Army-SPRING Army-Suicide Prevention Research

Army-Suicide Prevention Research on Implementation in the National Guard (Army-SPRING)

Every unit in the Connecticut Army National Guard has a Suicide Intervention Officer to provide suicide intervention education awareness for their unit, monitor for soldiers in crisis and connect soldiers with helping resources and agencies. Suicide Intervention Officers need support in this difficult role, yet there is limited guidance on how to help them. This study will shed light on how to support Suicide Intervention Officers and whether this support results in reduced suicide risk in their units.

Study Overview

• Status: Recruiting
• Conditions: Suicide
• Intervention / Treatment: Behavioral: Risk Reduction Group (Control); Behavioral: Army-SPRING

Detailed Description

Attachment 4: Lay Abstract Objective 1: The first objective is to spend 6 months collecting feedback from Army National Guard Soldiers and their family, the religious affairs team, and leadership on how best to reduce risk for suicide. We will also collect feedback from Suicide Intervention Officers, who are appointed to reduce risk for suicide in their unit, about how to support these officers in their important work.

Objective 2: The second objective is to compare two strategies to support Suicide Intervention Officers as they work closely with soldiers to reduce their risk for suicide. The 47 Suicide Intervention Officers in the Connecticut Army National Guard will be randomly assigned (like the flip of a coin) to one of two groups. The first group will attend an extra training (Control Group). The second group will become part of a community focused on reducing suicide risk, including access to online forums to support them in their work, support in leading Battle Drills focused on suicide prevention, and additional training and consultation (Army-SPRING Group). Chaplains/religious affairs specialists will also receive the Army-SPRING group training, but will not be randomized since there are only 5 total Chaplains and 5 religious affairs specialists.

Objective 3: The third objective is to study whether soldiers with Suicide Intervention Officers in the Army-SPRING Group (described in objective 2) report lower rates of suicide ideation and attempts than the Control Group.

Rationale: Every unit in the Connecticut Army National Guard has a Suicide Intervention Officer to provide suicide intervention education awareness for their unit, monitor for soldiers in crisis and connect soldiers with helping resources and agencies. Suicide Intervention Officers need support in this difficult role, yet there is limited guidance on how to help them. This study will shed light on how to support Suicide Intervention Officers and whether this support results in reduced suicide risk in their units.

CBPR Approach and Implementation: We have formed a community advisory board that includes Veterans of Army National Guard units in other states (Pennsylvania); Veterans of the Army with employment as a civilian in the Marines, Chaplains in the Connecticut National Guard on the Air Force (who are intimately familiar with the needs at CT but who are not employees of the Army National Guard), and members of the Suicide Prevention Task force. We have asked for their feedback on the design of the study and will meet with them monthly for the three months and then quarterly thereafter.

FY23 TBIPHRP HSRA Focus Area: This project relates to the Prevent and Assess area of encouragement namely: "Development, evaluation, and implementation of crosscutting prevention approaches targeting upstream factors or leveraging communities and peers to address multiple adverse outcomes such as suicide." Types of Patients Helped by the Research and How it will Help Them: This research will help Army National Guard Soldiers, who are at higher risk for suicide than Active Duty service members. It will help them by supporting Suicide Intervention Officers as they work to reduce risk for suicide among soldiers.

Potential clinical applications, Benefits and Risks: The clinical application is a strategy to support Suicide Intervention Officers, which could benefit soldiers in reducing their suicide risk.

Projected timeline: 4 years, including 6 months of preparatory work with our community advisory board, who will also provide input throughout.

Health and well-being of Service Members: This will help the health and well-being of service members by reducing their risk for suicide. It will help Suicide Intervention Officers by improving their confidence in supporting soldiers who are struggling with suicide risk. It will help Chaplains/Religious affairs specialists who regularly desire more training in suicide prevention and who are a well-used source of support for soldiers at risk.

• Study Type: Interventional
• Enrollment (Estimated): 57
• Phase: Phase 1

Contacts and Locations

• Study Contact: Name: Lily A Brown, PhD; Phone Number: 215-746-3346; Email: lilybr@pennmedicine.upenn.edu
• Study Contact Backup: Name: Marin Kautz, PhD; Phone Number: 805-235-7100; Email: marin.kautz@pennmedicine.upenn.edu

Study Locations

• United States
  • Connecticut
    • Hartford, Connecticut, United States, 06103
      • Not yet recruiting
      • Connecticut Army National Guard
      • Contact: Laura Stamatien, BS; Phone Number: 860-391-3799; Email: laura.e.stamatien.mil@army.mil
    • New Haven, Connecticut, United States, 06520
      • Active, not recruiting
      • Yale University
  • Pennsylvania
    • Philadelphia, Pennsylvania, United States, 19104
      • Recruiting
      • Center for the Treatment and Study of Anxiety, University of Pennsylvania
      • Contact: Lily A Brown, PhD; Phone Number: 215-746-3346; Email: lilybr@pennmedicine.upenn.edu
      • Contact: Marin Kautz, PhD; Phone Number: 8052357100; Email: marin.kautz@pennmedicine.upenn.edu

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Serving as an SIO or chaplain/religious affairs specialist for a unit of the CTARNG
• Willing to provide informed consent.

Exclusion Criteria:

• None

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Health Services Research
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Placebo Comparator: Risk Reduction Group (Control); Risk Reduction Group is a mandated training from National Guard Service members	Behavioral: Risk Reduction Group (Control); Risk Reduction Group is a mandated training from National Guard Service members
Experimental: Army-SPRING; Army-SPRING includes a package of implementation options to support implementation of suicide prevention duties	Behavioral: Army-SPRING; Army-SPRING includes a package of implementation options to support implementation of suicide prevention duties

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Reach - Interactions with soldiers involving discussions about suicide risk	Number of soldier interactions reporting suicide risk/Total number of interactions with soldiers	Weekly for 1 year
Reach - Self	Use of suicide prevention services for self, URI-3 item 75	Year 1
Reach - Intervening for others	Use of suicide prevention services for buddy, URI-3 item 74	Year 1

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Suicidal ideation	URI-3 item 15	Year 1
Suicide plans:	URI-3 item 15a	Year 1
Suicide attempts	URI-3 item 15b	Year 1
Adoption	Suicide intervention officer willingness to initiate all SIO duties; This will be operationalized as the total number of SIOs who reported willingness to complete all their suicide prevention-related activities	Up to 24 months
Implementation	Fidelity to all assigned suicide intervention officer duties; Fidelity will be assessed using self-report by the SIO, including the following questions: 1) Does your battalion know that you are their SIO?; and 2) Have you completed any trainings related to suicide prevention with your battalion? Finally, among SIOs randomized to ARMY-SPRING, we will assess their fidelity of leading the battle drills in a manner consistent with suicide prevention principals.	Up to 24 months
Acceptability	Acceptability of Intervention Measure (AIM)	Up to 24 months
Appropriateness	Intervention appropriateness measure (IAM)	Up to 24 months
Qualitative Interviews	Qualitative Interviews (Acceptability, appropriateness, climate, etc.)	Up to 24 months

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Intentions, attitudes, norms	Theory of Planned Behavior Questionnaire	Baseline, quarterly, year 1, year 2
Organizational culture	We use the support subscale of the Implementation Leadership Scale to assess how leadership influences implementation outcomes. Organizational culture measures the culture and climate in their battalion, feasibility and acceptability of implementing suicide prevention tasks	Baseline, quarterly, year 1, year 2
Maintenance	Suicidal ideation: URI-3 item 15; Suicide plans: URI-3 item 15a	Up to 24 months

Collaborators and Investigators

• Sponsor: University of Pennsylvania
• Collaborators: Yale University
• Investigators: Principal Investigator: Ashley Hagaman, PhD, Yale University; Principal Investigator: Lily Brown, PhD, University of Pennsylvania

Study record dates

Study Major Dates

• Study Start (Actual): March 19, 2025
• Primary Completion (Estimated): September 1, 2027
• Study Completion (Estimated): August 1, 2028

Study Registration Dates

• First Submitted: July 11, 2024
• First Submitted That Met QC Criteria: August 6, 2024
• First Posted (Actual): August 9, 2024

Study Record Updates

• Last Update Posted (Actual): October 20, 2025
• Last Update Submitted That Met QC Criteria: October 14, 2025
• Last Verified: October 1, 2025

More Information

Terms related to this study

• Keywords: suicide; military
• Additional Relevant MeSH Terms: Behavioral Symptoms; Self-Injurious Behavior; Behavior; Suicide
• Other Study ID Numbers: 855941

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: We will upload data into the NIMH Data Archives every 6 months.
• IPD Sharing Time Frame: Each 6 months once official data collection begins.
• IPD Sharing Access Criteria: Determined by the NIMH
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL; SAP; ICF; ANALYTIC_CODE; CSR

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No