Life Skills Training for Soldiers Arriving at Their First Duty Location

SAFEGUARD: Life Skills Training for Soldiers Arriving at Their First Duty Location

This project will evaluate the effectiveness of Level Up: Boost Your Life Skills ("Level Up"), a strengths based, military-specific life skills training program. The goal is to determine whether Level Up can decrease suicidal-related behaviors (SRBs) and other harmful behaviors, improve mental health, enhance job performance, and reduce early military separation. The Level Up program components will be made available to participants through an online platform or mobile app that can be downloaded onto their personal mobile devices. These training materials will help Soldiers learn and practice skills. The Level Up program will also involve personalized messages from a Level Up trainer and virtual booster sessions. Soldiers arriving at their first duty location will be randomized to receive either Level Up or a single session Army bystander intervention program. Participants will complete baseline and follow up surveys 1, 3, and 6 months post-baseline.

Study Overview

• Status: Recruiting
• Conditions: Mental Health; Resilience; Risk Reduction Behavior; Suicide Prevention; Performance at Work; Risky Behavior
• Intervention / Treatment: Behavioral: Level Up; Behavioral: ENGAGE

Detailed Description

Suicide remains a leading cause of death among Soldiers, especially those 17-24 years old in their first year of military service. This time is also marked by high rates of other harmful behaviors and of early separation from the Army. The Army invests billions of dollars in recruiting and training, yet many new Soldiers leave the service early or experience serious events like suicidal behaviors. Exposure to situational stressors involving such areas of life as romantic relationships and finances increases risk for suicide and other harmful behaviors. Implementing universal training programs to prevent these types of negative outcomes before they arise have enormous potential to bolster the mental toughness of new Soldiers during this difficult transition. The proposed project aims to prevent suicide-related behaviors (SRBs) and other behaviors qualifying for a Serious Incident Report (SIR) through an innovative, universal life skills program delivered at a critical transition point in Soldiers' careers-their first duty assignment. By focusing on this particularly high-risk period, this project seeks to reduce SRBs and related harmful behaviors among U.S. Army Soldiers. The proposed project will test the effectiveness of a recently developed, evidence-based training program designed to build life skills and coping strategies that can protect against suicide, other harmful behaviors, poor work performance, and premature separation during a Soldier's first duty assignment.

This project will evaluate the effectiveness of Level Up, a strengths based, military-specific life skills training program. The goal is to determine whether Level Up can decrease suicidal thoughts and behaviors, improve mental health, enhance job performance, and reduce early military separation. Previous studies show that building skills like stress management, problem-solving, and healthy communication can protect against SRBs and related problem behaviors. However, many of these programs failed to show long-term impact, partly due to limited engagement. Level Up is designed to overcome these limitations by combining interactive learning, mobile technology, personalized coaching, and on-demand virtual booster sessions. This hybrid format is intended to help Soldiers refresh their skills and engage with content at their preferred pace and rhythm. The Level Up program components include: 1) a 90-minute live group session during Soldiers' in-processing week at their first duty station, 2) a mobile app/online platform/workbook with brief, interactive self-guided exercises in core skill areas (e.g., managing stress, tactical thinking, healthy relationships), 3) personalized coaching via messages from trained staff during the first month of app use, and 4) virtual booster sessions over one year, focused on practical domains like finances, leadership, promotion tips, and personal relationships. Soldiers will be randomized to receive either Level Up or Engage, an existing single session Army bystander intervention program that will serve as a comparison training.

The Level Up program content draws from evidence-based psychological methods such as Cognitive Behavioral Therapy, Acceptance and Commitment Therapy, and motivational coaching adapted to fit military culture and tailored to be relevant, accessible, and engaging for newly assigned junior-ranking Soldiers, a group at high risk for suicide and other serious behavioral issues. By equipping them with essential life skills and support during their first year of service, the program aims to reduce SRBs and other behaviors qualifying for SIRs, develop psychosocial skills, and increase career success and satisfaction.

If effective, Level Up could be implemented Army-wide as a universal prevention program to improve mental health, readiness, and retention. There are minimal risks as the interventions are educational, although some participants may experience brief emotional discomfort during skill practice or reflection. All participants can opt out at any time, and all are provided with resources and additional support as needed. This study could have a transformative impact on military suicide prevention efforts, especially during early service when Soldiers are most vulnerable. By evaluating this scalable program in a large, real-world setting, the research will provide clear evidence about its benefits for reducing suicide and improving readiness. Results will also support development of predictive tools to identify which Soldiers may benefit most from added support. Findings will be shared across the Department of Defense to inform policy, training, and future resilience-building programs-ultimately improving the health, performance, and quality of life of Soldiers across the Force.

• Study Type: Interventional
• Enrollment (Estimated): 5000
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Life Skills Study Team; Phone Number: 301-295-9711; Email: life-skills-study-ggg@usuhs.edu

Study Locations

• United States
  • Texas
    • Fort Hood, Texas, United States, 76544
      • Recruiting
      • Fort Hood Installation Reception Center
      • Contact: Fort Hood Installation Reception Center; Phone Number: 254-449-3976; Email: pcsfortcavazos@army.mil

Participation Criteria

Eligibility Criteria

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

Description

Inclusion Criteria:

• Active duty Soldiers arriving at a military installation located in the South Central U.S. for their first duty location who are attending reception center activities

Exclusion Criteria:

• Soldiers who are not available to attend the in-person training
• Soldiers who are under the age of 18 years old
• Soldiers who do not have a smart phone that supports installation of the mobile app

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Level Up Program; The Level Up program is a hybrid intervention combining interactive learning, mobile/online technology, personalized coaching, and on-demand virtual booster sessions. The evidence-based training program was designed to build life skills and coping strategies that can protect against suicide, other harmful behaviors, poor work performance, and premature separation during a Soldier's first duty assignment.	Behavioral: Level Up; The Level Up program components include: A 90-minute live group session during Soldiers' in-processing week at their first duty station; A mobile app/online platform/workbook with brief, interactive self-guided exercises in core skill areas (e.g., managing stress, tactical thinking, healthy relationships); Personalized coaching via messages from trained Level Up staff during the first month of app use; Virtual booster sessions over one year, focused on practical domains like finances, leadership, promotion tips, and personal relationships; Other Names: Life Skills
Active Comparator: ENGAGE Training; ENGAGE is an existing single session Army bystander intervention program. The training program is based on bystander intervention and prosocial behavior research.	Behavioral: ENGAGE; ENGAGE training is a single 90-minute workshop aimed at developing leadership skills and confidence in handling professional and personal confrontations.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
The occurrence of any harmful behavior	The occurrence of any harmful behavior, either self-reported in follow up surveys or administratively reported	Within the 12 months after intervention randomization
The occurrence of any suicide-related behavior	The occurrence of any suicide-related behavior, either self-reported in follow up surveys or administratively reported	Within the 12 months after intervention randomization

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
The occurrence of any premature separations from service		Within the 12 months after intervention randomization
Poor performance as indicated either by written reprimands, designations in the NCOER, a corrective action plan, remedial training, flagging actions, demotion, Article 15, or barred reenlistment		Within the 12 months after intervention randomization
Personal deployment readiness	Walter Reed Army Institute of Research Land Combat Survey; Scale ranges from 4-20; Higher scores indicate higher perceived readiness	Within the 6 months after intervention randomization
Emotionality	Emotion Reactivity Scale (ERS) ; Scale ranges from0-4; Higher scores indicate higher of each maladaptive trait	Within the 6 months after intervention randomization
Job satisfaction	3-item Job Satisfaction Scale; Scale ranges from 3-15; Higher scores indicate higher perceived job satisfaction	Within the 6 months after intervention randomization
Depression symptom severity	Patient Health Questionnaire-2 (PHQ-2); Scale ranges from 0-8; Higher scores indicate more severe symptoms	Within the 6 months after intervention randomization
Anxiety symptom severity	Generalized Anxiety Disorder-2 (GAD-2); Scale ranges from 0-8; Higher scores indicate more severe symptoms	Within the 6 months after intervention randomization
Incidence of traumatic brain injuries	Number of traumatic brain injuries; based on the Army STARRS Surveys; No scale range; number indicates greater number of traumatic brain injuries	Within the 6 months after intervention randomization
Lifetime history of various mental/emotional health problems	Family History Screen (FHS); Scale ranges from 0-1; 0=No; 1=Yes	Within the 6 months after intervention randomization
Chronic stress severity	Personal Life Stress Scale (PLS); Scale ranges from 0-50; Higher scores indicate greater chronic stress severity	Within the 6 months after intervention randomization
Mental toughness	Sports Mental Toughness Questionnaire (SMTQ); Scale ranges from 5-25; Higher scores indicate higher confidence & constancy	Within the 6 months after intervention randomization
History of suicidal ideation, plan, & attempt	Columbia-Suicide Severity Rating Scale (C-SSRS) Full scale Baseline/Screening; Scale ranges from 0-1 0=No; 1=Yes	Within the 6 months after intervention randomization
Positive social networks	Supportive & Negative Social Interaction Scale (SIS); Scale ranges from 0-8; Higher scores indicate more positive/negative social support	Within the 6 months after intervention randomization
Negative social networks	Supportive & Negative Social Interaction Scale (SIS); Scale ranges from 0-8; Higher scores indicate more positive/negative social support	Within the 6 months after intervention randomization
Mattering/belonging	General Mattering Scale; Scale ranges from 0-20; Higher scores indicate higher perceived mattering to others	Within the 6 months after intervention randomization
Loneliness	3-Item Loneliness Screener; Scale ranges from 0-16; Higher scores indicate more frequency-severity of loneliness	Within the 6 months after intervention randomization
Adverse childhood events & trauma	Childhood Trauma Questionnaire - Short Form (CTQ-SF) ; Scale ranges from 0-44; Higher scores indicate more childhood maltreatment	Within the 6 months after intervention randomization
Conscientiousness	Big Five Inventory (BFI)16 & Personality Inventory for DSM-5 Brief Form (PID-5-BF); Scale ranges from 0-8; Higher scores indicate lower of each adaptive trait	Within the 6 months after intervention randomization
Mastery	Pearlin & Schooler's Psychological Coping Resources Measure; Scale ranges from 0-8; Higher scores indicate lower of each adaptive trait	Within the 6 months after intervention randomization
Openness	120-item International Personality Item Pool (IPIP); Scale ranges from 0-4; Higher scores indicate lower of each adaptive trait	Within the 6 months after intervention randomization
Problem-solving ability	Social Problem Solving Inventory-Revised (SPSI-R); Scale ranges from 0-8; Higher scores indicate lower of each adaptive trait	Within the 6 months after intervention randomization
Psychological well-being	Flourishing Scale; Scale ranges from 0-12; Higher scores indicate lower of each adaptive trait	Within the 6 months after intervention randomization
Resilience	Army STARRS Resilience Scale; Scale ranges from 0-16; Higher scores indicate lower of each adaptive trait	Within the 6 months after intervention randomization
Self-esteem	Rosenberg Self-Esteem Scale; Scale ranges from 0-8; Higher scores indicate lower of each adaptive trait	Within the 6 months after intervention randomization
Anxious, Cyclothymic, Depressive, & Hyperthymic temperament	Revised NEO Personality Inventory (NEO-PI-R) & the Temperament Evaluation of Memphis, Pisa, Paris & San Diego-autoquestionnaire version (TEMPS-A); Scale ranges from 0-8 for each temperament; Higher scores indicate higher of each maladaptive trait	Within the 6 months after intervention randomization
Borderline personality	McLean Screening Instrument for Borderline Personality Disorder; Scale ranges from 0-16; Higher scores indicate higher of each maladaptive trait	Within the 6 months after intervention randomization
Anger-hostility	Big Five Inventory (BFI)16 & Personality Inventory for DSM-5 Brief Form (PID-5-BF); Scale ranges from 0-8; Higher scores indicate higher of each maladaptive trait	Within the 6 months after intervention randomization
Impulsivity/negative urgency	Impulsive Behavior Scale - Short Form (SUPPS-P); Scale ranges from 0-8; Higher scores indicate higher of each maladaptive trait	Within the 6 months after intervention randomization
Introversion	Eysenck Personality Questionnaire - Brief Version (EPQ-BV)28 & Revised NEO Personality Inventory (NEO-PI-R); Scale ranges from 0-8; Higher scores indicate higher of each maladaptive trait	Within the 6 months after intervention randomization
Fearlessness about death	Acquired Capability for Suicide Scale; Scale ranges from 0-4; Higher scores indicate higher of each maladaptive trait	Within the 6 months after intervention randomization
Self-conscious	Widiger Five-Factor Rating Form - Revised31 & NEO Five-Factor Inventory (NEO-FFI); Scale ranges from 0-8; Higher scores indicate higher of each maladaptive trait	Within the 6 months after intervention randomization
Vulnerability	NEO Five-Factor Inventory (NEO-FFI); Scale ranges from 0-4; Higher scores indicate higher of each maladaptive trait	Within the 6 months after intervention randomization
Frequency of risky behaviors	Unit Risk Inventory (URI); Scale ranges from 0-1; 0=Never; 1=At least less than once a month	Within the 6 months after intervention randomization

Collaborators and Investigators

• Sponsor: Uniformed Services University of the Health Sciences
• Collaborators: Massachusetts General Hospital; Beth Israel Deaconess Medical Center; University of Michigan; Walter Reed Army Institute of Research (WRAIR); Harvard University; Henry M. Jackson Foundation for the Advancement of Military Medicine; Defense Health Agency
• Investigators: Principal Investigator: Thomas H Nassif, PhD, Uniformed Services University of the Health Sciences

Study record dates

Study Major Dates

• Study Start (Actual): December 10, 2025
• Primary Completion (Estimated): July 1, 2028
• Study Completion (Estimated): July 1, 2029

Study Registration Dates

• First Submitted: December 3, 2025
• First Submitted That Met QC Criteria: December 3, 2025
• First Posted (Estimated): December 16, 2025

Study Record Updates

• Last Update Posted (Actual): January 13, 2026
• Last Update Submitted That Met QC Criteria: January 9, 2026
• Last Verified: December 1, 2025

More Information

Terms related to this study

• Keywords: Prevention; Suicide Prevention; Risk Reduction; Military Health; Active-duty Military; Harmful Behaviors; Life Skills Training; First Duty Location; Level Up
• Additional Relevant MeSH Terms: Behavioral Symptoms; Self-Injurious Behavior; Suicide; Behavior; Personal Satisfaction; Suicide Prevention; Psychological Well-Being; Risk Reduction Behavior; engage 8200
• Other Study ID Numbers: USUHS.2025-162; Federal Award # HU00012520025 (Other Grant/Funding Number: Office of the Assistant Secretary of Defense for Health Affairs)

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