There is no conflict of interest.
Citation
Mahaffey, B. L., Mackin, D. M., Rosen, J., Schwartz, R. M., Taioli, E., & Gonzalez, A. (2021). The disaster worker resiliency training program: A randomized clinical trial. International Archives of Occupational and Environmental Health, 94, 9-21. https://doi.org/10.1007/s00420-020-01552-3
Highlights
- The study's objective was to examine the impact of the Disaster Worker Resiliency Training Program (DWRT) on health outcomes.
- The study used a randomized controlled trial that assigned disaster workers to the DWRT program or the control group. Using survey data and statistical models, the authors compared the outcomes between the treatment and control groups.
- The study did not find a significant relationship between DWRT program participation and health outcomes.
- This study receives a low evidence rating. This means we are not confident that any estimated effects would be attributable to the Disaster Worker Resiliency Training Program (DWRT); other factors are likely to have contributed. However, the study did not find statistically significant effects.
Intervention Examined
Disaster Worker Resiliency Training Program (DWRT)
Features of the Intervention
The DWRT program was created by the Substance Abuse and Mental Health Services Administration (SAMHSA) as an alternative to “psychological first aid.” It emphasized resilience through self-care, healthy behaviors, and social engagement. The program was developed after reviewing existing literature, engaging with the target population, and consulting with behavioral health experts. It included motivational interviewing, setting healthy goals, and relaxation exercises. The aim was to help workers recognize stress and seek help. Eight local agencies delivered the program in a 4-hour workshop. The participants were active disaster responders from eight agencies in the New York and Long Island metro area, specifically first responders to Hurricane Sandy.
Features of the Study
The study used a randomized controlled trial to examine the impact of the DWRT program on disaster workers’ health, stress, and posttraumatic stress disorder (PTSD) symptoms. After eligible participants completed the initial assessment and agreed to participate in the study, the authors randomly assigned 76 workers to the treatment group and 83 workers to the control group. The treatment group received the DWRT program services, while the control group was put on a waitlist. The treatment group had a higher percentage of men (52%), while the control group had a higher percentage of women (59%). Both groups had an average age of 51. Most participants in each group were White (68-72%), with around 10-15% Black and less than 11% identifying as Hispanic. Most of the participants worked full-time but also volunteered for Hurricane Sandy relief efforts. Data were collected through surveys at the start of the study and three months after the program. The authors used statistical models to compare the outcomes between treatment and control group members.
Findings
Health and safety
- The study did not find significant relationships between DWRT program participation and disaster workers’ health, stress, or PTSD.
Considerations for Interpreting the Findings
The study was a randomized controlled trial with high attrition because the authors excluded workers who were assigned to the treatment group but did not participate from the analyses. The authors also did not control for preexisting differences for sec or race/ethnicity in the analyses as required by the CLEAR protocol. These preexisting differences between the groups—and not the DWRT program—could explain the observed outcomes. Therefore, the study is not eligible for a high or moderate causal evidence rating.
Causal Evidence Rating
This study receives a low causal evidence rating because it was based on a randomized controlled trial with high attrition and the authors did not ensure that the groups were similar before program participation. This means we are not confident that any estimated effects would be attributable to DWRT; other factors are likely to have contributed. However, the study did not find statistically significant effects.