Combat Disorders, Military Spouses, Stress Disorders, Support Groups
Conditions
Keywords
spouses, social support, reintegration, families, military, post deployment, OEF/OIF
Brief summary
This study will expand the Department of Defense (DoD) one time, face-to-face post deployment BATTLEMIND training for spouses of Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) Guard/Reserve service members into year-long, telephone groups focusing on education, skills building and support. The goal is to build spouses' resilience to cope with reintegration, help them serve as a support system for returning service members, and ease the transition for families post-deployment.
Interventions
BEHAVIORALTelephone support groups
There was one intervention. Participants were enrolled in one of 14 telephone groups (each with a trained Group Leader and 6 participants) will focus on education, training in and practice of coping skills and cognitive restructuring (identifying and re-shaping negative and destructive thoughts), and support through 12 hour-long structured sessions. The content, modeled on Soldier BATTLEMIND, targets readjustment concepts based on the letters of BATTLEMIND, including Bonds, Adding and subtracting family roles, Taking control, Talking it out, Loyalty and commitment, Emotional balance, Mental health and readiness, Independence and interdependence, Navigating the system, Denial of self and a concluding session entitled Moving forward.
Sponsors
United States Department of Defense
Memphis VA Medical Center
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Healthy volunteers
No
Inclusion criteria
1. have a spouse who participated in OEF/OIF and is at least 1 month post-deployment; 2. if not married, must have lived as married for at least one year; 3. live with the service member when not deployed; 4. have been a spouse/significant other throughout the service member's deployment period; 5. and have a telephone.
Exclusion criteria
1. current diagnosis of schizophrenia or other major mental illness; 2. auditory impairment that would make telephone use difficult; or 3. service member refusal of assent for spouse to participate.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Spouse Self-report of Depression | Baseline, 6 months, and 12 months | Depression measured with the Patient Health Questionnaire (PHQ)-9 at baseline, six and 12 months. Scores range from 0-27 with lower scores indicating less depressive symptoms. |
| Anxiety | baseline, 6 months and 12 months | Anxiety measured with the Generalized Anxiety Disorder -7 (GAD-7)measured at baseline, six and 12 months. Scores range from 0-21, with lower scores indicating fewer anxiety symptoms. |
| Quality of Marriage | Baseline, 6 and 12 months | Measure of marriage quality using Quality Marriage Index at baseline, six and 12 months. Scores range from 6-45 with higher scores indicating better quality of marriage. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Family Coping | Baseline, 6 months and 12 months | Family problem solving measured at baseline, six and 12 months with the F-COPES measure. Scores range from 29-145 with higher scores indicating better coping. |
| Spouse Social Support | baseline, 6 months, and 12 months | Support measured with the Social Support Index at baseline, six and 12 months. Scores range from 0-68 with higher scores indicating better social support. |
| Family Communication | baseline, 6 months, and 12 months | Family communication measured with the Family Problem Solving Communication scale at baseline, six and 12 months. Scores range from 0-30 with higher scores indicating better communication. |
Countries
United States
Participant flow
Recruitment details
April 2009 - January 2010 and April 2010 - June 2010. There were 86 spouses enrolled in 14 groups. Spouses were recruited nationally through online methods such as websites and emails, mailings, and referrals from military, advocacy groups and veterans facilities. Twenty-six were referrals from the national Wounded Warrior Project office.
Participants by arm
| Arm | Count |
|---|---|
| Telephone Support 12 telephone support groups based on the letters of the word BATTLEMIND
Telephone support groups : 12 hour-long structured telephone groups (each with a trained Group Leader and 6 participants) will focus on education, training in and practice of coping skills and cognitive restructuring (identifying and re-shaping negative and destructive thoughts), and support. The content, modeled on Soldier BATTLEMIND, targets readjustment concepts based on the letters of BATTLEMIND. | 86 |
| Total | 86 |
Baseline characteristics
| Characteristic | Telephone Support |
|---|---|
| Age, Continuous | 37.4 years STANDARD_DEVIATION 9 |
| Region of Enrollment United States | 86 participants |
| Sex: Female, Male Female | 86 Participants |
| Sex: Female, Male Male | 0 Participants |
Adverse events
| Event type | EG000 affected / at risk |
|---|---|
| deaths Total, all-cause mortality | 0 / 86 |
| other Total, other adverse events | 0 / 86 |
| serious Total, serious adverse events | 0 / 86 |
Outcome results
Primary
Anxiety
Anxiety measured with the Generalized Anxiety Disorder -7 (GAD-7)measured at baseline, six and 12 months. Scores range from 0-21, with lower scores indicating fewer anxiety symptoms.
Time frame: baseline, 6 months and 12 months
Population: All participants with anxiety scores at 12 months
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Telephone Support | Anxiety | Anxiety score at baseline (n=86) | 8.9 units on a scale | Standard Deviation 5.7 |
| Telephone Support | Anxiety | Anxiety score at 6 months (n=77) | 6.7 units on a scale | Standard Deviation 5.1 |
| Telephone Support | Anxiety | Anxiety score at 12 months (n=70) | 6.7 units on a scale | Standard Deviation 5.6 |
Comparison: Change in scores measured across three time points (baseline, 6 and 12 months)p-value: <0.001Mixed Models Analysis
Primary
Quality of Marriage
Measure of marriage quality using Quality Marriage Index at baseline, six and 12 months. Scores range from 6-45 with higher scores indicating better quality of marriage.
Time frame: Baseline, 6 and 12 months
Population: All participants with quality marriage index scores at the three time points
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Telephone Support | Quality of Marriage | Marriage quality score at baseline (n=86) | 32.7 units on a scale | Standard Deviation 8 |
| Telephone Support | Quality of Marriage | Marriage quality score at 6 months (n=77) | 31.6 units on a scale | Standard Deviation 9.9 |
| Telephone Support | Quality of Marriage | Marriage quality score at 12 months (n=70) | 31.9 units on a scale | Standard Deviation 9.8 |
Comparison: Analysis was change in score over time (baseline, 6 months, 12 months)p-value: 0.26Mixed Models Analysis
Primary
Spouse Self-report of Depression
Depression measured with the Patient Health Questionnaire (PHQ)-9 at baseline, six and 12 months. Scores range from 0-27 with lower scores indicating less depressive symptoms.
Time frame: Baseline, 6 months, and 12 months
Population: All participants with depression data at baseline, six and twelve months
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Telephone Support | Spouse Self-report of Depression | Depression score at baseline (n=86) | 8.9 units on a scale | Standard Deviation 5.9 |
| Telephone Support | Spouse Self-report of Depression | Depression score at 6 months (n=77) | 7.4 units on a scale | Standard Deviation 5.6 |
| Telephone Support | Spouse Self-report of Depression | Depression score at 12 months (n=70) | 6.9 units on a scale | Standard Deviation 5.7 |
Comparison: Change in scores measured across three time points (baseline, 6 and 12 months)p-value: 0.003Mixed Models Analysis
Secondary
Family Communication
Family communication measured with the Family Problem Solving Communication scale at baseline, six and 12 months. Scores range from 0-30 with higher scores indicating better communication.
Time frame: baseline, 6 months, and 12 months
Population: All participants with family communication data at baseline, six and 12 months.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Telephone Support | Family Communication | Family communication score at baseline (n=85) | 19.9 units on a scale | Standard Deviation 6.2 |
| Telephone Support | Family Communication | Family communication score at 6 months (n=77) | 20.9 units on a scale | Standard Deviation 6.4 |
| Telephone Support | Family Communication | Family communication score at 12 months (n=70) | 20.9 units on a scale | Standard Deviation 6.2 |
Comparison: Analysis was change in score over time (baseline, 6 months, and 12 months)p-value: 0.1Mixed Models Analysis
Secondary
Family Coping
Family problem solving measured at baseline, six and 12 months with the F-COPES measure. Scores range from 29-145 with higher scores indicating better coping.
Time frame: Baseline, 6 months and 12 months
Population: All participants with family coping data at baseline, six and 12 months.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Telephone Support | Family Coping | Family coping score at baseline (n=85) | 104.3 units on a scale | Standard Deviation 13.8 |
| Telephone Support | Family Coping | Family coping score at 6 months (n=77) | 104.7 units on a scale | Standard Deviation 13.7 |
| Telephone Support | Family Coping | Family coping score at 12 months (n=70) | 105.7 units on a scale | Standard Deviation 14.5 |
Comparison: Analysis was change in score over time (baseline, 6 and 12 months)p-value: 0.2Mixed Models Analysis
Secondary
Spouse Social Support
Support measured with the Social Support Index at baseline, six and 12 months. Scores range from 0-68 with higher scores indicating better social support.
Time frame: baseline, 6 months, and 12 months
Population: All participants with social support data at baseline, six and 12 months.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Telephone Support | Spouse Social Support | Social Support score at baseline (n=86) | 44.0 units on a scale | Standard Deviation 8.6 |
| Telephone Support | Spouse Social Support | Social Support score at 6 months (n=77) | 46.0 units on a scale | Standard Deviation 10.2 |
| Telephone Support | Spouse Social Support | Social Support score at 12 months (n=70) | 45.5 units on a scale | Standard Deviation 10.1 |
Comparison: Analysis was change in scores over time (baseline, 6 months, and 12 months)p-value: 0.04Mixed Models Analysis