Table 3 Interventions for prevention studies

Resilience training

Trauma prevention training program

90-min sessions over 5 days

Program was designed to strengthen resilience during stressful encounters and teach methods of coping after exposure, thereby preventing the emergence of maladaptive symptoms and behaviors with adverse effects on professionalism.

Arble, E (2017) [31]

Quasi-experimental

Police

Police trauma resilience training

2-h training once/week for 10 weeks

An initial psycho-educational session, followed by ten small group sessions consisting of relaxation and imagery training with mental skill rehearsal. Twelve months later, psychophysiological stress and police work performance were assessed during a live critical incident simulation.

Arnetz, BB (2009) [32]

RCT

Police

Mindfulness-based resilience training

2-h class once/week for 8 weeks

A curriculum designed to train participants in a number of experiential exercises evoking qualities of mindfulness: mental focus, sustained attention, and a broad sense of personal and situational awareness. These exercises include versions of the body scan (body awareness exercise), sitting meditation, mindful movement, walking meditation, eating meditation, mindful martial arts exercises, and other elements of mindfulness-based stress reduction (MBSR). During class, there are periods of discussion exploring the experience of these exercises, as well as daily homework practice of the experiential mindfulness exercises, supplemented with several readings and journaling.

Christopher, MS (2016) [33]

Longitudinal cohort study

Police

Visuo-motor behavior rehearsal

10 and 20 min consecutively

Progressive relaxation portion and an imagery/mental rehearsal portion prior to undergoing a highly stressful, critical event training scenario involving “live fire.”

Shipley, P (2002) [34]

RCT

Police

Stress management

Stress management program

4 h/week for 6 weeks

The program included physiological and psychological interventions, such as relaxation training, physical exercise, dietary advice, rational emotive modeling, assertiveness/communication training.

Ackerley, DG (1986) [35]

RCT

Police

Stress reduction program

2.5 h × 4 sessions

The program utilized a cognitive-behavioral approach to training to teach stress awareness and stress control, including an assessment of current factors present in the policeman’s life which are stressful to him, a presentation of general information commonly used in stress management, and didactic interchange with class participants utilizing specific stressors listed by those participants.

Coulson, JE (1987) [36]

Quasi-experimental

Police

HeartMath® stress and emotional self-management training

4–6 h × 3 sessions over 1 month

Program provided practical techniques designed to reduce stress in the moment, improve physiological and emotional balance, increase mental clarity, and enhance performance and quality of life.

McCraty, R (1999) [37]

RCT

Police

Stress management training

8-h session

Stress awareness training and stress management training.

Oliver, WM (2009) [38]

Observational

Police

Stress management training

2-h sessions × 6

Stress awareness training and stress management training, with key components including self-monitoring in stressful situations, muscle relaxation, and development of adaptive self-statements.

Sarason, IG (1979) [39]

RCT

Police

Stress inoculation training

2-h sessions × 5 over 7 weeks

Three major components which generally followed the phases of (1) conceptualization, (2) skills acquisition and rehearsal, and (3) application and follow-through.

Digliani, JA (1994) [40]

RCT

Police

Cognitive-behavioral stress management

4 weekly sessions over 1 month

Key components include stress and trauma education, relaxation techniques, problem-solving, and communication skills. In the therapeutic part of the program, CBT techniques were used, while in the educational part of the program, stress and trauma-related issues were the focus.

Sijaric-Voloder, S (2008) [41]

RCT

Police

Suicide prevention

Suicide prevention program

6 months of presentations and online course

The program included (1) suicide awareness training, (2) suicide prevention training, and (3) education training for crisis management.

Finney, EJ (2015) [42]

Quasi-experimental

Firefighters

Badge of life psychological survival for police officers program/emotional self-care training program

NR

Suicide prevention program including awareness training, further awareness training materials available online to facilitate face-to-face delivery where preferred, annualized mental health “check-ups” with mental health professionals, and peer support programming.

Levenson, RL Jr (2010) [43]*

Descriptive

Police

Together for life program

NR

The program involved training for all officers, supervisors, and union representatives as well as establishing a volunteer helpline and a publicity campaign.

Mishara, BL (2012) [44]

Quasi-experimental

Police

Suicide prevention program

NR

This program included awareness training, gatekeeper training, a 24-h crisis telephone hotline, life skills and stress management workshops, a crisis intervention team, suicide postvention services, and changes to media reporting guidelines following the suicide of an officer.

Welch, J (1998) [45]

Quasi-experimental

Police

Other health promotions

Power to change performance program

5 modules over 2 days (positive emotion techniques); daily physiological readings

The program focused on stress and health risk reduction, including a positive-emotion refocusing technique with physiological feedback training (heart rhythms).

McCraty, R (2003) [46]

RCT

Correctional

Health assessment and promotion program

5–15 min each

Health assessment and motivational interviewing intervention, plus self-help materials for alcohol, smoking, and stress, an advice booklet, and audio cassette.

Richmond, RL (1999) [47]

RCT

Police

Safety & Health Improvement: Enhancing Law Enforcement Departments (SHIELD) wellness intervention

30-min sessions once/week for 12 weeks

Team-based intervention that fosters social support and accountability; each member of the team would discuss weekly goals and there was a scripted set of questions to answer out loud regarding successful strategies identified by subjects to reach the weekly goal.

Kuehl, KS (2016) [48]

RCT

Police

Health promotion through fitness training

30–40 min/session, 3×/week for 10 weeks

Aerobic (i.e., running) and anaerobic (i.e., weight training) structured group sessions. Intervention groups were encouraged to do unsupervised sessions at home when they missed sessions.

Norris, R (1990) [49]

NRCT

Police

Circuit weight training program

20 min/session, 3×/week for 16 weeks,

Circuit weight training, exercises, and sets of reps. Proper technique and individualized training guide provided.

Norvell, N (1993) [50]

RCT

Police

Education and aerobic conditioning

90-min sessions over 8 weeks (education); 3× 45-min sessions/week for 8 weeks (aerobic conditioning)

Exercise/fitness education and aerobic conditioning sessions.

Short, MA (1984) [51]

RCT

Police

Yoga program

75-min classes 6×/week for 4 non-continuous weeks

Classes involved Kripalu yoga (focusing on mindfulness, deep relaxation, yoga postures, meditation, and breathing).

Jeter, PE (2013) [52]

Quasi-experimental

Police

Educational sessions with sleep screening

30-min (mandatory educational sessions)

The program included (1) mandatory educational sessions for sleep, (2) voluntary sleep disorders screening, and (3) sleep disorders diagnosis and treatment for those who screened at risk for a sleep disorder.

Sullivan, JP (2017) [53]

RCT

Firefighters

Sleep hygiene training

NR

Workshop on self-management techniques for controlling insomnia, with the intention of heightening subjects’ awareness and increasing their knowledge of sleep hygiene.

Holbrook, MI (1994) [54]

Quasi-experimental

Police