improvement that was sustained upon follow-up one month later. The study's authors concluded that "The HR/IH psychoeducational approach deserves further study as a brief intervention for stress-reduction in HIV-positive patients." A 2007 pilot study funded by the National Institutes of Health evaluated HR in lowering stress among Somali and Oromo refugee women who had experienced violence and torture in their homelands, but for whom Western-style psychotherapeutic treatment of trauma was not culturally appropriate. The pilot study showed that "the use of HR with refugee trauma survivors was feasible, culturally acceptable, and relevant to the participants." In a post-intervention focus group, "many women reported using new strategies to calm down, quiet their minds and make healthier decisions." Co-investigator Cheryl Robertson, Assistant Professor in the School of Nursing at the University of Minnesota, was quoted as saying, "This is a promising intervention that doesn't involve the use of highly trained personnel. And it can be done in the community." The Visitacion Valley Community Resiliency Project (VVCRP) was reviewed by an independent evaluator hired by the Pottruck Foundation. Her final report notes that "Early program evaluation...found that the VVCRP was successful in reducing individuals’ feelings of depression and isolation, and increasing their sense of happiness and self-control. The cumulative evaluation research conducted on the VVCRP and the HR model in general concludes that HR is a powerful tool for changing individuals’ beliefs and behaviors." In the Summary of Case Studies, the report goes on to state, "The VVCRP was effective over a period of five years of sustained involvement in two major neighborhood institutions...at influencing not just individuals, but also organizational policies, practices, and culture. This level of organizational influence is impressive when the relatively modest level of VVCRP staff time and resources invested into making these changes is taken into account. The pivotal levers of change at each organization were individual leaders who were moved by the HR principles to make major changes in their own beliefs, attitudes, and behaviors, and then took the initiative to inspire, enable, and mandate similar changes within their organizations. This method of reaching "critical mass" of HR awareness within these organizations appears to be both efficient and effective when the leadership conditions are right. However, this pathway to change is vulnerable to the loss of the key individual leader." Research efforts on effectiveness Pransky has reviewed the research on HR (through 2001) in relation to its