Moderators of a resiliency group intervention for frontline clinicians during the COVID-19 pandemic

Louisa G Sylvia; Nevita George; Dustin J Rabideau; Joanna M Streck; Evan Albury; Daniel L Hall; Christina M Luberto; Helen R Mizrach; Giselle K Perez; Sydney Crute; Darshan H Mehta; Mary Susan Convery; Sara E Looby; Gregory Fricchione; Maurizio Fava; Sabine Wilhelm; Elyse R Park

doi:10.1016/j.jad.2021.06.036

Moderators of a resiliency group intervention for frontline clinicians during the COVID-19 pandemic

J Affect Disord. 2021 Oct 1:293:373-378. doi: 10.1016/j.jad.2021.06.036. Epub 2021 Jun 24.

Authors

Louisa G Sylvia¹, Nevita George², Dustin J Rabideau³, Joanna M Streck³, Evan Albury², Daniel L Hall⁴, Christina M Luberto⁴, Helen R Mizrach⁵, Giselle K Perez⁶, Sydney Crute⁵, Darshan H Mehta⁶, Mary Susan Convery⁶, Sara E Looby³, Gregory Fricchione⁶, Maurizio Fava³, Sabine Wilhelm³, Elyse R Park⁴

Affiliations

¹ Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA; Dauten Family Center for Bipolar Treatment Innovation, Boston, MA, USA. Electronic address: lsylvia2@mgh.harvard.edu.
² Massachusetts General Hospital, Boston, MA, USA; Dauten Family Center for Bipolar Treatment Innovation, Boston, MA, USA.
³ Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.
⁴ Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA; Benson-Henry Institute, Boston, MA, USA; Benson-Henry Institute for Mind Body Medicine, Boston, MA, USA.
⁵ Massachusetts General Hospital, Boston, MA, USA; Benson-Henry Institute for Mind Body Medicine, Boston, MA, USA.
⁶ Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA; Benson-Henry Institute, Boston, MA, USA.

Abstract

Background: To mitigate the psychological burdens of COVID-19 for frontline clinicians (FCs), we adapted an existing evidence-based resiliency program, Stress Management and Resilience Training Relaxation Response Program (SMART-3RP), for FCs. This analysis explores moderators of stress coping to determine which subgroups of FCs benefited most from SMART-3RP.

Methods: 102 FCs from Mass General Brigham hospitals engaged in the adapted SMART-3RP. Assessments were completed at group entry (Week 0) and completion (Week 4). The primary outcome was stress coping, and we examined 15 possible baseline moderators. We fit linear mixed effects regression models and assessed potential baseline moderators using a likelihood ratio test. We report model-based estimates and confidence intervals for each moderator-by-time interaction (i.e., differential effect), where positive/negative values indicate more/less improvement in average perceived stress coping.

Results: Stress coping improved from Week 0 to Week 4 (mean improvement [95% CI] = 0.9 [0.6 to 1.2]). FCs with higher anxiety (differential effect [95% CI] = 0.3 [0.1 to 0.4]), depression (0.4 [0.2 to 0.6]), and loneliness (0.4 [0.1 to 0.6]), but lower levels of mindfulness (CAMS-R_focus: 1.0 [0.4 to 1.6]; CAMS-R_accept: 1.3 [0.7 to 2.0]) and self-compassion (0.4, [0.1 to 0.8]) at baseline experienced greater benefits in perceived stress coping from the SMART-3RP. Baseline health uncertainty along with sociodemographic and work characteristics did not moderate stress coping.

Discussion: Results highlight particular sub-populations of FCs that may benefit more from a stress management intervention, especially during emergency responses (e.g., COVID-19 pandemic).

Keywords: COVID-19 pandemic; Frontline clinicians; Resiliency program; Stress coping.

MeSH terms

Adaptation, Psychological
COVID-19*
Humans
Pandemics
Resilience, Psychological*
SARS-CoV-2
Stress, Psychological / epidemiology
Stress, Psychological / therapy

Abstract

MeSH terms

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