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Full spectrum transition assistance: preventing loneliness and social isolation in military members during moves

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Full spectrum transition assistance: preventing loneliness and social isolation in military members during moves

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Content Running head: FULL SPECTRUM TRANSITION ASSISTANCE 1
Full Spectrum Transition Assistance
Capstone Project for Eradicating Social Isolation
James Bailey
University of Southern California
DSW Cohort 5
Jennifer Lewis, Ph.D.
Doctor of Social Work
SOWK 722 10/30/2019
December 2019
FULL SPECTRUM TRANSITION ASSISTANCE 2
Executive Summary
Various triggers push or draw people away from society, which leads to isolation, chronic
depression, anxiety, suicide ideation, and negative health effects that result in early death. A
socially isolated person has a two to three-fold increase in mortality over someone with at least
one meaningful social relationship (House, 2001). The author chose to contribute to the Grand
Challenge of Eradicating Social Isolation because of his own experiences in the military while
going through ten transitional periods, which resulted in perceived isolation, anxiety, depression,
and related hospitalizations. The American norm of individualism forces individuals to identify
and solve problems alone. Self-report stigma also prevents military members from seeking help.
Social isolation is preventable; therefore, developing effective solutions will pay huge dividends
in elevating socioeconomic outcomes in America. The intervention presented herein is called
Full Spectrum Transition Assistance (FSTA), which is a 12-week Social Worker guided group
therapy that will start a few weeks before a scheduled transition for its beneficiaries. Outcomes
include decreasing loneliness and limiting the number of stressful life events undertaken during a
move. This intervention has an exponential diffusion opportunity for approximately 700,000
active-duty military moves annually. It is innovative because the Department of Defense (DoD)
has no program that transitions military members as a group, nor takes an active role in ensuring
they are prepared for the emotional trauma that moving inflicts on individuals and families.

FULL SPECTRUM TRANSITION ASSISTANCE 3
Table of Contents

Conceptual Framework 5

Prevalence and Incidence of the Social Problem 5
Relevant Concepts 5
Research and Practice 7
Resulting Gaps 10
Theories of Change 11
General Description of Project 12

Problems of Practice and Innovation 12

Program Development 12
Intervention Design 13
Change Strategy 13
Innovation Justification 14
Program Goals for Impact 15
Logic Model 15
Contribution to Grand Challenge 15
Stakeholder Feedback on Solution and Feasibility 16
Analysis of Position within History, Policy, and Public Knowledge 18
Evidence or Data to Show Impact 19
Political, Organizational, and Community Allies 20
Political, Organizational, and Community Obstacles 22
Alternative Pathways Analysis 22

Project Structure, Methodology, and Action Components 23

Implementation Plan and Timeline 23
Revenue Strategy 23
Budget Format and Cycle 24
Phases of the Intervention 25
Units of Service 27
Staffing Plans and Costs 27
Other Spending Plans and Costs 28
Line-Item Budget 28
Revenue vs. Costs (Bottom Line) 29
Evaluating Milestone Achievement 29
Evaluating Goals of the Intervention 30
Plan for Stakeholder Involvement 32
Communication Strategy 33
Dissemination Plan for Broader Impact 33
Ethical Concerns and Negative Consequences 34

Conclusion, Actions, and Implications 35
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References 36

Appendices 42

Appendix A: Panopto Prototype for FSTA Asynchronous Training 42
Appendix B: Four Phases of FSTA Intervention 43
Appendix C: Logic Model for FSTA 44
Appendix D: FSTA Partner Agreement 45
Appendix E: Systems Development Life Cycle (SDLC) 46
Appendix F: Gantt Chart for FSTA Pilot Implementation 47
Appendix G: Line-Item Budget for FSTA 48
Appendix H: UCLA Loneliness Scale 49
Appendix I: Holmes-Rahe Life Stress Inventory 50
Appendix J: FSTA Qualitative Instrument 51
Appendix K: 5-Step Stakeholder Engagement Model 52

FULL SPECTRUM TRANSITION ASSISTANCE 5
Capstone Project for Eradicating Social Isolation
Conceptual Framework
Prevalence and Incidence of the Social Problem
Individuals with fewer social connections have a much higher chance of contracting a
variety of debilitating ailments. According to Cacioppo & Cacioppo (2014), research in social
epidemiology suggests that the absence of positive social relationships is a significant risk factor
for broad-based morbidity and mortality. Loneliness has also been found to be a risk factor for
increased vascular resistance and blood pressure, metabolic syndrome, fragmented sleep,
increased hypothalamic pituitary adrenocortical activity, altered gene expression indicative of
decreased inflammatory control and increased glucocorticoid insensitivity, diminished immunity,
and diminished impulse control (Cacioppo & Cacioppo, 2014). Moving is one of the most
stressful life events experienced by humans, which often leads to social isolation. Military
members and their families go through relocations every 2-3 years (GAO, 2001). Every year,
nearly 700,000 active-duty moves occur within the military, and another 1,300 people transition
out of the military world to become completely civilian (Tilghman, 2015).
Relevant Concepts
Individualism. Americans tend to give people their space and privacy when they appear
to withdraw from society. Social withdraw is the most common telltale sign of depression
(Soong, n.d.). Withdrawal is seen as a shift away from being socially present. These shifts are
more obvious when an extremely extroverted person abruptly becomes reclusive; however,
introverted people may also be observed progressively withdrawing from society. The
normative behavior in focus is that of the bystanders doing nothing to reach out to persons who
appear to withdraw. Americans seek increased wealth and individualization of leisure time,
FULL SPECTRUM TRANSITION ASSISTANCE 6
which is in part responsible for a decline in civic participation (Rosenblat, 2016). Although
privacy and individualism should understandably be protected and valued, reaching out to make
connections is the lifeblood that binds communities. Belonging to society gives meaning and
purpose to every individual’s communal role. Therefore, this norm needs to be exploited to the
extent that Americans can use situational discernment to successfully cultivate healthy
connectedness while adequately protecting their privacy at the same time.
Military culture. Members avoid social events in order to minimize potential harm to
themselves or their reputations. Article 92 of the Uniform Code of Military Justice (UCMJ)
covers unprofessional relationships, which are treated like fraternization. This law applies to
relationships both on and off duty, between officers, between enlisted personnel, or between
officers and enlisted personnel, or even between military and civilian employees. This norm is
connected to social isolation because it deters military members from attempting to establish
meaningful connections in social settings. Social butterfly behavior can be viewed in the
military as not caring about job security. This norm also provides a reason for bystanders to
make rational sense of a service member’s withdrawal behavior. Veterans tend to continue this
behavior into their civilian life because they were conditioned to avoid social events for years.
When it is normal for military members to avoid social events, it can be argued that joining the
military is an initial step in the direction of becoming socially isolated.
Stigma. Military members tend not to seek counseling after experiencing traumatic
events in order to repel any career damaging mental health diagnoses. Many military career
fields involve being placed in hostile fire or combat situations where agile tactical reaction is
crucial to survival. The ability to react instantly may be the difference between life and death.
This ability can become degraded if a person is experiencing morbid thoughts or even
FULL SPECTRUM TRANSITION ASSISTANCE 7
questioning the purpose of the military mission. Some of these reservations may be valid
rational thoughts while others may be the result of PTSD. Regardless of the source of these
internal struggles, military members could benefit from counseling sessions, which may help
rationalize their reservations and facilitate more agility on the battlefield. As a blanket policy,
many operational career fields, such as pilots and Special Forces, will dismiss members who are
diagnosed with any sort of mental health problem.
Anomie. Veterans are susceptible to anomie as they transition throughout military
service. Sociologist Émile Durkheim used the word anomie to describe a normless society, or a
society without social regulation. Anomie is a social condition in which there is a disintegration
or disappearance of the norms and values that were previously common in society (Crossman,
2018). Anomie can occur during and after periods of radical change to the social, economic, or
overall identity of a person’s life. It is a transition phase wherein the values and norms common
during one period of time are no longer valid, but new ones have not yet evolved to take their
place (Crossman, 2018). Veterans feel disconnected from their communities during periods of
anomie because they no longer see the norms and values that they once held dear reflected in
their new reference group. Veterans who are transitioning throughout their careers and then
moving onto civilian life will almost assuredly experience anomie, which leads very easily to
social isolation.
Research and Practice
Grand Challenge aims. The three policy recommendations published by the American
Academy of Social Work and Social Welfare (AASWSW) for meeting the Grand Challenge of
Eradicating Social Isolation are to:
1) Increase access to high-quality child care that strengthens social connections.
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2) Build more age-friendly communities that strengthen social connections.
3) Reform solitary confinement. (Butts, 2016)
Unfortunately, the policy recommendations do not yet establish precedence for focus on the
military or veteran populations, or more importantly occurrences of social isolation resulting
from traumatic experiences and abrupt transitional periods in life. Most work in ending social
isolation has been aimed at the elderly population.
Sponsorship programs. Each branch of the military maintains and ensures that
adequate quality of life programs are available to support their service members. Sponsorship
and transition assistance programs (TAP) are similarly structured across all military branches,
but their executive authority resides at the squadron or unit level; therefore, no formal uniform
continuity in quality of life programs exists under the DoD umbrella (Military One Source,
2018). Through interviews with 40 veterans and military members, the author deduced that the
most successful transitions involved sponsors who were advocates during the whole moving
process (Personal communication, June 5-28, 2018). Unfortunately, not all units have such
programs, and few sponsors are properly trained.
Suicide prevention programs. The Department of Veteran Affairs (VA) began a crisis
hotline in 2007 in collaboration with the National Suicide Prevention Lifeline (1-888-273-
TALK). People in jobs requiring significant levels of aptitude, sacrifice, and education seem to
be those with above-average risk of suicide (Mental Health Daily, n.d.). Veterans take their lives
at nearly double the rate of the average population (Leardmann, Powell, & Smith, 2013). The
National Suicide Prevention Lifeline is funded by the federal Substance Abuse and Mental
Health Services Administration (SAMHSA) and administered by the Mental Health Association
of New York City (MHA-NYC) (NSPL, n.d.). Veterans, military service members, and their
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advocates who call are directed to crisis line counselors at the VA in Canandaigua, NY. Zero
Suicide is a commitment by SAMHSA, which proposes that suicide deaths for individuals under
care within health and behavioral health systems are preventable, and that a systematic approach
to quality improvement in these settings is both available and necessary to keep suicidal patients
from falling between the cracks (SAMHSA, 2017).
Veteran crisis hotline. The VA began an online Veterans Chat service in 2009 to
supplement their crisis line and provide information or services to veterans, active-duty military,
and advocates who prefer an online platform to communicate. In 2010, the American
Foundation for Suicide Prevention (ASFP) and the VA implemented an online assessment. This
Veterans Self-Check Quiz is actually an adaptation of AFSP’s evidence-based Interactive
Screening Program, an anonymous, web-based method for identifying college students who are
at risk for suicide. Users anonymously complete an online questionnaire for depression, stress,
drug and alcohol use, PTSD, traumatic brain injury, and suicidal thoughts and behaviors (U.S.
Congress, 2012). Submitting the Self-Check Quiz generates a signal to the Chat Counselors, and
then the user is directed to stay on the website to receive the Counselor’s personal response,
which typically occurs in 15–30 minutes (U.S. Congress, 2012). Informational materials can be
viewed on the website while waiting for assistance from a counselor.
It is difficult to gather reliable evidence about the effectiveness of suicide prevention
hotlines, but Dr. Madelyn Gould of Columbia University found that of Lifeline callers, 12% of
suicidal callers said that talking to someone at Lifeline prevented them from harming or killing
themselves, almost 50% followed through with a counselor's referral to seek emergency services
or contacted mental health services, and about 80% said that Lifeline had something to do with
keeping them alive (Tracy, 2017). Although the goal of suicide prevention hotlines is to prevent
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suicide, experts have a very difficult task in gathering available data beyond subjective
testimonies of callers and call center counselors. Research shows record numbers of calls occur
immediately after celebrities commit suicide, or after presidential elections when the outcome
did not go the callers’ way. The amount of calls taken from distraught callers is quantifiable, but
it is still questionable how many calls would have otherwise resulted in suicide.
Military wellness program. The Navy and Marine Corps Public Health Center
(NMCPHC) put out a three-part proactive handbook series on preventing social isolation in
2014. The goal of this packet is to provide information, education, and resources for early
intervention to help prevent military service members from becoming socially isolated
(NMCPHC, 2014). It is rightfully titled Preventing Social Isolation on All Fronts. The three
parts are short and easy to follow for each respective target audience, which includes the
veterans, caregivers, and service providers. This proactive series contains a very useful social
engagement conversation guide, which serves as a screening worksheet to detect and measure
levels of social withdrawal or social isolation. A plan of action worksheet helps organize
veterans’ goals and focuses attention on progress. A section on social engagement strategy
includes tips that veterans have reported being helpful in creating or maintaining meaningful
relationships. Finally, a resource guide lists available support services and contact numbers.
Resulting Gaps
Social and demographic trends have influenced the increasing number of adults at risk for
loneliness, which contributes to an amplified risk for physical and mental illness. Rising indirect
implications and costs of loneliness have led to many innovative loneliness reduction
interventions. According to Masi, Chen, Hawkley, and Cacioppo (2010), four primary
intervention strategies exist for treating loneliness, which include:
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1) Improving social skills,
2) Enhancing social support,
3) Increasing opportunities for social contact, and
4) Addressing maladaptive social cognition.
According to Mann et al. (2017), effective loneliness interventions include changing
cognitions, supported socialization (socially-focused supporter), social skills training, and
psychoeducation. Among randomized comparison studies, the most successful interventions
addressed maladaptive social cognition (Masi et al., 2010). This evidence led the author to
design a group delivery intervention that incorporates the aforementioned strategies, with a focus
on social cognition skills for a proactive solution to loneliness-prone life events, such as moving.
Theories of Change
Many stakeholders share a sense of resolve for the outcomes of FSTA. This intervention
embodies the collective impact theory, which incorporates a joint understanding and concerted
effort to affect change (Kania & Kramer, 2011). Existing intervention programs are focused on
the effects of PTSD and TBI among veteran populations, while active-duty military communities
continue to be silenced by self-report stigma. Existing programs typically offer face-to-face
counseling, which falls short of assembling a cohort of individuals who could support each other
as they are geographically dispersed throughout the planet.
Humans are social beings who are most comfortable when connected, sharing strong
emotions and stories, and led by charismatic leaders who provide a safe environment (Morgan,
2015). According to Ralph Stacey (2006), theories of personal change differ from each other
according to the assumptions made about the nature of the individual, the relationship between
the person and society, and the nature of causality. Three different concepts of the individual
FULL SPECTRUM TRANSITION ASSISTANCE 12
person are distinguished, namely, the autonomous, the expressivist, and the social individual.
From the perspective of social individuals, the individual is a cultural being, necessarily
dependent on others, who only develops a mind in interaction with others. From this
perspective, individual change cannot be separated from change in the groups to which an
individual belongs.
General Description of Project
FSTA is a new and innovative intervention that will strengthen resiliency and battle
loneliness in active-duty beneficiaries as they go through relocations every 2-3 years. A social
worker will begin meeting with a cohort one month before their planned relocations to guide
three months of weekly meetings via a virtual teleconferencing platform on topics that will
increase their chances of success. The key component of this intervention is the group delivery,
which will build a support network for each beneficiary. These topics will coincide with
predicted activities experienced during each week of the moving process. Topics include suicide
awareness, logistical requirements, relationship maintenance, cognitive behavioral therapy
(CBT), and physical fitness.
Problems of Practice and Innovation
Program Development
Intervention statement. Social workers will facilitate interactive cohorts of individual
military members and their families going through relocations to ensure meaningful connections
are maintained, and integration into new communities becomes successful.
The author’s proposed innovation is called Full Spectrum Transition Assistance (FSTA).
The technology revolves around the ability of all personnel to have Internet access to meet in
weekly online classroom sessions. The beneficiaries and social workers will connect with each
FULL SPECTRUM TRANSITION ASSISTANCE 13
other and monitor completion of predetermined milestones through the Panopto online platform
(see Appendix A). Curriculum will guide cohort meetings that educate beneficiaries on
maintaining health, wellness, and connectedness. Individual meetings will be tailored to specific
needs of each beneficiary, if needed. Quantitative assessments and journey maps will also be
used to identify emotional dips and spikes along the way.
Intervention Design
Maintaining connectedness is the mission of the FSTA program. The main activities of
the program include admission of beneficiaries a month prior to relocation, technology
setup/data input, weekly cohort meetings, asynchronous knowledge transfer, weekly surveys,
goal setting, and individual/family strategic planning. The weekly cohort meetings will be
instructor-guided two-hour group sessions using a virtual video teleconferencing platform. The
social worker will also schedule additional one-hour individual sessions with each beneficiary,
when needed. Family members will be encouraged to participate in the individual sessions.
Activities will last a total of 12 weeks to cover the complete moving process with group support.
Change Strategy
The blended strategy of FSTA can be broken down into eight discrete strategies, as listed
in the Expert Recommendations for Implementing Change (ERIC) compilation (Brownson,
Colditz, & Proctor, 2017). These eight discrete strategies are planned to coincide with the EPIS
Framework chronologically; however, each strategy may be carried out cyclically or
simultaneous with others to ensure effective and efficient completion of each component:
1) Change the physical structure & equipment by globalizing the intervention through the
use of a video teleconference (VTC) platform.
FULL SPECTRUM TRANSITION ASSISTANCE 14
2) Promote adaptability by defining four separate phases of intervention delivery, which are
Disconnecting, Travel, Reconnecting, and finally Networking (see Appendix B).
3) Access new funding to facilitate implementation by connecting the community partner
with private donors to facilitate revenue flows.
4) Conduct clinical small tests by enlisting 300 beneficiaries to take part in a pilot for the
first year of implementation with a staff of four social workers, and compare collected
research data to 300 control group participants.
5) Develop a formal implementation blueprint through the use of a detailed Gantt chart,
informative logic model, and a realistic budget for implementation of the pilot.
6) Obtain and use stakeholders’ feedback by administering instruments and evaluating data.
7) Stage implementation scale up by planning long-term diffusion throughout all four DoD
military branches.
Innovation Justification
Personal experience. After ten military relocations, the author experienced chronic
disconnection and alienation, which ultimately resulted in two divorces and severe depression.
These personal experiences with loneliness and isolation are the catalyst for developing this
intervention. According to John and Stephanie Cacioppo (2014), the absence of positive social
relationships is a significant risk factor for broad-based morbidity and mortality. As the author
continued to develop the intervention and research related topics, he developed a versed
awareness of the causes and effects of social isolation. The culmination of experience and
research has led him to developing a program that aims to curb the negative effects of social
isolation at its core, in order to correct coping behaviors before they become habits that lead to a
life of loneliness and isolation for the target population.
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Program Goals for Impact
FSTA program goals can be split into three categories, which are 1) short-term related to
the pilot, 2) long-term related to complete DoD coverage, and then 3) exponential diffusion into
other agencies/industries outside of the military. The attached Gantt chart shows a timeline for
pilot implementation, which is the foundation that will prove the success of FSTA. The yearlong
pilot will also serve as a research study for 300 intervention beneficiaries that will be compared
to another 300 control group participants. At the completion of the pilot, there will be enough
data collected from two quantitative instruments, plus programmatic improvements, that a
detailed analysis can be published to report the levels of outcome and goal achievement.
Logic Model
The logic model (see Appendix C) illustrates the requirements and intended outcomes of
the intervention. Providing adequate inputs, the activities and participation levels will produce
the stated outcomes. The design of the logic model highlights the outcomes of resiliency,
increased connectedness, and less perceived isolation, which is appropriately and directly linked
to the problem. The long-term impacts are that the innovation will be diffused for all eligible
beneficiaries, suicide and divorce rates will decline, stigma will subside, increased connectedness
will replace loneliness, and that other populations will benefit by using this intervention model.
Contribution to Grand Challenge
This innovation is transformational with regard to the continuum of innovation. This is
an intervention with exponential opportunities that can be offered to almost 2 million people
each year. Among the 12 Grand Challenges of Social Work is the challenge to Eradicate Social
Isolation by promoting effective ways to deepen social connections and community for people of
all ages (Fong, Lubben, & Barth, 2018). Moving is one of the most stressful events experienced
FULL SPECTRUM TRANSITION ASSISTANCE 16
by humans. Being separated from society can lead to isolation, chronic depression, negative
health effects, early death, and even suicide (Stone & Crosby, 2014). During a moving event,
people will become acutely isolated because their meaningful connections are suspended. Some
people will also become reclusive as a coping mechanism during a move. Loneliness and social
isolation have gained increasing attention as social determinants of health, with impacts
comparable to smoking, alcoholism, physical inactivity, and obesity (Dickens, Richards,
Greaves, & Campbell, 2011). Veterans also take their lives at nearly double the rate of the
average population (LeardMann, Powell, & Smith 2013). The author’s focus is to implement an
intervention that battles social isolation and strengthens resiliency in military members. FSTA
has the potential to be diffused as an evidence-based practice in all industries requiring moves.
Stakeholder Feedback on Solution and Feasibility
In collecting information through interviews and research, the author found many of the
terms used by social workers and entrepreneurs are not well known in the military community.
U.S. Army Sergeant Jerome Wickham at the Landstuhl Regional Medical Facility (LRMC) was
interviewed in Germany where he serves as the non-commissioned officer in-charge at the
behavioral health clinic. After the author explained to him that one of social work’s Grand
Challenges is Eradicating Social Isolation, He replied that he was not aware of the phrase and
explained how his office screens for the existence of depression or anxiety with the SIGECAPS
test, and then tries to determine symptoms and causes. Sgt. Wickham offered this information:
“Isolation has been known to be a contributing factor of depression in the local military
community. Not so much with younger enlisted people because they all live in the
barracks and are basically forced to be around each other most of their tour. Officers and
high-ranking enlisted soldiers experience social isolation more frequently. The military
FULL SPECTRUM TRANSITION ASSISTANCE 17
forbids fraternization, which makes socializing for these individuals quite difficult. Mere
rumors of any favoritism or unprofessional relationships within the ranks could be
grounds for termination proceedings.” (Personal communication, February 13, 2018)
Therefore, even when surrounded by people at work, there is little chance for certain military
members to create and cultivate meaningful connections with other people. This rule of
forbidding fraternization was established to safeguard rigid fairness and objectivity within the
military ranks, but it can also be categorized as a cause for some instances of social isolation.
Government furloughs affect federal social workers. Sergeant Wickham explained how
their social workers become immediately furloughed when the government shuts down, which
directly impacts their own personal lives, as well as those of the soldiers and civilians in their
care. Other documented research points to how job loss leads to isolation, which leads to
negative health effects. New York sociologist Kate Strully focused on people who attributed
their job loss to factors beyond their control (Heibutzki, n.d.). About 80 percent of this group
reported new illnesses within 18 months of their layoff where arthritis, heart disease and other
cardiovascular-related problems were the most commonly reported conditions among this group
(Heibutzki, n.d.). Layoffs contribute in many ways to the negative effects of social isolation.
American civilians who work for the U.S. government abroad also have unique logistical
stressors that will surface in conjunction with losing their jobs; they instantly become tourists on
a 90-day stay limit through their passport. This could add to the social isolation effect as the
person’s priority will become finding a new job locally or relocating within a very narrow
timeframe. If a person normally spends most of his time socializing with co-workers, the loss of
a job can also mean the loss of a group of friends and an active social life (Beck, 2015).
Currently, there is a trend of abandoning furloughed individuals and spouses by allowing them to
FULL SPECTRUM TRANSITION ASSISTANCE 18
fend alone with obtaining new employment. These examples reveal how an individual’s social
foundation can shrink during a period in life when moral support is needed the most.
Analysis of Position within History, Policy, and Public Knowledge
Major barriers. Potential barriers that affect implementation of the proposed
intervention include the sociopolitical context, resource limitations, funding access,
technological development, stakeholder relations, bureaucratic red tape, recruiting experts, and
retaining essential personnel. The largest barrier is that military organizations and quality of life
advocates do not currently view military relocations as vulnerable events that warrant increased
hardening efforts. According to Bach-Mortensen, Lange, and Montgomery (2018), the thematic
synthesis of 31 studies identified resource limitation, in particular staff and finance, to be the
most reported barrier to organizations implementing evidence-based interventions. Also,
inadequate internal or external capability may contribute to escalating time and cost overruns
resulting in project abandonment (Nah, Islam, & Tan, 2007). Although the FSTA program
houses a promising intervention, the infrastructure provided by the underlying organization and
its management is key to sustaining operational success.
Major facilitators. To counter the myriad of stymied barriers, a list of facilitators
include networks of military, nonprofit, and academic organizations that seek to uncover similar
interventions, academic partners that can provide technological solutions, community partners
that can assist with funding options, existing reliable test instruments, and the use of a small pilot
for initial feasibility testing. Although there are many philanthropic funding resources available,
finding and securing large donations requires an established nonprofit, which a community
partner provides to facilitate accessible revenue streams (Community Partners, n.d.). Funding
partners will sign a partner agreement, which serves as a pledged commitment (see Appendix D).
FULL SPECTRUM TRANSITION ASSISTANCE 19
Implementation climate. Considering the stated barriers and facilitators, the FSTA
intervention is poised for a successful implementation. Regardless which political party controls
Congress; the macro political environment will always support either military programs or social
programs. According to Cormack (2018), democrats typically push social assistance programs,
while republicans give little pushback as long as veterans are the recipients of such aid. This
intervention promotes bipartisan agendas.
Evidence or Data to Show Impact
Much of the available evidence on negative health outcomes related to social isolation
can be perceived as indirectly linked, or even anecdotal. However, there is quantitative evidence
that shows how much the military and their families are adversely affected by unemployment,
suicide, divorce, and frequent moving requirements. Military members move on average 10
times more than civilians. They also have approximately double the occurrence of suicide and
divorce (Morris, n.d.). According to Beutel et al. (2017), the top five reasons people become
lonely and isolated are 1) death of a loved one, 2) moving from friends and family, 3) Isolation at
work or school, 4) divorce or separation, and 5) losing a job. There are currently approximately
750,000 U.S. military spouses. They deal with all these loneliness triggers at a severely
increased rate. They raise children while the other parent is deployed, put their careers on hold,
earn about 38% less than their peers, and suffer a 24% unemployment rate (Defense Manpower
Data Center, 2015). There are currently 1.4 million active-duty military members that move
every 2-3 years; however, they also deploy often from their transient homes to fight in conflicts,
which puts them and their families at an increased risk of interpersonal problems even after
settling into a new home. The data supports the need for this target population to receive FSTA
to fortify their ability to thwart loneliness.
FULL SPECTRUM TRANSITION ASSISTANCE 20
Political, Organizational, and Community Allies
Auspices. The auspices of the FSTA initiative will be the Board of Directors at
Community Partners, which is a nonprofit organization in Southern California. “Community
Partners’ Fiscal Sponsorship program is a comprehensive alternative to starting up and running a
nonprofit organization” (Community Partners, n.d.). The author chose to seek a fiscal
sponsorship for a number of reasons. Firstly, Community Partners has been established as a
501(c)3 nonprofit organization since 1992, so they have the longevity, staff, and experience
needed to gain trust from potential funders for FSTA. Secondly, the author believes his time will
be better spent on implementing the intervention, rather than building a new nonprofit
organization from the ground up. Lastly, a fiscal partnership will immediately add to the
administrative support required, and champion-level energy needed for sustainment. Connecting
with Community Partners will result in fees of only 9% on all private grants and individual
contributions raised for the intervention (Community Partners, n.d.).
Political climate. Military programs are better funded during active conflicts, but
republican presidents tend to push for increases in military and veteran program funding,
regardless. Conversely, democrats tend to favor social programs, so this innovation actually has
the potential to be accepted on both sides of the political aisle. Also, many technological and
evidence-based best practices will be disseminated to further uncover effective universal
solutions to the Grand Challenge. The author views the political climate as optimistically filled
with support.
Potential collaborators. Collaboration with other government agencies, non-profits, and
foreign enterprises will help cultivate success. Collaborating with congress is inevitable, as the
legislative branch will ultimately be appropriating funds for related DoD programs. Specific
FULL SPECTRUM TRANSITION ASSISTANCE 21
congressional bodies involved with oversight on such a policy are the armed services, aging,
budget, appropriations, and veterans’ affairs committees.
Understanding diversity will help build networks required to advocate for veterans. The
Mighty is a digital health community created to empower and connect people facing health
challenges and disabilities. Their website is themighty.com, which posts video stories in real-
time and has over a million registered users. The Mighty also enlists celebrity personalities to
host interviews, bridge the generational differences, and publish testimonies on many platforms,
such as YouTube. This potential collaborator will add value through storytelling.
There are currently support organizations within all four services of the armed forces that
provide invaluable care to military members. Among them is the Navy Suicide Prevention
Branch, which authors the 1 Small ACT Toolkit. The Navy requires its sailors to be in remote
locations or onboard ships for extended periods of time. Sailors spend their careers in
environments much more prone to social isolation than its sister services. The Navy is already
leading efforts in mental health counseling and suicide prevention.
The RAND Corporation is a nonprofit organization that was founded in 1948 by a few
military aviation legends, General Henry “Hap” Arnold, Donald Douglas Sr., and Major General
Curtis LeMay. Headquartered in Santa Monica, California, this organization is comprised of
three major parts, which include a think tank, a consultancy, and a university. According to the
RAND Corporation (2019), their mission is to provide public policy solutions to their customers
at cabinet-level agencies, charitable trusts, city governments, and community nonprofits. Among
the specific programs highlighted in their 2018 annual report is the Military Families on the
Move program, which focused on the immense stress that a third of all military members go
through every year in moving to new duty stations (Tong et al., 2018). In this effort, the RAND
FULL SPECTRUM TRANSITION ASSISTANCE 22
Corporation reviewed previous studies, interviewed experts, and analyzed survey data to
conclude that service members and their families need more lead time to prepare for each move,
but for the most part rebound within about two months (Tong et al., 2018).
Political, Organizational, and Community Obstacles
Many veterans live abroad in foreign countries that have no U.S. congressional
representation. Social justice requires that all who qualify can access social programs equally.
Some locations have existing U.S. military communities and hospitals on military bases;
however, retirees and U.S. civilians are not allowed to access military healthcare programs. This
limitation requires them to seek care on the foreign economy. Diplomatically teaming with
foreign facilities may assist with offering this program to non-military persons and those moving
to non-U.S. countries.
Communities in foreign countries involve language, legal, and cultural barriers that
impede the ability of social workers or sponsors to effectively assist beneficiaries with
community integration. This will be an ongoing unique struggle for a single social worker to
provide adequate support for a cohort that is moving to many different countries.
Alternative Pathways Analysis
The author foresees a few potential challenges and has devised contingency plans to
respond to these events. If a champion nonprofit model cannot assist with implementation of the
pilot, the author will build a nonprofit to seek funding donors and facilitate implementation
directly. Another alternative is to network with supporting commanders at individual military
bases who could task military social workers to facilitate transitions as an additional duty. If
military leadership is apprehensive to assign troops to the pilot program, social media will be
leveraged to attract volunteer participants. Finally, if adequate technology development is
FULL SPECTRUM TRANSITION ASSISTANCE 23
unsuccessful, the pilot will use certain functions of Facebook, Google, email, teleconferencing
platforms, and other existing programs to sufficiently connect with beneficiaries.
Project Structure, Methodology, and Action Components
Implementation Plan and Timeline
Using the seven phases of the Systems Development Life Cycle (SDLC)(see Appendix
E), the author plans to fully implement FSTA into the DoD within two years. The Gantt chart
(see Appendix F) illustrates the SDLC business plan tasks and their expected duration over the
next couple years. With peak military relocation occurring during the summer months, and fiscal
years beginning every October, the pilot should be completed and ready for full-scale FSTA
implementation throughout the DoD by the end of September in the year 2021. Long-term
sustainability will be achieved through demonstrating valuable outcome delivery. The flexibility
of offering the system through government contracts, or as a federal program, will ensure an
indefinite bridge across the vulnerable transition period.
Revenue Strategy
The first year of the intervention will require $630,000 in operational funding. This sum
includes staff wages for a program director and four social workers, IT support, and related
equipment/tools. A large portion of this funding will stream from grants and philanthropic
groups, such as the EOD Warrior Foundation and the Threat Management Group. These
organizations are in the business of implementing military quality of life programs. They also
invest in research activities that develop public policy solutions for military and veteran
populations. Therefore, it makes sense for the author to seek major grant funding from these
organizations as a Big Bettor (Foster, Kim, & Christiansen, 2009) funding model. The author
has secured verbal agreements from both organizations to contribute to the pilot phase of FSTA.
FULL SPECTRUM TRANSITION ASSISTANCE 24
Another revenue source will be in the form of donations from individuals, which will be
marketed through the Veterans of Foreign Wars (VFW). This funding model is known as the
Member Motivator because individuals donate money for a purpose that is integral to their
everyday lives and is something from which they draw a collective benefit (Foster et al., 2009).
Individual donations will come with few limitations on how the money can be spent, which will
allow flexibility in running the intervention program.
Eventually, FSTA will become a federal government program, or receive its funding
primarily through government grants and contracts as a nonprofit entity. This Public Provider
(Foster et al., 2009) funding model will depend on the auspices of the U.S. Congress for DoD
budget approval, and typically come in the form of reimbursements. Therefore, FSTA will
remain flexible and open to building a portfolio of funding models to sustain a revenue strategy.
Budget Format and Cycle
The budget format selected for this program is the line-item budget (see Attachment G).
This budget format provides financial control and allows for flexibility with spending on items
that fit under each requirement. Most of the program revenue streams from a small list of
investors, while 70% of the expenses are marked for personnel salaries. Therefore, budgeting for
this capstone requires only broad strokes for the implementation of the program.
The budget cycle for this program will align with the federal government’s fiscal year,
which begins annually on October first. The budget cycle consists of four stages, which include
planning and submission, approval, execution, and audit and evaluation (Lee, Johnson, & Joyce,
2013). The planning and submission stage typically begins in the spring, 1.5 years before the
budget year starts (Lee et al., 2013). This first stage with the FSTA program is a responsibility
of the director, who will list strategic goals while soliciting the advice of other stakeholders, and
FULL SPECTRUM TRANSITION ASSISTANCE 25
then prepare a budget that illustrates how much the program will cost and how it will be paid for.
This budget will be given to the auspices of the program for approval, which encompasses the
second stage of the budget cycle. Approval occurs during the winter before the fiscal year
begins. The auspices may require some adjustments to be made before approval is given. After
approval, the execution stage will be allowed to commence, which happens throughout the
budgeted fiscal year as money is being spent on operations. The final stage is audit and
evaluation, which is designed to guarantee executive compliance with set goals, or to ensure the
program’s administration carried out business as planned.
Phases of the Intervention
The intervention consists of four distinct phases that flow in linear chronological order
throughout the moving process (see Appendix B). The first phase is called disconnecting, in
which the beneficiary is notified of the requirement to move to a new location, as spelled out in
his official military Permanent Change of Station (PCS) orders. At this point the beneficiary
becomes aware that his time in the immediate location has a nearing expiration date. The PCS
orders qualify the beneficiary for registration into the FSTA program. After an initial meeting
and registration is completed, the weekly cohort and individual sessions with an assigned social
worker will begin. This will prepare the beneficiary for the move both mentally and logistically.
The social worker will act as an advisor to the beneficiary and provide a checklist with
references on what to expect, the importance of maintaining meaningful connections, and how to
complete tasks. Events during this phase include packing up household goods, working with
moving companies, obtaining a flight plan/itinerary, and properly saying goodbye to existing
relationships.
FULL SPECTRUM TRANSITION ASSISTANCE 26
The actual travel to the new location signals the start of the second phase of FSTA called
travel/limbo. In this phase the beneficiary will put his learned FSTA behaviors and theory into
practice. Historically, this is the point where a military member enters the feeling of limbo
because he no longer is involved with the usual day-to-day belonging to a specific workplace or
community. Weekly cohort and individual sessions will be tailored to support the beneficiary
with getting through the travel process, which might include leave en-route or vacation time with
family at various locations along the way.
Upon arrival in the new location, the beneficiary will transition to the reconnecting
phase. Events at this point include the logistical requirements of house hunting, receiving
household goods, in-processing at the new workplace, and integrating into the new community.
During this phase the beneficiary will naturally be viewed as an outsider, while many
introductions will take place each day. The social worker will focus on helping the beneficiary
make new connections and maintain a resilient mindset throughout this vulnerable process.
The final networking phase of FSTA is designed to sustain the beneficiary indefinitely.
As compared to Maslow’s Hierarchy of Needs, the first three phases of FSTA involve
maintaining the basic physiological, safety, and social needs while going through a move. This
final phase of FSTA focuses primarily on sustaining those basic needs through building a robust
and lasting network of people and resources. People need to sense they are valued by others and
making a contribution to the world around them through participation in professional activities,
academia, athletics, or other hobbies (Cherry, 2018). Psychological needs involve empowerment
and self-esteem, which are paramount in sustaining the outcomes of this intervention. According
to Cherry (2018), those who lack self-esteem and respect of others can develop feeling of
inferiority, which will lead to unhealthy coping mechanisms such as social isolation.
FULL SPECTRUM TRANSITION ASSISTANCE 27
Units of Service
The first year of FSTA will service 300 beneficiaries. Since the pilot’s beneficiaries are
military members, their dependent family members could also be counted as indirectly benefiting
from this program, but they are not counted as beneficiaries herein. Each beneficiary will go
through 12 weeks of both cohort and individual sessions, which will last two hours for each
group session and an hour for each individual session. Therefore the total count of events during
the first year is 10,800 (300x12x3) sessions. This workload will be divided between four social
workers, which equates to 2,700 (10,800/4) sessions conducted by each social worker per year.
The FSTA program has a cost structure designed to conduct 10,800 sessions with 300
beneficiaries. After combining all fixed and variable costs, the total revenue required to deliver
this program is $630,000. When dividing the total cost by the number of sessions planned with
beneficiaries ($630,000/10,800) the break-even point per unit of service is $58.33.
Staffing Plans and Costs
The context of the staff required to conduct FSTA activities is also related to the number
of beneficiaries serviced in the first year. The author used the general schedule (GS) equivalent
pay scales to allocate adequate salary amounts for FSTA staff. One director is needed to create
all program objectives, develop curriculum, lead employees, oversee implementation, and
network with stakeholders. Directors who perform congruent administrative work in the federal
government fill positions at the GS-14 level, which is a grade generally reserved for top-level
supervisors, and professionals holding advanced degrees (Federal Pay, 2018). The frontline staff
will be filled by four MSW-level social workers that will be entrusted with carrying out activities
directly with the beneficiaries. Job announcements found at USAJobs.gov that require an MSW
FULL SPECTRUM TRANSITION ASSISTANCE 28
are typically at the GS-12 pay grade level. Therefore, the budget allots for the social worker
staff salary to be equivalent to a tenured GS-12.
Accounting for personnel salaries within the FSTA program is quite simple. Using the
full-time equivalent (FTE) method, the director will account for a $100,000 annual salary, while
each of the four social workers will account for a $70,000 salary. The allotted $50,000 for IT
will go to a team that will develop asynchronous videos. All personnel expenses equal $430,000.
Other Spending Plans and Costs
The non-personnel expenses will round out the FSTA implementation efforts and provide
foundational resources for the first year. Firstly, furnishing the staff of the program with
adequate computing equipment is an absolute must. Five sets of laptops, software packages,
cellphones, and related peripheral devices will cost $10,000 and last for three years. In-kind
office space accounts for a $30,000 asset value and refers to home offices of all the staff, as they
will primarily telework. Office supplies, marketing, cell phone/data plans, and website
maintenance fees account for $7,000. A major piece of the program puzzle involves contracting
out IT support to manage needed virtual platforms, licensing, and provide customer support,
which is budgeted for $90,000. Finally, as mentioned earlier, the Community Partner
partnership will come at a 9% fee on all private donations received by FSTA, which equates to a
total of $54,000. All non-personnel expenses generate a total of $181,000.
Line-Item Budget
The line-item budget for the first year of FSTA operations covers cost and revenue
assumptions listed throughout this paper (see Appendix G). Explanations are provided for each
revenue source and expense item to justify the estimated amounts. This budget is the foundation
to monitor productivity and efficiency for FSTA operations.
FULL SPECTRUM TRANSITION ASSISTANCE 29
Revenue vs. Costs (Bottom Line)
Upon review of the line-item budget for the first year of FSTA operations, the projected
revenues and expenditures can be more easily understood. The capital required is largely to pay
for the staff’s salaries. There is no training cost component because the staff are already trained
to the MSW level and any further training will be on FSTA proprietary methods, approved
curriculum changes, or policy authored by the program director. Total revenue required is
$630,000, which will offset the listed expenses of $621,000 to arrive at a surplus in the amount
of $9,000. The surplus will be set-aside for unforeseen overruns, program improvements, and
other contingency purposes.
Evaluating Milestone Achievement
In order to evaluate the implementation of the FSTA program, the Stages of
Implementation Completion (SIC) format will be used. The SIC was developed to measure the
implementation progression throughout predefined stages to effectively monitor and evaluate the
completion of specific milestones, and account for the time of completion for each activity
(Chamberlain, Brown, & Saldana, 2011). The author chose to use the seven stages of life-cycle
development as an outline for program implementation, which is integrated with the attached
Gantt chart (Innovative Architects, n.d.)(see Appendix F). Applying the SIC format to the seven
implementation stages defined by the author, FSTA activities in the first year will be observed
and monitored to document the dates of initiation and completion for each stage. For the sake of
successful future implementation efforts, it is also important to document which stages are not
completed and why. Following the intent of the SIC will ensure all key milestones of the
program are efficiently implemented, which will become the foundation for an effective
intervention.
FULL SPECTRUM TRANSITION ASSISTANCE 30
Evaluating Goals of the Intervention
Overarching goal. The strategic goal of the FSTA intervention is to curb the negative
effects experienced by military members as a result of frequent relocations. In other words, the
intervention seeks to protect its beneficiaries from social isolation, which results from moving.
Measuring instruments. The outcomes of the intervention will be evaluated by
administering two quantitative assessment instruments. The first is the UCLA Loneliness Scale
(Russell, Peplau, & Ferguson, 1978), which is a 20-item, 4-point Likert scale, general measure of
loneliness (PsycTESTS, 2018)(see Appendix H). The second is the Holmes-Rahe Life Stress
Inventory, which is a list of 43 events that will quantitatively assess levels of stressful life events
occurring in the lives of beneficiaries (see Appendix I). The premise of the stress inventory is
that stressors can be ranked by the degree of change or upheaval they typically cause in
individuals’ lives (Noone, 2017). Additionally, a qualitative questionnaire will capture any
programmatic improvement suggestions submitted by beneficiaries (see Appendix J). These
instruments are a mixed-methods approach to glean sufficient output data that will allow for
objective evaluation of the stated outcomes.
Process objective #1. MSW-guided cohorts of 25 beneficiaries moving at the same time
while participating in weekly group sessions, which last two hours each with a focus on
cognitive behavioral therapy and cultivating meaningful connections.
Outcome objective #1. To decrease military movers’ perceived loneliness by 50%
throughout the 12-week intervention period as measured by scores on the UCLA Loneliness
Scale, and then compared to the control group.
Process objective #2. Beneficiaries will receive education on stressful life events, which
include seemingly positive events that can add significantly to overall anxiety levels.
FULL SPECTRUM TRANSITION ASSISTANCE 31
Outcome objective #2. To decrease the amount of stressful life events by 50% as
measured by differences between initial and 12-week test scores on the Holmes-Rahe Stress
Inventory, and then compared to the control groups test scores.
Data collection. Program activities will produce outcomes, as stated in the attached
logic model. A classic experimental research study will randomly assign 300 movers to the
intervention group, while another 300 will be in the control group. The outcomes will be
measured through administering the UCLA Loneliness Scale and the Holmes-Rahe Life Stress
Inventory to both the beneficiaries and the control group. Both instruments will be given on the
first day they enter the program as a pre-test, then again after the 12-week program to measure
how well beneficiaries have thwarted loneliness and resisted adding stressful events to their
lives. A final post-test will be given one year later to substantiate effectiveness. A qualitative
survey will also be given to the intervention group with the 12-week post-test to capture any
additional feedback, which will likely assist with program development.
Success measures. The outcomes desired include less feelings of reporting stigma and
limbo, while increasing resiliency and connection-making skills. Long-term impacts anticipated
are a 50% decrease in social isolation, suicide, and divorce rates. The instruments will be able to
gather the presence of perceived isolation, suicide ideation, and amount of stressful events
experienced by participants, but long-term impacts on the rates of suicide and divorce will need
to be measured by other means and future census data. A matrix of data will be evaluated to
determine the levels of beneficiary participation; attendance in group/individual sessions and
completion of each FSTA phase. The intervention will be seen as a success if half of the
beneficiaries report increased or maintained levels of resiliency, connectedness, community
inclusion, networking abilities, and knowledge of resources to seek further assistance.
FULL SPECTRUM TRANSITION ASSISTANCE 32
Plan for Stakeholder Involvement
There are many stakeholders who have much to gain from the implementation of this
intervention. All beneficiaries will directly reap the benefits of feeling connected and valued in
their living environments. The military will benefit from a superior reputation as a great career
option. Communities will prosper as beneficiaries become more involved where they live and
work. Local economies will flourish when military members spend more time outside of their
houses. Social workers will find more employment with this innovation because approximately
10,000 positions will be needed to cover the whole military target population. Barriers exist in
gaining congressional approval for the complete full-scale policy; however, many technological
and organizational network solutions will grow as a result of FSTA.
Stakeholder engagement must be handled with care, and win-win solutions will be sought
by the program director. Diversity and inclusiveness are vital to success when working with
both internal and external stakeholders. To ensure fair and equitable treatment, the pilot will use
random sampling for selection of beneficiaries. Hiring of staff will be done with the upmost of
objectivity, and consideration will be given to the location of applicants, as the pilot will take
place on U.S. Army bases in Germany. Federal guidelines of equal employment opportunity will
be followed to prevent the perception of workplace discrimination. The FSTA qualitative
questionnaire will be given at intervention completion to aid in the evaluation of beneficiary
inclusiveness. Stakeholders will be encouraged to participate in collaborative discussions, which
will cultivate their capacity to engage. These considerations will promote the inclusive
transparent culture, and treat stakeholders as top customers. The 5-step Stakeholder Engagement
Model will be used as a guide (see Appendix K) including core values to remain respectful,
purposeful, inclusive, timely, and transparent (AccountAbility, 2015).
FULL SPECTRUM TRANSITION ASSISTANCE 33
Communication Strategy
The communication strategy for FSTA is a basic public relations plan. The first step was
in defining goals and objectives that have been illustrated in the attached logic model. The
second step will be ongoing as FSTA redefines and grows its target audience beyond the already
listed stakeholders. Third, establishing fixed dates to meet with funders, high-level military
officials, social workers at seminar events, and beneficiaries will be a quarterly strategy. Each
quarter, an op-ed will be published on the FSTA website and be pushed out on social media.
Key note speakers will be asked to attend FSTA introductions to inspire beneficiaries, pass on
programmatic statistics, and outcomes achieved. Key messages will educate, inform and compel
stakeholders to take action in eradicating social isolation among target populations. The goal is
to turn audiences into advocates of the FSTA mission, which will help spread the word and
increase demand in other populations for the program. Success of the communication strategy
will come in a feedback loop as beneficiaries fill out qualitative assessments, and when future
clients report how they became aware of the intervention.
Dissemination Plan for Broader Impact
Dissemination plan. The final consideration of this implementation plan is to
proactively broadcast the outcomes and impacts produced throughout the implementation of
FSTA. Disseminating the data that results from the chosen processes is vital in educating other
researchers and champions on the potential benefits for their own widespread use. The author
seeks to strengthen and build his alliance with USC’s Center for Innovation and Research on
Veterans & Military Families in order to cultivate knowledge of a new evidence-based practice
that can curb social isolation before destructive coping behaviors harden. As a minimum, this
dissemination approach will answer some questions or spark further research questions while
FULL SPECTRUM TRANSITION ASSISTANCE 34
adding to the available research material in the field of eradicating social isolation. The primary
goal of FSTA is to collaborate with military stakeholders to champion large scale and
exponential implementation throughout the DoD to reach and proactively treat the entire active-
duty military population.
Ethical Concerns and Negative Consequences
Ethical Issues. The DoD forces its military members to move quite frequently, which
creates a situation full of ethical conflict and unique implications for the members and their
families. Among the National Association of Social Workers (NASW) Code of Ethics is the
value of Importance of Human Relationships (NASW, 2017). Almost every military working
spouse is forced to either lose a job or become separated from family during each PCS, which
increases their vulnerability to social isolation.
Another ethical concern is that the military does not consider extenuating circumstances
of each PCS case to ensure the needs of family members are addressed adequately. According to
the NASW (2017), the value of Social Justice instills the principle for social workers to
challenge social injustice with a focus on poverty, unemployment, and discrimination. Since
there is no diagnosis of “vulnerability to loneliness and social isolation due to being left alone or
unemployed, resulting from a forced move of a military family member,” there is no avenue to
sufficiently protect military families from social injustice during a PCS.
Equitable hiring. Job announcements for all MSW positions will be advertised on job
websites and shared on social media sites. All applicable laws and ethical considerations will be
made in relation to diversity and inclusion. Considering all human resources variables along
with the first year of FSTA originating in Germany, the first attempt will be to fill the staff
positions with qualified candidates who reside as military spouses in the local area.
FULL SPECTRUM TRANSITION ASSISTANCE 35
Conclusion, Actions, and Implications
Full Spectrum Transition Assistance aims to eradicate social isolation by implementing
proactive group CBT-based learning for active-duty military and family members during
required moves. The project is highly innovative because no congruent effort is being done by
any other organization. The current method of military relocation simply forces members to go
it alone without training them on how to deal with stressful events while maintaining
relationships. FSTA will save lives and eventually improve the quality of life for millions of
potential beneficiaries annually. Related activities will produce the sustainable outcomes of
keeping beneficiaries connected to meaningful relationships, reducing suicide ideation, and
integrating them successfully into new communities. With the fairly small pilot proposed herein,
there is low risk to implement and perform a research study on the first-year beneficiaries, as
compared to the potential rewards of outcome achievement. Limitations include the possibility
of limited beneficiary participation, that the research study will not show a significant
improvement over the control group, and that the DoD could choose not to fund or allow full-
scale diffusion of the program. However, the author has contingency plans in place for
alternative implementation pathways. The process of preventing social isolation systematically
will reduce negative social determinants of health among military populations, which will
produce benefits that can contribute to many of the Grand Challenges, increase the readiness of
America’s war fighting capability, and sustain healthy lifestyles for all beneficiaries. Ultimately,
this intervention can be modeled and diffused globally to benefit many other target populations
and reduce the occurrence of social isolation due to relocation requirements.
FULL SPECTRUM TRANSITION ASSISTANCE 36
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Appendix A
Panopto Prototype for FSTA Asynchronous Training

Link to Prototype:
https://pro.panopto.com/Panopto/Pages/Viewer.aspx?tid=795423dd-0890-4d6c-a0de-
aada008697d5

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Appendix B
Four Phases of FSTA Intervention

FULL SPECTRUM TRANSITION ASSISTANCE 44
Appendix C
Logic Model for FSTA

FULL SPECTRUM TRANSITION ASSISTANCE 45
Appendix D
FSTA Partner Agreement

FULL SPECTRUM TRANSITION ASSISTANCE 46
Appendix E
Systems Development Life Cycle (SDLC)

FULL SPECTRUM TRANSITION ASSISTANCE 47
Appendix F
Gantt Chart for FSTA Pilot Implementation

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Appendix G
Line-Item Budget for FSTA
Program Director: James Bailey
Program Period: 10/01/2020 through 09/30/2021

Revenue
EOD Warrior Foundation 300,000 Philanthropic group capital investment
Threat Management Group 250,000 Philanthropic group capital investment
Individual Donations 50,000 Received from VFW marketing efforts
Total Revenue 600,000

Other Revenue
In-Kind Office Space 30,000 5 employee’s home-office value @500/mo
Total Other Revenue 30,000

Total Program Revenue 630,000

Expenses
Personnel
Director Salary 100,000 1 FTE @ 100,000
Social Workers Salaries 280,000 4 FTE @ 70,000
Tech Developer 50,000 Cost of IT media development
Total Personnel 430,000

Equipment
Computing Equipment 10,000 Laptops, peripheral, & cell phone purchases
Total Equipment 10,000

Operating Expenses
Lease/Rent 30,000 5 employee’s home-office value @500/mo.
Office Supplies 2,000 Pens, paper, printing, & other (reimbursed)
Marketing Supplies 2,000 Handouts & FSTA media @ 300 beneficiaries
Telephone/Data 2,000 Cell phone/data plans for all employees
Web Site/Maintenance 1,000 Fees to maintain website/hub for intervention
Administrative Support 90,000 Contracted IT support to manage virtual space
Community Partner Fees 54,000 9% of private (non-governmental) donations
Total Operating Expenses 181,000

Total Program Expenses 621,000

Surplus/Deficit 9,000 Contingency/reserve funds

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Appendix H
UCLA Loneliness Scale

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Appendix I
Holmes-Rahe Life Stress Inventory

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Appendix J
FSTA Qualitative Instrument

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Appendix K
5-Step Stakeholder Engagement Model

Adapted from the Stakeholder Engagement Standard AA1000SES (AccountAbility. 2015)

Abstract (if available)

Abstract Various triggers push or draw people away from society, which leads to isolation, chronic depression, anxiety, suicide ideation, and negative health effects that result in early death. A socially isolated person has a two to three-fold increase in mortality over someone with at least one meaningful social relationship (House, 2001). The author chose to contribute to the Grand Challenge of Eradicating Social Isolation because of his own experiences in the military while going through ten transitional periods and dealing with perceived isolation, anxiety, depression, and related hospitalizations. The American norm of individualism forces individuals to identify and solve problems alone. Self-report stigma also prevents military members from seeking help. Social isolation is preventable

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Asset Metadata

Creator Bailey, James Clarke (author)

Core Title Full spectrum transition assistance: preventing loneliness and social isolation in military members during moves

School Suzanne Dworak-Peck School of Social Work

Degree Doctor of Social Work

Degree Program Social Work

Publication Date 12/18/2019

Defense Date 11/22/2019

Publisher University of Southern California (original), University of Southern California. Libraries (digital)

Tag active duty,dependents,evidence based practice,Loneliness,Military,OAI-PMH Harvest,social isolation,spouse

Language English

Contributor Electronically uploaded by the author (provenance)

Advisor Lewis, Jennifer (committee chair), Arriaran, Karla P. (committee member), Rank, Michael G. (committee member)

Creator Email eodbailey50@yahoo.com,jcbailey@usc.edu

Permanent Link (DOI) https://doi.org/10.25549/usctheses-c89-258276

Unique identifier UC11673193

Identifier etd-BaileyJame-8099.pdf (filename),usctheses-c89-258276 (legacy record id)

Legacy Identifier etd-BaileyJame-8099.pdf

Dmrecord 258276

Document Type Capstone project

Rights Bailey, James Clarke

Type texts

Source University of Southern California (contributing entity), University of Southern California Dissertations and Theses (collection)

Access Conditions The author retains rights to his/her dissertation, thesis or other graduate work according to U.S. copyright law. Electronic access is being provided by the USC Libraries in agreement with the a...

Repository Name University of Southern California Digital Library

Repository Location USC Digital Library, University of Southern California, University Park Campus MC 2810, 3434 South Grand Avenue, 2nd Floor, Los Angeles, California 90089-2810, USA