Pathways to Resilience III: Beyond Nature vs. Nurture

Health:

Abtract #95
A Novel Community-Based Intervention To Enhance Health Promotion, Risk Factor Management And Chronic Disease Prevention
Presenter: Shannon Ryan-Carson
Abstract:
Chronic disease is a highly expensive but preventable problem to the healthcare system. Evidence suggests that impacting modifiable behaviours and risk management factors in the areas of physical inactivity, unhealthy diet, stress, and obesity can alleviate the burden of chronic disease problem to a large extent. Despite this recognition, the challenge is embedding these recognized priorities into the community and in primary care in a sustainable and meaningful manner. Primary Health Care (PHC) in Capital Health responded to this challenge by developing and implementing a free, interprofessional and community-based service, namely, the Community Health Teams that offers health and wellness, risk factor management, wellness navigation and behaviour-based programming.  In this presentation, the development and implementation of the CHTs will be discussed. Preliminary outcomes for the model are significant and promising.

Abstract #184
Differences In The Use Of Coping Strategies In High- And Low-Resilience Individuals From Four different Health-Related Conditions
Presenter: Helena Hernansaiz-Garrido Co - Presenters: Rocío Rodríguez-Rey, Jesús Alonso-Tapia, Miguel Ángel Ruiz-Díaz, Carmen Nieto-Vizcaíno
Abstract:
Shown resilience vary in degree across situations, and although coping strategies have been conceptualised as ‘styles’, different situations trigger different degrees of coping strategies use. 
The aim of the study was relating use of coping strategies to resilience outcomes in different problem situations. Individuals who were HIV+ (N=60), had cancer (N=22), had children with cancer (N=62) or were healthy (N=249; total N=393) completed the subjective contextual resilience scale (SCRS) –which considers five problem areas– and a contextual coping scale (CCS) that comprised eight strategies. We obtained a high- and a low-resilience group for each sample and conducted ANOVAs to study what coping strategies differed in degree of use between the high and low resilience groups in each sample.
Results show that HIV+ high- and low-resilience groups differed in their use of all strategies except for problem-solving and thinking-avoidance strategies. Cancer groups differed only in rumination, and parents groups did in rumination, self-blaming, positive-thinking and thinking-avoidance. Lastly, healthy groups differed in rumination, emotional expression, self-blaming and positive-thinking.
In conclusion, some strategies are more important for certain types of problem situations, so different interventions should be implemented depending on the specific problem.

Abstract #221
Are Stress, Distress and Resilience Associated with Renal Complications in Youth with Type 2 Diabetes? Preliminary Results from the iCARE Cohort Study
Presenter: Sayma Malik 
Abstract:
Are stress, distress and resilience associated with renal complications in youth with type 2 diabetes? Preliminary results from the iCARE cohort study.
Malik S, Dart AB, Sellers EA, Wicklow B, Dean H, Walker J, Chateau D, Blydt-Hansen TD, McGavock J
Youth with type 2 diabetes (T2DM) are at high risk for renal failure in early adulthood. The iCARE study is evaluating the association between psychological factors and albuminuria (early marker of kidney complications) in a cohort of First Nations youth with T2DM. Methods:Youth with T2DM 10-25 years of age were recruited from the Manitoba Diabetes Education Resource for Children and Adolescents. A case-control study (cases with and controls without albuminuria) was performed to assess the association between perceived stress (PSS-14), distress (K6), and resilience (RSCA) with the presence of albuminuria. Results: 122 youth with T2DM have been recruited to date (40 with albuminuria and 82 without). No differences were seen in BMI z-scores or perceived stress, between cases and controls. Youth with albuminuria displayed higher A1c (worse glycemic control), elevated systolic blood pressure, and more significant psychological distress.  Resiliency (specifically mastery) was the same between groups, however associated with better glycemic control. Conclusions:Psychological distress is independently associated with albuminuria in youth onset T2DM, in addition to poor glycemic control and hypertension. Lower levels of distress and higher levels of mastery are associated with better glycemic control.