- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04043936
Increasing Help-Seeking in Military Service Members
April 12, 2023 updated by: Thomas Joiner, Florida State University
Increasing Connection to Care Among Military Service Members at Elevated Suicide Risk: A Randomized Controlled Trial of a Web-Based Intervention
There is sufficient evidence that military service members markedly underutilize behavioral health care services, in part, due to stigma.
This study proposes to examine a novel application of a cognitive bias modification (CBM) intervention designed to target stigma-related cognitions among service members at elevated suicide risk not currently engaged in behavioral health treatment.
Study Overview
Status
Completed
Detailed Description
This study proposes to examine a novel application of a cognitive bias modification (CBM) intervention designed to target stigma-related cognitions among service members at elevated suicide risk not currently engaged in behavioral health treatment.
Interventions that leverage CBM principles involve the completion of brief, web-based tasks in which participants are presented with a series of stimuli (e.g., words, sentences) and trained to respond to those stimuli in a manner that is positive or neutral, rather than negative and unhelpful.
Consistent with the theoretical rationale for Cognitive Behavioral Therapy, CBM interventions function by reshaping negative cognitions.
Repeated reinforcement of adaptive cognitions enhances functioning and reduces distress.
CBM interventions have efficacy in reducing maladaptive cognitions across a range of psychiatric symptoms.
However, limited data exist regarding the use of CBM to target help-seeking stigma cognitions.
Study Type
Interventional
Enrollment (Actual)
160
Phase
- Not Applicable
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Contact
- Name: Marielle Gomez
- Phone Number: 850-644-9362
- Email: militarystudy@psy.fsu.edu
Study Locations
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Florida
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Tallahassee, Florida, United States, 32306
- Florida State University
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Virginia
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Portsmouth, Virginia, United States, 23708
- Naval Medical Center Portsmouth
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Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
18 years and older (Adult, Older Adult)
Accepts Healthy Volunteers
No
Description
Inclusion Criteria:
- current active duty U.S. military service member
- lifetime history of suicidal ideation per a self-report version of the SITBI-SF and/or
- current elevated suicide risk factors (i.e., screening positive for clinically significant suicidal ideation [DSI-SS Total Score > 2], depression [PHQ-9 Total Score > 14], anxiety [GAD-7 Total Score > 9], PTSD [PCL-5 Total Score > 32], alcohol use [AUDIT-C Total Score > 3 for men and > 2 for women], and/or anger [DARS Total Score > 22])
- no current behavioral health service use (i.e., ongoing care with a provider to receive psychiatric medications, therapy, and/or counseling)
Exclusion Criteria:
- unable to provide informed consent
- lack of Internet access via a computer, tablet, and/or mobile phone
- scheduled to be stationed outside the continental U.S. any time during the 11 weeks following study enrollment (i.e., during the study period)
- imminent suicide risk (i.e., suicide risk warranting hospitalization) based on the Joiner et al. and Chu et al. Decision Tree Framework.
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Health Services Research
- Allocation: Randomized
- Interventional Model: Factorial Assignment
- Masking: Single
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Cognitive Bias Modification for Help-Seeking Stigma (CBM-HS)
CBM-HS is a 15-minute web-based intervention designed to alter maladaptive cognitions related to mental health help-seeking.
In this task, individuals are presented with a series of statements regarding beliefs about using behavioral health services.
Individuals then select "True" or "False" in response to each statement.
Incorrect responses (i.e., demonstrating help-seeking stigma) are followed by corrective feedback.
Conversely, correct responses (i.e., promoting help-seeking) are positively reinforced.
Participants in this condition will complete three separate 15-minute CBM-HS sessions.
|
Cognitive bias modification (CBM) is an intervention designed to target stigma-related cognitions among individuals at elevated suicide risk not currently engaged in behavioral health treatment.
It involves the completion of brief, web-based tasks in which participants are presented with a series of stimuli (e.g., words, sentences) and trained to respond to those stimuli in a manner that is positive or neutral, rather than negative and unhelpful.
Consistent with the theoretical rationale for Cognitive Behavioral Therapy, CBM interventions function by reshaping negative cognitions.
Repeated reinforcement of adaptive cognitions enhances functioning and reduces distress.
Other Names:
|
Sham Comparator: Placebo Cognitive Bias Modification
Participants randomized to this condition will complete a CBM task with a neutral stimuli.
The duration of the CBM-Placebo task will be comparable to the duration of the CBM-HS task (i.e., three 15-minute sessions).
|
Cognitive bias modification (CBM) is an intervention designed to target stigma-related cognitions among individuals at elevated suicide risk not currently engaged in behavioral health treatment.
It involves the completion of brief, web-based tasks in which participants are presented with a series of stimuli (e.g., words, sentences) and trained to respond to those stimuli in a manner that is positive or neutral, rather than negative and unhelpful.
Consistent with the theoretical rationale for Cognitive Behavioral Therapy, CBM interventions function by reshaping negative cognitions.
Repeated reinforcement of adaptive cognitions enhances functioning and reduces distress.
|
Active Comparator: Self-Directed Psychoeducation
Participants randomized to this condition will review psychoeducation on mental health literacy, mental illness stigma, and treatment options.
Readings will be compiled from resources available in the public domain.
The duration will be comparable to the duration of study tasks for individuals in the CBM-HS study condition (i.e., three 15-minute sessions).
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Material presented with information on mental health literacy, mental health stigma, & treatment options.
This is based on the idea that increasing knowledge about psychiatric symptoms and treatment options encourages help-seeking behavior and engagement.
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Perceived Stigma and Barriers to Care for Psychological Problems Scale (PS)
Time Frame: 2-Month Follow-up
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The 11-item PS measures the extent to which various concerns might affect an individual's decision to seek psychiatric treatment.
Items are rated on a 5-point scale; higher scores (range: 11-55) indicate greater perceived barriers to care.
The PS has been used extensively in military populations and has exhibited acceptable to good internal consistency.
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2-Month Follow-up
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Readiness to Change
Time Frame: 2-Month Follow-up
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Consistent with past research, we will use an adaptation of the Readiness to Change Scale to assess readiness to engage in help-seeking behaviors.
Responses to each of the 6 items are anchored on an 11-point scale, with higher scores (range: 0-60) indicating greater readiness to engage in behavioral health care.
Past research using this approach has yielded good internal consistency.
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2-Month Follow-up
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Self-Stigma of Seeking Help (SSOSH)
Time Frame: 2-Month Follow-up
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The SSOSH is a 10-item measure of help-seeking stigma.
Responses are rated on a 5-point scale; higher scores (range: 0-50) reflect greater self-stigma associated with seeking help.
The scale has demonstrated strong reliability and validity, and it differentiates between young adults who do and do not seek help for mental health problems.
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2-Month Follow-up
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World Mental Health Composite International Diagnostic Interview (WMH-CIDI)
Time Frame: 2-Month Follow-up
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A self-report version of the WMH-CIDI Services subscale will be utilized to assess the presence/absence of specific structural and attitudinal barriers to care.
This WMH-CIDI has been used extensively among adult community samples, including among individuals at elevated suicide risk.
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2-Month Follow-up
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Client Satisfaction Questionnaire-8 (CSQ-8)
Time Frame: 2-Month Follow-up
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The CSQ-8 is an 8-item self-report measure that assesses client satisfaction with services, including mental health care services (range: 8-32).
The CSQ-8 has demonstrated strong psychometric properties, including among psychotherapy patients.
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2-Month Follow-up
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Intervention Acceptability and Feasibility Questionnaire
Time Frame: 2-Month Follow-up
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Acceptability and feasibility will be measured using recruitment and retention rates and open-ended treatment satisfaction questions administered to participants at post-treatment (e.g., "What aspects of the intervention could be improved?").
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2-Month Follow-up
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Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Collaborators
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (Actual)
April 19, 2020
Primary Completion (Actual)
March 31, 2023
Study Completion (Actual)
March 31, 2023
Study Registration Dates
First Submitted
August 1, 2019
First Submitted That Met QC Criteria
August 1, 2019
First Posted (Actual)
August 2, 2019
Study Record Updates
Last Update Posted (Actual)
April 13, 2023
Last Update Submitted That Met QC Criteria
April 12, 2023
Last Verified
April 1, 2023
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- 043716
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
NO
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
No
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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