A Cluster-Randomized Control Trial of a Workplace Resilience Intervention for Child Care Providers' Mental Health & Well-Being

ABSTR ACT Work-related stressors take a heavy toll on individuals’ health and well-being as made even more evident by the increased awareness of essential workers during the pandemic and its still lingering impact on workplace settings that already had the largest structural inequities. Resilience programs have arisen as a promising workplace

strategy to improve mental health and well-being for those at greatest risk; however, emerging programs are limited by time- and resource-intensive in-person strategies limiting scalability and practicality for the most marginalized of the workforce. Additionally, the literature on resilience programs are largely from preliminary

studies that lack of a priori sample size calculations, diversity of participants, and long-term maintenance following the intervention, as well as inadequate control groups, which limits translation prompting calls for more rigorous designs to evaluate the efficacy of these programs. Consistent with the aim of PAR-24-086 to test a

fully remotely delivered clinical trial with no in-person contact, this team has developed and translated the Stress Management and Resilience Training (SMART) program for web-based delivery. Our pilot work demonstrates feasibility, usability, satisfaction, and initial efficacy of the brief self-paced web-based learning sessions (1 hour

per week) with only 5-10 minutes of daily practice suggesting a fully powered study is timely and warranted. An adequately powered, cluster randomized controlled trial to test the efficacy of the web-based SMART program compared to a matched attention control in a high-need, diverse, and under-resourced and under-studied

segment of essential workers – childcare workers - will be conducted. Participants (640 childcare workers from 80 childcare centers) will be randomly assigned to either SMART or a matched attention control condition with the primary outcome of mean change in resilience assets and resources (Connor-Davison Resilience Scale).

Measures will be collected at four timepoints: baseline (0 months), post-intervention (3 months), and long-term maintenance (9 and 15 months). Secondary outcomes will include changes in overall mental health, negative and positive mental health indicators, social support, and organizational assets and resources. Additionally, we

will explore potential moderators’ (e.g., sociodemographic, social determinants of health) influence on treatment effects. The RE-AIM Framework will be used to determine reach and representativeness, and potential for organizational level adoption, implementation, and maintenance of the SMART program. This study fills key

research gaps of previous resilience work in an underserved population in critical need of mental health and well-being resources with implications for the feasibility and impact of remote programming in other marginalized segments of the workforce.