A Digital Resilience Intervention for Emergency Medical Service Workers

Not Applicable

Completed

• Conditions: Feasibility; Acceptability; Adoptability; Meaning Made; Adaptive Self-reflection; Recovery Activities; Recovery Experiences; Post Traumatic Stress Disorder PTSD; Anxiety; Depression

• Registration Number: NCT06861400
• Lead Sponsor: Syracuse University

Brief Summary

Emergency medical service (EMS) workers (i.e., ambulance service providers) experience triple the risk for anxiety, depression, and posttraumatic stress disorder (PTSD) compared to the general U.S. population. These mental disorders impact health and well-being across the life course. Thus, there is a critical need for interventions targeting key risk factors that can reduce EMS workers' mental health risk. Chronic stress represents such a risk factor and is a routine feature of the EMS profession due to the demands of providing emergency medical care. Self-Reflective Resilience-Recovery Activity Promotion Training (SRR-RAPT) promotes finding positive meaning in stressors by building self-awareness of the coping and regulatory responses used to manage them; evaluating those responses; adapting them based upon their perceived effectiveness; and developing a plan for managing similar stressors in the future based on what can be learned from the current situation. In addition to prompting self-monitoring and active reflection on stressors and coping responses, SRR-RAPT encourages practicing recovery activities that permit a person's stressor induced strain level to return to baseline. The primary objective of the current study is to evaluate the feasibility, acceptability, and adoptability of SRR-RAPT among EMS personnel. A secondary objective was to examine the intervention's effect on hypothesized mechanisms of action predicted to vary in response to the intervention, as well as consider the intervention's ability to reduce mental health symptoms. It is hypothesized that the intervention will be associated with more positive meaning made, adaptive self-reflection, recovery activities, and recovery experiences, as well as lower levels of mental health symptoms.

Detailed Description

Not available

Study Timeline

• Study Start: 2023-06-28
• Primary Completion: 2023-12-20
• Study Completion: 2023-12-20
• Study First Submitted: 2025-02-24
• Study First Submitted QC: 2025-02-28
• Status Verified: 2025-03
• Last Update Submitted: 2025-03-05
• Study First Posted: 2025-03-06
• Last Update Posted: 2025-03-10

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 83

Inclusion Criteria

• Full-time or part-time employee at an emergency medical service agency
• ≥ 18 years of age
• ≥ 1 emergency medical service shift scheduled in the next 8 days from recruitment date.

Exclusion Criteria

• Not a full-time or part-time employee at an emergency medical service agency
• < 18 years of age
• < 1 emergency medical service shift scheduled in the next 8 days from recruitment date.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: CROSSOVER

Primary Outcome Measures

Name	Time	Method
Time period required to achieve target sample size	From study initiation until at least 80 participants are recruited, up to 12 months	The number of months it takes to recruit the number of participants necessary to reach the target sample size.
Number of participants recruited and randomized each week of the study	From study initiation until at least 80 participants are recruited, up to 12 months	A count of the number of participants who are recruited and randomized each week that the study is taking place.
Acceptability	Day 8 of the intervention	Assessed with 3 items asking about respondents' perceptions that the intervention was helpful ("I found that answering the questions about managing stressful experiences and practicing recovery behaviors was helpful"); useful ("I found that answering the questions about managing stressful experiences and practicing recovery behaviors was useful"); and not burdensome ("I found that answering the questions about managing stressful experiences and practicing recovery behaviors was not too burdensome"). Respondents rated each item on a scale ranging from 1 ("Strongly Disagree") to 5 ("Strongly Agree"). Ratings are summed to yield a total daily score.
Adoptability	Day 8 of the intervention	Assessed with 3 items asking about respondents intention to use what they had learned from the intervention in the future ("I will keep using these questions to help manage stressful experiences and practice recovery activities in the future." "I will try to use these questions in the future when managing stressful experiences and trying to practice recovery activities." "I plan to use some of the approaches that I came up with in my responses to the questions about managing stressful experiences and practicing recovery behaviors in the future"). Respondents rate each item on a scale ranging from 1 ("Strongly Disagree") to 5 ("Strongly Agree"). Ratings are summed to yield a total daily score.

Secondary Outcome Measures

Name	Time	Method
Meaning Made	Days 1 to 8 of the intervention	Assessed using 3 items with the highest factor loadings on the positive reframing, acceptance, and religion subscales of the Brief COPE plus one additional item representing growth ("I identified lessons that I can learn from the challenge"). Respondents rate how much they performed the strategy described in response to any stressful or challenging experiences they encountered today. Ratings are made on a scale ranging from 1 ("Not at all") to 4 ("I did this a lot"). Ratings are summed to yield a total daily score.
Adaptive Self-Reflection	Days 1 to 8 of the intervention	Derived from 3 items used in prior research. Each day respondents rate how much they agree with the following statements describing how they reacted to challenging and stressful events they encountered today: "I noticed the strategies that I used to cope with today's stress experiences", "I considered how I approach stressful experiences in my life", and "After attempting to deal with any of today's stressful experiences, I thought about how well my approach worked." Ratings are made on a scale ranging from 1 ("Strongly Disagree") to 5 ("Strongly Agree"). Ratings are summed to yield a total daily score.
Recovery Experiences	Days 1 to 8 of the intervention	Derived from 8 items with the highest factor loadings from the detachment, relaxation, mastery, and control subscales of the Recovery Experiences Questionnaire. Respondents report how much they agree with each statement describing what they did during their off-job time today on a scale ranging from 1 ("Totally Disagree") to 5 ("Totally Agree"). Ratings are summed to yield a total daily score.
PTSD Symptom Severity	Days 1 to 8 of the intervention	Short -form of the PTSD Checklist for DSM-5. Each day respondents rate how bothered they are by PTSD symptoms on a scale ranging from 0 ("Not at all") to 4 ("Extremely"). Ratings are summed to yield a total daily score.
Recovery Activities	Days 1 to 8 of the intervention	Pittsburgh Enjoyable Activities Test. For each item, respondents indicate whether they did the activity described today when they were not working ("Yes" vs "No"). Endorsed items are summed to yield a total daily count.
Depression Symptom Severity	Days 1 to 8 of the intervention	PROMIS-dep-4a questionnaire. Each day respondents rate the extent they experienced depression symptoms on a scale ranging from 1 ("Not at all") to 5 ("All of the time"). Ratings are summed to yield a total daily score.
Anxiety Symptom Severity	Days 1 to 8 of the intervention	PROMIS-anx-4a questionnaire. Each day respondents rate the extent they experienced anxiety symptoms on a scale ranging from 1 ("Not at all") to 5 ("All of the time"). Ratings are summed to yield a total daily score.

Trial Locations

Locations (1)

Syracuse University; 🇺🇸 Syracuse, New York, United States