An interventional study of Level Up in Risk Reduction Behavior, Suicide Prevention and Risky Behavior, sponsored by Uniformed Services University of the Health Sciences. Recruiting at 1 site in United States. Open to participants aged 18 Years and older, including healthy volunteers. Per ClinicalTrials.gov, last updated 2026-09-25.
Sponsored by Uniformed Services University of the Health Sciences · Not applicable, Interventional, and Prevention
This project will evaluate the effectiveness of Level Up: Boost Your Life Skills ("Level Up"), a strengths based, military-specific life skills training program. The goal is to determine whether Level Up can decrease suicidal-related behaviors (SRBs) and other harmful behaviors, improve mental health, enhance job performance, and reduce early military separation. The Level Up program components will be made available to participants through an online platform or mobile app that can be downloaded onto their personal mobile devices. These training materials will help Soldiers learn and practice skills. The Level Up program will also involve personalized messages from a Level Up trainer and virtual booster sessions. Active duty Soldiers who are currently stationed at Fort Hood, Texas and are members of a participating platoon will be randomized to receive either Level Up or Training as Usual (TAU). Participants will complete baseline and follow up surveys 1, 3, and 6 months post-baseline.
The first four years of service is widely known to be an especially high-risk period for suicide-related behaviors (SRBs) among Soldiers. In addition, most suicides occur among younger Soldiers aged 17-24 years-old (40%) and 25-29 years-old (26%) compared to older Soldiers (30-34 years-old= 18%, 35+ years-old = 16%). Situational stressors are prevalent among Soldiers who die by suicide, particularly in the areas of relationship problems (42%), workplace issues (29%), and financial issues (10%). These findings align with growing literature attesting to the direct relationship between such situational stressors and later SRBs in the military This time is also marked by high rates of other harmful behaviors and of early separation from the Army. The Army invests billions of dollars in recruiting and training, yet many new Soldiers leave the service early or experience serious events like suicidal behaviors. Exposure to situational stressors involving such areas of life as romantic relationships and finances increases risk for suicide and other harmful behaviors. Implementing universal training programs to prevent these types of negative outcomes before they arise have enormous potential to bolster the mental toughness of new Soldiers during this difficult transition. The proposed project aims to prevent suicide-related behaviors (SRBs) and other behaviors qualifying for a Serious Incident Report (SIR) through an innovative, universal life skills program delivered to Soldiers at Fort Hood. The proposed project will test the effectiveness of a recently developed, evidence-based training program designed to build life skills and coping strategies that can protect against suicide, other harmful behaviors, poor work performance, and premature separation. A majority of Soldiers in a typical operational unit are of enlisted rank and 30 years of age or younger, which as discussed earlier is the demographic of highest risk for suicide. Therefore, the purpose of this study will remain focused on evaluating the effectiveness of Level Up for reducing SRBs among early career Soldiers.
This project will evaluate the effectiveness of Level Up, a strengths based, military-specific life skills training program. The goal is to determine whether Level Up can decrease suicidal thoughts and behaviors, improve mental health, enhance job performance, and reduce early military separation. Previous studies show that building skills like stress management, problem-solving, and healthy communication can protect against SRBs and related problem behaviors. However, many of these programs failed to show long-term impact, partly due to limited engagement. Level Up is designed to overcome these limitations by combining interactive learning, mobile technology, personalized coaching, and on-demand virtual booster sessions. This hybrid format is intended to help Soldiers refresh their skills and engage with content at their preferred pace and rhythm. The Level Up program components include: 1) four weekly 2-hour live group sessions, 2) a mobile app/online platform/workbook with brief, interactive self-guided exercises in core skill areas (e.g., managing stress, tactical thinking, healthy relationships), 3) personalized coaching via messages from trained staff during the first month of app use, and 4) virtual booster sessions over one year, focused on practical domains like finances, leadership, promotion tips, and personal relationships. Soldiers will be randomized to receive either Level Up or TAU.
The Level Up program content draws from evidence-based psychological methods such as Cognitive Behavioral Therapy, Acceptance and Commitment Therapy, and motivational coaching adapted to fit military culture and tailored to be relevant, accessible, and engaging for Soldiers. By equipping them with essential life skills and support, the program aims to reduce SRBs and other behaviors qualifying for SIRs, develop psychosocial skills, and increase career success and satisfaction.
If effective, Level Up could be implemented Army-wide as a universal prevention program to improve mental health, readiness, and retention. There are minimal risks as the interventions are educational, although some participants may experience brief emotional discomfort during skill practice or reflection. All participants can opt out at any time, and all are provided with resources and additional support as needed. This study could have a transformative impact on military suicide prevention efforts, especially during early service when Soldiers are most vulnerable. By evaluating this scalable program in a large, real-world setting, the research will provide clear evidence about its benefits for reducing suicide and improving readiness. Results will also support development of predictive tools to identify which Soldiers may benefit most from added support. Findings will be shared across the Department of War to inform policy, training, and future resilience-building programs-ultimately improving the health, performance, and quality of life of Soldiers across the Force.
291 studies on the registry are indexed under Risk Reduction Behavior; 39 are open to participants now.
This study's planned enrollment of 5,000 is above the median of 201 across 250 interventional studies indexed under Risk Reduction Behavior.
Browse Risk Reduction Behavior studies →Uniformed Services University of the Health Sciences is the lead sponsor of 45 studies on the registry; 12 are open to participants now.
Counted across the registry records on this site, refreshed daily.
The criteria were revised on the registry on Sep 25, 2026. See what changed
Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.
Exclusion Criteria:
The Level Up program is a hybrid intervention combining interactive learning, mobile/online technology, personalized coaching, and on-demand virtual booster sessions. The evidence-based training program was designed to build life skills and coping strategies that can protect against suicide, other harmful behaviors, poor work performance, and premature separation during a Soldier's first duty assignment.
Behavioral: Level Up
TAU will serve as the study control condition. TAU will consist of other mandatory training activities determined by their unit. TAU activities include access to a variety of standard Army training resources at Fort Hood that support the mental health and well-being of Soldiers and lower risk of harmful behaviors.
The Level Up program components include: * Four weekly 2-hour live group sessions * A mobile app/online platform/workbook with brief, interactive self-guided exercises in core skill areas (e.g., managing stress, tactical thinking, healthy relationships) * Personalized coaching via messages from trained Level Up staff during the first month of app use * Virtual booster sessions over one year, focused on practical domains like finances, leadership, promotion tips, and personal relationships
The occurrence of any harmful behavior
The occurrence of any harmful behavior, either self-reported in follow up surveys or administratively reported
Time frame: Within the 12 months after intervention randomization
The occurrence of any suicide-related behavior
The occurrence of any suicide-related behavior, either self-reported in follow up surveys or administratively reported
Time frame: Within the 12 months after intervention randomization
The occurrence of any premature separations from service
Time frame: Within the 12 months after intervention randomization
Poor performance as indicated either by written reprimands, designations in the NCOER, a corrective action plan, remedial training, flagging actions, demotion, Article 15, or barred reenlistment
Time frame: Within the 12 months after intervention randomization
Personal deployment readiness
Walter Reed Army Institute of Research Land Combat Survey; Scale ranges from 4-20; Higher scores indicate higher perceived readiness
Time frame: Within the 6 months after intervention randomization
Emotionality
Emotion Reactivity Scale (ERS) ; Scale ranges from0-4; Higher scores indicate higher of each maladaptive trait
Time frame: Within the 6 months after intervention randomization
Job satisfaction
3-item Job Satisfaction Scale; Scale ranges from 3-15; Higher scores indicate higher perceived job satisfaction
Time frame: Within the 6 months after intervention randomization
Depression symptom severity
Patient Health Questionnaire-2 (PHQ-2); Scale ranges from 0-8; Higher scores indicate more severe symptoms
Time frame: Within the 6 months after intervention randomization
Anxiety symptom severity
Generalized Anxiety Disorder-2 (GAD-2); Scale ranges from 0-8; Higher scores indicate more severe symptoms
Time frame: Within the 6 months after intervention randomization
Incidence of traumatic brain injuries
Number of traumatic brain injuries; based on the Army STARRS Surveys; No scale range; number indicates greater number of traumatic brain injuries
Time frame: Within the 6 months after intervention randomization
Lifetime history of various mental/emotional health problems
Family History Screen (FHS); Scale ranges from 0-1; 0=No; 1=Yes
Time frame: Within the 6 months after intervention randomization
Chronic stress severity
Personal Life Stress Scale (PLS); Scale ranges from 0-50; Higher scores indicate greater chronic stress severity
Time frame: Within the 6 months after intervention randomization
Mental toughness
Sports Mental Toughness Questionnaire (SMTQ); Scale ranges from 5-25; Higher scores indicate higher confidence \& constancy
Time frame: Within the 6 months after intervention randomization
History of suicidal ideation, plan, & attempt
Columbia-Suicide Severity Rating Scale (C-SSRS) Full scale Baseline/Screening; Scale ranges from 0-1 0=No; 1=Yes
Time frame: Within the 6 months after intervention randomization
Positive social networks
Supportive \& Negative Social Interaction Scale (SIS); Scale ranges from 0-8; Higher scores indicate more positive/negative social support
Time frame: Within the 6 months after intervention randomization
Negative social networks
Supportive \& Negative Social Interaction Scale (SIS); Scale ranges from 0-8; Higher scores indicate more positive/negative social support
Time frame: Within the 6 months after intervention randomization
Mattering/belonging
General Mattering Scale; Scale ranges from 0-20; Higher scores indicate higher perceived mattering to others
Time frame: Within the 6 months after intervention randomization
Loneliness
3-Item Loneliness Screener; Scale ranges from 0-16; Higher scores indicate more frequency-severity of loneliness
Time frame: Within the 6 months after intervention randomization
Adverse childhood events & trauma
Childhood Trauma Questionnaire - Short Form (CTQ-SF) ; Scale ranges from 0-44; Higher scores indicate more childhood maltreatment
Time frame: Within the 6 months after intervention randomization
Conscientiousness
Big Five Inventory (BFI)16 \& Personality Inventory for DSM-5 Brief Form (PID-5-BF); Scale ranges from 0-8; Higher scores indicate lower of each adaptive trait
Time frame: Within the 6 months after intervention randomization
Mastery
Pearlin \& Schooler's Psychological Coping Resources Measure; Scale ranges from 0-8; Higher scores indicate lower of each adaptive trait
Time frame: Within the 6 months after intervention randomization
Openness
120-item International Personality Item Pool (IPIP); Scale ranges from 0-4; Higher scores indicate lower of each adaptive trait
Time frame: Within the 6 months after intervention randomization
Problem-solving ability
Social Problem Solving Inventory-Revised (SPSI-R); Scale ranges from 0-8; Higher scores indicate lower of each adaptive trait
Time frame: Within the 6 months after intervention randomization
Psychological well-being
Flourishing Scale; Scale ranges from 0-12; Higher scores indicate lower of each adaptive trait
Time frame: Within the 6 months after intervention randomization
Resilience
Army STARRS Resilience Scale; Scale ranges from 0-16; Higher scores indicate lower of each adaptive trait
Time frame: Within the 6 months after intervention randomization
Self-esteem
Rosenberg Self-Esteem Scale; Scale ranges from 0-8; Higher scores indicate lower of each adaptive trait
Time frame: Within the 6 months after intervention randomization
Anxious, Cyclothymic, Depressive, & Hyperthymic temperament
Revised NEO Personality Inventory (NEO-PI-R) \& the Temperament Evaluation of Memphis, Pisa, Paris \& San Diego-autoquestionnaire version (TEMPS-A); Scale ranges from 0-8 for each temperament; Higher scores indicate higher of each maladaptive trait
Time frame: Within the 6 months after intervention randomization
Borderline personality
McLean Screening Instrument for Borderline Personality Disorder; Scale ranges from 0-16; Higher scores indicate higher of each maladaptive trait
Time frame: Within the 6 months after intervention randomization
Anger-hostility
Big Five Inventory (BFI)16 \& Personality Inventory for DSM-5 Brief Form (PID-5-BF); Scale ranges from 0-8; Higher scores indicate higher of each maladaptive trait
Time frame: Within the 6 months after intervention randomization
Impulsivity/negative urgency
Impulsive Behavior Scale - Short Form (SUPPS-P); Scale ranges from 0-8; Higher scores indicate higher of each maladaptive trait
Time frame: Within the 6 months after intervention randomization
Introversion
Eysenck Personality Questionnaire - Brief Version (EPQ-BV)28 \& Revised NEO Personality Inventory (NEO-PI-R); Scale ranges from 0-8; Higher scores indicate higher of each maladaptive trait
Time frame: Within the 6 months after intervention randomization
Fearlessness about death
Acquired Capability for Suicide Scale; Scale ranges from 0-4; Higher scores indicate higher of each maladaptive trait
Time frame: Within the 6 months after intervention randomization
Self-conscious
Widiger Five-Factor Rating Form - Revised31 \& NEO Five-Factor Inventory (NEO-FFI); Scale ranges from 0-8; Higher scores indicate higher of each maladaptive trait
Time frame: Within the 6 months after intervention randomization
Vulnerability
NEO Five-Factor Inventory (NEO-FFI); Scale ranges from 0-4; Higher scores indicate higher of each maladaptive trait
Time frame: Within the 6 months after intervention randomization
Frequency of risky behaviors
Unit Risk Inventory (URI); Scale ranges from 0-1; 0=Never; 1=At least less than once a month
Time frame: Within the 6 months after intervention randomization
Plan to share: No
No publications or documents are linked to this record.
Started Dec 2025 (actual). Primary completion is estimated for Dec 2027, 24 months after the start.
Of 167 non-industry interventional studies with no phase under Risk Reduction Behavior, half reached primary completion within 25 months of starting (the median), counting those still running; a quarter within 13 and three quarters within 42. This study's planned 24 months is close to that.
Counting every sponsor, half of 169 studies reached it within 25 months; a quarter within 13 and three quarters within 46.
Since we started tracking on Sep 25, 2026, the dates moved once, on Sep 25, 2026: primary completion Jul 2028 → Dec 2027 and completion Jul 2029 → Dec 2027.
Earlier changes are on the record history on ClinicalTrials.gov ↗
How these figures are worked out, and which studies are left out of them.
From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗
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Uniformed Services University of the Health Sciences