Practical resiliency training for healthcare workers during COVID-19: results from a randomised controlled trial testing the Community Resiliency Model for well-being support

Abstract

ObjectiveTo introduce the Community Resiliency Model (CRM) as mental well-being support for healthcare workers working through the height of the COVID-19 pandemic.DesignRandomised controlled trial with a no treatment control group.SettingTwo large urban health systems in the Southern United States between October 2020 and June 2021.ParticipantsEligible participants were currently employed as healthcare workers within the participating healthcare systems. 275 employees registered and consented electronically in response to email invitations. 253 participants completed the baseline survey necessary to be randomised and included in analyses.InterventionParticipants were assigned 1:1 to the control or intervention group at the time of registration. Intervention participants were then invited to 1-hour virtual CRM class teaching skills to increase somatic awareness in the context of self and other care.Main outcome measuresSelf-reported data were collected rating somatic awareness, well-being, symptoms of stress, work engagement and interprofessional teamwork.ResultsBaseline data on the total sample of 275 (53% nurses) revealed higher symptoms of stress and lower well-being than the general population. The intervention participants who attended a CRM class (56) provided follow-up survey data at 1 week (44) and 3 months (36). Significant improvement for the intervention group at 3 months was reported for the well-being measures (WHO-5, p<0.0087, d=0.66; Warwick-Edinburgh Mental Well-Being Scale, p<0.0004, d=0.66), teamwork measure (p≤0.0002, d=0.41) and stress (Secondary Traumatic Stress Scale, p=0.0058, d=46).ConclusionBaseline results indicate mental health is a concern for healthcare workers. Post intervention findings suggest that CRM is a practical approach to support well-being for healthcare workers during a crisis such as this pandemic. The simple tools that comprise the model can serve as a starting point for or complement self-care strategies to enhance individual resilience and buffer the effects of working in an increasingly stressful work environment.

A Rapid Access Brief Psychotherapy Intervention to Respond to Healthcare Workers in Ontario Whose Mental Health was Negatively Impacted During the COVID-19 Pandemic: Une brève intervention de psychothérapie à accès rapide pour répondre aux travailleurs de la santé de l'Ontario dont la santé mentale a été affectée négativement pendant la pandémie de COVID-19

“…Improvements in depression and anxiety symptoms replicate prior work on HCW treatment during COVID-19, 18–23,41 with a larger and Canadian sample. The current study extends the literature to reveal positive changes associated with treatment in perceived stress, 22,24 fear of COVID-19 and insomnia, all of which have been reported at high levels in HCWs during the pandemic.…”

“…In general, existing studies suggest that brief interventions focused on improving HCWs' mental health during COVID-19 were associated with reductions in anxiety, [18][19][20][21][22][23] depression, [18][19][20][21] stress, 22,24 and sleep disturbance, 19 while others found no changes in anxiety, 25,26 depression, 25 stress, [25][26][27] and insomnia. 21,25 The interventions used included resilience enhancement, [22][23][24]28 cognitive behaviour therapy (CBT), 18,20,21 acceptance and commitment therapy, 27 and mindfulness. 19,[25][26][27] Many of the aforementioned studies had small sample sizes, were conducted outside of North America, and started months to over a year after the pandemic onset.…”

“…17 Despite the widely established negative mental health effects of the pandemic on HCWs, little published work has examined mental health interventions for HCWs during the COVID-19 pandemic. In general, existing studies suggest that brief interventions focused on improving HCWs' mental health during COVID-19 were associated with reductions in anxiety, [18][19][20][21][22][23] depression, [18][19][20][21] stress, 22,24 and sleep disturbance, 19 while others found no changes in anxiety, 25,26 depression, 25 stress, [25][26][27] and insomnia. 21,25 The interventions used included resilience enhancement, [22][23][24]28 cognitive behaviour therapy (CBT), 18,20,21 acceptance and commitment therapy, 27 and mindfulness.…”

Workforce Engagement for Compassionate Advocacy, Resilience, and Empowerment (WE CARE)

“…Participants used CRM skills for selfstabilization during stressful and traumatic work events. [43][44][45] PFA training is a free Coursera course, developed by Johns Hopkins University, and is used as a tool to promote personal and community resilience using the RAPID (Reflective listening, Assessment of needs, Prioritization, Intervention, and Disposition) model. [46][47][48][49] This is offered to individuals experiencing any type of distress.…”

“…Those who received the CRM intervention reported improved well-being, greater resiliency, less secondary traumatic stress, and fewer physical symptoms of stress. Participants used CRM skills for self-stabilization during stressful and traumatic work events 43-45…”