Improving Resilience and Combating Burnout in US Army Health Care Teams

Coleman, Alyssa M.; Hartzell, Meredith M.; Oh, Robert C.; Funari, Tamara S; Rivera, Luis Omar; Brown, Jill A.

doi:10.3122/jabfm.2020.03.190350

Cited by 5 publications

(5 citation statements)

References 12 publications

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“…The M2H program for chronic LBP was adapted from an existing program focused on a “whole person” approach to delivering medical care [ 20 , 21 ]. The M2H program for chronic LBP was operationalized at a more detailed and condition-specific level than the overall M2H program in order to facilitate implementation.…”

Section: Discussionmentioning

confidence: 99%

“…These recommendations coincided with efforts to transform Army Medicine from a traditional health care system to a System for Health that maintains, restores and improves health through physical, emotional, social and spiritual fitness [ 19 ]. The Office of the Army Surgeon General developed several strategies to facilitate the transition to a System for Health including “Move to Health” [ 20 ], which is built on the “Whole Health” program in the VHA [ 21 ]. Whole Health is focused on transforming health care delivery to embrace person-centered, holistic care emphasizing the power of self-management to strengthen innate healing capacities using both complementary and integrative health (CIH) approaches and population health resources [ 21 ].…”

Section: Introductionmentioning

confidence: 99%

“…The Move to Health (M2H) program represents a comprehensive approach to shift from a disease-focused, biomedical model towards a person-centered strategy to optimize well-being through engaged patients who are empowered to improve their own health [ 20 ]. The concept is best visualized through the M2H wheel, where the components of the wheel represent the various health domains, and at the center is the individual person (Fig.…”

Section: Introductionmentioning

confidence: 99%

“…The original M2H wheel comprised eight health domains for patients [ 20 ]. We condensed these into five larger domains to facilitate implementation (five intervention approaches; Fig.…”

Section: Introductionmentioning

confidence: 99%

“…Mindfulness is also considered a core component of the M2H program, and is labeled specifically in the center of the original M2H wheel alongside the individual person to show that mindfulness is used to guide their interaction with each domain [ 20 ], providing a strategy that the person can use to focus their attention on the implications of each domain presented to them. Mindfulness is another tool to supplement the MI approach to enabling behavior change.…”

Section: Introductionmentioning

confidence: 99%

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Move to health-a holistic approach to the management of chronic low back pain: an intervention and implementation protocol developed for a pragmatic clinical trial

et al. 2021

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Background The prevalence of chronic pain conditions is growing. Low back pain was the primary cause of disability worldwide out of 156 conditions assessed between 1990 and 2016, according to the Global Burden of Disease Study. Conventional medical approaches have failed to identify effective and long-lasting approaches for the management of chronic pain, and often fail to consider the multiple domains that influence overall health and can contribute to the pain experience. Leading international organizations that focus on pain research have stated the importance of considering these other domains within holistic and multidisciplinary frameworks for treating pain. While the research behind the theoretical link between these domains and chronic pain outcomes has expanded greatly over the last decade, there have been few practical and feasible methods to implement this type of care in normal clinical practice. Methods The purpose of this manuscript is to describe an implementation protocol that is being used to deliver a complex holistic health intervention at multiple sites within a large government health system, as part of a larger multisite trial for patients with chronic low back pain. The Move to Health program developed by the US Army Medical Command was tailored for specific application to patients with low back pain and begins by providing an empirical link between eight different health domains (that include physical, emotional, social, and psychological constructs) and chronic low back pain. Through a six-step process, a health coach leverages motivational interviewing and information from a personal health inventory to guide the patient through a series of conversations about behavioral lifestyle choices. The patient chooses which domains they want to prioritize, and the health coach helps implement the plan with the use of SMART (Specific, Measurable, Attainable, Realistic, Time-bound) goals and a series of resources for every domain, triaged from self-management to specialist referral. Discussion Complex interventions described in clinical trials are often challenging to implement because they lack sufficient details. Implementation protocols can improve the ability to properly deliver trial interventions into regular clinical practice with increased fidelity. Trial registration Implementation of this intervention protocol was developed for a clinical trial that was registered a priori (clinicaltrials.gov #NCT04172038).

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…The original M2H wheel comprised eight health domains for patients [ 20 ]. We condensed these into five larger domains to facilitate implementation (five intervention approaches; Fig.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Move to health-a holistic approach to the management of chronic low back pain: an intervention and implementation protocol developed for a pragmatic clinical trial

et al. 2021

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Promoting resilience and psychological wellbeing of military providers: The Navy Medicine Caregiver Occupational Stress Control (CgOSC) program

Delaney

Gerardi

Beauchamp

et al. 2022

Military Psychology

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Challenges With Engaging Military Stakeholders for Clinical Research at the Point of Care in the U.S. Military Health System

Rhon

Teyhen

2021

Military Medicine

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The DoD has a specific mission that creates unique challenges for the conduct of clinical research. These unique challenges include (1) the fact that medical readiness is the number one priority, (2) understanding the role of military culture, and (3) understanding the highly transient flow of operations. Appropriate engagement with key stakeholders at the point of care, where research activities are executed, can mean the difference between success and failure. These key stakeholders include the beneficiaries of the study intervention (patients), clinicians delivering the care, and the military and clinic leadership of both. Challenges to recruitment into research studies include military training, temporary duty, and deployments that can disrupt availability for participation. Seeking medical care is still stigmatized in some military settings. Uniformed personnel, including clinicians, patients, and leaders, are constantly changing, often relocating every 2-4 years, limiting their ability to support clinical trials in this setting which often take 5-7 years to plan and execute. When relevant stakeholders are constantly changing, keeping them engaged becomes an enduring priority. Military leaders are driven by the ability to meet the demands of the assigned mission (readiness). Command endorsement and support are critical for service members to participate in stakeholder engagement panels or clinical trials offering novel treatments. To translate science into relevant practice within the Military Health System, early engagement with key stakeholders at the point of care and addressing mission-relevant factors is critical for success.

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Improving Resilience and Combating Burnout in US Army Health Care Teams

Cited by 5 publications

References 12 publications

Move to health-a holistic approach to the management of chronic low back pain: an intervention and implementation protocol developed for a pragmatic clinical trial

Move to health-a holistic approach to the management of chronic low back pain: an intervention and implementation protocol developed for a pragmatic clinical trial

Promoting resilience and psychological wellbeing of military providers: The Navy Medicine Caregiver Occupational Stress Control (CgOSC) program

Challenges With Engaging Military Stakeholders for Clinical Research at the Point of Care in the U.S. Military Health System

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