There is no conflict of interest.
Citation
Canady, B. E., Zullig, K. J., Brumage, M. R., & Goerling, R. (2021). Intensive mindfulness-based resilience training in first responders: A pilot study. Health Behavior and Policy Review, 8(1):60-70. https://doi.org/10.14485/HBPR.8.1.6
Highlights
- The study's objective was to examine the impact of a residential Mindfulness-based Resilience Immersion Training (MBRT-I) on health outcomes.
- The study used an interrupted time series design to compare health outcomes of first responders before and after they participated in a residential mindfulness program. The authors used data from surveys conducted before and after the intervention.
- The study found a statistically significant relationship between MBRT-I participation and operational stress 30 days post-intervention and lower fatigue 90 days post-intervention.
- This study receives a low evidence rating. This means we are not confident that the estimated effects are attributable to MBRT-I program; other factors are likely to have contributed.
Intervention Examined
Mindfulness-based Resilience Immersion Training (MBRT-I)
Features of the Intervention
First responders often face traumatic events, leading to stress disorders and avoidant coping. Mindfulness training can improve mental health in trauma-affected populations. Residential trainings minimize distractions, enhance experience, and foster trust and cultural change. This study examined a 2.5-day residential MBRT-I program for first responders in West Virginia, including law enforcement officers (LEOs), firefighters, and EMS personnel. The program provided a dedicated training space to reduce resistance to mindfulness, develop mindfulness skills, and learn stress management techniques from certified trainers. Participants followed a structured schedule that included mindfulness practices, such as breath awareness and concentration, integrated into their daily activities like eating and sleeping. A follow-up session was held 30 days after the program ended.
Features of the Study
The study used an interrupted time series design to compare the outcomes of participants before and after participation in the MBRT-I program. The intervention was conducted at a residential retreat setting in West Virginia. The sample included 30 participants who worked as first responders in West Virginia during the intervention and were available and willing to participate. The majority of the participants were White, men, and employed as law enforcement officers (LEOs). The study used a baseline survey to collect participants' demographic details and their emotional and mental health status. Follow-up surveys were conducted to evaluate changes in emotional and mental health immediately after the intervention, as well as at 30 days and 90 days after the intervention. Statistical models controlling for participants' sex and age were used to compare health outcomes before and after the program.
Findings
Health and safety
- The study found that MBRT-I program participation was significantly related to decreased operational stress 30 days after the intervention. No significant relationship was found immediately following the intervention or 90 days post-intervention.
- The study found that MBRT-I program participation was significantly related to decreased fatigue 90 days after the intervention. No significant relationship was found immediately following the intervention or 30 days post-intervention.
- The study did not find a statistically significant relationship between MBRT-I program participation and self-reported mindfulness, organizational stress, perceived stress, sleep, anger, or health at any post-intervention time point.
Considerations for Interpreting the Findings
The authors compared the outcomes of participants before and after they participated in the MBRT-I program. For these types of designs, the authors must observe outcomes for multiple periods before the intervention to rule out the possibility that participants had increasing or decreasing trends in the outcomes examined before enrollment in the program. For example, if participants who had decreasing stress tended to enroll in the program, we would anticipate further decreases over time, even if they did not participate in the program. Without knowing the trends before program enrollment, we cannot rule this out.
Causal Evidence Rating
The quality of causal evidence presented in this report is low because the authors did not account for trends in outcomes before the intervention. This means we are not confident that the estimated effects are attributable to the MBRT-I intervention; other factors are likely to have contributed.