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Geraci JC, Dichiara A, Greene A, Gromatsky M, Finley E, Kilby D, Frankfurt S, Edwards ER, Kurz AS, Sokol Y, Sullivan SR, Mobbs M, Seim RW, Goodman M. Supporting servicemembers and veterans during their transition to civilian life using certified sponsors: A three-arm randomized controlled trial. Psychol Serv 2023; 20:248-259. [PMID: 37384439 PMCID: PMC10755060 DOI: 10.1037/ser0000764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/01/2023]
Abstract
Transitioning servicemembers and veterans (TSMVs) face difficulties throughout their reintegration to civilian life, including challenges with employment, poor social connection, and elevated risk for suicide. To meet the needs of this high-risk population, national initiatives have leveraged community-based interventions. Authors conducted a three-arm randomized controlled trial (n = 200) to evaluate two community-based interventions. The first, Team Red, White, and Blue (RWB), connects TSMVs to their community through physical/social activities. The second, Expiration Term of Service Sponsorship Program (ETS-SP) provides one-on-one certified sponsors to TSMVs who provide support during the reintegration process. TSMVs were assessed at baseline, 3, 6, and 12 months. The primary hypothesis was not supported as reintegration difficulties and social support were not significantly different for participants randomly assigned to the two community-based interventions (Arm-2/RWB and Arm-3/RWB + ETS-SP), when the data from the separate arms were collapsed and combined, compared to the waitlist. The results did support the secondary hypothesis as Arm-3/RWB + ETS-SP had less reintegration difficulties over 12 months and initially had more social support compared to Arm-2/RWB, which suggest that augmenting interventions with sponsors outperforms participation in community-based interventions alone. Overall, the results show some limitations of the studied community-based interventions, as implemented and researched within this study. The authors identified factors that may have contributed to the null findings for the primary hypothesis, which can be addressed in future studies, such as addressing the unique needs of TSMVs, enrolling TSMVs into interventions prior to military discharge, measuring and improving participation levels, and providing stepped-care interventions based on risk levels. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Joseph C. Geraci
- Transitioning Servicemember/Veteran And Suicide Prevention Center (TASC), VISN 2 Mental Illness Research, Education and Clinical Center, James J. Peters VA Medical Center, Bronx, NY
- Center of Excellence for Research on Returning War Veterans, VISN 17, Doris Miller VA Medical Center, Waco, TX
- Resilience Center for Veterans & Families, Teachers College, Columbia University, NY, NY
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Ariana Dichiara
- Transitioning Servicemember/Veteran And Suicide Prevention Center (TASC), VISN 2 Mental Illness Research, Education and Clinical Center, James J. Peters VA Medical Center, Bronx, NY
| | - Ashley Greene
- Transitioning Servicemember/Veteran And Suicide Prevention Center (TASC), VISN 2 Mental Illness Research, Education and Clinical Center, James J. Peters VA Medical Center, Bronx, NY
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Molly Gromatsky
- Transitioning Servicemember/Veteran And Suicide Prevention Center (TASC), VISN 2 Mental Illness Research, Education and Clinical Center, James J. Peters VA Medical Center, Bronx, NY
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Erin Finley
- Center of Excellence for Research on Returning War Veterans, VISN 17, Doris Miller VA Medical Center, Waco, TX
- Center for the Study of Healthcare Innovation, Implementation, and Policy (CSHIIP), VA Greater Los Angeles Healthcare System
| | - Daniel Kilby
- Transitioning Servicemember/Veteran And Suicide Prevention Center (TASC), VISN 2 Mental Illness Research, Education and Clinical Center, James J. Peters VA Medical Center, Bronx, NY
- Resilience Center for Veterans & Families, Teachers College, Columbia University, NY, NY
| | - Sheila Frankfurt
- Center of Excellence for Research on Returning War Veterans, VISN 17, Doris Miller VA Medical Center, Waco, TX
- Central Texas Veterans Healthcare System, Temple, TX
| | - Emily R. Edwards
- Transitioning Servicemember/Veteran And Suicide Prevention Center (TASC), VISN 2 Mental Illness Research, Education and Clinical Center, James J. Peters VA Medical Center, Bronx, NY
- Department of Psychiatry, Yale School of Medicine, New Haven, CT
| | - A. Solomon Kurz
- Center of Excellence for Research on Returning War Veterans, VISN 17, Doris Miller VA Medical Center, Waco, TX
| | - Yosef Sokol
- Transitioning Servicemember/Veteran And Suicide Prevention Center (TASC), VISN 2 Mental Illness Research, Education and Clinical Center, James J. Peters VA Medical Center, Bronx, NY
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Sarah R. Sullivan
- Transitioning Servicemember/Veteran And Suicide Prevention Center (TASC), VISN 2 Mental Illness Research, Education and Clinical Center, James J. Peters VA Medical Center, Bronx, NY
| | - Meaghan Mobbs
- Transitioning Servicemember/Veteran And Suicide Prevention Center (TASC), VISN 2 Mental Illness Research, Education and Clinical Center, James J. Peters VA Medical Center, Bronx, NY
| | - Richard W. Seim
- Center of Excellence for Research on Returning War Veterans, VISN 17, Doris Miller VA Medical Center, Waco, TX
| | - Marianne Goodman
- Transitioning Servicemember/Veteran And Suicide Prevention Center (TASC), VISN 2 Mental Illness Research, Education and Clinical Center, James J. Peters VA Medical Center, Bronx, NY
- Center of Excellence for Research on Returning War Veterans, VISN 17, Doris Miller VA Medical Center, Waco, TX
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY
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Geraci JC, Mobbs M, Edwards ER, Doerries B, Armstrong N, Porcarelli R, Duffy E, Loos CM, Kilby D, Juanamarga J, Cantor G, Sutton L, Sokol Y, Goodman M. Expanded Roles and Recommendations for Stakeholders to Successfully Reintegrate Modern Warriors and Mitigate Suicide Risk. Front Psychol 2020; 11:1907. [PMID: 32973608 PMCID: PMC7471060 DOI: 10.3389/fpsyg.2020.01907] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 07/10/2020] [Indexed: 11/13/2022] Open
Abstract
This article draws upon the legends of warriors from ancient Greece and other traditions to illuminate the journey of Modern Warriors (MWs) who have served in the United States military over the last century. It then turns to stakeholders that can assist current MWs in their reintegration to civilian life and mitigate suicide risk. Until this point, without an existing and coordinated local, federal, non-profit, and private system, rates of suicide for post-9/11 MWs after leaving the military have greatly increased, especially for young and women MWs. This is due in part to the military satisfying many of MWs’ needs by providing units, leaders, and a mission during the Departure and Initiation stages of the MW journey. However, as MWs exit the military and face the difficult task of reintegration, the absence of units, leaders, and mission leads to deteriorating psychological health and increasing suicide risk. Written primarily by post-9/11 MWs, this article proposes recommendations for stakeholders to better reintegrate MWs and mitigate suicide risk. The authors strive to develop a system that satisfies MWs’ reintegration needs and enables MWs to be well positioned to continue their next ‘mission’ – to serve and improve society.
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Affiliation(s)
- Joseph C Geraci
- Transitioning Servicemember/Veteran and Suicide Prevention Center, VISN 2 Mental Illness Research, Education and Clinical Center, James J. Peters VA Medical Center, The Bronx, NY, United States.,Resilience Center for Veterans and Families, Teachers College, Columbia University, New York City, NY, United States.,Institute for Veterans and Military Families, Syracuse University, Syracuse, NY, United States
| | - Meaghan Mobbs
- Resilience Center for Veterans and Families, Teachers College, Columbia University, New York City, NY, United States
| | - Emily R Edwards
- Transitioning Servicemember/Veteran and Suicide Prevention Center, VISN 2 Mental Illness Research, Education and Clinical Center, James J. Peters VA Medical Center, The Bronx, NY, United States
| | - Bryan Doerries
- Theater of War Productions, New York City, NY, United States
| | - Nicholas Armstrong
- Institute for Veterans and Military Families, Syracuse University, Syracuse, NY, United States
| | | | - Elana Duffy
- Pathfinder.vet, New York City, NY, United States
| | | | - Daniel Kilby
- Transitioning Servicemember/Veteran and Suicide Prevention Center, VISN 2 Mental Illness Research, Education and Clinical Center, James J. Peters VA Medical Center, The Bronx, NY, United States.,Resilience Center for Veterans and Families, Teachers College, Columbia University, New York City, NY, United States
| | - Josephine Juanamarga
- Resilience Center for Veterans and Families, Teachers College, Columbia University, New York City, NY, United States
| | - Gilly Cantor
- Institute for Veterans and Military Families, Syracuse University, Syracuse, NY, United States
| | - Loree Sutton
- NYC Department of Veterans' Services, New York City, NY, United States
| | - Yosef Sokol
- Transitioning Servicemember/Veteran and Suicide Prevention Center, VISN 2 Mental Illness Research, Education and Clinical Center, James J. Peters VA Medical Center, The Bronx, NY, United States
| | - Marianne Goodman
- Transitioning Servicemember/Veteran and Suicide Prevention Center, VISN 2 Mental Illness Research, Education and Clinical Center, James J. Peters VA Medical Center, The Bronx, NY, United States
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Abstract
During routine inhalation toxicity studies, microscopic examination of tissues from lungs which have shown small, but statistically significant increases, in organ weight has failed to show evidence of any pathological change. Historically, increases, thought to be due to mild oedema, have been difficult to identify microscopically. A method suitable for dealing with large numbers of rodents has been developed, which can detect microscopically changes associated with small increases in lung weight. The lungs were inflated with formalin vapour and fixed in 10% buffered formalin. Histological processing methods were varied to obtain the best demonstration of oedema. Fixation methods were compared using alpha-naphthylthiourea-induced oedematous lungs. The left lobe was inflated with formalin vapour and the rest of the lung was distended with 10% buffered formalin. The best demonstration of oedema followed formalin vapour fixation. Evidence of oedema, indicated by lung weight increases of approximately 10%, was seen microscopically in formalin-vapour-fixed lungs, but was not seen in the lobes distended with 10% buffered formalin. Application of this technique to other species including cats and dogs has also proved successful.
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