Moral Distress, Mental Health, and Risk and Resilience Factors Among Military Personnel Deployed to Long-Term Care Facilities During the COVID-19 Pandemic: Research Protocol and Participation Metrics.

BACKGROUND: The earliest days of the COVID-19 pandemic in Canada were marked by a significant surge in COVID-19 cases and COVID-19-related deaths among residents of long-term care facilities (LTCFs). As part of Canada's response to the COVID-19 pandemic, Canadian Armed Forces (CAF) personnel were mobilized for an initial emergency domestic deployment to the hardest-hit LTCFs (Operation LASER LTCF) to support the remaining civilian staff in ensuring the continued delivery of care to residents. Akin to what was observed following past CAF international humanitarian missions, there was an expected increased risk of exposure to multiple stressors that may be psychologically traumatic and potentially morally injurious in nature (ie, related to core values, eg, witnessing human suffering). Emerging data from health care workers exposed to the unprecedented medical challenges and dilemmas of the early pandemic stages also indicated that such experiences were associated with increased risk of adverse mental health outcomes. OBJECTIVE: This study aims to identify and quantify the individual-, group-, and organizational-level risk and resilience factors associated with moral distress, moral injury, and traditional mental health and well-being outcomes of Operation LASER LTCF CAF personnel. This paper aimed to document the methodology, implementation procedures, and participation metrics. METHODS: A multimethod research initiative was conducted consisting of 2 primary data collection studies (a quantitative survey and qualitative interviews). The quantitative arm was a complete enumeration survey with web-based, self-report questionnaires administered at 3 time points (3, 6, and 12 mo after deployment). The qualitative arm consisted of individual, web-based interviews with a focus on understanding the nuanced lived experiences of individuals participating in the Operation LASER LTCF deployment. RESULTS: CAF personnel deployed to Operation LASER LTCF (N=2595) were invited to participate in the study. Data collection is now complete. Overall, of the 2595 deployed personnel, 1088 (41.93%), 582 (22.43%), and 497 (19.15%) responded to the survey at time point 1 (3 mo), time point 2 (6 mo), and time point 3 (12 mo) after deployment, respectively. The target sample size for the qualitative interviews was set at approximately 50 considering resourcing and data saturation. Interest in participating in qualitative interviews surpassed expectations, with >200 individuals expressing interest; this allowed for purposive sampling across key characteristics, including gender, rank, Operation LASER LTCF role, and province. In total, 53 interviews were conducted. CONCLUSIONS: The data generated through this research have the potential to inform and promote better understanding of the well-being and mental health of Operation LASER LTCF personnel over time; identify general and Operation LASER LTCF-specific risk and protective factors; provide necessary support to the military personnel who served in this mission; and inform preparation and interventions for future missions, especially those more domestic and humanitarian in nature. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/44299.

Conducting research during the COVID-19 pandemic: the Op LASER study. / Mener des recherches au cours de la pandémie de COVID-19 : l'étude sur l'Opération LASER.

The Canadian Armed Forces (CAF) deployed 2595 regular and reserve force personnel on Operation (Op) LASER, the CAF's mission to provide support to civilian staff at longterm care facilities in Ontario and in the Centres d'hébergement de soins de longue durée in Quebec. An online longitudinal survey and in-depth virtual discussions were conducted by a multidisciplinary team of researchers with complementary expertise. This paper highlights the challenges encountered in conducting this research and their impact on the design and implementation of the study, and provides lessons learned that may be useful to researchers responding to similar public health crises in the future.

There are a number of challenges involved in conducting longitudinal research in an applied military setting during a global public health crisis such as the COVID-19 pandemic. These challenges include but are not limited to a sudden transition to a distributed remote work environment, tight timelines, the need to obtain approvals from different agencies and departments, having to prioritize multiple study objectives, and survey fatigue. To overcome these challenges in future public health crises, it is important to (1) develop and maintain collaborative networks across government, academia and industry; (2) develop a standard set of pre-deployment demographic and health indicators to establish a baseline; and (3) use mixed methods approaches for a richer understanding of mental health trajectories following stressful events.

La réalisation d'une enquête longitudinale dans un contexte militaire concret pendant une crise mondiale de santé publique, comme la pandémie de COVID-19, vient avec son lot de défis. Parmi ces défis, on peut relever une transition subite vers un environnement de travail à distance, des délais serrés, la nécessité d'obtenir des approbations de différents organismes et ministères, la nécessité de prioriser plusieurs objectifs d'étude et la lassitude à l'égard des enquêtes. Pour relever ces défis au cours des futures crises de santé publique, il sera essentiel : 1) de créer et d'entretenir des réseaux de collaboration qui relieront le gouvernement, le milieu universitaire et les divers secteurs d'activité, 2) de créer un ensemble normalisé d'indicateurs démographiques et sanitaires avant le déploiement, en vue de l'obtention de données de référence et 3) de recourir à des méthodes mixtes pour mieux comprendre les trajectoires en matière de santé mentale à la suite d'événements stressants.

Age differences in recollection: three patterns of enhanced encoding.

Memory encoding conditions can be manipulated in a variety of ways, and many of these methods result in improved recollection for both younger and older adults relative to baseline conditions. Previous results have shown differential age-related patterns of improvement, however, with some manipulations giving equal improvement to young and old participants, some benefiting older adults more, and others benefiting younger adults more. In 2 experiments, the authors show that presenting pictures with words benefited older more than younger participants, word generation benefited both groups equally, and an encoding condition requiring novel integrative processing benefited younger more than older adults. The authors discuss these results in terms of the enhanced elaboration afforded and processing demanded by differential combinations of age groups and encoding conditions.