Accelerating Psychological Health Research Findings into Clinical Practice Through the Practice-Based Implementation Network Model.

The benefits of new clinical research developments often take years to reach patients. As such, the Departments of Defense (DoD) and Veterans Affairs built the Practice-Based Implementation (PBI) Network as an infrastructure to facilitate more rapid translation of psychological health (PH) research into clinical practice changes to improve the quality of care for military and Veteran patients. To regularly identify research findings appropriate for enterprise implementation, the DoD PBI Network developed a model aligned with the Consolidated Framework for Implementation Research to select and pilot PH practice change. Within this model, practice change pilots were selected following a survey of field clinicians, a public call for proposals, annual meeting of implementation science subject matter experts, and final pilot selection by PH strategic leaders. These components facilitated commitment and engagement from Military Health System PH leadership, as well as clinicians, leading to increased stakeholder buy-in and efficiency with selecting and piloting PH practice change. The DoD PBI Network model has been refined for future PH research translation pilots. It serves as a first operational model for annual implementation of PH research findings in the DoD and may be of use to other entities engaged in practice change implementation.

Effect of concussion and blast exposure on symptoms after military deployment.

OBJECTIVE: To examine whether blast exposure alone and blast-associated concussion result in similar neurologic and mental health symptoms. METHODS: A 14-item questionnaire was administered to male US Marines on their return from deployment in Iraq and/or Afghanistan. RESULTS: A total of 2,612 Marines (median age 22 years) completed the survey. Of those, 2,320 (88.9%) reported exposure to ≥1 blast during their current and/or prior deployments. In addition, 1,022 (39.1%) reported ≥1 concussion during the current deployment, and 731 (28.0%) had experienced at least 1 prior lifetime concussion. Marines were more likely to have sustained a concussion during the current deployment if they had a history of 1 (odds ratio [OR] 1.5, 95% confidence interval [CI] 1.2-2.0) or ≥1 (OR 2.3, 95% CI 1.7-3.0) prior concussion. The most common symptoms were trouble sleeping (38.4%), irritability (37.9%), tinnitus (33.8%), and headaches (33.3%). Compared to those experiencing blast exposure without injury, Marines either experiencing a concussion during the current deployment or being moved or injured by a blast had an increased risk of postinjury symptoms. CONCLUSIONS: There appears to be a continuum of increasing total symptoms from no exposure to blast exposure plus both current deployment concussion and past concussion. Concussion had a greater influence than blast exposure alone on the presence of postdeployment symptoms. A high blast injury score can be used to triage those exposed to explosive blasts for evaluation.

The association between bullying dynamics and psychological distress.

This study examined the association between past experience of victimization (PEV), perceived risk of victimization (PRV), and nonspecific psychological distress (NSPD). Repeated measures-analysis of variance and hierarchical regression analyses were conducted on 186 seventh grade middle school students from an urban university-research-affiliated school. Results indicated that gender, PEV, and PRV significantly predicted NSPD. There were no gender differences in either the total number of past experience of victimization or depressive and/or anxious feelings reported. However, the types of victimization experienced as well as perceived risk of victimization appeared to be gender-related in that boys were significantly higher than girls on past experience of physical aggression and property aggression but significantly lower than girls on past experience of emotional aggression and perceived risk of victimization. In gender-specific analyses, PRV mediated the effects of PEV on NSPD for girls but not boys. The reasons for these findings, as well as implications for social policies and future directions, are discussed.