Preparing Soldiers to Manage Acute Stress in Combat: Acceptability, Knowledge and Attitudes.

Objectives: iCOVER training is designed to prepare individuals in high-risk occupations to manage acute stress reactions in team members. Building on an initial pilot study, the present study evaluated iCOVER with soldiers just prior to their deployment to combat, documenting their feedback and changes in knowledge and attitudes.Methods: National guardsmen received a 1-hr training in iCOVER in the weeks prior to deploying to Iraq and Afghanistan. Surveys were administered before iCOVER training (i.e., "pre-training") and immediately afterward (i.e., "post-training"). In all, 129 of 146 (88.4%) soldiers consented to participate in the evaluation, and all consenting soldiers completed both surveys.Results: Participants rated iCOVER highly in terms of usefulness, relevance, and importance. Knowledge scores improved significantly from pre-training to post-training. In terms of attitudes, participants were more confident in their ability to handle an acute stress reaction, were more confident in their unit's ability to handle an acute stress reaction, were more likely to report their leaders emphasized the need to address acute stress, and were less likely to report stigma related to acute stress from pre-training to post-training.Conclusions: iCOVER training offers high-risk teams an opportunity to prepare for encountering acute stress in team members, strengthening the ability of teams to provide support to one another and respond effectively.