A Systems Approach to Controlling Harmful Behavior: United States Navy Case Study.

چکیده اصلی

INTRODUCTION: The Navy and other organizations have developed various programs, policies, and interventions to address harmful behaviors (HB), primarily focusing on individual actions from psychological and sociological perspectives. However, an organizational systems perspective can reveal how broader organizational structures influence these behaviors. This study applies systems-theoretical modeling and analysis to explore why current efforts fall short and how organizational redesign can better mitigate HB. MATERIALS AND METHODS: Systems Theoretic Accident Model and Process (STAMP), a framework for modeling causality in complex systems, views losses as failures in control or unsafe interactions rather than simply malfunctions or human behaviors. It emphasizes system constraints and control structures. Applied to suicide and suicide-related behaviors (SRB), STAMP examined underreporting of Sailor contact with nonmandatory reporters (e.g., Chaplains, Fleet & Family Services, Military and Family Life Counselors, and Military OneSource) and inconsistencies in SRB reporting during safety position changes. The study identified control relationships and feedback mechanisms through policy reviews and interviews with current and former Navy personnel. Policy analysis established an initial "ideal" control structure, whereas interviews refined the final model. RESULTS: Significant underreporting of HB incidents was found, primarily due to nonmandatory reporters' roles in the SRB system. Since no data are collected on Sailor interactions with these reporters, current methods fail to capture the full scope of HB interventions. Additionally, inconsistencies in reporting arise as safety-related personnel rotate, leading to varying prioritization of SRB prevention efforts. Personnel turnover affects policy implementation, disrupting intervention continuity. Standardized reporting mechanisms are needed to ensure consistency despite staff changes. CONCLUSIONS: The U.S. Department of Defense's Integrated Primary Prevention efforts target HB through systemic changes at organizational and leadership levels. Systems-theoretical approaches, such as control structure modeling and System-Theoretic Process Analysis , offer a structured framework for guiding these changes. Future research will apply the STAMP model to other HB categories, including sexual harassment and substance abuse, to further validate its effectiveness and improve HB prevention in military environments.

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