Summary: SMART-OP (Stress Management and Resilience Training for Optimal Performance) is a self-guided, multimedia, interactive, computer-based, stress management, and resilience training program based on evidenced-based cognitive-behavioral principles and emotion regulation approaches. The main aim of this project is to evaluate SMART-OP for efficacy and acceptability in a randomized controlled trial (RCT) with a sample of stressed but healthy flight controllers/instructors at NASA-Johnson Space Center (JSC). So far 22 eligible participants have been randomized either to SMART-OP or to a wait-list control, and 13 of these have already completed the study including post-assessment. Three of eligible participants dropped out prior to the pre-assessment citing time constraints.
Study Implementation: The randomized controlled trial was launched at the end of our first year, and this year implementation has successfully continued with 20 new participants who have either completed or are currently in the process of completing SMART-OP. The self-guided SMART-OP sessions are conducted weekly and take about 35-45 minutes to complete. Participants are randomized either to begin SMART-OP right away, or to a 6-week wait-list control. Before and after training, and before and after the wait period, participants complete a pre- or post-assessment that takes about two hours and is administered by the Nutritional Biochemistry Lab at JSC. So far, 32 pre- and post-assessments have been successfully completed, as well as 76 SMART-OP training sessions.
Recruitment: Participant recruitment is being addressed by the UCLA team in conjunction with Test Subject Screening (TSS) and Behavioral Health & Performance (BHP) element personnel. Several presentations were made by the Principal Investigator at JSC to generate study interest, and advertising is regularly done in the JSC Today. Since the time of this report last year, 62 new potential participants have expressed interest (through informational sessions/presentations, and advertisements) in the study. Thirty-one of those have been cleared by TSS, we have screened 30 for eligibility, and 17 met inclusion criteria (no medical or psychiatric diagnoses, but stressed based on self-report).
Revisions: Four revisions to the originally proposed procedures were made during this past year. Most importantly we replaced the Attention Control condition with a wait-list control (WLC) condition. The Attention Control condition was eliminated due to concerns that this was not a sufficiently beneficial use of participants’ time, and because WLC is a more externally valid comparison group condition in the population of flight controllers. We also made a minor change to our eligibility screening procedure, and included an additional measure of stress to our pre- and post-assessment protocols. Lastly, we eliminated the proposed 3-month follow-up due to time constraints, and because the wait-list control group can serve as its own control condition by comparing within-subject changes across three assessments. An Institutional Review Board (IRB) approval for these revisions was obtained from JSC in April 2015.
Data collection: Collected data is extracted weekly by our research team, and a system for data entry is currently being developed in preparation for data analysis. We will be looking at over 500 variables of data, including self-report measures of stress, resilience, depression, anxiety, personality, emotion, sleep, and health behaviors, psychophysiological data such as 24-hour heart rate, alpha amylase, and cortisol, and user feedback such as perceived system usability, working alliance, and treatment credibility.