The Covid-19 HEalth caRe wOrkErS (HEROES) Study
- Conditions
- Mental Health DisorderDepressionCovid-19SARS-CoV-2Stress DisorderAnxiety
- Interventions
- Other: Exposure to the SARS-CoV-2 and its consequences
- Registration Number
- NCT04352634
- Lead Sponsor
- University of Chile
- Brief Summary
Since December 2019 the world has been shaken with an enormous global threat: the Covid-19 pandemic. This new kind of coronavirus is generating an unprecedented impact both on the general population and on the healthcare systems in most countries. Health services are trying to expand their capacity to respond to the pandemic, taking actions such as increasing the number of beds; acquiring necessary equipment to provide intensive therapy (ventilators), and calling retired health professionals and health students so they can assist the overwhelmed health care workforce. Unfortunately, these organizational changes at health facilities, along with the fears and concerns of becoming ill with the virus or infecting their families, put an enormous emotional burden on workers in health services which may lead to negative outcomes on mental health in this population.
Recent cross-sectional studies in China indicate that health service workers exposed to people with Covid-19 reported higher rates of depressive and anxious symptoms. This negative impact on mental health among health workers in China has also been informally reported in other countries where the Covid-19 pandemic has been devastating in its effects (such as Spain and Italy), as well as in countries where the pandemic is becoming a growing public health problem. This is particularly relevant in regions with fewer resources (Latin America, North Africa), where there are limited means and the response from the health system is usually insufficient. Moreover, it is necessary to study these negative effects longitudinally considering that some effects will appear over time (post-traumatic stress).
The COVID-19 HEalth caRe wOrkErS (HEROES) study is a large, bottom-up, South-North initiative aimed to evaluate the impact of the COVID-19 pandemic on the mental health of health care workers (HCWs). HEROES encompasses a wide variety of academic institutions in 19 LMICs and 8 HICs, in partnership with the Pan American Health Organization (PAHO) and with support from the World Health Organization (WHO). The HEROES study is led by Dr. Rubén Alvarado at University of Chile, and Dr. Ezra Susser and Franco Mascayano at Columbia U Mailman School of Public Health.
- Detailed Description
Since December 2019 the world has been shaken with an enormous global threat: the Covid-19 pandemic. This new kind of coronavirus is generating an unprecedented impact both on the general population and on the healthcare systems in most countries. Health services are trying to expand their capacity to respond to the pandemic, taking actions such as increasing the number of beds; acquiring necessary equipment to provide intensive therapy (ventilators), and calling retired health professionals and health students so they can assist the overwhelmed health care workforce. Unfortunately, these organizational changes at health facilities, along with the fears and concerns of becoming ill with the virus or infecting their families, put an enormous emotional burden on workers in health services which may lead to negative outcomes on mental health in this population. Based on the literature to date, Covid-19 is significantly larger than previous pandemics in terms of the number of affected people worldwide, its spread across countries, its impact on healthcare systems and the severity of measures that have been taken by governments. Immediate consequences are palpable in the health care system. Many healthcare workers are overwhelmed by the increased workload; the lack of supplies and materials to provide appropriate treatment; the lack of clinical guidelines on prioritization and triage; and the increased feelings of isolation and loneliness. Previous research indicates that these negative effects can last over time and lead to the development of serious mental health problems such as post-traumatic stress disorder.
Recent cross-sectional studies in China indicate that health service workers exposed to people with Covid-19 reported higher rates of depressive and anxious symptoms. This negative impact on mental health among health workers in China has also been informally reported in other countries where the Covid-19 pandemic has been devastating in its effects (such as Spain and Italy), as well as in countries where the pandemic is becoming a growing public health problem. This is particularly relevant in regions with fewer resources (Latin America, North Africa), where there are limited means and the response from the health system is usually insufficient. Moreover, it is necessary to study these negative effects longitudinally considering that some effects will appear over time (post-traumatic stress). Also, it is necessary to take into account the nature and the extent of the health response (e.g., deployment, increased workload) in order to advance our understanding of these complex phenomenon and to inform policy and develop the kind of supports that this population deems useful.
The COVID-19 HEalth caRe wOrkErS (HEROES) study is a large, bottom-up, South-North initiative aimed to evaluate the impact of the COVID-19 pandemic on the mental health of health care workers (HCWs). HEROES encompasses a wide variety of academic institutions in 19 LMICs and 8 HICs, in partnership with the Pan American Health Organization (PAHO) and with support from the World Health Organization (WHO). The HEROES study is led by Dr. Rubén Alvarado at University of Chile, and Dr. Ezra Susser and Franco Mascayano at Columbia U Mailman School of Public Health.
Participants will complete an online questionnaire, which will be completely self-administered. It will take approximately 12 minutes and includes sociodemographic data, questions on work activity, training, fears and concerns related to Covid-19, as well as the GHQ-12 and a series of questions on other mental health issues (e.g., suicide, acute stress), resilience and psycho/social factors (e.g., formal and informal support).
Recruitment & Eligibility
- Status
- UNKNOWN
- Sex
- All
- Target Recruitment
- 2000
- Legal age
- Currently working on a health service that provides care to COVID-19 patients
- Give informed consent
- Inability to use electronic devices (required to complete the survey)
Study & Design
- Study Type
- OBSERVATIONAL
- Study Design
- Not specified
- Arm && Interventions
Group Intervention Description Healthcare workers Exposure to the SARS-CoV-2 and its consequences Workers who interact with people with confirmed or suspected COVID-19 at different health services (primary care centers, emergency units, specialized care units, inpatient care units, critically ill patient units, among others). Potential participants will include any type of worker in these centers, including clinical and administrative staff, as well as supportive staff (e.g., food services)
- Primary Outcome Measures
Name Time Method Anxiety and depressive symptoms 12 months The 12-item version of the General Health Questionnaire (GHQ-12) is a self-reported instrument that measures symptoms of anxiety and depression. It provides cut-off points to identify people at risk of anxiety and/or depression, which differ slightly between countries
- Secondary Outcome Measures
Name Time Method Experiences, fears and concerns about the Covid-19 12 months Ad hoc survey on experiences, fears, and concerns about Covid-19
Suicide ideation (frequency) 12 months 5-point Likert item from the Columbia Suicide Severity Rating Scale (C-SSRS). Higher scores indicate higher frequency.
Acute stress symptoms 12 months Ad hoc 3-item survey to evaluate acute stress disorder. Higher values of the 5-points Likert scales suggest higher frequency of symptoms
Psycho/social support and network 12 months Ad hoc survey on support network. The answers to the multiple items will be adjusted so higher values indicate higher levels of psychological and social support
Training and resource prioritization 12 months Ad hoc survey on Covid-19 training and resource prioritization
Anxiety and depressive symptoms 6 months The 12-item version of the General Health Questionnaire (GHQ-12) is a self-reported instrument that measures symptoms of anxiety and depression. It provides cut-off points to identify people at risk of anxiety and/or depression, which differ slightly between countries
Resilience 12 months The Brief Resilience Scale (BRS) is a 6-item self-reported instrument that measures resilience. The range of scores is 6-30. Higher scores indicate higher resilience levels.
Suicide ideation (presence) 12 months Item from the Columbia Suicide Severity Rating Scale (C-SSRS) that measures suicidal ideation with a dichotomous answer (presence/absence)
Trial Locations
- Locations (21)
Columbia University
🇺🇸New York, New York, United States
University of Sydney
🇦🇺Sidney, New South Wales, Australia
University of Chile
🇨🇱Santiago, Chile
Society for Emergecy and Disaster Medicine CzMA JEP
🇨🇿Kladno, Bohemia, Czechia
Universidad Nacional de Costa Rica
🇨🇷Heredia, Costa Rica
Hochschule Emden/Leer
🇩🇪Emden, Niedersachsen, Germany
University of Cagliari
🇮🇹Cagliari, Italy
Hospital La Paz Institute for Health Research (IdiPAZ)
🇪🇸Madrid, Spain
Koc University
🇹🇷Istanbul, Sariyer, Turkey
Razi Hospital La Manouba
🇹🇳Tunis, La Manouba, Tunisia
PNFA Salud Colectiva Instituto de Altos Estudios Dr Arnoldo Gabaldon
🇻🇪Maracay, Aragua, Venezuela
Centro de Investigaciones de las Ciencias de la Salud -CICS- Facultad de Ciencias Médicas Universidad de San Carlos de Guatemala -USAC-
🇬🇹Guatemala City, Guatemala
The Institute for Development Research Advocacy and Applied Care (IDRAAC)
🇱🇧Beirut, Lebanon
King Abdullah International medical research center
🇸🇦Riyadh, Central, Saudi Arabia
National Institute of Health Named After Academician S. Avdalbekyan
🇦🇲Yerevan, Armenia
Salud Global
🇧🇴Sucre, Chuquisaca, Bolivia
Ponce Health Sciences University
🇵🇷Ponce, Puerto Rico
Logotipo del comercio Instituto Jalisciense De Salud Mental (SALME)
🇲🇽Guadalajara, Jalisco, Mexico
Maastricht University
🇳🇱Maastricht, Limburg, Netherlands
University of Ibadan
🇳🇬Ibadan, Oyo State, Nigeria
Universidad del Chubut
🇦🇷Rawson, Chubut, Argentina