Objectives We evaluated a military resilience intervention which aimed to help UK military recruits to manage their personal health and well-being more effectively.
Methods Trainers within six pre-existing training teams were randomly allocated by team to deliver a resilience-based intervention (SPEAR) or usual training (control) during recruit training. 23 trainers delivered SPEAR; 18 delivered the control training. 707 recruits participated (n=358 SPEAR and n=349 controls). Outcome measures were obtained before and after recruit training and 3 months later. Measures of post-traumatic stress disorder (PTSD), common mental disorder (CMD) symptoms, alcohol use, homesickness and mental health stigmatisation were obtained at baseline. Repeat baseline scales plus measures of help-seeking, cohesion, leadership and training impact were obtained at the two follow-up points.
Results Response rates were 91.7% (baseline), 98.1% (post) and 73.6% (follow-up). Following adjustment for potential confounders, levels of PTSD, CMD symptoms, alcohol misuse, help-seeking and homesickness were not significantly different between groups at any measurement point. Stigmatisation was significantly lower among SPEAR recipients at baseline but was not significantly different at the two follow-up points. Following adjustment for mental health confounders, there were no significant between-group differences in perceptions of leadership and cohesion and in ratings of six training outcomes at the two follow-up points.
Conclusions We found no evidence that resilience-based training had any specific benefit to the health and well-being of UK military recruits.
- mental health
- occupational health practice
- intervention studies
- training and education
- defence force personnel
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Contributors NJ wrote the draft manuscript and participated in all stages of the research project. NG contributed to the design of the study and writing the manuscript. HB contributed to the design of the study and writing the manuscript. LH contributed to all stages of the study and writing the manuscript. CW contributed to all stages of the study and writing the manuscript. AM provided logistic support at all stages of the study and contributed to writing the manuscript.
Funding This work was supported and funded by the Ministry of Defence.
Disclaimer The views expressed are those of the author(s) and not necessarily those of the UK MoD.
Competing interests At the time of the study NJ, NG, LH and CW were based at King’s College London which, for the purpose of the study and other military-related studies, receives funding from the UK Ministry of Defence (MoD). AM was based with the military organisation that provided the training element of the intervention tested in the study and participated in training delivery. AM was blind to the collection and analysis of the study outcomes. NJ, NG, LH, CW and AM’s salaries were totally or partially paid by the UK MoD. The UK MoD provides support to the Academic Department of Military Mental Health, and the salary of NJ is covered totally by this contribution. NG is the Royal College of Psychiatrists’ Lead for Military and Veterans’ Health, a trustee of Walking with the Wounded, and an independent director at the Forces in Mind Trust; however, he was not directed by these organisations in any way in relation to his contribution to this study. NJ is a full-time member of the UK armed forces seconded to King’s College London.
Patient consent Obtained.
Ethics approval The authors assert that all procedures contributing to this work comply with the ethical standards of the relevant national and institutional committees on human experimentation and with the Helsinki Declaration of 1975, as revised in 2008. The study was approved by the Ministry of Defence Research Ethics Committee (766/MODREC/16 dated 24 November 2016).
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement We have unpublished data that did not have a direct relationship with the study outcomes. We will further explore these data and publish further studies in due course.
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