Evaluation of an Ecological Intervention Targeting Helpers in the Aftermath of Disasters
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Ecological interventions hold promise for meeting the needs of post-disaster communities, yet little systematic quantitative evidence is available about such programs. This study evaluated the short-term outcomes of participants in the Strategies for Trauma Awareness and Resilience (STAR) program, a novel and exemplar ecological intervention for helpers working in post-disaster settings. It is a one week training and support program for helpers working in disaster-affected communities. Changes in the psychological distress of 42 STAR participants, across four STAR sessions, were assessed and identified as primary outcome variables. Knowledge, attitude, and intended practice changes were also assessed, along with perceived support, using a pre (T1)/post (T2) design. These indicators were then tested as possible predictors of participantsâ changes in distress. An integrity check was conducted on a sample of the seminar modules to assess fidelity to the program manual. Qualitative data were also gathered from follow up visits conducted with two participants. These data were used to help interpret quantitative findings, as well as to plan for future studies of how STAR effects might extend out from helpers into their home communities. Results showed that participants exhibited significant changes in knowledge, attitudes, and intended practices from the beginning of the seminar to the end. Results also showed significant decreases in psychological distress over the STAR week. Regression analyses showed that changes in knowledge, attitudes, and practice, as well as perceived social support during the seminar, explained significant amounts of variance in self reported trauma symptoms at T2. Variance in T2 burnout and compassion fatigue explained by these predictors was notable but not statistically significant due to lack of power. Results suggest that STAR can change knowledge and attitudes of helpers from disaster communities and that participants in this program experience decreases in distress during their stay. The lack of a valid comparison group makes causal interpretations of these findings premature. Findings also suggest that changes in distress are not caused by, or even significantly related to, learning that takes place during the STAR week. The mechanism for distress reduction during the STAR week is an unresolved question. Other significant unresolved questions remain regarding the STAR intervention and ways the present findings can be generalized to ecological interventions more broadly. For example, while the current study suggests important changes occur in helpers during the STAR week, it is of central importance to explore how these changes translate into the disaster-affected home communities. Discussion also focuses on the difficulties involved in conducting systematic research with organizations and helpers whose primary goals are practical or clinical, not scientific. Despite the questions that remain, taken together, results point to the promise of STAR to address the mental health needs of helpers and perhaps eventually disaster communities.
- Doctoral Dissertations