5 - (SYM 101) Preferences for the Adaptation of a Resiliency Intervention Among Nurses Providing HIV Care in South Africa

Background: Nurses providing HIV care in South Africa (SA) experience high levels of stress and burnout, which in turn may negatively impact patients. Interventions to support nurses are needed. A group-based resiliency intervention of eight, 90-minute sessions (the SMART-3RP), aims to reduce stress through skills that facilitate: (1) elicitation of the relaxation response to downregulate the sympathetic nervous system; (2) improved stress appraisal and coping; and (3) enhanced connectedness to self and others. Though this intervention has been adapted to increase resilience among populations in the US (e.g., older women with HIV, frontline clinicians during the COVID pandemic), it has not yet been adapted for providers in resource-limited settings.

Methods: To elicit feedback on intervention adaptations, focus groups were conducted from with 14 professional nurses (12 women, 2 men) providing HIV care in the public sector in Durban, South Africa. Focus groups explored preferred method of intervention delivery (i.e., in person, virtually, or hybrid; one-on-one or group), the amount of time they could participate each week, and the use of social media (e.g., to connect with other participants, to enhance skills practice). Data were analyzed using content analysis.

Results: Mean age was 42.0 years old (SD=9.2) and average time working at their current clinic was 8.9 years (SD=7.7). Most preferred an in-person, group format, believing this would enhance their interaction with one another, allowing for open dialogue and deeper engagement with 3RP material. Participants stressed the importance of (1) having an interventionist present to answer questions and facilitate engagement, and (2) ensuring support from clinic management, which would communicate the value of the program to both staff and patients, and (3) normalization of talking about stress. Participants were supportive of using social media (e.g., WhatsApp) to maintain connectedness with other participants and support ongoing skill use.

Conclusions:  Participants highlighted the importance of social interaction to enhance engagement, hands-on access to resources, and support from clinic management. Normalization of discussing stress is needed before learning strategies. Based on these findings, the team will adapt this intervention into three, 2-hour, in-person group sessions to allow for a more succinct intervention period. Participants will be able to access a closed WhatsApp group, moderated by the interventionist, to support ongoing use of skills in an upcoming pilot.