Combat and operational stress programs and interventions: A scoping review using a tiered prevention framework.

Area of Science:

• Military Psychology
• Public Health
• Behavioral Health

Background:

• Department of Defense policy since 1999 mandates Combat and Operational Stress Control (COSC) programs.
• These programs aim to prevent, identify, and manage combat and operational stress effects.
• US service members in deployed, operational, or field settings are the target population.

Purpose of the Study:

• To provide a narrative review of Combat and Operational Stress Control (COSC) programs.
• To organize COSC programs into a prevention framework.
• To identify gaps and future directions for COSC programs.

Main Methods:

• Systematic search of peer-reviewed articles and government reports (2001-2020).
• Identification and evaluation of COSC programs for US service members.
• Categorization of programs using a tiered prevention model and rating for level of evidence.

Main Results:

• 36 evaluations of 19 COSC programs were identified.
• Most programs demonstrated effectiveness in achieving target outcomes.
• Behavioral health outcomes were reported for 13 programs; six focused on knowledge and behavior change.

Conclusions:

• COSC interventions show promise for stress management in service members.
• Over half of the programs had evidence from randomized study designs.
• Future evaluations should consider a joint curriculum within a tiered prevention framework.