The present study evaluated two relapse-prevention interventions intended to help women smokers maintain the "quit status" mandated during Navy basic training. Women with any smoking experience before entering the Navy (N = 2,781) were assigned to either a control group or to one of two intervention groups (access to a telephone help line or receive a series of monthly mailings) after graduating from basic training. Smoking/quit rates at 3, 6, and 12 months after graduation were assessed with mailed surveys. Response rates to the surveys ranged from 39% to 52%. There were no phone or mail intervention effects: cessation rates for the three conditions at the 12-month follow-up were 43% for control, 45% for the mail intervention, and 41% for the phone intervention. Results suggest the need for more aggressive relapse-prevention efforts, although quit rates were higher than expected "spontaneous" quit rates, indicating an impact of the totally smoke-free recruit training environment.
The use of Web-based programs for a variety of health education, risk reduction, and health promotion purposes can be a valuable tool in the effort to improve the health of a population. Providing theory-based personalized feedback through such a method can be particularly useful in alcohol misuse prevention efforts. A brief alcohol use feedback program was developed for members of the U.S. Marine Corps, and user-satisfaction ratings were collected from 167 participants. Approximately 44% of the sample found the program to be useful or very useful, and 46% of the sample reported that they were likely or very likely to recommend the Web site to others. The Web-based format with tailored responses was preferred by 85% of respondents over other more traditional methods of alcohol training, and 80% of participants felt that the feedback was appropriate for Marines in their community. Significantly higher usefulness, likelihood of recommending the program to others, and overall ratings of the program were reported among younger and nonheavy-drinking participants (p < .05). Results indicate that this computerized assessment and feedback program is a promising mechanism with which to provide personalized alcohol misuse prevention information.
Although there is significant need for mental health care among service members, stigma surrounding these services, along with myths associated with behavioral health treatment, discourages care seeking. This study evaluated the effect of a video designed to demystify mental health treatment on barriers to seeking care among military personnel.Methods: Participants were 294 active duty U.S. Marine Corps personnel who were randomly assigned to the intervention video only, the intervention video with discussion, or an attentional control video. Participants completed questionnaires that assessed social stigma regarding mental health treatment and willingness to seek help at pretest, posttest, and 6-week follow-up; personal desire for mental health care was assessed at pretest and 6-week follow-up.Results: Participants who viewed the intervention video in either condition showed significant and similar decreases in social stigma and increases in willingness to seek help at posttest (p,.001), whereas participants in the control group showed no change at posttest in either variable. Although social stigma did not differ by intervention group at the 6-week follow-up, participants in either intervention were 2.56 times more likely than participants in the control group to report a personal desire for mental health care at the 6-week follow-up (p=.05). There were no significant differences between the two interventions on the main outcomes. Conclusions:A video in which mental health care providers explain the treatment process may be effective as an initial stand-alone social stigma reduction intervention. Additional efforts are likely needed to sustain effects and to realize increases in help-seeking behavior.
Introduction Sleep disturbance is prevalent among service members; however, little is known about factors that compromise sleep in unique operational environments, such as naval ships. Given the importance of sleep to health and performance, it is critical to identify both causes and potential solutions to this serious issue. The objective of this qualitative study was to elucidate the barriers to sleep and the strategies service members use to improve their sleep and combat fatigue while living and working aboard ships (i.e., underway). Methods and Materials Interviews were conducted with 22 active duty service members assigned to sea duty. The semi-structured interview guide assessed the experiences of service members sleeping in shipboard environments. Interview transcripts were analyzed using applied thematic content analysis by two independent coders. Results Participants were largely male (77.8%) and enlisted (88.9%). The most common barrier to obtaining sufficient sleep was stress, followed by rotating schedules, and environmental factors (e.g., noise and light). Additionally, many participants reported prioritizing other activities over sleep when off duty. Many participants did not report using any specific strategies to improve their sleep while underway. Among those who did, most described mitigating environmental barriers (e.g., noise-cancelling headphones or sleep masks). However, some participants also acknowledged these strategies are not always feasible, either attributable to cost or because sailors must be able to respond to alarms or commands. Notably, few sailors reported using stress mitigation or relaxation strategies to help sleep. Ingesting caffeine was the only strategy sailors reported using to alert themselves while fatigued. Conclusions Service members reported many unique barriers to sleep in the shipboard environment, yet many did not report the use of strategies to mitigate them. Further, few used alerting techniques when fatigued. This at-risk population could benefit from targeted educational interventions on sleep-promoting behaviors, prioritization of sleep, and fatigue mitigation.
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