The Journal of mHealth Vol 1 Issue 3 (June 2014) - Page 40

Understanding Stress and Post-traumatic Growth Understanding Stress and Post-traumatic Growth A course for returning veterans on Tiatros-Research, a flexible HIPAA-Compliant collaboration platform for clinical research Authors: K.P Norman, M. Dallman, K. Cerrone, S. Norman, D. Altobello, J. Homchowdhury BACKGROUND Young people serving in the armed forces are given extensive periods of military training at entry to prepare them for service life. During training, they are provided with concepts and constructs of the military culture to ensure they are physically, mentally and emotionally fit for the tasks ahead. By contrast, preparation for return from the military to civilian life, jobs and family is given far less time and attention, even though this is an equally great change from their recent lives, experiences and the personal growth that occurred while they were in the military culture. There remains stigma associated with reporting mental difficulties that may accompany the transition from military to civilian life and because of this, there is some distrust in seeking answers to these openly[1, 2]. Moreover, sleep disturbances[3], risky behaviours[4, 5], family problems[5] and homelessness[6], are common in returning veterans even in those without diagnoses of mental difficulties. With the goal of helping those in, or leaving the military to resolve some of these issues both conveniently and in private, the Young Adult and Family Center (YAFC) in the Department of Psychiatry at the University of California, San Francisco has teamed up with Tiatros Inc. to leverage its scalable, cloud-based, socialnetwork styled software platform that enables collaborative, individual-centric services. Using the HIPAA compliant Tiatros solution, we have designed an initial course that enhances understanding of their experiences by the Veterans. The first course emplaced within Tiatros. 'Next Mission: Stress Resilience 38 June 2014 and Personal Growth', is an exploration of the neurophysiology, biology and narrative process of the military experience to help service members tell their own stories and better understand their own journey into, through and out of the military. The course is intended also to develop the connections and sense of community that are so important to transitioning veterans. The course is given over sixteen 2-hour classes. Each class is comprised of 3 parts : The narrative portion is based on the 6 stages in Joseph Campbell's Hero with a Thousand Faces[7] and is illustrated with clips from movies and readings; A neuroscience portion deals with the common changes that occur in the brain after stress and trauma; The third portion is comprised of mindfulness and writing exercises. There are two sets of writing assignments for each class: Journal writing for twenty minutes a day which is entirely private to the individual student, and writing in response to questions based on the narrative content and neuroscience portions of the course which can be viewed by course moderators and other students within the Tiatros solution. Additionally, in the final sessions the students present to the others in the class group their course projects that are to be related to some aspect of the monomyth as it relates to their personal journey. Course administrators post an individual invitation to each student to sign up for the course using Tiatros' secure messaging function. The platform supports secure communications (to one or to many) through various contemporary social networking methods including: Posts; audio and video blogging; Video chats; SMS; and, multi-party video conferencing, while allowing simultaneous but separate communication threads among various subsets of students and instructors in the class. Tiatros uses a number of proprietary technical strategies to preset and enforce access rights that ensure the privacy of communications. Easy-to-use and redundant methods assure that instructors can exercise complete and instant control over which communications are available to everyone and which are available to only a subset of the class community. The course administrators have access through Tiatros to the site of each student who is taking the course to ensure the safety of all participants. Students individually control the degree of interstudent interaction. Because Tiatros' proprietary content management and delivery engine handles content files of any size, and content files that are created in virtually any underlying application, including all common document , image, audio and video formats, all of the course classes and content are contained entirely within Tiatros. Fidelity of the content files is fully preserved and the viewing experience is identical to that experienced while watching a movie downloaded from a premium online service to a laptop. Content is streamed directly to mobile phones, and tablets as well as to laptop computers. Importantly, this capability in reverse permits flexibility in the format of student to the required homework; the student is allowed to choose from the most personally appropriate medium: video, uploaded photographs, written and/or and hand-drawn pictorial responses. Assignments and course content are stored within the course Library on Tiatros. The course administrators can easily pre-set an automatic delivery schedule