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陆军预防自杀和干预培训的重大改进:一个机构间合作,制定新的“ACE 基础+1”课程。

Key Improvements to the Army's Suicide Prevention and Intervention Training: An Interagency Collaboration to Develop the New "ACE Base +1" Curriculum.

机构信息

Research Transition Office, Center for Military Psychiatry and Neuroscience, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA.

TechWerks LLC, San Antonio, TX 78209, USA.

出版信息

Mil Med. 2024 Aug 19;189(Suppl 3):357-365. doi: 10.1093/milmed/usae127.

Abstract

INTRODUCTION

Suicide is a prevalent problem impacting the military community. The U.S. Army recognized the need to address this complex issue; one line of effort has been to provide suicide prevention and intervention education and training that is informed by current research, doctrine, and implementation best practices. The purpose of this article is to outline and present the genesis of the Army's new suicide prevention and intervention training-"Ask, Care, Escort (ACE) Base +1"-that aligns with the DoD newly published regulation-driven initiatives.

MATERIALS AND METHODS

The development of the "ACE Base +1" curriculum was a collaborative effort between two organizations within the Defense Health Agency: The Defense Centers for Public Health-Aberdeen and the WRAIR. A multidisciplinary team was formed by selecting specific operational and subject-matter experts from each organization based on educational qualifications and practical experiences expected to aid the development of curriculum content (e.g., subject-matter experts) and/or the training design. Revisions to the curriculum were informed by the Army's existing suicide prevention training module, current research in suicide prevention and public health, updated and relevant Army regulations, and current public health policy guidance from the CDC and the Department of Suicide Prevention Office. A detailed account of the systematic and iterative curriculum development process is provided.

RESULTS AND CONCLUSIONS

The interagency collaborative efforts resulted in a suite of training products, "ACE Base +1" version 1.3 that is modernized in training content, delivery methods, and design. Four primary elements shaped the final products: (1) A modular framework allowing a tailored approach to mandatory training, (2) a public-health approach that focuses on earlier intervention opportunities while building trust and cohesion, (3) a training design centered on peer discussions and behavioral rehearsal, and (4) an expansion of the curriculum to be inclusive of the entire Army community. Practical implications for each element are discussed.As the program of record, "ACE Base +1" training satisfies the annual requirement for all Active Army, Army National Guard, U.S. Army Reserve, and Department of the Army (DA) civilians. Both the training content (e.g., public-health concepts) and design of "ACE Base +1" reflect a comprehensive approach, focused on developing concrete, applicable skills that support the shared responsibility to suicide prevention and intervention. Limitations, such as delayed interagency collaboration and time constraints, are discussed. Future directions include recommendations for future curriculum projects, specifically within military populations, such as interprofessional, interagency collaboration, and selecting a multidisciplinary team of subject-matter experts. Additionally, WRAIR plans to continue their support to Directorate of Prevention, Resilience and Readiness with the expansion of the +1 menu of trainings, ongoing program evaluation, and longitudinal analysis to inform future revisions and ensure the content and delivery methods remain modernized, relevant, and effective.

摘要

简介

自杀是一个普遍存在的问题,影响着军队社区。美国陆军认识到需要解决这个复杂的问题;努力的一个方向是提供基于当前研究、教义和实施最佳实践的预防和干预自杀的教育和培训。本文的目的是概述并介绍美国陆军新的预防和干预自杀培训计划——“Ask、Care、Escort(ACE)基础+1”,该计划与国防部新发布的法规驱动倡议保持一致。

材料和方法

“ACE 基础+1”课程的开发是国防卫生局两个组织之间的合作:国防公共卫生中心-阿伯丁和 WRAIR。一个多学科团队是通过从每个组织中选择具有教育资格和实践经验的特定运营和主题专家来组建的,预计这些专家将有助于课程内容(例如,主题专家)和/或培训设计的开发。课程的修订由陆军现有的预防自杀培训模块、预防自杀和公共卫生方面的当前研究、更新和相关的陆军法规以及疾病预防控制中心和自杀预防办公室的当前公共卫生政策指导提供信息。本文提供了一个详细的系统和迭代课程开发过程的说明。

结果和结论

机构间的合作努力产生了一系列培训产品,即“ACE 基础+1”版本 1.3,该版本在培训内容、交付方法和设计方面进行了现代化改进。有四个主要因素塑造了最终产品:(1)一个模块化框架,允许采用针对强制性培训的定制方法;(2)一种公共卫生方法,侧重于早期干预机会,同时建立信任和凝聚力;(3)以同伴讨论和行为排练为中心的培训设计;(4)扩大课程范围,涵盖整个陆军社区。讨论了每个元素的实际影响。作为记录在案的计划,“ACE 基础+1”培训满足了所有现役陆军、陆军国民警卫队、美国陆军预备役和陆军部(DA)平民的年度要求。“ACE 基础+1”的培训内容(例如,公共卫生概念)和设计反映了一种全面的方法,侧重于培养支持预防和干预自杀的共同责任的具体、适用技能。讨论了一些限制因素,例如机构间合作的延迟和时间限制。未来的方向包括为未来的课程项目提供建议,特别是在军事人群中,例如专业间、机构间的合作以及选择多学科的主题专家团队。此外,WRAIR 计划继续支持预防、弹性和准备主任,扩大+1 培训菜单,进行持续的项目评估和纵向分析,以告知未来的修订,并确保内容和交付方法保持现代化、相关和有效。

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