A Nurse-Led, Well-Being Promotion Using the Community Resiliency Model, Atlanta, 2020-2021.

The wrath of COVID-19 includes a co-occurring global mental health pandemic, raising the urgency for our health care sector to implement strategies supporting public mental health. In Georgia, a successful nurse-led response to this crisis capitalized on statewide organizations' existing efforts to bolster well-being and reduce trauma. Partnerships were formed and joint aims identified to disseminate a self-care modality, the Community Resiliency Model, to organizations and communities throughout the state. (Am J Public Health. 2022;112(S3):S271-S274. https://doi.org/10.2105/AJPH.2022.306821).

The Community Resiliency Model, an interoceptive awareness tool to support population mental wellness.

The objective of this article is to describe the Community Resiliency Model (CRM)®, a sensory-focused, self-care modality for mental well-being in diverse communities, and CRM's emerging evidence base and neurobiological underpinnings as a task-sharing intervention. Frieden's Health Impact Pyramid (HIP) is used as a lens for mental healthcare interventions and their public health impact, with CRM examples. CRM, a sensory awareness model for self-care and mental well-being in acute and chronic stress states, is supported by neurobiological theory and a growing evidence base. CRM can address mental wellness needs at multiple levels of the HIP and matches the task-sharing concept to increase access to mental health resources globally. CRM has the potential for making a significant population mental health impact as an easily disseminated, mental health, self-care modality; it may be taught by trained professionals, lay persons, and community members. CRM carries task-sharing to a new level: scalable and sustainable, those who learn CRM can share the wellness skills informally with persons in their social networks. CRM may alleviate mental distress and reduce stigma, as well as serve a preventive function for populations facing environmental, political, and social threats.

Practical resiliency training for healthcare workers during COVID-19: results from a randomised controlled trial testing the Community Resiliency Model for well-being support.

OBJECTIVE: To introduce the Community Resiliency Model (CRM) as mental well-being support for healthcare workers working through the height of the COVID-19 pandemic. DESIGN: Randomised controlled trial with a no treatment control group. SETTING: Two large urban health systems in the Southern United States between October 2020 and June 2021. PARTICIPANTS: Eligible participants were currently employed as healthcare workers within the participating healthcare systems. 275 employees registered and consented electronically in response to email invitations. 253 participants completed the baseline survey necessary to be randomised and included in analyses. INTERVENTION: Participants were assigned 1:1 to the control or intervention group at the time of registration. Intervention participants were then invited to 1-hour virtual CRM class teaching skills to increase somatic awareness in the context of self and other care. MAIN OUTCOME MEASURES: Self-reported data were collected rating somatic awareness, well-being, symptoms of stress, work engagement and interprofessional teamwork. RESULTS: Baseline data on the total sample of 275 (53% nurses) revealed higher symptoms of stress and lower well-being than the general population. The intervention participants who attended a CRM class (56) provided follow-up survey data at 1 week (44) and 3 months (36). Significant improvement for the intervention group at 3 months was reported for the well-being measures (WHO-5, p<0.0087, d=0.66; Warwick-Edinburgh Mental Well-Being Scale, p<0.0004, d=0.66), teamwork measure (p≤0.0002, d=0.41) and stress (Secondary Traumatic Stress Scale, p=0.0058, d=46). CONCLUSION: Baseline results indicate mental health is a concern for healthcare workers. Post intervention findings suggest that CRM is a practical approach to support well-being for healthcare workers during a crisis such as this pandemic. The simple tools that comprise the model can serve as a starting point for or complement self-care strategies to enhance individual resilience and buffer the effects of working in an increasingly stressful work environment.

Translating What Works: A New Approach to Improve Diabetes Management.

BACKGROUND: The most efficacious strategies to improve diabetes control include case management, health care team changes, patient education, and facilitated transmission of patient data to clinicians ("facilitated relay"), but these strategies have not been translated to permit general use in clinical practice. METHODS: A web-based decision support program was developed to include these features, and assessed in patients who had A1c ≥7.0% despite using metformin with/without sulfonylureas or insulin. Staff entered patients' glucose data, obtained management recommendations, reviewed the plan with a clinician, and discussed the new plan with patients. RESULTS: 113 subjects were 96% male and 32% black, with average age 65.6 years and BMI 32.8. During prior primary care, A1c averaged 8.32 ± 0.16% (SEM). In all patients, baseline A1c was 8.18 ± 0.11%, and decreased to 7.54 ± 0.12%, 7.16 ± 0.13%, and 7.54 ± 0.16% at 3, 6, and 12 months, respectively, all P < .001. In 42 subjects who provided glucose data and made requested changes in medications, A1c was 8.12 ± 0.09% at baseline and fell to 7.29 ± 0.11%, 6.98 ± 0.10%, and 7.05 ± 0.10% at 3, 6, and 12 months, respectively, all P < .001. Chart review of 16 subjects followed for 12 months demonstrated that hypoglycemia (symptoms and/or glucose <70 mg/dl) averaged less than 1 episode/patient/month, and there was no severe hypoglycemia. CONCLUSIONS: A novel decision support program improved A1c with little hypoglycemia. Use of this approach should allow primary care teams to keep patients well controlled, and reduce the need for specialist referrals.