Provider Wellbeing during the COVID-19 Pandemic: Findings from a Survey of Staff Employed By Refugee Resettlement Agencies in Arizona

Background and Purpose

The COVID-19 pandemic, in combination with significant political and social events, have had implications for the employees of refugee resettlement agencies at all levels of organizational hierarchy. The aim of this study was to highlight issues related to wellbeing among employees of refugee resettlement agencies to inform organizational policies and practices.

Methods

Using a purposive sampling approach, key contacts at five resettlement agencies shared the survey link with staff in December 2020. Participants self-administered the survey in Qualtrics. Survey items consisted of demographic questions and quantitative measures of health/wellbeing (HERO index); stressors related to the pandemic, political climate, and racism; pandemic-related concerns; perceived stress; quality of work-life; and self-care. Bivariate and multivariate analyses examined associations between participant demographics, stressors, and health/wellbeing. Participants elaborated on key domains in response to eight open-ended questions; these data were analyzed using a context analysis.

Results

Sixty individuals completed the survey. The final sample was 81% female, 24% foreign-born, 30% People of Color, and averaged 38 years old (range: 21 – 68). Forty-two percent of the sample were caseworkers and therapists, 42% were supervisors and coordinators, and 10% held leadership positions. Burnout (M=1.73, SD=1.01) and stress scores (M=7.33, SD2.87) were low, indicating resiliency; however, participants expressed high levels of stress and potential for burnout in qualitative responses. U.S.-born participants had higher rates of burnout compared to people born outside the U.S. (t(57)=2.13, p<.05). U.S.-born participants reported statistically more negative effects of the political climate relating to their wellbeing compared to people born outside the U.S. (t(57)=-2.65, p<.05). People of Color reported significantly more negative impacts of racism relating to their wellbeing in comparison to White participants (t(58)=2.86, p<.05). The three areas of greatest concern during the COVID-19 pandemic were client hardships, health of loved ones, and feeling cut off from family and friends. People of Color reported more concerns compared to White participants (t(58)=-3.16, p<.01). All respondents reported low scores on self-care practices. Barriers to practicing self-care were lack of time, inability to step away from current events, and work obligations. Results from the regression analysis indicated that gender, quality of work-life, and stress were associated with health/wellbeing problems (F(8, 50) = 11.89, p<.001). Specifically, women scored 15 percentage points higher than men on the HERO Index. For every percentage point increase in quality of work-life, respondents were 8 percentage points less likely to report problems affecting wellbeing. For every percentage point increase in stress, the number of reported problems increased on the HERO Index by 6 percentage points.

Conclusions and Implications

These findings suggest that addressing key elements of work-life and reducing stress has the potential to influence provider wellbeing. Resettlement agencies should acknowledge the hardships staff face, provide space for staff to express and process concerns, and uphold transparency in decision-making. Employers should explore trauma-informed organizational models and training for staff at all levels. Finally, refugee resettlement agencies can enhance workplace support by strengthening departmental teams and supportive supervision, and boosting opportunities for peer support.