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Intervention Summary

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Team Resilience

Team Resilience is a training intervention for young adults who work in a restaurant. The intervention aims to enhance participants' individual resiliency and increase their healthy behaviors (e.g., reduce alcohol use, lower personal stress), thereby contributing to a positive work environment. It also helps participants to set goals, address tobacco and alcohol use, manage stress, and improve communication skills, and it provides information on how to access support (e.g., an employee assistance program [EAP], community resources). By incorporating group interaction and peer-to-peer communication, Team Resilience is designed to disseminate the skills learned by participants into the work environment, providing a benefit to employees who are not directly exposed to the intervention.

Before restaurant employees are trained, managers receive training in leadership competencies and supportive techniques for working with young adults. This training lays a foundation of support for the employee training, and it provides managers with an orientation to the employee training's core content, which is based on five features of resilience: centering (e.g., wellness, stress management), compassion (e.g., empathy, character strength), community (e.g., helping others), confidence (e.g., positive self-focus, self-control), and commitment (e.g., goals). Formulated as the metaphor "life as a journey," the employee training is provided through three 2-hour sessions, held on 3 consecutive days at the restaurant where the participants are employed:

  • Session 1 (The Map) introduces the principles of resilience, such as personal efficacy and supportive social relationships, and emphasizes their relevance to young restaurant employees.
  • Session 2 (The Terrain and Compass) explores such topics as stress management, work-life boundaries, and responding to coworkers who have alcohol or drug use problems. During this session, participants set goals for themselves in one of the topic areas and explore how to reach them.
  • Session 3 (The Destination) covers communication strategies and introduces peer referral to encourage coworkers and friends to get help for problems (e.g., by directing them to an EAP or other resources).

Sessions are led by a trained facilitator and include group discussion, team exercises, role-play, and activities for practicing communication skills. To reinforce the topics covered, each session also includes 30-45 minutes for playing Journey to Resilience, a board game that resembles a restaurant floor plan (including a bar) and incorporates familiar work situations that occur in a restaurant. Some of the employees who have attended at least two sessions are selected as "ambassadors" and receive training to help maintain the program at the restaurant.

A single 60- to 90-minute booster training session is conducted about 6 months after the three-session employee training. Its purpose is to review key topics and exercises from the three-session training and to provide handouts and information a second time.

Descriptive Information

Areas of Interest Mental health promotion
Substance abuse prevention
Outcomes Review Date: February 2012
1: Recurring heavy drinking
2: Alcohol-related work problems
3: Exposure to problem coworkers
4: Personal stress
Outcome Categories Alcohol
Employment
Family/relationships
Mental health
Ages 18-25 (Young adult)
Genders Male
Female
Races/Ethnicities American Indian or Alaska Native
Asian
Black or African American
Hispanic or Latino
White
Race/ethnicity unspecified
Settings Workplace
Geographic Locations Urban
Suburban
Implementation History Team Resilience was implemented in 2007 within 28 restaurants (in Illinois and Texas) that were part of a national casual dining restaurant chain.
NIH Funding/CER Studies Partially/fully funded by National Institutes of Health: No
Evaluated in comparative effectiveness research studies: No
Adaptations No population- or culture-specific adaptations of the intervention were identified by the developer.
Adverse Effects No adverse effects, concerns, or unintended consequences were identified by the developer.
IOM Prevention Categories Universal
Selective

Quality of Research
Review Date: February 2012

Documents Reviewed

The documents below were reviewed for Quality of Research. The research point of contact can provide information regarding the studies reviewed and the availability of additional materials, including those from more recent studies that may have been conducted.

Study 1

Bennett, J. B., Broome, K. M., Aden, C., Rigdon, W. D., Petree, R. D., & Mitchell, K. (2010). Team Resilience research report (health promotion for young restaurant workers). Fort Worth, TX: Organizational Wellness & Learning Systems.

Broome, K. M., & Bennett, J. B. (2011). Reducing heavy alcohol consumption in young restaurant workers. Journal of Studies on Alcohol and Drugs, 72(1), 117-124.  Pub Med icon

Study 2

Bennett, J. B., Broome, K. M., Aden, C., Rigdon, W. D., Petree, R. D., & Mitchell, K. (2010). Team Resilience research report (health promotion for young restaurant workers). Fort Worth, TX: Organizational Wellness & Learning Systems.

Petree, R. D., Broome, K. M., & Bennett, J. B. (2012). Exploring and reducing stress in young restaurant workers: Results of a randomized field trial. American Journal of Health Promotion, 26(4), 217-224.  Pub Med icon

Outcomes

Outcome 1: Recurring heavy drinking
Description of Measures Recurring heavy drinking was assessed with a single survey item. Participants indicated how many days out of the past 30 they consumed five or more drinks on the same occasion. Responses of 5 days or more indicated recurring heavy drinking.
Key Findings A 12-month longitudinal study was conducted with employees in 28 full-service restaurants that were part of a national casual dining restaurant chain. A set of restaurants within each of four metropolitan areas (three in Texas and one in Illinois) was identified on the basis of size and location. These restaurants were then randomly assigned to the intervention and control conditions (14 restaurants each). Employees who participated in the intervention group received Team Resilience, and those in the control group received no training.

From baseline through the end of the follow-up periods (combining data from 6- and 12-month assessments), the reduction in recurring heavy drinking was greater for participants in the intervention group than it was for those in the control group (p = .049). However, there were no significant differences between the groups from the 6- to 12-month follow-up.
Studies Measuring Outcome Study 1
Study Designs Experimental
Quality of Research Rating 2.8 (0.0-4.0 scale)
Outcome 2: Alcohol-related work problems
Description of Measures Alcohol-related work problems were assessed with 4 survey items. Respondents indicated the number of times in the past 6 months they experienced the following problems: going to work with a hangover, missing work or calling in sick because of a hangover, working while under the influence of alcohol, and generally not working as well or as long (e.g., taking longer-than-usual breaks or lunches) because of alcohol use. Each item was dichotomized to represent the presence or absence of each type of problem in the past 6 months (1 = one or more times; 0 = never). These dichotomous items were summed to create an index ranging from 0 to 4, with higher values indicating more alcohol-related work problems.
Key Findings A 12-month longitudinal study was conducted with employees in 28 full-service restaurants that were part of a national casual dining restaurant chain. A set of restaurants within each of four metropolitan areas (three in Texas and one in Illinois) was identified on the basis of size and location. These restaurants were then randomly assigned to the intervention and control conditions (14 restaurants each). Employees who participated in the intervention group received Team Resilience, and those in the control group received no training.

From the 6- to 12-month follow-up, participants in the intervention group had a reduction in alcohol-related work problems (by about one-third), and participants in the control group had a slight increase (p = .04).
Studies Measuring Outcome Study 1
Study Designs Experimental
Quality of Research Rating 2.3 (0.0-4.0 scale)
Outcome 3: Exposure to problem coworkers
Description of Measures This outcome was assessed with the Exposure to Problem Co-workers Scale, a 4-item measure of the extent to which participants encountered problems among coworkers, including laziness, irresponsibility, inconsistent managers, arguments, rudeness, and hostility. Using a scale ranging from 0 (never) to 4 (almost always), participants rated the frequency of exposure to each item (e.g., "problems between people at work [they bicker, argue, or are rude to each other]").
Key Findings A 12-month cross-sectional study was conducted with employees in 28 full-service restaurants that were part of a national casual dining restaurant chain. A set of restaurants within each of four metropolitan areas (three in Texas and one in Illinois) was identified on the basis of size and location. These restaurants were then randomly assigned to the intervention and control conditions (14 restaurants each). Employees who participated in the intervention group received Team Resilience, and those in the control group received no training. A repeated cross-sectional approach was used to ensure that all employees were eligible for the study, regardless of previous participation, such that at each follow-up point, both previously assessed participants and new participants were assessed.

Compared with employees in control group restaurants, employees in intervention group restaurants had a decrease in exposure to problem coworkers in their work environment from baseline to the 12-month follow-up (p = .01).
Studies Measuring Outcome Study 2
Study Designs Experimental
Quality of Research Rating 2.3 (0.0-4.0 scale)
Outcome 4: Personal stress
Description of Measures This outcome was assessed by the Personal Stress Scale, a 4-item measure of the challenges experienced by participants outside of work, such as personal lack of direction, budgeting finances, problems with a boyfriend or girlfriend, and managing time. Using a scale ranging from 0 (never) to 4 (almost always), participants indicated the frequency of each item (e.g., "difficulty managing my time for work, family, school, or other responsibilities").
Key Findings A 12-month cross-sectional study was conducted with employees in 28 full-service restaurants that were part of a national casual dining restaurant chain. A set of restaurants within each of four metropolitan areas (three in Texas and one in Illinois) was identified on the basis of size and location. These restaurants were then randomly assigned to the intervention and control conditions (14 restaurants each). Employees who participated in the intervention group received Team Resilience, and those in the control group received no training. A repeated cross-sectional approach was used to ensure that all employees were eligible for the study, regardless of previous participation, such that at each follow-up point, both previously assessed participants and new participants were assessed.

Compared with employees in control group restaurants, employees in intervention group restaurants had a decrease in personal stress from baseline to the 12-month follow-up (p = .001) and from the 6- to 12-month follow-up (p = .02).
Studies Measuring Outcome Study 2
Study Designs Experimental
Quality of Research Rating 2.3 (0.0-4.0 scale)

Study Populations

The following populations were identified in the studies reviewed for Quality of Research.

Study Age Gender Race/Ethnicity
Study 1 18-25 (Young adult) 54% Male
46% Female
73% Race/ethnicity unspecified
17% Hispanic or Latino
10% Black or African American
Study 2 18-25 (Young adult) 52% Female
48% Male
76.2% White
14% Hispanic or Latino
12.1% Black or African American
3.2% American Indian or Alaska Native
3.2% Race/ethnicity unspecified
1.8% Asian

Quality of Research Ratings by Criteria (0.0-4.0 scale)

External reviewers independently evaluate the Quality of Research for an intervention's reported results using six criteria:

  1. Reliability of measures
  2. Validity of measures
  3. Intervention fidelity
  4. Missing data and attrition
  5. Potential confounding variables
  6. Appropriateness of analysis

For more information about these criteria and the meaning of the ratings, see Quality of Research.

Outcome Reliability
of Measures
Validity
of Measures
Fidelity Missing
Data/Attrition
Confounding
Variables
Data
Analysis
Overall
Rating
1: Recurring heavy drinking 3.5 3.5 2.3 2.0 2.3 3.3 2.8
2: Alcohol-related work problems 1.8 2.0 2.3 2.0 2.3 3.3 2.3
3: Exposure to problem coworkers 2.0 1.8 2.3 2.0 2.5 3.3 2.3
4: Personal stress 2.0 1.8 2.3 2.0 2.5 3.3 2.3

Study Strengths

Most of the measures had adequate reliability and face validity and addressed specific predictions of the studies. Similar scores for the alcohol-related work problems measure across time present some evidence of item stability. There was some evidence of intervention fidelity: a trained observer attended a randomly chosen subset of sessions and completed a fidelity checklist; data on dosage indicated that participants attended at least two of the training sessions; and participants provided positive ratings on three key areas of the training content. Also in one of the studies, missing data were not a problem. In the longitudinal study, attrition rates were similar for the intervention and control groups, and in the cross-sectional study, attrition was not an issue. A major strength of both studies is the use of a clustered randomized study design. The intervention and control groups were similar on baseline demographic, work, and outcome variables. The sample size was sufficient to test the hypotheses of the studies and was larger than average for applied worksite-based research with longitudinal follow-up. In both studies, analyses were appropriate for the type of data available and the research design.

Study Weaknesses

Although a low Cronbach's alpha value (.57) might be expected for the survey items used to capture alcohol-related work problems (i.e., the items assessed four discrete events, and a positive response to one item would likely result in a negative response to another item), it is still problematic that limited evidence is provided to support the measure's reliability. The measures used in the cross-sectional study were developed by the researchers and did not have the benefit of additional validation through other studies. In both studies, the sampling strategy increased the likelihood of selection bias. Although a randomized controlled design was used, there is still a strong likelihood that positive outcomes can be attributed to other potential confounding factors because of the fact that not all participants in the intervention group were directly exposed to the complete training. Power calculations were not reported.

Readiness for Dissemination
Review Date: February 2012

Materials Reviewed

The materials below were reviewed for Readiness for Dissemination. The implementation point of contact can provide information regarding implementation of the intervention and the availability of additional, updated, or new materials.

Organizational Wellness & Learning Systems, Inc. (2009). Team Resilience [CD-ROM]. Fort Worth, TX: Author.

Organizational Wellness & Learning Systems, Inc. (n.d.). Team Resilience: Fidelity training guide. Fort Worth, TX: Author.

Organizational Wellness & Learning Systems, Inc. (n.d.). Team Resilience: Health promotion for young workers in the restaurant industry. Fort Worth, TX: Author.

Organizational Wellness & Learning Systems, Inc. (n.d.). Team Resilience: Journey of resilience, ambassador training, and booster session. Fort Worth, TX: Author.

Organizational Wellness & Learning Systems, Inc. (n.d.). Team Resilience: Manager training materials [Binder]. Fort Worth, TX: Author.

Organizational Wellness & Learning Systems, Inc. (n.d.). Team Resilience session 1: The map. Fort Worth, TX: Author.

Organizational Wellness & Learning Systems, Inc. (n.d.). Team Resilience session 2: The terrain & compass. Fort Worth, TX: Author.

Organizational Wellness & Learning Systems, Inc. (n.d.). Team Resilience session 3: The destination. Fort Worth, TX: Author.

Organizational Wellness & Learning Systems Web site, http://www.organizationalwellness.com

Other implementation materials:

  • Emerging adult dimensions
  • Journey of Resilience: The Restaurant Game (with playing board)
  • Resilience and NUDGE laminated cards
  • Team Resilience marketing brochure
  • Team Resilience welcome brochure
  • The Five C's of Resilience

Readiness for Dissemination Ratings by Criteria (0.0-4.0 scale)

External reviewers independently evaluate the intervention's Readiness for Dissemination using three criteria:

  1. Availability of implementation materials
  2. Availability of training and support resources
  3. Availability of quality assurance procedures

For more information about these criteria and the meaning of the ratings, see Readiness for Dissemination.

Implementation
Materials
Training and Support
Resources
Quality Assurance
Procedures
Overall
Rating
3.5 3.0 2.8 3.1

Dissemination Strengths

A detailed replication manual, provided on CD-ROM, describes the intervention materials; outlines the roles and responsibilities of implementers; and provides training descriptions, cost information, and step-by-step implementation instructions. Four facilitator guides provide specific instructions for delivering the training sessions to employees, including the Journey of Resilience game, ambassador training, and a booster session. Program materials are colorful and detailed. Reproducible handouts and customizable marketing materials are easily accessible from CD-ROM. Before the employee training is conducted, a separate training for restaurant managers is required, which builds the leadership skills of managers and orients them to the core components of the intervention. Training is also required for individuals who want to become a program facilitator; in addition, a minimum of 2 hours of technical support and assistance is required, which strengthens implementation fidelity. Fidelity checklists are available to carefully track the activities and expectations for each session.

Dissemination Weaknesses

The replication manual includes research-related information that may be confusing to potential implementers. No information regarding the intervention is available on the developer's Web site. Little guidance is given on the use of fidelity checklists and participant evaluation tools to assess outcomes and improve program performance.

Costs

The cost information below was provided by the developer. Although this cost information may have been updated by the developer since the time of review, it may not reflect the current costs or availability of items (including newly developed or discontinued items). The implementation point of contact can provide current information and discuss implementation requirements.

Item Description Cost Required by Developer
Team Resilience CD-ROM (includes the replication manual, implementation materials, fidelity training guide, and session evaluations) Varies depending on the site (minimum of $349 per CD-ROM) Yes
Team Resilience facilitator guides (set of 4, which includes guides for conducting each of the three sessions and a guide for conducting the Journey of Resilience game, ambassador training, and booster session)
  • $49.95 per hard-copy guide
  • $29.97 per electronic guide
Yes
Preparation and customization of program materials Varies depending on the site and level of customization (minimum of $500) No
2- to 10-hour, off-site manager training and supervisor orientation (via Webinar and phone) $249 per hour and $129.95 per participant (for 3-10 participants) Yes, one manager training option is required
2- to 10-hour, on-site manager training and supervisor orientation $295 per hour and $129.95 per participant (for 3-10 participants), plus travel expenses Yes, one manager training option is required
Manager training materials (includes handouts, CD-ROM with slides, instructional guides, and 1-hour consultation) Varies depending on the site (minimum of $595) Yes
Heart Centered Leadership (book for manager training) $27 each Yes
Leaving Legacy (DVD for manager training) $24.95 each Yes
Cognitive Map (map for manager training) $349 each Yes
Materials and tools for employee training $800 plus $128 for each of the three sessions Yes
4.5-day, on-site training of facilitators $1,895 per participant (minimum of 6 participants), plus travel expenses Yes
On-site, phone, or email technical assistance $125 per hour, plus travel expenses if necessary Yes, at least 2 hours
Technical assistance protocols $100 each No
Program evaluation and outcome monitoring (includes use of various survey instruments) Contact program developer No

Additional Information

Participants from different implementation sites can come together to attend an on-site training of facilitators. The approximate total cost to an implementation site to deliver the three-session training to 15 employees (including participants' salaries, facilitator training and program delivery, optional incentives, and administrative support) ranges from $2,368 to $4,779. The developer offers discounts for nonprofit agencies that want to implement the intervention.

Replications

No replications were identified by the developer.

Contact Information

To learn more about implementation or research, contact:
Joel Bennett, Ph.D.
(817) 921-4260
owls@organizationalwellness.com

Consider these Questions to Ask (PDF, 54KB) as you explore the possible use of this intervention.