Development of a Family-Based, Post-Deployment Intervention

说明（由申请人提供）：随着在伊拉克和阿富汗的军事行动继续进行，从这些战区返回的军事人员人数正在增加。军事人员在部署后返回家园，面临各种心理社会功能障碍和精神症状的重大风险。此外，回国军事人员的家庭成员，特别是婚姻/恋爱伙伴也经历了严重的痛苦和损害。相对较少的研究侧重于在未选择的返回军事人员样本中减少这些损害，以前也没有研究特别侧重于返回人员家庭制度的干预努力。该项目旨在通过为返回的军事人员及其伙伴制定一项简短、易于管理、以家庭为基础的干预措施来满足这些需求。更具体地说，目前的项目建议调整家庭干预电话跟踪（FITT）干预措施，该干预措施以前是为了促进经历其他类型重大过渡事件的患者和配偶的适应而开发的，适用于战区部署后返回家园的士兵和海军陆战队员的过渡。按照目前的概念，这种经过调整的家庭干预电话跟踪-部署调整（fit - dr）将包括与这对夫妇的一次会面，然后给返回的人员及其伴侣打一系列电话。这些呼吁将侧重于监测和解决被确定为归国军事人员及其重要人员面临的重要问题的具体领域的问题。更具体地说，本提案的总体目标是进一步发展FITT-DR干预措施，并收集有关该干预计划有效性的初步数据。我们建议：1。为FITT-DR干预制定一份全面和临床相关的手册。2. 制定、实施和评估供应商培训计划。3. 开发和测试依从性和能力评级量表的可靠性和有效性，以评估提供者对干预手册的依从性及其提供干预的能力。4. 在回国军事人员及其伴侣的样本中开展一项随机对照试点研究，以：a)评估拟议干预措施的可行性和可接受性，以及b)估计FITT-DR与常规治疗相比的效果大小，减少：a)心理社会功能障碍和b)精神症状。这项初步研究将为更大规模的临床试验奠定基础，以评估这种新的干预措施对退伍军人的影响。

DESCRIPTION (provided by applicant): With the continuing military engagements in Iraq and Afghanistan, the number of returning military personnel from these war zones is increasing. Military personnel returning home following deployment are at significant risk for a wide variety of impairments in psychosocial functioning and psychiatric symptoms. In addition, family members of returning military personnel, and particularly marital/romantic partners also experience significant levels of distress and impairment. Relatively few studies have focused on reduction of these impairments among unselected samples of returning military personnel, and no previous study has specifically focused intervention efforts on the family system of returning personnel. This project seeks to address these needs by developing a brief, easily administered, family-based intervention for returning military personnel and their partners. More specifically, the current project proposes to adapt the Family Intervention Telephone Tracking (FITT) intervention, previously developed to facilitate adaptation among patients and spouses experiencing other types of major transitional events, to the transition of soldiers and marines returning home following war zone deployment. As currently conceptualized, this adapted intervention Family Intervention Telephone Tracking-Deployment Readjustment (FITT-DR) will consist of 1 meeting with the couple followed by a series of telephone calls to the returning personnel and his/her partner. These calls will focus on monitoring and problem-solving targeted to specific areas identified as important issues facing returning military personnel and their significant others. More specifically, the overall aim of this proposal is to further develop the FITT-DR intervention and to collect preliminary data on the efficacy of this intervention program. We propose to: 1. Develop a comprehensive and clinically relevant manual for the FITT-DR intervention. 2. Develop, implement and evaluate a provider training program. 3. Develop and test the reliability and validity of adherence and competence rating scales to evaluate providers' adherence to the intervention manual and their competence in delivering the intervention. 4. Conduct a randomized controlled pilot study in a sample of returning military personnel and their partners to: a) assess the feasibility and acceptability of the proposed intervention, and b) to provide an estimate of effect size of the efficacy of FITT-DR in comparison to treatment as usual reducing: a) impairments in psychosocial functioning and b) psychiatric symptoms. This pilot study will lay the groundwork for a larger clinical trial evaluating this new intervention for returning military personnel.