{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T15:35:14Z","timestamp":1786116914716,"version":"build-2736575974"},"reference-count":31,"publisher":"Oxford University Press (OUP)","issue":"Supplement_1","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100000006","name":"Office of Naval Research","doi-asserted-by":"publisher","award":["N-00014-23-1-2551"],"award-info":[{"award-number":["N-00014-23-1-2551"]}],"id":[{"id":"10.13039\/100000006","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>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 &amp; 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 \u201cideal\u201d control structure, whereas interviews refined the final model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Significant underreporting of HB incidents was found, primarily due to nonmandatory reporters\u2019 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The U.S. Department of Defense\u2019s 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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/milmed\/usag135","type":"journal-article","created":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T15:48:14Z","timestamp":1773330494000},"page":"483-492","source":"Crossref","is-referenced-by-count":0,"title":["A Systems Approach to Controlling Harmful Behavior: United States Navy Case Study"],"prefix":"10.1093","volume":"191","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5535-6827","authenticated-orcid":false,"given":"Elizabeth White","family":"Baker","sequence":"first","affiliation":[{"name":"Information Systems Department, Virginia Commonwealth University , Richmond, VA 23284-4000,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy G","family":"Leveson","sequence":"additional","affiliation":[{"name":"Engineering Systems Laboratory, Massachusetts Institute of Technology , Cambridge, MA 02139,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dale W","family":"Russell","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Uniformed Services University of the Health Sciences , Bethesda, MD 20814,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,8,6]]},"reference":[{"key":"2026080608585966200_usag135-B1","doi-asserted-by":"publisher","first-page":"103","DOI":"10.1186\/s40359-023-01134-1","article-title":"Prevalence and correlates of destructive behaviors in the US Naval Surface Forces from 2010","volume":"11","author":"Lai","year":"2023","journal-title":"BMC Psychol"},{"key":"2026080608585966200_usag135-B2","volume-title":"Oral presented at: Office of Naval Research","author":"Bowling","year":"2022"},{"key":"2026080608585966200_usag135-B3","author":"Centers for Disease Control and Prevention","year":"2007"},{"key":"2026080608585966200_usag135-B4","doi-asserted-by":"crossref","DOI":"10.7551\/mitpress\/8179.001.0001","volume-title":"Engineering a Safer World: Systems Thinking Applied to Safety","author":"Leveson","year":"2012"},{"key":"2026080608585966200_usag135-B5","first-page":"680","volume-title":"An Introduction to System Safety Engineering","author":"Leveson","year":"2023"},{"key":"2026080608585966200_usag135-B6","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1007\/978-0-387-85764-0_14","volume-title":"Sourcebook of Family Theories and Methods: A Contextual Approach","author":"Whitchurch","year":"1993"},{"key":"2026080608585966200_usag135-B7","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1037\/h0021697","article-title":"Explorations in ecological psychology","volume":"20","author":"Barker","year":"1965","journal-title":"Am Psychol"},{"key":"2026080608585966200_usag135-B8","doi-asserted-by":"crossref","first-page":"533","DOI":"10.7208\/chicago\/9780226924601.001.0001","volume-title":"Steps to an ecology of mind.","author":"Bateson","year":"2000"},{"key":"2026080608585966200_usag135-B9","doi-asserted-by":"publisher","first-page":"134","DOI":"10.1093\/bjps\/I.2.134","article-title":"An outline of general system theory","volume":"1","author":"Von Bertalanffy","year":"1950","journal-title":"Br J Philos Sci"},{"key":"2026080608585966200_usag135-B10","doi-asserted-by":"publisher","first-page":"332","DOI":"10.1038\/s44159-023-00193-w","article-title":"Systems-based thinking in psychology and the mental health sciences","volume":"2","author":"Ebrahimi","year":"2023","journal-title":"Nat Rev Psychol"},{"key":"2026080608585966200_usag135-B11","doi-asserted-by":"publisher","first-page":"407","DOI":"10.2307\/255139","article-title":"The history and status of general systems theory","volume":"15","author":"Von Bertalanffy","year":"1972","journal-title":"Acad. 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