strategies have the strongest cross-cutting impacts on short-, intermediate-, and long-term outcomes associated with prevention of deleterious outcomes. Although there is evidence for prevention effects on a broad array of behaviors for children and youth, violence prevention and psychological health more research is needed to build a body of prevention evidence for adults and for military contexts. In addition, it is critical to consider the unique life events, military career cycle, and organizational structure of the military. Examples include deployments, permanent changes of station (PCS), and the impact of combat, including combat-related traumatic brain injuries (TBI), psychosocial health, behaviors, relationships, and influence of teams and leaders.

Preventive intervention approaches at multiple levels of social ecology (i.e., individual, relationship, community, and society) are critical to having a population level impact on harmful behaviors. Therefore, the DOD seeks comprehensive prevention approaches that address multiple levels of the social ecological model. Such approaches use multiple, synergistic strategies across social ecology to promote healthy behaviors and prevent unhealthy and unsafe behaviors, as well as to increase protective factors and reduce risk factors associated with experiencing or engaging in violent, harmful, or abusive behaviors.

There is a critical need for effective solutions for current and future Service Members and their families impacted by harmful behaviors and psychological health issues. The recent success of some prevention interventions in the general population provide promising evidence for crosscutting prevention approaches. Therefore, this MTEC opportunity focuses on theory-based research to support program development, program efficacy/effectiveness testing (excluding program evaluation for the purposes of enhancing or managing programs), and implementation of military primary prevention approaches that have cross-cutting impacts on multiple outcomes of interest including but not limited to suicide, sexual violence, harassment, domestic abuse, alcohol and substance use, and psychological health issues. The primary goal is to adapt or create cross-cutting interventions that address risk and protective factors and behaviors across the social ecology in order to prevent a range of harmful behaviors in a military population and promote health and readiness. The research project award recipients were selected from the Offerors who responded to MTEC’s Request for Project Proposals (21-05-Cross-Cutting).

Better Together: A Primary Prevention Intervention Targeting Transdiagnostic Interpersonal Emotion Regulation among Military Couples

Project Team: Henry M. Jackson Foundation for the Advancement of Military Medicine

Award Amount: $1.40M

Project Duration: 24 months

Project Objective: The Suicide Care, Prevention, and Research (CPR) Initiative will partner with the Navy Chaplain Corps to develop and preliminarily evaluate Better Together, a primary prevention intervention that equips military service members and their romantic partners with Interpersonal emotion regulation (IER) strategies to cope with stressors as a unified team.

 Enhancing Utility and Evaluating Cross-Cutting Outcomes of the Sexual Communication and Consent (SCC) Program

Project Team: RTI International

Award Amount: $1.91M

Project Duration: 36 months

Project Objective: Since 2014, RTI International has worked with the U.S. Air Force to develop and test the Sexual Communication and Consent (SCC) program, a tailored training that targets prevention of sexual assault perpetration, victimization, and revictimization. A large feasibility study at Air Force Basic Military Training suggested that SCC was feasible and acceptable and was associated with improvements in proximal outcomes linked to sexual assault; now, additional research is needed to make the program appropriate for other military training settings and to test the cross-cutting effects of the program. For the proposed project, RTI will develop a web-based multi-platform solution for hosting SCC; expand a DoD-funded evaluation of SCC at the U.S. Air Force Academy to include secondary outcomes and to test different ways to implement the new technology; and undertake community-based participatory research (CBPR) to understand the optimal level of SCC adaptation for new military audiences and settings.

Integrating Social Networks and Team Intervention Approaches to Reduce Ostracism in the Military

Project Team: University of Kentucky

Award Amount: $1.85M

Project Duration: 36 months

Project Objective: We respond to the call on developing effective primary prevention programming to optimize health promotion and prevent various forms of violent, abusive, and harmful acts within military contexts. We focus on ostracism, the experience of being excluded or ignored by others, as a proximal factor that leads to both self-directed (e.g., psychological health issues, suicide ideation) and other-directed (e.g., harassment, sexual violence) harmful behaviors. We propose a 3-year plan to 1) partner with military units to identify salient factors that lead to ostracism; 2) design and implement an evidence-based intervention to reduce ostracism in the military; 3) test the effectiveness of a team-based intervention on reducing ostracism in a randomized controlled trial. This proposal is novel in that it moves beyond the typical individual-centered and clinically-focused approach to adopt a network and team-based approach to prevent a phenomenon that leads to more severe forms of harmful acts in the military.

Protective Environments: Military Community Engagement to Prevent Firearm-Related Violence

Project Team: University of Colorado Anschutz

Award Amount: $1.48M

Project Duration: 34 months

Project Objective: Our goal is to facilitate implementation of acceptable, effective interventions for prevention of suicide and other non-fatal and fatal violence in military populations, with a particular focus on voluntary reductions in firearm access during at-risk periods as a way to decrease the risk of death. In this three-year project, we will use community engagement to adapt and test an existing intervention at Buckley Air Force Base in Aurora, Colorado.

Cross-cutting Prevention Through an Upstream Focus on Social Determinants of Health Within Military Settings

Project Team: Arizona State University

Award Amount: $2.39M

Project Duration: 36 months

Project Objective: The proposed solution for this project is to adapt and conform our proven cross-cutting prevention program model for use within diverse military settings. This model has been developed, shaped and implemented with military, veteran and family populations over the past ten years. Our aim is to reduce harmful behaviors and increase signature behaviors through upstream prevention strategies that address all of the social determinants of health. These adaptable solutions build upon existing military infrastructure, prevention programming, and add a new level of internal and external coordination for prevention service delivery.