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Supporting Community Health Workers After a Disaster: Findings From a Mixed-Methods Pilot Evaluation Study of a Psychoeducational Intervention

Published online by Cambridge University Press:  28 June 2016

Tara Powell*
Affiliation:
University of Illinois at Urbana-Champaign, School of Social Work, Urbana, Illinois
Paula Yuma-Guerrero
Affiliation:
Colorado State University, School of Social Work, Fort Collins, Colorado.
*
Correspondence and reprint requests to Tara Powell, MSW, MPH, PhD, Assistant Professor, University of Illinois at Urbana-Champaign, School of Social Work, 1010 W. Nevada Street, Urbana, IL 61801 (e-mail: [email protected]).

Abstract

Objective

Community health workers (CHWs) in disaster-affected areas are at risk for emotional distress, as they support others while they may be in the process of rebuilding their own lives. The Resilience and Coping for the Healthcare Community (RCHC) intervention was developed in response to the stress CHWs faced after Hurricane Sandy. The intervention uses psychoeducation to help participants identify common stress responses, recognize signs of job burnout, and utilize healthy coping strategies.

Methods

A mixed-methods pilot of the RCHC intervention was conducted in 2013 with a convenience sample of staff from 6 federally qualified health centers (n=69). Validated measures of stress, coping, compassion fatigue and satisfaction, burnout, stress, and social provisions and a measure of perceived knowledge were administered at baseline, after the workshop, and at a 3-week follow-up. Semi-structured interviews were conducted with 10 randomly selected participants and were analyzed by using content analysis.

Results

From baseline to the post-workshop assessment, perceived knowledge scores increased from 24.59 to 30.34, t(62)=5.16 (P<0.001), and acute stress scores decreased significantly from 10.53 to 6.78, t(64)=4.74 (P<0.001). Significant increases from baseline to the 3-week follow-up (n=45) were found for perceived knowledge (24.05 to 27.24; t(40)=5.37; P<0.001), and social provisions (27.34 to 28.39; t(44)=2.15; P<0.05).

Conclusions

Our qualitative findings indicated that the respondents valued learning about common stress responses and incorporating coping as part of a daily routine. Team building and normalization of emotions were seen as ancillary benefits that would reduce stress levels in the workplace. In conclusion, the RCHC intervention shows promise and should be investigated further in experimental studies. (Disaster Med Public Health Preparedness. 2016;page 1 of 8)

Type
Original Research
Copyright
Copyright © Society for Disaster Medicine and Public Health, Inc. 2016 

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References

1. Ursano, RJ, Cerise, FP, DeMartino, R, et al. The impact of disasters and their aftermath on mental health. Prim Care Companion J Clin Psychiatry. 2006;8(1):4-11. http://dx.doi.org/10.4088/PCC.v08n0101.Google ScholarPubMed
2. Benedek, DM, Fullerton, C, Ursano, RJ. First responders: mental health consequences of natural and human-made disasters for public health and public safety workers. Annu Rev Public Health. 2007;28(1):55-68. http://dx.doi.org/10.1146/annurev.publhealth.28.021406.144037.CrossRefGoogle ScholarPubMed
3. National Association of Community Health Centers. American’s Health Centers. Fact Sheet. http://nachc.org/research-and-data/research-fact-sheets-and-infographics/. Published March 2016. Accessed June 7, 2016.Google Scholar
4. Turner, RJ, Avison, WR. Status variations in stress exposure: implications for the interpretation of research on race, socioeconomic status, and gender. J Health Soc Behav. 2003;44(4):488-505. http://dx.doi.org/10.2307/1519795.CrossRefGoogle ScholarPubMed
5. Norris, FH, Friedman, MJ, Watson, PJ, et al. 60,000 disaster victims speak: part I. An empirical review of the empirical literature, 1981–2001. Psychiatry. 2002;65(3):207-239. http://dx.doi.org/10.1521/psyc.65.3.207.20173.CrossRefGoogle Scholar
6. Epstein, RS, Fullerton, CS, Ursano, RJ. Posttraumatic stress disorder following an air disaster: a prospective study. Am J Psychiatry. 1998;155(7):934-938. http://dx.doi.org/10.1176/ajp.155.7.934.CrossRefGoogle ScholarPubMed
7. Ozen, S, Sir, A. Frequency of PTSD in a group of search and rescue workers two months after 2003 Bingol (Turkey) earthquake. J Nerv Ment Dis. 2004;192(8):573-575. http://dx.doi.org/10.1097/01.nmd.0000135573.47316.67.Google Scholar
8. Guo, Y-J, Chen, C-H, Lu, M-L, et al. Posttraumatic stress disorder among professional and non-professional rescuers involved in an earthquake in Taiwan. Psychiatry Res. 2004;127(1-2):35-41. http://dx.doi.org/10.1016/j.psychres.2004.03.009.CrossRefGoogle Scholar
9. Grieger, TA, Fullerton, CS, Ursano, RJ, et al. Acute stress disorder, alcohol use, and perception of safety among hospital staff after the sniper attacks. Psychiatr Serv. 2003;54(10):1383-1387.CrossRefGoogle ScholarPubMed
10. Figley, CR. Compassion Fatigue: Coping With Secondary Traumatic Stress Disorder in Those Who Treat the Traumatized. Florence, KY: Psychology Press; 1995.Google Scholar
11. Sabin-Farrell, R, Turpin, G. Vicarious traumatization: implications for the mental health of health workers? Clin Psychol Rev. 2003;23(3):449-480. http://dx.doi.org/10.1016/S0272-7358(03)00030-8.CrossRefGoogle ScholarPubMed
12. McCann, IL, Pearlman, LA. Vicarious traumatization: a framework for understanding the psychological effects of working with victims. J Trauma Stress. 1990;3(1):131-149. http://dx.doi.org/10.1007/BF00975140.CrossRefGoogle Scholar
13. Saakvitne, KW, Pearlman, LA, Abrahamson, DJ. Transforming the pain: a workbook on vicarious traumatization. WW Norton New York; 1996.Google Scholar
14. Bills, CB, Levy, NA, Sharma, V, et al. Mental health of workers and volunteers responding to events of 9/11: review of the literature. Mt Sinai J Med. 2008;75(2):115-127.CrossRefGoogle ScholarPubMed
15. Salston, M, Figley, CR. Secondary traumatic stress effects of working with survivors of criminal victimization. J Trauma Stress. 2003;16(2):167-174. http://dx.doi.org/10.1023/A:1022899207206.CrossRefGoogle ScholarPubMed
16. Litz, BT, Gray, MJ, Bryant, RA, et al. Early intervention for trauma: current status and future directions. Clin Psychol Sci Pract. 2002;9(2):112-134. http://dx.doi.org/10.1093/clipsy.9.2.112.CrossRefGoogle Scholar
17. Lukens, EP, McFarlane, WR. Psychoeducation as evidence-based practice: considerations for practice, research, and policy. Brief Treat Crisis Interv. 2004;4(3):205-225. http://dx.doi.org/10.1093/brief-treatment/mhh019.CrossRefGoogle Scholar
18. Madrid, PA, Grant, R. Meeting mental health needs following a natural disaster: Lessons from Hurricane Katrina. Prof Psychol Res Pr. 2008;39(1):86-92. http://dx.doi.org/10.1037/0735-7028.39.1.86.CrossRefGoogle Scholar
19. Howard, JM, Goelitz, A. Psychoeducation as a response to community disaster. Brief Treat Crisis Interv. 2004;4(1):1-10. http://dx.doi.org/10.1093/brief-treatment/mhh001.CrossRefGoogle Scholar
20. Green, L, Oades, L, Grant, A. Cognitive-behavioral, solution-focused life coaching: enhancing goal striving, well-being, and hope. J Posit Psychol. 2006;1(3):142-149. http://dx.doi.org/10.1080/17439760600619849.CrossRefGoogle Scholar
21. Stamm, BH. The Concise ProQOL Manual. http://www.proqol.org/uploads/ProQOL_Concise_2ndEd_12-2010.pdf. Published 2010. Accessed June 7, 2016.Google Scholar
22. Stamm, BH. The ProQOL Manual: The Professional Quality of Life Scale: Compassion Satisfaction, Burnout & Compassion Fatigue/Secondary Trauma Scales. Baltimore, MD: Sidran Press; 2005.Google Scholar
23. Cohen, S, Kessler, R, Underwood Gordon, L. Perceived Stress Scale. New York: Oxford University Press; 1994.Google Scholar
24. Cox, T, Mackay, CJ. The measurement of self-reported stress and arousal. Br J Psychol. 1985;76(2):183-186. http://dx.doi.org/10.1111/j.2044-8295.1985.tb01941.x.CrossRefGoogle ScholarPubMed
25. Cutrona, CE, Russell, D, Rose, J. Social support and adaptation to stress by the elderly. Psychol Aging. 1986;1(1):47-54. http://dx.doi.org/10.1037/0882-7974.1.1.47.CrossRefGoogle ScholarPubMed
26. Folkman, S, Lazarus, RS. If it changes it must be a process: study of emotion and coping during three stages of a college examination. J Pers Soc Psychol. 1985;48(1):150-170. http://dx.doi.org/10.1037/0022-3514.48.1.150.CrossRefGoogle ScholarPubMed
27. Endler, NS, Parker, JD. Multidimensional assessment of coping: a critical evaluation. J Pers Soc Psychol. 1990;58(5):844-854. http://dx.doi.org/10.1037/0022-3514.58.5.844.CrossRefGoogle ScholarPubMed
28. Chesney, MA, Folkman, S, Taylor, J. Coping Self-Efficacy Scale. http://caps.ucsf.edu/uploads/tools/surveys/pdf/CopingSelf-EfficacyScale.pdf. Version 06-08-10. Accessed June 20, 2013.Google Scholar
29. Chesney, MA, Neilands, TB, Chambers, DB, et al. A validity and reliability study of the coping self‐efficacy scale. Br J Health Psychol. 2006;11(3):421-437. http://dx.doi.org/10.1348/135910705X53155.CrossRefGoogle ScholarPubMed
30. Hsieh, H-F, Shannon, SE. Three approaches to qualitative content analysis. Qual Health Res. 2005;15(9):1277-1288. http://dx.doi.org/10.1177/1049732305276687.CrossRefGoogle ScholarPubMed
31. Adams, RE, Figley, CR, Boscarino, JA. The compassion fatigue scale: its use with social workers following urban disaster. Res Soc Work Pract. 2008;18(3):238-250. http://dx.doi.org/10.1177/1049731507310190.CrossRefGoogle ScholarPubMed
32. Berger, W, Coutinho, ESF, Figueira, I, et al. Rescuers at risk: a systematic review and meta-regression analysis of the worldwide current prevalence and correlates of PTSD in rescue workers. Soc Psychiatry Psychiatr Epidemiol. 2012;47(6):1001-1011. http://dx.doi.org/10.1007/s00127-011-0408-2.CrossRefGoogle Scholar
33. Skogstad, M, Skorstad, M, Lie, A, et al. Work-related post-traumatic stress disorder. Occup Med (Chic Ill). 2013;63(3):175-182. http://dx.doi.org/10.1093/occmed/kqt003.Google Scholar
34. Jacobson, JM. Compassion fatigue, compassion satisfaction, and burnout: reactions among employee assistance professionals providing workplace crisis intervention and disaster management services. J Workplace Behav Health. 2006;21(3-4):133-152. http://dx.doi.org/10.1300/J490v21n03_08.Google Scholar