Law enforcement officers (LEOs) are exposed to significant stressors, elevating their risk for aggression and excessive use of force, as well as mental health consequences, including post-traumatic stress disorder, burnout, alcohol misuse, depression, and suicide. The proposed study will identify, optimize and refine best clinical and research practices across two sites to ensure success in a future multisite efficacy trial assessing preventative effects of Mindfulness-Based Resilience Training on physiological, behavioral, and psychological outcomes.
Law enforcement officers (LEOs) are exposed to significant stressors, elevating their risk for aggression and excessive use of force. Such dysfunctional stress reactivity can lead to devastating consequences for their community, including unjustified shootings, severe beatings, and fatal chokings. It can also lead to serious consequences for the LEOs, including elevated incidence of post-traumatic stress disorder, burnout, alcohol misuse, depression, and suicide. A recent meta-analysis of LEO stress reduction programs found little evidence to demonstrate that such approaches are effective, highlighting the urgent need for preventive interventions targeting the stress inherent to policing. Mindfulness training is a promising approach with high-stress populations that has been shown effective in reducing stress and increasing resilience. In a recent pilot feasibility study (R21AT008854), the study team established initial feasibility, acceptability, and adherence to procedures in a single-site RCT assessing Mindfulness-Based Resilience Training (MBRT), a preventive intervention designed to improve LEO mental health and resilience, and reduce aggression and excessive use of force. The R21 data suggest physiological mechanisms and potential clinical benefit in a sample of LEOs. Relative to waitlist control, MBRT participants showed improvements in stress reactivity, aggression, burnout, occupational stress, sleep disturbance, and psychological flexibility. Implemented at two sites, the proposed study is designed to establish optimal protocols and procedures for a future full-scale, multi-site trial assessing effects of MBRT versus an attention control (Stress Management Education) and a no-intervention control, on physiological, behavioral, and psychological outcomes. To prepare for this future clinical trial, this study will: a) enhance efficiency of recruitment, engagement and retention; b) optimize lab, assessment, and data management procedures; c) optimize intervention training and ensure fidelity to intervention protocols; and d) assess participant experience and optimize outcome measures across sites. The long-term objective of this line of research is to develop an intervention that will reduce violence and increase resilience among LEOs, as well as yield significant benefits for communities and residents they serve.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
SINGLE
Enrollment
109
MBRT is an 8-week program combining training in standardized mindfulness practices targeting factors that facilitate resilience, CBT, and psychoeducation. It contains experiential and didactic exercises including body scan, sitting and walking meditation, mindful movement and discussions.
SME was designed as an active control condition for other Mindfulness-Based Intervention trials. SME uses a group-based didactic approach with modules on physiological and dietary effects of stress, time management, sleep physiology and insomnia, nutrition, exercise, stress hardiness, and factors mitigating impacts of stress.
University of New Mexico
Albuquerque, New Mexico, United States
Pacific University
Forest Grove, Oregon, United States
Change in Aggression
Buss-Perry Aggression Questionnaire-Short Form. Scores range from 1-5, with higher scores indicating greater aggression.
Time frame: baseline, post-intervention (week 8), 3-month followup, 6-month followup
Change in C-reactive Protein
Blood spot analysis of high-sensitivity C-reactive protein.
Time frame: baseline, post-intervention (8 weeks), 3 month followup
Change in Interleukin-6
Blood spot analysis of interleukin-6.
Time frame: baseline, post-intervention (8 weeks), 3 month followup
Change in Interleukin-10
Blood spot analysis of interleukin-10.
Time frame: baseline, post-intervention (8 weeks), 3 month followup
Change in Tumor Necrosis Factor-alpha
Blood spot analysis of tumor necrosis factor-alpha.
Time frame: baseline, post-intervention (8 weeks), 3 month followup
Change in Psychological Resilience
Brief Resilience Scale. Scores range from 1-5, with higher scores indicating greater resilience.
Time frame: baseline, post-intervention (8 weeks), 3 month followup, 6 month followup
Change in Alcohol Use
Patient Reported Outcome Measurement System (PROMIS) Alcohol Use. Scores range from 39-77, with higher scores indicating greater alcohol use.
Time frame: baseline, post-intervention (8 weeks), 3 month followup, 6 month followup
Change in Alcohol Use Negative Consequences
Patient Reported Outcome Measurement System (PROMIS) Alcohol Use Negative Consequences.Scores range from 39-77, with higher scores indicating greater alcohol use negative consequences.
Time frame: baseline, post-intervention (8 weeks), 3 month followup, 6 month followup
Change in Depression
Patient Reported Outcome Measurement System (PROMIS) Depression. Scores range from 38-80, with higher scores indicating more depression.
Time frame: baseline, post-intervention (8 weeks), 3 month followup, 6 month followup
Change in Suicidal Thinking
Concise Heath Risk Tracking Scale-Self-Report. Scores range from 7-35, with higher scores indicating greater suicidal ideation.
Time frame: baseline, post-intervention (8 weeks), 3 month followup, 6 month followup
Change in Trauma Symptoms
PTSD Checklist for DSM-5. Scores ranges from 0-80, with higher scores indicating greater PTSD symptoms.
Time frame: baseline, post-intervention (8 weeks), 3 month followup, 6 month followup
Change in Burnout
Oldenburg Burnout Inventory. Scores range from 1-4, with higher scores indicating greater burnout.
Time frame: baseline, post-intervention (8 weeks), 3 month followup, 6 month followup
Change in Sustained Attention
Sustained Attention to Response Task. A computer-based go/no-go task that requires participants to withhold behavioral response to a single, infrequent target presented amongst a background of frequent non-targets. Increased errors indicates less sustained attention.
Time frame: baseline, post-intervention (8 weeks), 3 month followup, 6 month followup
Change in Perceived Stress
Perceived Stress Scale-10. Scores range from 0-40, with higher scores indicating greater perceived stress.
Time frame: baseline, post-intervention (8 weeks), 3 month followup, 6 month followup
Change in Sleep Disturbance
Patient Reported Outcome Measurement System (PROMIS) Sleep Disturbance. Scores range from 32-76, with higher scores indicating greater sleep disturbance.
Time frame: baseline, post-intervention (8 weeks), 3 month followup, 6 month followup
Change in Self-Compassion
Self-Compassion Scale-Short Form. Scores range from 1-5, with higher scores indicating greater self-compassion.
Time frame: baseline, post-intervention (8 weeks), 3 month followup, 6 month followup
Change in Mindfulness
Five Facet Mindfulness Questionnaire-Short Form. Scores range from 1-5, with higher scores indicating greater mindfulness.
Time frame: baseline, post-intervention (8 weeks), 3 month followup, 6 month followup
Change in Interoceptive Awareness
Multidimensional Assessment of Interoceptive Awareness-II. Scores range from 1-6, with higher scores indicating greater interoceptive awareness.
Time frame: baseline, post-intervention (8 weeks), 3 month followup, 6 month followup
Treatment Acceptability
Postcourse satisfaction survey. Scores range from 4-16, with higher scores indicating greater treatment acceptability. Measure only administered to Mindfulness-Based Resilience Training and Stress Management Education arms.
Time frame: post-intervention (8 weeks)
Treatment Compliance
Objective assessment of duration of homework practice. Measure only administered to Mindfulness-Based Resilience Training and Stress Management Education arms.
Time frame: post-intervention (8 weeks)
Treatment Expectancy and Credibility
Expectancy/Credibility Questionnaire. Scale for measuring treatment expectancy and rationale credibility for use in clinical outcome studies. Scores range from 7-21, with higher scores indicating greater expectancy and credibility.
Time frame: baseline
Global Impression of Change
Clinical Global Impressions Scale. Measure of perceived change in functioning as a result of the intervention. Scores range from 3-21, with higher scores indicating a greater impression of change. Measure only administered to Mindfulness-Based Resilience Training and Stress Management Education arms.
Time frame: post-intervention (8 weeks)
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