Faculty Bibliography

INTRODUCTION/BACKGROUND:Hazardous alcohol use in the military exceeds that of the general population and is associated with a host of negative personal, health, social, emotional, and occupational consequences. Prevention is a cost-effective way to reduce problematic drinking. Despite numerous reviews and meta-analyses synthesizing the literature on prevention programs targeting civilians, there is a dearth of such resources specifically targeting active duty service members and other military personnel. The purpose of this systematic review was to summarize existing evidence-based prevention programs that have documented success in reducing the onset of alcohol problems in young adults, emphasizing programs that may be implementable in the U.S. military. MATERIALS AND METHODS/METHODS:We identified alcohol prevention programs through two methods: we conducted (1) a meta-review of evidence-based prevention programs in clearinghouses and (2) a systematic review of alcohol-prevention evaluations in military settings. RESULTS:Integrated results review 6 prevention programs that were identified as a good fit based on inclusion criteria (i.e., universal or selective prevention, administrable to individuals or small groups) with sufficient support for effectiveness. All included programs demonstrate research supporting their application in either active duty or veteran populations. CONCLUSIONS:This review adds to the literature by synthesizing the current evidence-based prevention programs targeting the onset of alcohol problems, with an emphasis on those programs that have strong potential for successful implementation among military populations. Specific recommendations and considerations for implementation are provided.

INTRODUCTION/BACKGROUND:Although an open-group model is often used in substance use treatment, there are no evidence-based open-group treatment protocols. A large federal substance treatment agency (the Alcohol and Drug Abuse Prevention and Treatment Program within the Department of the Air Force) requested an evidence-informed open-group treatment protocol to treat alcohol misuse to implement throughout their clinics. MATERIALS AND METHODS/METHODS:The research team: (a) compiled and reviewed manuals for empirically supported closed groups, general literature, and best practices; (b) developed an overarching and unifying framework; (c) drafted preliminary pilot materials; (d) implemented and refined groups with providers via ongoing feedback; and (e) evaluated feasibility and usability of, and participant engagement in, the program. Providers gave detailed weekly feedback in meetings on program content and process. RESULTS:The feedback was positive in both phases. With the addition of new installations, program content and delivery continued to be perceived as useful in meeting patient and provider needs. CONCLUSIONS:Effective delivery of an evidence-based open-group treatment can be achieved with basic training of providers in the protocol.

BACKGROUND:The authors aimed to measure dental fear prevalence via the first national census-matched US adult sample and, among fearful people, interest in evidence-based digital fear treatment (ie, computerized, mobile application, and telehealth approaches) or reasons for declining. METHODS:A cross-sectional census-matched online survey (n = 1,003) was conducted (October 31-November 11, 2024) ensuring representation of US adult demographic characteristics. Dental fear was assessed using the validated Gatchel single-item scale (from 0 [no fear] through 10 [extreme fear]). People with moderate through severe fear were asked about their interest in digital treatment and, if they refused, about their reasons for declining. RESULTS:The prevalence was 72.6% (95% CI, 70.9% to 74.3%), with 45.8% reporting moderate fear and 26.8% reporting severe fear. Among fearful people, 71.2% (95% CI, 69.4% to 73.0%) were interested in digital treatment. Those who declined indicated skepticism about effectiveness (31.8%), satisfaction with their coping strategies (23.4%), and time concerns (22.3%). CONCLUSIONS:Dental fear remains widespread in the United States, suggesting little progress in prevalence reduction. The high interest in digital treatment indicates demand for accessible interventions. PRACTICAL IMPLICATIONS/CONCLUSIONS:Brief digital dental fear treatments offer potential for widespread dissemination. Public health messaging must address skepticism about treatment effectiveness and value among the fearful patients not yet interested (≈ 30%).

Child welfare caseloads are frequently higher than optimal, leading to provider burnout and turnover. This study aims to identify which case, provider, and organizational factors differentiate providers with higher versus lower burnout and leave intentions. Participants were 26 Family Advocacy Program providers and 17 supervisors at 11 U.S. Department of the Air Force installations who provided data for seven months. We used linear mixed-effects model tree algorithms to determine the factors that distinguish favorable and unfavorable outcomes. The model predicting burnout yielded three significant partitioning variables: (a) number of cases on the high risk for violence and child sexual maltreatment response team lists, (b) command support, and (c) years since licensure. The model predicting leave intentions yielded five significant partitioning variables: (a) client challenge, (b) number of cases, (c) ease of reaching commanders of on-base tenant units, (d) percentage of clients receiving substance abuse treatment services, and (e) command support. This study is a first step toward developing dynamic caseload management tools.

The need for standardized criteria in partner and child maltreatment response systems is critical for providing fair decisions, allocating family support, producing reliable research findings, and aiding prevention efforts, among other tasks. The primary goal of this study was to replicate Heyman and Slep's (see record 2009-23534-017) study-whether maltreatment incident determination committee decisions of local sites matched those of master reviewers. This study extended the prior work by testing if specific training techniques (i.e., social worker self-assessments, motivation-enhanced briefs, per-case feedback) increased the master reviewer-site concordance of the Field-Tested Assessment, Intervention-Planning, and Response (FAIR) system. Overall agreement between the master reviewers and the committees was 87%, indicating good agreement but falling just below the 91%-92% achieved in earlier FAIR dissemination studies. Sites were randomly assigned to one of eight training conditions using a multiphase optimization strategy design. The full factorial model was not statistically significant, indicating that the training techniques were not associated with committees' voting fidelity. The replicated agreement findings indicate that the FAIR system can be implemented successfully on a large scale and produce consistently good agreement on family maltreatment case decisions. Areas for future research are discussed (e.g., testing and usage of evidence-informed training techniques). (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Over fifteen percent of the global population experiences dental fear, and although evidence-based treatments exist, adoption of these treatments is almost non-existent. Informed by our prior research examining barriers to adopting face-to-face behavioral treatments in dental operatories, this study examined dentists' responses to three stepped-care Cognitive Behavioral Therapy for Dental Fear (CBT-DF) formats that use technology. All approaches offer an automated component as the first step (a mobile app) and either an in-person, virtual reality (VR), or video telehealth session as the second step. This study aims to understand which of these approaches would most likely be adopted by private practice dentists and why. Eight focus groups/solo interviews with a total of 13 private practice dentists were conducted with the aim to assess barriers and facilitators to implementing three stepped-care approaches of CBT-DF. The qualitative data obtained from these interviews was coded and analyzed according to Rogers' framework of innovation (relative advantage, compatibility, complexity, trialability, and observability). The results indicated that participants acknowledged the value of interventions to address dental fear, as they had personal experiences with fearful patients that impacted their practices. Participants responded positively to the automated component of treatment (the app) and were more wary of treatment options requiring office space and staff time (in-person VR and in-person mental health provider). The telehealth option received the most favorable response, although some doubts were expressed regarding relative efficacy and patient accountability. Thus, dissemination of an app-telehealth treatment model that allows dentists to serve as referral partners is promising, given dentists' incentives to decrease patient fear while avoiding opportunity cost (e.g., occupied chairs and staff time).

OBJECTIVES/OBJECTIVE:Although several brief cognitive behavior therapy (CBT)-based treatments for dental fear have proven efficacious, these interventions remain largely unavailable outside of the specialty clinics in which they were developed. Leveraging technology, we sought to increase access to treatment for individuals with dental fear through the development of a mobile application (Dental FearLess). MATERIALS AND METHODS/METHODS:To assess the resonance of our app as an avenue for dental fear treatment, we conducted a study assessing the usability, feasibility, and acceptability of the beta app. Participants with moderate to severe dental fear (N = 80) completed the app and reported on the perceived usability of the mobile interface (Systems Usability Scale, SUS; α = .82) and credibility of the intervention (Credibility and Expectancy Questionnaire, CEQ; α = .88). A sub-sample of participants naïve to the app (n = 10) completed the app during a think-aloud procedure, sharing their candid thoughts and reactions while using the app, prior to reporting on usability and credibility metrics. RESULTS:Overall usability (M = 78.5, SD = 17.7) and credibility (M = 21.7, SD = 5.5) of the beta version of the app were good. The think-aloud data further corroborated the app's acceptability, while highlighting several areas for user improvement (i.e., aesthetics, navigation, engagement). CONCLUSIONS:Usability and acceptability results are promising for the viability of an accessible, feasible, self-administered intervention for dental fear. Refinements made based on user feedback have produced a clinical-trial-ready mobile application. App refinement decisions, informed by user feedback, are representative of the larger literature-that is, of the ubiquitous negotiations m-health developers must make across treatment fidelity, usability, and engagement. Implications for future research are discussed.