The Efficacy of a Brief Resilience Training Program for Hurricane Sandy Disaster Responders

Study Overview
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Brief Summary
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The goal of this project is to adapt and test the efficacy of the National Institute of Environmental Health and Safety (NIEHS) Disaster Worker Resilience Training (DWRT) Program for Superstorm Sandy responders. The DWRT is a brief, 4-5 hour training program designed to improve resilience for stress reactions in active emergency responders. A total of 120 participants will be recruited. 60 will receive the DWRT, and 60 will be assigned to a waitlist control condition. A three-month assessment period will be utilized to enable us to evaluate the effects of the intervention. Participants assigned to the waitlist condition will be offered the option to participant in the course following completion of the 3 month wait period. It is hypothesized that, participants attending the DWRT program, as compared to those in the waitlist condition, will show increased resilience at three months post-intervention as indicated by lower perceived stress, greater posttraumatic growth, more positive health behaviors (e.g., sleep, nutrition, exercise), and fewer new PTSD and depression symptoms. It is predicted that participants attending the DWRT program, as compared to those in the waitlist condition, will demonstrate greater awareness of the mental health effects of disasters, including the symptoms of PTSD and depression. It is predicted that, participants attending the DWRT program, as compared to those in the waitlist condition, will endorse more positive attitudes towards mental health care, including willingness to seek treatment if needed.

Detailed Description
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This project is a scientific collaboration between the World Trade Center (WTC) Health Program at Stony Brook University (SBU), the Epidemiology Program at North Shore-LIJ Health System (NSLIJ), and Rutgers University. The goal is to adapt and test the efficacy of the National Institute of Environmental Health and Safety (NIEHS) Disaster Worker Resilience Training (DWRT) Program for Sandy responders by leveraging data from the ongoing projects and the expertise of collaborators at these sites. The DWRT program was originally designed for and piloted with responders to the 2010 Deep Water Horizon oil spill. Knowledge from the ongoing Sandy projects will be used to tailor this intervention to address Sandy-specific risk factors and unique features of the responder communities in the New York Metropolitan area. Responders identified from ongoing projects at SBU (N=1500, 50% anticipated eligible) and other current local disaster responders will be targeted for enrollment. The objectives are to: (1) to adapt the DWRT program for this population; (2) recruit and randomly assign responders (N = 120) to the DWRT program or a waitlist control condition; (3) assess the efficacy of this intervention to enhance resilience over a three month period; and (4) host forums with community stakeholders to share information on this program and its outcomes. The expected outcomes are: (1) efficacy data on the DWRT program, and (2) qualitative data on the acceptability of this intervention to Sandy responders. The products are: (1) a final report; (2) articles for publication; (3) abstracts for national conferences; and (4) a training manual, participant workbook, and presenter materials.

Official Title
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The Efficacy of a Brief Resilience Training Program for Hurricane Sandy Disaster Responders

Conditions
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Psychological Stress

Intervention / Treatment
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* Behavioral: Disaster Worker Resiliency Training


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Participated as a volunteer or professional in Hurricane Sandy relief efforts. Report that they are still an active disaster responder (i.e., they may be called upon to participate in future disaster relief efforts) as either a volunteer or professional. Exclusion Criteria: An inability to comprehend the intervention in English.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Resiliency Training<br>Intervention: Disaster Worker Resiliency Training (DWRT) Program. | Behavioral: Disaster Worker Resiliency Training<br>* The Disaster Worker Resilience Training (DWRT) Program is a 4 hour program which consists of a participant training manual, an instructor-training manual, and a digital presentation. It uses adult training techniques that emphasize active participation in individual and group experiential learning activities. The curriculum is organized into a preface and four chapters, each with action oriented learning objectives. Overall program objectives include a demonstrate an ability to: 1) Recognize signs and symptoms of disaster work-related stress, 2) Obtain support through employer and community resources, and 3) Build resilience by using stress reduction and coping strategies.<br>* Other names: Disaster Worker Resilience Training (DWRT) Program;|
| No Intervention: Waitlist<br>Waitlist control: Participants to be offered the program after completion of the trial. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Perceived Stress | Perceived Stress Scale (PSS; Cohen, Karmarck, and Mermelstein, 1983). | 3 months post-intervention | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Post-Traumatic Stress Disorder Symptoms | PTSD Checklist for DSM-5 (PCL-5; Weathers, Litz, Keane, Palmieri, Marx, & Schnurr, 2013). | 3 months post-intervention | 
| Depression Symptoms | Patient Health Questionnaire-9 (PHQ-9; Spitzer, Kroenke, & Williams, 1999). | 3 months post-intervention | 
| Mental Illness Stigma | Attitudes Towards Mental Illness Questionnaire (ATMIQ). | 3 months post-intervention | 
| Attitudes Towards Seeking Professional Help | Attitudes Towards Seeking Professional Help Survey (ATSPH; Bacon, Fischer & Farina, 1995). | 3 months post-intervention | 
| Post-traumatic Growth | Post-Traumatic Growth Inventory-Short Form (PTGI-SF; Cann et al., 2010). | 3 months post-intervention | 
| Health Promoting Behaviors | Health Promoting Lifestyles Profile-II (HPLP-II; Walker, Sechrist, & Pender, 1995). | 3 months post-intervention | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Prevention, Perceived Stress, Psychological Stress, Disaster Worker, Superstorm Sandy, Mental Health, Psychological Resilience