Resilience-promoting Interventions Research Articles

How nurses can promote resilience among adolescents receiving active cancer treatment: A scoping review.

Explore knowledge on resilience-promoting interventions among adolescents receiving active cancer treatment. The question used to guide the research was: How can nurses promote resilience among adolescents receiving active cancer treatment? Adolescence is a very turbulent stage of development (Young, 2014). A cancer diagnosis at this age contributes to emotional distress and reduces quality of life (Sodergren et al., 2017). However, some youth develop positive coping mechanisms that lead to increased resilience (Bellizzi et al., 2012; Sodergren et al., 2017). Because nurses often care for these patients over an extended period of time, they can play an important role in fostering this resilience. Three databases (CINAHL, PubMed and PsycArticles) were consulted in February 2023, using research limiters "2013-2023" and "adolescents" (teenagers) both in French and in English. Potentially relevant sources were selected based on the guidelines identified by Pollock et al., (2021). Data were extracted, analyzed and presented using the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews checklist (Tricco et al., 2018). The results were categorized, using deductive reasoning, as either protective factors or risk factors, in line with the Resilience in Illness Model (RIM; (Haase et al., 2014, 2017). Finally, potential interventions were identified where nurses can foster resilience among adolescents actively undergoing cancer treatment. The method used returned 86 studies, 17 of which met the selection criteria. Of these, 10 were quantitative in nature, three were qualitative, three were theoretical (including literature reviews and meta-analyses) and one was an editorial. The majority (n = 15) were published in the United States. There have been no studies specifically examining the role of nurses in promoting resilience among adolescents undergoing active cancer treatment since 2013. Based on the findings of this paper, considering that information has been published on the role nurses serve in caring for adolescents who have a chronic illness other than cancer, the conclusion is that pediatric oncology nurses can be key players in promoting resilience among patients at this stage of development. Studies focusing specifically on this topic would be useful in determining how to facilitate adaptation and foster resilience effectively among adolescents receiving active cancer treatment.

Six-month psychopathological symptom trajectories following the COVID-19 outbreak: Contrasting mental health outcomes between nurses and the general population.

The COVID-19 pandemic prompted a social, economic and health crisis that had a major impact on the mental health of the global community, particularly nurses. The objective of the current study is to conduct a longitudinal evaluation of the trajectory of depressive, anxiety, trauma, and fear of COVID-19 symptoms, comparing self-reports of nurses and the general population over a six-month period. Self-report questionnaires were administered online to a sample of 180 nurses and 158 individuals from the general population for the baseline assessment (T1) and follow-up at 6 months (T2). Levels of symptoms reported by nurses were generally greater and tended to worsen over time, as opposed to the levels of symptoms reported by the general population that tended to improve. Levels of depressive, anxiety, and trauma symptoms were significantly different between nurses and the general population over time. Levels of fear of COVID-19 declined significantly from T1 to T2 in both groups. These results suggest that it is crucial to monitor the longer-term effects of COVID-19 and to develop resilience-promoting interventions tailored to the unique needs of this vulnerable group.

Social Support, Resilience, and Mental Health Among Three High-Risk Groups in Hong Kong: A Mediation Analysis.

To compare the prevalence of anxiety/depression, resilience, and social support among nurses, foreign domestic helpers (FDHs), and residents living in subdivided units (SDUs), and to examine their associations in these high-risk groups in Hong Kong during Omicron waves. We recruited 1,014 nurses, 621 FDHs, and 651 SDU residents from December 2021 to May 2022 in this cross-sectional survey. The depression, anxiety, social support, and resilience levels were measured by the validated scales. The multivariate binary logistic regression and causal mediation analysis were applied to examine the associations. We observed a prevalence of 17.7% in anxiety and 21.6% in depression which were the highest in SDU residents, followed by FDHs, and lowest in nurses. Social support was associated with increased resilience levels and decreased risks of anxiety/depression. The association of social support with mental disorders was partly mediated by resilience, accounting for 30.9% and 20.9% of the total effect of social support on anxiety and depression, respectively. Public health strategies should target improving social support and providing resilience-promoting interventions to help reduce mental disorders in vulnerable groups.

Resilience after adversity: an umbrella review of adversity protective factors and resilience-promoting interventions.

Resilience is the dynamic adaptive process of maintaining or recovering mental health from stressors, such as trauma, challenging life circumstances, critical transitions, or physical illnesses. Resilience after adversity can be fostered through protective factors and the implementation of interventions that promote resilience. Hence, it is essential to investigate both protective and vulnerable factors to reduce the negative effects of unfavorable life events and increase resilience through positive risk-response interventions. To assess the effect of previous adversity, protecting factors, and resilience-promoting interventions to possess resilience after adversity in a global context. The study included English language articles sourced from PubMed, Embase, Scopus, Web of Sciences, the Cochrane Database of Systematic Reviews, Scopus, and Google Scholar published before 15 April 2024. These articles reported the effect of adversity, protecting factors, and/or resilience-promoting interventions to possess resilience after adversity in a global context without a population age limitation. The quality of the included studies was assessed using the Assessment of Multiple Systematic Reviews. A weighted inverse-variance random-effects model was applied to find the pooled estimates. The subgroup analysis, heterogeneity, publication bias, and sensitivity analysis were also assessed. A total of 44 articles (n = 556,920 participants) were included in this umbrella review. From the random-effects model analysis, the pooled effect of adversity on the development of resilience was 0.25 (p < 0.001). The pooled effects of adversity-protective factors and resilience-promoting interventions after adversity were 0.31 (p < 0.001) and 0.42 (p < 0.001), respectively. The pooled effects of specific adversity protective factors were 0.26, 0.09, 0.05, 0.34, 0.23, and 0.43 for the availability of support, cognitive ability, community cohesion, positive self-perception, religious involvement, and self-regulation, respectively. The pooled effects of specific resilience-promoting interventions were 0.30, 0.21, 0.51, and 0.52 for cognitive behavior therapy (CBT) interventions, mindfulness-based interventions, mixed interventions, and resilience-promoting interventions, respectively. The findings of this umbrella review revealed that people who experienced early adversity can develop resilience later in life. The study highlights the need to consider adversity protective factors, such as availability of support (family, friends, and school), cognitive ability, community cohesion, positive self-perception, religious involvement, and self-regulation, and resilience-promoting interventions, including CBT interventions, mindfulness-based interventions, and mixed interventions, to enhance resilience promotion programs.

Health Resilience in Arabic-speaking Adult Refugees With Type 2 Diabetes: A Grounded Theory Study During the COVID-19 Pandemic

ObjectivesThis qualitative study aimed to describe the lived experiences of Arabic-speaking refugees in managing their type 2 diabetes mellitus (T2DM) while resettling during the COVID-19 pandemic, and to generate a grounded theory of how resilience is used to facilitate living well while facing multiple health stressors. MethodsA grounded theory approach was used to conceptualize the dynamic process of resilience in living well with diabetes. Five recently resettled adult refugees with T2DM (2 women and 3 men) participated in unstructured individual interviews in Arabic in New Brunswick, Canada, during the pandemic’s second wave (October 2020 to March 2021). Interview data were transcribed and analyzed thematically using open, axial, and core category coding followed by member checking. ResultsParticipants identified self-reliance as the core driver for decision-making, actions, and interpretations in health management while experiencing unplanned instability. The process was found to be facilitated by 4 distinct constructs: knowledge seeking, positive outlook, self-care, and creativity. ConclusionsThe substantive model derived from this study supports a strengths-based approach to clinical assessment and care of refugees with T2DM, notably during disrupted access to primary and preventive services due to forced resettlement and pandemic mitigation measures. More research is needed to increase understanding of how self-reliance can be optimized in resilience-promoting interventions to facilitate diabetes management among populations in posttraumatic circumstances.

Childhood bullying victimization, emotion regulation, rumination, distress tolerance, and depressive symptoms: A cross-national examination among young adults in seven countries.

Existing research suggests a robust association between childhood bullying victimization and depressive symptoms in adulthood, but less is known about potential mediators of this link. Furthermore, there is limited cross-national research evaluating similarities and differences in bullying victimization and its associations with mental health. The current study addressed gaps in the literature by evaluating cognitive and affective responses to stress (i.e., emotion regulation, rumination, and distress tolerance) as potential mediators of the link between recalled bullying victimization and current depressive symptoms among 5909 (70.6% female) college students from seven countries. Results revealed specific indirect associations of bullying victimization through distress tolerance and three out of four facets of rumination, as well as a persistent direct association of childhood bullying on adulthood depression. Emotion regulation strategies were not significantly associated with bullying victimization and did not mediate its association with depressive symptoms. Constrained multigroup models indicated that results were invariant across country and gender. Findings provide evidence of statistical mediation in a cross-sectional sample and await replication in prospective studies. Rumination and distress tolerance may be promising targets for resilience-promoting interventions among children experiencing peer victimization. Ongoing research is needed to clarify cross-national patterns in childhood bullying, identify additional mediators accounting for the remaining direct association, and evaluate emotion regulation as a potential moderator of associations between bullying victimization and adult mental health.

Reflections of South African educators on the enablement of at-risk learners with protective systems via the Read-me-to-Resilience intervention

Resilience-promoting interventions, such as the Read-me-to-Resilience intervention strategy, that consists of culturally relevant indigenous stories has been shown to encourage resilience in acquired immunodeficiency syndrome (AIDS) orphans. In this study, educator participants reflected on the protective systems that the Read-me-to-Resilience stories might offer for at-risk learners within their school context. Resilience protective systems include self-regulation, attachment relationships, agency and mastery motivation systems, cultural traditions and religion, cognitive competence and meaning making. The exploration of the Read-me-to-Resilience intervention as a protective strategy was rooted in the social-ecological perspective of resilience, which focuses on positive adjustment to adversity through resilience protective systems. Fifteen South African educators were requested to implement the Read-me-to-Resilience intervention strategy within their school context. Participation in the study was voluntary. An explorative qualitative research approach was used. Three unstructured focus-group interviews were conducted, and research diaries were kept by the participants. The educator participants reported that the indigenous African stories had promoted problem-solving and leadership skills, personal positive strengths and attachment relationships and had stimulated renewed appreciation for resources within the traditional African culture. Relevant literature on protective systems for resilience development supports my research findings. It is proposed that culturally relevant stories, as an inexpensive strategy, should be utilised within the school community to promote adaptive and preventive protective systems for at-risk learners.

Resilience in children and youth in street situations in León, Nicaragua.

There are tens of millions of children and youth in street situations (CYSS) worldwide, the majority of whom are males living in low- and middle-income countries. Many of these children demonstrate impressive adaptability and resilience. The focus of the current research was on the resilience of male CYSS in León, Nicaragua. Qualitative data were collected through individual interviews and focus groups with CYSS, their family members, community members, and staff of a local nonprofit, with the objective of exploring and consolidating local understandings of resilience. Grounded theory analysis of qualitative data yielded a context-specific conceptual model of resilience as it pertains to CYSS in León. Six qualities were identified to represent the experience of resilience in this group: agency, belonging, flexibility, protection, self-regulation, and self-worth. The knowledge generated from this research can serve as a foundation to develop and implement resilience-promoting interventions for CYSS.

Resilience-promoting interventions for children and youth experiencing chronic stress in rural contexts: A convergent segregated mixed methods systematic review

Resilience-promoting interventions for children and youth experiencing chronic stress in rural contexts: A convergent segregated mixed methods systematic review

Examining Associations Between Resilience and Sexual Health Among South African Girls and Young Women Living With and Without HIV

Resilience, or multilevel processes related to thriving, offers a strengths-based approach to reducing HIV and sexual risk behaviors among girls and young women. Processes of resilience may change based on the experience of living with HIV. However, little is known about how resilience and serologically verified HIV status influence sexual health. Using weighted cross-sectional data collected during 2017-2018 from South African girls and young women aged 15-24 (N = 7237), this article examines associations between resilience and three sexual risk behaviors among those living with and without HIV. Logistic regression models indicated greater resilience scores were associated with reduced odds of engaging in transactional sex and early sexual debut. Results also identified differing associations between resilience and sexual risk behaviors by HIV status. Findings provide implications for programming to prevent HIV and improve sexual health while underscoring the need for tailored resilience-promoting interventions for South African girls and young women living with HIV.

Effects of Resilience-Promoting Interventions on Cancer Patients' Positive Adaptation and Quality of Life: A Meta-analysis.

Resilience-promoting interventions (RPIs) are increasingly used for cancer patients. However, there are few comprehensive reports on the efficacy of RPIs in cancer patients. A meta-analysis of randomized controlled trials (RCTs) was conducted to systematically evaluate the effects of RPIs on resilience, posttraumatic growth (PTG), and quality of life in cancer patients. Two authors conducted independent literature searches in electronic databases (PubMed, Scopus, Web of Science, MEDLINE, EBSCO [ASC], Cochrane library, China National Knowledge Infrastructure, Wan Fang Data, and Chinese Scientific and Technological Journal Database) from the first available date to February 2021. Then, eligible studies were selected, data for meta-analysis were extracted, and the risk of bias was evaluated. Sixteen independent randomized controlled trials with 1620 participants were included. Meta-analysis showed that RPIs significantly improved the level of resilience and PTG among cancer patients. Further analysis indicated that both group and individual interventions could enhance resilience and PTG levels. However, RPIs did not significantly enhance the quality of life in cancer patients. Clinical evidence from current randomized controlled trials shows that RPIs can improve the positive adaptation in cancer patients through either group intervention or individual intervention methods. In the future, the impact of RPIs on the quality of life needs further validation. Interventions to enhance the positive adaptation for patients with cancer are needed. Considering that both group and individual forms of RPIs can improve resilience and PTG, future clinical intervention methods can be considered in combination with the specific situation of research implementation.

Psychological resilience, activities of daily living, and cognitive functioning among older male Tekun adults in rural long-term care facilities in China

ABSTRACT Most of the rural long-term care (LTC) facilities in China are ill-equipped to manage the physical and psychological needs of older residents with dementia. These facilities mostly consist of older male Tekun (socially and economically vulnerable) adults. Preventing or delaying the onset of dementia is especially crucial for these older Tekun adults. A sample of 711 older male Tekun adults from rural LTC facilities in the Anhui province of China was used to investigate the association between psychological resilience and cognitive functioning, and to examine the moderating effect of activities of daily living (ADLs) on that association. Linear and quantile regression found that resilience was positively associated with cognitive functioning for the total sample, with a greater effect among those with a lower level of cognitive functioning. The benefit of resilience on cognitive functioning was observed only in participants with disability in ADLs. Our findings present evidence in support of interventions to foster psychological resilience and potentially improve cognitive functioning among vulnerable older adults. Resilience-promoting intervention is a strength-based approach that aligns with social work values and can be used in practice. The implications for social work practice were discussed.

Resilience and Coping Self-Efficacy among Family Medicine Residents in times of COVID-19 pandemic: Interplay and contribution of sociodemographic, professional, lifestyle and health-related factors

Background: Family Medicine Residents face stressors related to their professional responsibilities, ethics, and relationships with patients, supervisors, and society. These stressors were found to increase during the COVID-19 crisis and can lead to maladaptive coping and affect their resilience. Objectives: to assess family medicine residents’ level of resilience coping self-efficacy during COVID-19 crisis. Method: A cross-sectional study was conducted among 208 family medicine residents in the Western region of Saudi Arabia. Resilience and coping self-efficacy were assessed using the Connor-Davidson Resilience Scale-25 items (CD-RISC-25) and coping self-efficacy scale (CSES), respectively. Professional stressors including work environment satisfaction (WES) were assessed. Results: The mean (SD) CD-RISC-25 and CSEC score was 54.53 (19.69) out of 100 and 136.81 (63.67) out of 260, respectively. Suboptimal resilience was independently associated with shorter (&lt;10 min.) consultation time (OR=3.83, p=0.023) and lower CSES score (OR=0.98, p&lt;0.001), with 32.5% variance. CSES score was independently explained by WES score (B=16.06, p&lt;0.001), spiritual fulfillment (B=11.71, p=0.011), and home-job travel time (B=9.12, p=0.032) in a positive relationship; whereas it was negatively associated with history of significant disease (B= -28.66, p=0.002). Conclusion: Family medicine residents are at high-risk for psychological distress during the COVID-19 crisis, indicated by low resilience and coping self-efficacy levels. The model suggests high impact of WES and spiritual fulfillment in coping self-efficacy indicating relevance in resilience-promoting interventions. Keywords: Resilience, CD-RISC-25, coping, medical residents, COVID-19, stressors

The Pursuit of Resilience: A Meta-Analysis and Systematic Review of Resilience-Promoting Interventions

The Pursuit of Resilience: A Meta-Analysis and Systematic Review of Resilience-Promoting Interventions

Resilience in survivors of critical illness: A scoping review of the published literature in relation to definitions, prevalence, and relationship to clinical outcomes.

Survivors of critical illness face substantial challenges in their recovery, including physical and cognitive dysfunction. Resilience is the ability to adapt and maintain one's mental health after facing such challenges. Higher resilience levels have been found to be beneficial throughout the illness trajectory in cancer patients, but resilience has not been widely researched in critical care patients. We undertook a scoping review to identify published studies on resilience following critical illness and describe: how resilience has been measured; the prevalence of low resilience in critical care patients; and what associations (if any) exist between resilience and clinical outcomes. We searched: PubMed, Medline, PsychINFO, CINAHL, Web of Science, Cochrane Library, to identify relevant studies. We found 882 unique titles: 17 were selected for full text review, 10 were considered relevant. These included ICU inpatients and survivors, and trauma and sepsis survivors. A broad critical appraisal of each study was undertaken. The overall quality of published studies was low: there was wide variation in resilience-assessment tools across the studies, including the timing of measurement; only one used a validated tool. Estimates of low resilience ranged from 28%-67%, but with varying populations, high risk of inclusion bias, and small samples. Higher resilience levels were significantly associated with lower depression, anxiety, post-traumatic stress, pain, anger, executive dysfunction, and difficulty with self-care in critical care patients and survivors. Future studies should use validated resilience assessment, determine the optimum timing, and explore prevalence, associations with outcomes, and resilience-promoting interventions in non-selected or clearly defined populations.

Resilience as a mediator between compassion fatigue, nurses' work outcomes, and quality of care during the COVID-19 pandemic

BackgroundNurses in the frontline of the battle against COVID-19 are highly vulnerable to compassion fatigue (CF), which may affect their mental health, work effectiveness, and patient safety outcomes. However, no studies have investigated nurses' CF in relation to job outcomes and care quality during the pandemic. AimsThis study aims to examine the mediating role of resilience in the relationship between CF and frontline nurses' job outcomes (job satisfaction and turnover intention) and care quality. DesignAn online, cross-sectional survey containing five self-report scales was used to collect data from 270 frontline nurses in selected hospitals in the Philippines. ResultsOverall, 38.5% of frontline nurses experienced medium to high CF during the second wave of the pandemic. Increased CF was associated with poorer nurse-reported quality of care (β = −0.145, p = 0.019), lower job satisfaction (β = −0.317, p = 0.001), and higher organizational turnover intention (β = 0.301, p = 0.001). Moreover, resilience fully mediated the relationship between CF and quality of care (β = −0.088, p = 0.169), and partially mediated the relationship between CF and job satisfaction (β = −0.259, p = 0.001), and CF fatigue and organizational turnover intention (β = 0.272, p = 0.001). ConclusionFrontline nurses are at risk of developing CF during the pandemic. Psychological resilience reduces the negative impact of CF on frontline nurses' job satisfaction, turnover intention, and the quality of care in their assigned unit. Proactive measures to reduce CF should be prioritized by nursing administrators. Resilience-promoting interventions could foster job satisfaction and retention in nurses and, hence, the quality of care delivered in their units.

Predictors of Resilience Among Adolescent Girls and Young Women Who Have Experienced Intimate Partner Violence and Sexual Violence in South Africa.

South Africa has some of the highest rates of intimate partner and sexual violence globally, with prevalence ranging from 10% to 21% among adolescent girls and young women (AGYW). Yet, few studies characterize the relationship between violence and resilience. Identifying factors associated with resilience following exposure to violence can guide the development of strength-based interventions that change modifiable protective factors to bolster resilience. Data were derived from a cross-sectional survey of AGYW aged 15 to 24 years in South Africa that took place from 2017 to 2018. This survey was part of a national evaluation of a South African combination HIV intervention for AGYW funded by the Global Fund to Fight AIDS, TB, and Malaria. A sample of 4,399 observations was achieved through a systematic random sampling frame of 35% of households in districts where AGYW were at highest risk for HIV, and where the intervention was implemented. Resilience was assessed using the Connor-Davidson Resilience Scale. Intimate partner and sexual violence were assessed using: (a) an adapted version of a questionnaire from the World Health Organization's 2005 multicountry study on domestic violence against women, and (b) questions on lifetime experience of forced sex/rape. Nearly a third of AGYW (29.6%) reported intimate partner emotional and/or physical and/or sexual violence in the past year. Nearly a quarter of AGYW (23.74%) reported emotional violence, 17.48% reported physical violence, and 6.37% reported sexual violence from intimate partners. Nearly 8% (7.72%) reported forced sex/rape from intimate partners and/or nonpartners. More equitable gender norms, higher social support, and hazardous drinking were positively associated with higher resilience among those who experienced physical or sexual violence. This study addresses a gap in the resilience and violence literature. Future research should focus on the development of resilience-promoting interventions for individuals who have experienced violence.

Resilience in women with breast cancer: A systematic review.

Resilience refers to a dynamic process that promotes a successful adaptation to cancer-related adversity. The aim of this systematic review was to identify the biopsychosocial factors involved in the resilience of women with breast cancer and to integrate evidence on the interventions that can contribute to significantly enhancing it. Three databases were searched. In all, 923 articles were identified and, of these, 39 peer-reviewed articles were included. Resilience was associated with multiple clinical, sociodemographic, social, psychological and physiological variables, with psychological factors being the most important contributors to the development of resilience. Some protective factors were identified, such as social support, several dimensions of quality of life (QOL) and adaptive coping strategies. Psychological distress was the variable most frequently linked to reductions in resilience, finding a bidirectional relationship between them. Resilience-promoting interventions were found to be effective in improving participants' psychological well-being. Resilience is a relevant factor related with several sociodemographic, clinical, psychosocial and physiological variables in women with breast cancer. However, limitations such as the wide variability of instruments used together with the heterogeneity and small size of the samples restrict the generalizability of our conclusions.

Job security and the promotion of workers’ wellbeing in the midst of the COVID-19 pandemic: A study with Canadian workers one to two weeks after the initiation of social distancing measures

Background: Due to the current coronavirus (COVID-19) crisis, workplaces have had to make significant alterations in the way they conduct business. This, in addition to the current financial instability, may put workers at risk of experiencing job insecurity and, in turn, lower wellbeing. Job insecurity is a key determinant of wellbeing, but little is known on how it is impacted by public health crises, and more specifically how it relates to workers’ positive and negative wellbeing in the midst of a pandemic. Research is lacking on resilience levers that workplace interventions should target to support wellbeing in times of insecurity. Objective: Framed from a multidisciplinary perspective (public health, positive and organizational psychology), the study explores (1) workers’ job (in)security during the COVID-19 pandemic one to two weeks after social distancing measures were implemented by Canadian governments, (2) how job (in)security relates to wellbeing during the pandemic, and (3) the potential positive effects of workplace-related resilience levers. Method: 1,073 Canadian workers working full-/part-time or who were temporarily laid off completed an online survey, including measures of wellbeing at work or in general, job security and potential resilience levers (workplace disaster preparedness, policy, social capital). Results: Multiple regression findings highlight that marginalized workers (e.g., women, migrants, people facing financial hardships) reported lower job security, and having temporarily lost one’s job was negatively associated with job security. Low job security was related to lower scores across measures of wellbeing. Distress was high in the sample. Workplace disaster preparedness, policy and social capital were associated with higher wellbeing. The effects of these resilience levers tended to be stronger at higher job security levels. Discussion: Recommendations include a systemic, collaborative approach that includes policies fostering job security as well as resilience-promoting interventions in the workplace to protect/increase the wellbeing of workers during COVID-19.

A Resilience Intervention for Adults with Type 2 Diabetes: Proof-of-Concept in Community Health Centers.

Given the psychological stress associated with managing type 2 diabetes (T2D), resilience-promoting interventions may particularly benefit populations experiencing high levels of stress (e.g., racial/ethnic minority and lower-income individuals). Federally qualified Community Health Centers (CHCs) primarily serve these patients and are therefore ideal settings for resilience-promoting T2D programs. This proof-of-concept study tested the Resilience-Based Diabetes Self-Management Education (RB-DSME) intervention within a CHC. Thirty-five patients with T2D (M age = 51years, 71% female, 60% Hispanic, 69% annual household income < $20,000) at two clinics within the CHC completed the RB-DSME, consisting of eight bi-weekly classes and two monthly support groups. In this treatment-only design, resilience resources, self-management behaviors, and physical and mental health outcomes were measured at baseline and 6months. Attendance (M = 7.66/10) and program satisfaction (M = 6.79/7) were high. Participants improved adaption to stress (d = .67), adaptive coping (d = .60), diabetes empowerment (d = .57), and finding positive meaning (d = .85). Large increases in self-management behaviors (d = 1.38) and number of steps (d = 1.11) were also observed. Participants lowered A1C from baseline (M = 8.79%) to 6months (M = 8.11%; d = .50), along with diabetes distress (d = 1.31), depressive symptoms (d = .80), and general perceived stress (d = .55). This study demonstrated the ability of the RB-DSME to improve resilience resources, self-management behaviors, and health outcomes among racial/ethnic minority and lower-income patients with T2D at clinics within a CHC. A larger, randomized trial should more rigorously test the RB-DSME in this clinical setting.