Population Impact of Wingman-Connect Implemented by the US Air Force

This study involves collection of implementation data and analysis of USAF de-identified administrative data on base-level suicide attempt rates following US Air Force (USAF) delivery of Wingman-Connect training at 8 operational AF bases, as part of a force-wide scale out of the program. Implementation of Wingman-Connect by the USAF will occur over 51 months. The AF has agreed to stagger implementation based on a randomized stepped-wedge design. Once Wingman-Connect has been initiated at each base, all entering first-term Airmen will receive Wingman-Connect, with \~17,400 total Airmen receiving Wingman-Connect across all bases.

Implementation. The study will directly collect data from USAF prevention personnel who are involved in the delivery of the intervention to measure fidelity and measure implementation barriers and facilitators. These base-level data are essential to test Wingman-Connect impact on suicide attempt rates in a general USAF population, to study Wingman-Connect diffusion, and to refine implementation processes and tools.

Suicide Rates. Bases routinely provide their base-wide suicide attempt rates to the Air Force Medical Readiness Agency (AFMRA). AFMRA will provide these routinely-collected aggregate administrative data to this study in order to analyze changes in base-level suicide attempt rates (USAF administrative data) among the 8 bases.

The US Air Force is putting into regular practice the Wingman-Connect Program in the context of First Term Airmen Courses (FTAC) across all 68 operational bases, beginning with 8 bases in two Major Commands (AFGSC, AMC). University of Rochester researchers will provide facilitator training and ongoing fidelity monitoring. Wingman-Connect uses a network health theoretical framework to strengthen two suicide-protective functions of social networks: 1) Strengthening positive social bonds, and 2) Building healthy norms that incentivize adaptive coping. Implementation of Wingman-Connect by the USAF will occur over 51 months. The AF has agreed to stagger implementation based on a randomized stepped-wedge design. Pairs of bases will begin implementation of the program in all FTAC at 3 months intervals and continue over a 51 month total period. Data collection will begin with the start of implementation at each base.

Implementation. The study will directly collect data from USAF prevention personnel who are involved in the delivery of the intervention to measure fidelity and measure implementation barriers and facilitators at each location. Prevention personnel will complete measures every 6 months. Due to turnover of personnel (training site administrators every 6 months) we anticipate 8-12 individual respondents per site across the study period, and 4-6 respondents at each site per data point, for a possible total of N=96 respondents. These participants are also expected to reflect the demographics of the USAF as a whole. Measures will include base climate, uptake of program, USAF implementers' fidelity delivering Wingman-Connect and engagement in training/technical support.

Suicide Rates. Bases routinely provide their base-wide suicide attempt rates to the Air Force Medical Readiness Agency (AFMRA). To test effectiveness of Wingman-Connect delivered by the USAF on these bases, the AFMRA will provide these routinely-collected aggregate administrative data to this study in order to analyze changes in base-level suicide attempt rates (USAF administrative data) among the 8 bases. AFMRA will provide suicide attempt and suicidal behavior data for Airmen of E1-E4 ranks (incoming first term Airmen) on each base every 6 months.

Eligibility Criteria:
Inclusion Criteria:

* Data from bases in the Air Force Global Strike Command (AFGSC) \& Air Mobility Command (AMC) MajComs.
* 96 implementers (4-5 per base over at each data point, and 8-12 respondents per site across the study period)

Exclusion Criteria:

* none