OBJECTIVES:
Stress and anxiety-related problems are some of the most common and costly behavioral health problems in society. For those working in operational environments (i.e., astronauts, flight controllers, military), stress and anxiety-related problems before, during, or after missions can seriously compromise efficiency, safety, and performance. To address behavioral health issues like stress, it is important to maximize the privacy, validity, and acceptability of the training and countermeasures used. Technology-based behavioral health programs (e.g., computer or web-based programs) are effective for treating behavioral health problems. These programs increase availability of evidence-based interventions to individuals who are not able or willing to receive such in-person treatments. Prior research validated the autonomous multimedia resilience training program the investigators created (i.e., Stress Management and Resilience Training for Optimal Performance; SMART-OP). SMART-OP interactively trains users to manage stress and build resilience over six weekly training sessions lastly approximately 45 minutes each. Results from a randomized controlled trial with a stressed but otherwise healthy sample (N=66) indicated that SMART-OP decreased perceived stress, improved perceived control over stress, and was rated as significantly more useful than an attention control group that received marketed videos and published material on stress management. SMART-OP was also rated as “excellent” in terms of user-friendliness, acceptability, and had low dropout, and high homework adherence.
APPROACH:
The investigators propose to evaluate the effectiveness, usefulness, and usability of SMART-OP with a sample of flight controllers and instructors (including those in training flow) at Johnson Space Center (JSC) by comparing it to an attention control group. Additionally, they will examine the effects of self-guided stress management and resilience training on biomarkers for stress (i.e., cortisol, a-amylase), heart rate, and cognitive and behavioral performance. Based on several meetings with the Space Flight Resource Management (SFRM) Working Group, investigators learned that trainees are not progressing through the training flow satisfactorily and that they identified stress as a potential contributor to poor trainee performance. Additionally, stress was identified as an area of concern to address with flight controller and instructors. Since SMART-OP significantly reduced perceived stress, increased perceived control over stressors, and was rated as highly useful, SMART-OP could provide helpful stress management training for flight controllers. Also, since SMART-OP is evidence-based, confidential, and self-directed, it may be more acceptable to flight controller trainees than other programs.
RESULTS:
This experiment is in progress. However, preliminary results are available.
Study Implementation: The majority of work during 2013-2014 was spent on various aspects of implementing the study at JSC. The study is designed to be conducted in a self-guided fashion where possible which means the study participant needs to conduct much of the assessment and all of the stress management training independently (i.e., without research coordinators). IRB protocols and approvals were obtained at JSC and UCLA to conduct the study. Biweekly teleconferences with NASA BHP personnel addressed various areas of study implementation and maintained regular communication. Progress during this period covered several areas including reserving and setting up a study room on site to conduct the study including assessments. Study computers and iPads were programmed and authenticated for use in the study. Additional study materials were purchased including heart rate monitors. There were several logistical/technical issues/hurdles that were addressed to give the UCLA research team required access to conduct the study from afar. Accomplishing this involved regular communication with JSC BHP and IT staff and personnel. The UCLA research team made two trips to JSC to address various aspects of study implementation including giving several informational session presentations for study recruitment; adding software and other information to JSC computers for assessments and stress management training sessions; testing computers for functionality and reliability; and testing the downloading of training session and assessment data for functionality.
Assessment Procedures: The UCLA research team created several assessment tasks required for the study. The tasks involved computer programming so that study participants could conduct much of the assessments in a self-guided fashion. These involved creating online questionnaires, programming for computerized tasks designed to frustrate/stress users, modification of the neuropsychological battery for use in current study, creation of study protocols instructing the user how to conduct assessments and stress management training sessions on their own. The JSC Nutritional Biochemistry Lab (NBL) is leading a portion of the assessment procedures which involve collection of saliva and urine to measure stress biomarkers (cortisol and alpha amylase). This part of the assessment procedures was developed jointly between the UCLA and NBL teams, protocols formulated, and then the procedures were tested during the visits of the UCLA team to JSC.