A propensity score analysis of brief worksite crisis interventions after the World Trade Center disaster: implications for intervention and research.
BACKGROUND
Postdisaster crisis interventions have been viewed by some as appropriate to enhance the mental health status of persons affected by large-scale traumatic events. However, studies and systematic reviews have challenged the effectiveness of these efforts.


OBJECTIVE
The focus of this study was to examine the impact of brief mental health interventions received by employees at the worksite after the World Trade Center disaster (WTCD) among workers in New York City (NYC).


METHODS
The data for the present study come from a prospective cohort study of 1121 employed adults interviewed by telephone in a household survey 1 year and 2 years after the WTCD. All study participants were living in NYC at the time of the attacks. For the current study, we used propensity scores to match intervention cases (n = 150) to nonintervention controls (n = 971) using a 1:5 matching ratio based on a bias-corrected nearest-neighbor algorithm.


RESULTS
Approximately 7% of NYC adults (approximately 425,000 persons) reported receiving employer-sponsored, worksite crisis interventions related to the WTCD provided by mental health professionals. In addition, analyses indicated that attending 1 to 3 brief worksite sessions was associated with positive outcomes up to 2 years after the WTCD across a spectrum of results, including reduced alcohol dependence, binge drinking, depression, PTSD severity, and reduced anxiety symptoms.


CONCLUSIONS
Although our study had limitations, it is one of the few to suggest that brief postdisaster crisis interventions may be effective for employees after mass exposure to psychologically traumatic events. The reasons for the effectiveness of these interventions are unclear at this time and warrant further investigation.
Boscarino
Joseph A
JA
Division of Health & Science Policy, The New York Academy of Medicine, New York, New York, USA. jaboscarino@geisinger.edu
Adams
Richard E
RE
Foa
Edna B
EB
Landrigan
Philip J
PJ
D000328:Adult; D015331:Cohort Studies; D003419:Crisis Intervention / Q000706:statistics & numerical data*; D003863:Depression / Q000517:prevention & control; D005500:Follow-Up Studies; D019538:Health Care Surveys; D006801:Humans; D009519:New York City; D009786:Occupational Health Services / Q000706:statistics & numerical data*; D010043:Outcome and Process Assessment, Health Care; D011446:Prospective Studies; D047851:September 11 Terrorist Attacks; D017678:Sex Distribution; D012959:Socioeconomic Factors; D013313:Stress Disorders, Post-Traumatic / Q000517:prevention & control; D016896:Treatment Outcome