PRP047: Changing Our Mental and Emotional Trajectory to Improve Mental Health in Rural Communities: the COMET Program

Linda Zittleman, MSPH; Maret Felzien; Joseph Carrica III; Christin Sutter; Kristen Curcija, MPH; Tamara Oser, MD; John Westfall, MD, MPH


Context: Multiple challenges face rural community members in accessing mental health care and support. The High Plains Research Network Community Advisory Council, mental health professionals, and researchers developed an intervention to help community members be more prepared to support others’ mental health needs – especially before a condition becomes an emergency – in every day conversations and settings. The program, Changing Our Mental and Emotional Trajectory (COMET), trains community members in the seven-question COMET Conversational Health Questionnaire to “be the other person.” Objective: Describe training implementation and evaluation results. Study Design: Quantitative descriptive survey. Setting: Trainings in community settings in rural Colorado. Population Studied: Health professionals, extension agents, and other community members from diverse occupational backgrounds that attended the COMET Training. Intervention/Instrument: 90-minute training with a mix of experiential and didactic sections that cover local epidemiology of mental health, what being “the other person” mean, the COMET questions, role-playing, and action planning. Trainees complete a short survey before and after training on behavior intentions, resources, and training content. Outcome Measures: Number of trainings, participant descriptives, participants’ assessment of training structure, content, and intentions to use. Results: 42 people attended three COMET trainings at community venues in rural Colorado. Trainees included farmers/ranchers, law enforcement, coroner, health care professionals, teachers, and retail workers. Of these, 78% reported they were likely to tell someone that they’ve noticed a change in their mood or behavior after training compared to 50% before, and 81% were likely to invite an acquaintance or co-worker to tell them more about a potentially emotional situation after training compared to 57% before. 74% reported an 8 or higher on a scale of 1-10 for likelihood of using the COMET questions in the next 3 months. Demographics and applications for primary care settings will be presented. Conclusion: COMET provides community members with a tool to identify and support others who may be experiencing mental health distress. Community members report that a short but interactive training opportunity increases their likelihood of engaging others in mental health conversations to support social connection and reduce risk for crisis.
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Laura Mentch

The poster clearly presented the COMET project and engaged my interest in participating in a similar training. I hope you will find a way to elicit the impact of receivers of the intervention. Let us know!

Linda Zittleman

Thank you for your interest, Laura! We appreciate your comment and are working to assess the impact you described. Stay tuned! Feel free to contact any of us.

Viv Ramsden 11/19/2020

Thank you for normalizing the difficult conversation around mental health and wellness. I look forward to hearing about or reading the qualitative results.

Linda Zittleman

Thank you, Viv!

Emily Godfrey 11/22/2020

Congrats Linda on wining the PaCE award for this wonderful and important work! I love the community members helping community members model.

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