Follow-Up
Note: * p = 0.05, ** p < 0.01.
The overall comparisons of least square means were conducted across time points for each variable, presented in Figure 1 , Figure 2 and Figure 3 . Proximal outcomes of and SFA self-efficacy ((χ 2 , 4) = 9.45, p = 0.051) and resilience ((χ 2 , 4) = 11.47, p < 0.05) significantly differed across time points. In addition, the average number of resources participants are aware of significantly differed across timepoints ((χ 2 , 4) = 9.55, p < 0.05). All outcomes generally increased over time (see Figure 2 , Figure 3 and Figure 4 ).
SFA self-efficacy across all time points.
Resilience across all time points.
Awareness of wellbeing resources across all time points.
Mean differences across time points did not significantly differ for the perception of organizational support ((χ 2 , 4) = 5.67, p = 0.225), stress ((χ 2 , 4) = 2.44, p = 0.656), burnout ((χ 2 , 4) = 6.03, p = 0.197), or utilization of resources ((χ 2 , 4) = 2.57, p = 0.632). When examined for change between the two-time points of baseline and 12 months, there are two additional significant results. Perceptions of organizational support significantly increased from baseline to 12 months (Mean difference = 0.396; p = 0.0278), and there was a borderline significant decrease in burnout (Mean difference = −0.287; p = 0.057).
Workplace stress, emphasized during the COVID-19 pandemic, remains a prominent issue among healthcare professionals. The authors of the present study sought to examine the use of Stress First Aid (SFA) as a targeted, self-care, and peer-support intervention to address healthcare worker wellbeing. Proximal outcomes were hypothesized to increase from baseline to 12-month follow-up, including self-efficacy, resource awareness and utilization, resilience, and perceptions of organizational support. At the same time, potential decreases in distal outcomes of stress and burnout were also explored. Generalized estimating equations (GEE) highlighted significant increases across three-month intervals from baseline to 12-month follow-up for self-efficacy, resource awareness, and resilience rates. Additionally, when considering only changes from baseline to 12-month follow-up, a significant increase was found in perceptions of organizational support and a borderline significant decrease in rates of burnout. In the present study, significance was not found for the utilization of resources or rates of stress.
This longitudinal study reveals unique shifts in the data across the 12 months. Rates of SFA self-efficacy increased, then decreased at month nine, followed by an increase at the twelve-month follow-up. A similar pattern emerged for rates of burnout, where, though not significant, participants reported higher rates at month nine before dropping in month twelve. Survey participation was also notably lower at month nine; however, response rates increased again at the twelve-month follow-up. There was a significant spike in COVID-19 cases in January 2022 [ 51 ], which may be reflected in the relative decrease in participation and feelings of self-efficacy at month nine, according to data that were collected in February and March 2022. Natural fluctuations in external stressors may account for some of the observed variability; however, a time-matched control group would be needed to further assess this hypothesis.
Another a point of interest is that the rates of resilience stayed fairly consistent during months 3–9, with a marked increase at the 12-month follow-up. Given the extended period of high-acuity work at the height of the pandemic for this sample of nurses, it is feasible that there was less capacity for resilience building initially, when the focus was required to be on addressing basic needs (i.e., fear of contamination) [ 52 ]. Resilience, as a construct, is generally measured as a state characteristic, not a trait characteristic, and may require more time under intervention exposure to see a quantifiable shift [ 53 ]. A larger sample size and dose/response analysis may be beneficial in determining this threshold for change. It is also likely that the threshold is variable-dependent, with SFA self-efficacy showing its greatest increase at the six-month time point.
SFA aims to build protective factors to increase resilience and mitigate stress reactions. These factors can hopefully contribute longitudinally to decreased distress and burnout, and in this study, some significant change was found between baseline and 12-month follow-up for distal outcomes. However, the authors generally expected to see less change in measures of stress and burnout in the context of implementing SFA during a pandemic. Because significant change was found for distal outcomes even in this context, we are hopeful that in less stressful circumstances, the use of SFA can further contribute to a reduction in stress and burnout, mainly when the organization uses the model to build leadership’s capacity to assess and address systemic issues which may have a more direct impact on stress and burnout. This focus should have an additive effect on the SFA goal of increasing awareness of stress injuries, helpful self-care, and peer support actions, resources, and access to care, as well as its goal of helping to identify, assist, and link into care those individuals who may be at risk for developing stress injuries that could predispose them to longer-term mental health conditions. Future studies should inspect the longer-term impact of SFA utilization across a healthcare system and potential company-wide cultural shifts in the discussion of stress and burnout.
The findings from this study are significant because, in contrast to prior studies [ 33 , 35 ], this study protocol committed to implementing SFA in the recommended flexible way, with local SFA Coaches supported by more experienced supervisors. This approach yielded greater self-efficacy, resilience, and resource knowledge than studies with a more controlled, rigid format with less supervision [ 33 , 35 ]. This makes the current findings and guidelines more generalizable to the recommended implementation of SFA in high-stress work environments. Organizations that have the time and dedicated resources to follow up with multiple training opportunities, support from SFA Coaches, and multi-tiered ways to implement SFA actions should find better results in reduction in stress, increased coping self-efficacy, and perceived social and organizational support, mainly when initiated before public health emergencies rather than during a pandemic.
As noted previously, SFA is in alignment with implementation principles recommended for complex environments and public health emergencies, such as using research- or theory-informed frameworks to empower adaptive actions within a flexible approach to solve problems that a system cannot yet anticipate [ 47 ]. Building upon existing informal networks of support with a built-in level of trust allows for faster implementation, and greater trust allows HCWs to adapt actions to their moment-to-moment capacity. SFA, implemented this way, allows individuals and systems to define and move towards reduced stigma and enhanced communication about the ongoing necessary actions toward greater wellbeing and system effectiveness.
The results of this study should be interpreted considering several limitations, with implications for future research. First, the present study had a relatively small sample size. Power was sufficient for the proposed statistical analyses; increasing the sample size in future studies may allow for group differentiation such as by role type, gender, and other variables. Additionally, a larger sample size or oversampling for additional demographic variables or variables of otherwise interest would have allowed for a more nuanced understanding of the effects of SFA among healthcare workers. The current study focused on healthcare workers in a behavioral health setting without specific control or comparison groups. For example, comparing study findings to control groups of other healthcare workers outside of a psychiatric setting may have been advantageous. While our outcomes assessment followed the proximal and distal outcomes of the Stress First Aid intervention, future repeated assessment of variables would strengthen causal inference and potential temporal mediation models. Whereas the present study focused on several proximal outcomes associated with occupational stress and burnout, future research might investigate additional outcomes. Research has found associations between occupational stress and other behavioral health outcomes, including substance use disorders and depression [ 54 ] among healthcare workers.
This study sought to extend the use of the peer support intervention, Stress First Aid, to healthcare workers during the COVID-19 pandemic. Findings provide preliminary support for the potential efficacy of SFA as a means of shifting culture around the discussion of emotional wellbeing, as well as an awareness and utilization of employee health resources. It will be important to continue to observe the potential impact of SFA during non-pandemic times as it has been used as a resilience-building, prevention strategy in military and first responder settings. It is possible that in less critical times, the impact on the more distal outcomes would be easier to observe because there would be fewer competing stressors. Further, results support the need to investigate implementation, dissemination and sustainability indicators as those will be integral in wider adoption of the model.
We would like to express our gratitude to the healthcare providers for their unwavering commitment to their work. We thank them for their partnership in the Stress First Aid program.
This research received no external funding.
Conceptualization, M.H.B., D.B., P.D., M.B.M., M.S., L.T., A.W.-M., P.W., R.J.W. and R.M.S.; methodology, H.M.C., P.S., G.Z. and R.M.S.; software, G.Z. and R.M.S.; validation, R.M.S.; data curation, G.Z. and R.M.S.; writing—original draft preparation, M.H.B., H.M.C., P.S. and R.M.S.; writing—review and editing, M.H.B., H.M.C., P.S., D.B., P.D., A.G., M.B.M., M.S., L.T., A.W.-M., G.Z., P.W., R.J.W. and R.M.S.; visualization, H.M.C. and G.Z.; supervision, M.H.B., M.S., L.T., P.W., R.J.W. and R.M.S.; project administration, M.H.B. and A.G. All authors have read and agreed to the published version of the manuscript.
Ethical review and approval were waived for this study based on the determination that it constitutes non-human subjects research, specifically focusing on quality improvement-oriented programmatic evaluation.
Informed consent was waived as the study primarily focused on the analysis of existing program evaluation data and was determined to be non-human subjects’ research.
Conflicts of interest.
The authors declare no conflicts of interest.
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Real-life case studies highlight the invaluable impact of prompt and effective first aid interventions. In this article, we'll explore a few case studies that demonstrate how first aid made a real difference in emergencies, underscoring the importance of being prepared to respond when it matters most. 1. Cardiac Arrest Saved by CPR.
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The First Aid Scenario Library contains a whole database full of great first aid practice scenarios for first aiders and trainers to use and add to. We also have some brilliant articles and resources on how to best train different skills and topics.
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Case study — Aidium First Aid Mobile App. Brandon Campbell · Follow. Published in. Bootcamp · 6 min read · May 14, 2022--Listen. Share. Project Overview. Aidium is a responsive website, mobile, and tablet app that helps users learn first-aid. Project Timeline. December 2021 to February 2022.
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There are 4 modules in this course. Stress First Aid (SFA) is a peer support toolkit designed to preserve life, prevent further harm, and promote recovery. Stress First Aid offers a flexible menu of options for recognizing and addressing stress reactions. It can be used for self-care, to help co-workers with stress reactions, or to help someone ...
Adapting Aid Lessons from Six Case Studies 3 2. RESEARCH APPROACH ADAPT's research so far has been grounded in six cases of adaptive management in practice. Our research approach was built on three pillars: evidence of adaptation in projects and programs; purposive selection of a diverse set of cases; and a qualitative, inductive research ...
This short resource brings together the blended learning stories and experiences of seven National Societies in the RC/RC network practicing blended first aid training. Each case study highlights an element of the innovation that is happening in first aid training in RC/RC National Socieites. It is clear that there is a good deal of innovative ...
The Head of Year (AS) conceived the idea of first aid training as part of a project-based learning "Health Week" module. Six emergency medicine physician instructors for the course were recruited. ... (4 to 7 students/team) to compete with 1 another on responding to a case study scenario over 30 minutes ...
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Anatomy of First Aid - A Case Study Approach. Editor: Ronald A. Bergman, PhD Emeritus Professor Department of Anatomy and Cell Biology. The University of Iowa. Contributing Computer and Graphics Specialists: Michelle Leveille Nola J. Riley, B.A. Peer Review Status: Internally Peer Reviewed First Published: November 2004 Last Revised: November 2004.
First aid training is a cost-effective way to decrease the burden of disease and injury in low- and middle-income countries (LMIC). Since evidence from Western countries has shown that children are able to learn first aid, first aid training of children in LMIC may be a promising way forward. Hence, our project aim was to develop contextualized materials to train sub-Saharan African children ...
The authors of the present study sought to examine the use of Stress First Aid (SFA) as a targeted, self-care, and peer-support intervention to address healthcare worker wellbeing. Proximal outcomes were hypothesized to increase from baseline to 12-month follow-up, including self-efficacy, resource awareness and utilization, resilience, and ...
A Case Study This case study was made possible by support from the U.S. Agency for International Development (USAID) and the U.S. President's Emergency Plan for AIDS Relief under the terms of Cooperative Agreement GPO-A-00-03-00003-00. The opinions expressed are
Projects . Images . People . Assets . People to Hire . Cancel. magnifying glass. View your notifications within Behance. View your notifications within Behance. Log In; Sign Up; magnifying glass ... KeepGoing First Aid Case Study.
The 'Good Aid' project centred around in-depth case studies of 'successful' aid-supported projects and programmes, eight of which are included in this special issue. This article introduces the project and situates it within the literature on state fragility, impact evaluation and aid successes, to show how these analyses can contribute to ...
Evidence suggests that aid to Kenya is highly volatile. Volatility of overall aid (at current prices) was 24.1 per-cent compared to 17.2 percent for Africa and 13.9 per-cent for all developing ...
The TIB Portal allows you to search the library's own holdings and other data sources simultaneously. By restricting the search to the TIB catalogue, you can search exclusively for printed and digital publications in the entire stock of the TIB library.