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The Efficacy of Resiliency Training Programs: A Systematic Review and Meta-Analysis of Randomized Trials

Author

Listed:
  • Aaron L Leppin
  • Pavithra R Bora
  • Jon C Tilburt
  • Michael R Gionfriddo
  • Claudia Zeballos-Palacios
  • Megan M Dulohery
  • Amit Sood
  • Patricia J Erwin
  • Juan Pablo Brito
  • Kasey R Boehmer
  • Victor M Montori

Abstract

Importance: Poor mental health places a burden on individuals and populations. Resilient persons are able to adapt to life’s challenges and maintain high quality of life and function. Finding effective strategies to bolster resilience in individuals and populations is of interest to many stakeholders. Objectives: To synthesize the evidence for resiliency training programs in improving mental health and capacity in 1) diverse adult populations and 2) persons with chronic diseases. Data Sources: Electronic databases, clinical trial registries, and bibliographies. We also contacted study authors and field experts. Study Selection: Randomized trials assessing the efficacy of any program intended to enhance resilience in adults and published after 1990. No restrictions were made based on outcome measured or comparator used. Data Extraction and Synthesis: Reviewers worked independently and in duplicate to extract study characteristics and data. These were confirmed with authors. We conducted a random effects meta-analysis on available data and tested for interaction in planned subgroups. Main Outcomes: The standardized mean difference (SMD) effect of resiliency training programs on 1) resilience/hardiness, 2) quality of life/well-being, 3) self-efficacy/activation, 4) depression, 5) stress, and 6) anxiety. Results: We found 25 small trials at moderate to high risk of bias. Interventions varied in format and theoretical approach. Random effects meta-analysis showed a moderate effect of generalized stress-directed programs on enhancing resilience [pooled SMD 0.37 (95% CI 0.18, 0.57) p = .0002; I2 = 41%] within 3 months of follow up. Improvement in other outcomes was favorable to the interventions and reached statistical significance after removing two studies at high risk of bias. Trauma-induced stress-directed programs significantly improved stress [−0.53 (−1.04, −0.03) p = .03; I2 = 73%] and depression [−0.51 (−0.92, −0.10) p = .04; I2 = 61%]. Conclusions: We found evidence warranting low confidence that resiliency training programs have a small to moderate effect at improving resilience and other mental health outcomes. Further study is needed to better define the resilience construct and to design interventions specific to it. Registration Number: PROSPERO #CRD42014007185

Suggested Citation

  • Aaron L Leppin & Pavithra R Bora & Jon C Tilburt & Michael R Gionfriddo & Claudia Zeballos-Palacios & Megan M Dulohery & Amit Sood & Patricia J Erwin & Juan Pablo Brito & Kasey R Boehmer & Victor M Mo, 2014. "The Efficacy of Resiliency Training Programs: A Systematic Review and Meta-Analysis of Randomized Trials," PLOS ONE, Public Library of Science, vol. 9(10), pages 1-15, October.
    • Handle: RePEc:plo:pone00:0111420
    DOI: 10.1371/journal.pone.0111420
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    References listed on IDEAS

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    1. David Moher & Alessandro Liberati & Jennifer Tetzlaff & Douglas G Altman & The PRISMA Group, 2009. "Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement," PLOS Medicine, Public Library of Science, vol. 6(7), pages 1-6, July.
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    1. Desireé Ruiz-Aranda & Carmen Mateo-Rodriguez & Isabel Serrano Olmedo & Clara García García & Alicia Justel Enríquez & María Asunción Martinez-Brocca, 2020. "Relationship between Resilience and Quality of Life in Patients with Fear of Hypoglycemia: The Mediating Effects of Anxiety and Depression," Sustainability, MDPI, vol. 12(20), pages 1-11, October.
    2. Hiromi Tobe & Mariko Sakka & Sachiko Kita & Mari Ikeda & Kiyoko Kamibeppu, 2022. "The Efficacy of a Resilience-Enhancement Program for Mothers Based on Emotion Regulation: A Randomized Controlled Trial in Japan," IJERPH, MDPI, vol. 19(22), pages 1-20, November.
    3. Justin Mausz & Elizabeth Anne Donnelly & Sandra Moll & Sheila Harms & Meghan McConnell, 2022. "Mental Disorder Symptoms and the Relationship with Resilience among Paramedics in a Single Canadian Site," IJERPH, MDPI, vol. 19(8), pages 1-14, April.
    4. Firman Firman & Agus Prianto & Mindaudah Mindaudah, 2023. "The role of religiosity in strengthening resilience, work involvement, and worker performance in Jombang Regency, East Java Indonesia," Technium Social Sciences Journal, Technium Science, vol. 45(1), pages 353-371, July.
    5. Madlaina Niederhauser & Regula Zueger & Sandra Sefidan & Hubert Annen & Serge Brand & Dena Sadeghi-Bahmani, 2022. "Does Training Motivation Influence Resilience Training Outcome on Chronic Stress? Results from an Interventional Study," IJERPH, MDPI, vol. 19(10), pages 1-14, May.
    6. Mafalda Ferreira & António Marques & Paulo Veloso Gomes, 2021. "Individual Resilience Interventions: A Systematic Review in Adult Population Samples over the Last Decade," IJERPH, MDPI, vol. 18(14), pages 1-17, July.
    7. Ambra Mara Giovannetti & Rui Quintas & Irene Tramacere & Andrea Giordano & Paolo Confalonieri & Michele Messmer Uccelli & Alessandra Solari & Kenneth Ian Pakenham, 2020. "A resilience group training program for people with multiple sclerosis: Results of a pilot single-blind randomized controlled trial and nested qualitative study," PLOS ONE, Public Library of Science, vol. 15(4), pages 1-26, April.
    8. Melissa R. Marselle & Sara L. Warber & Katherine N. Irvine, 2019. "Growing Resilience through Interaction with Nature: Can Group Walks in Nature Buffer the Effects of Stressful Life Events on Mental Health?," IJERPH, MDPI, vol. 16(6), pages 1-25, March.

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