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Heather WoltersPatricia KannapelPeggy GolfinAdam ClemensShannon DesrosiersThomas GeraghtyChristopher GonzalesKim Fletcher
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The Army Resilience Directorate (ARD) asked CNA to assist the Army in better understanding cross-cutting (shared) risk and protective factors associated with multiple harmful behaviors: suicide, substance misuse, domestic violence, sexual harassment and assault, discrimination, and extremism. Specifically, ARD wants us to identify cross-cutting risk and protective factors at each level of a socio-ecological model (SEM) that considers influences on behavior at the individual, interpersonal, community, and society levels. This study supports ARD initiatives to develop integrated prevention strategies that enhance the protective factors and mitigate the risk factors at appropriate touchpoints across Soldiers’ careers. This integrated prevention approach aligns with recommendations from the Centers for Disease Control and Prevention and recent efforts within the Department of Defense (DOD) and the Army.

Several questions guide the effort to develop an evidence-based integrated prevention program model that addresses cross-cutting risk and protective factors at the optimal points in Soldiers’ careers. This report, the first for this project, addresses two key questions. First, what risk and protective factors are associated with the target harmful behaviors at each level of an Army-specific SEM? Second, what evidence-based prevention principles and strategies address these cross-cutting risk and protective factors? Subsequent reports will examine existing Army prevention programs for their alignment with the Army SEM and effective prevention principles, identify gaps, and make recommendations for developing an integrated prevention approach.

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DISTRIBUTION STATEMENT A. Approved for public release; distribution unlimited.


  • Pages: 98
  • Document Number: DRM-2022-U-031820-2Rev
  • Publication Date: 1/30/2023