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Completed

NCT Number: NCT06861400

A Digital Resilience Intervention for Emergency Medical Service Workers

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.

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Key information

Conditions

Feasibility Acceptability Adaptive Self-reflection Adoptability Anxiety Anxiety Disorders Behavior Behavioral Symptoms Combat Disorders Depression Meaning Made Mental Disorders Post Traumatic Stress Disorder PTSD Recovery Activities Recovery Experiences Stress Disorders, Traumatic Trauma and Stressor Related Disorders

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Syracuse University

Syracuse, New York, 13244, United States

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

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.

Treatment and study plan

Self-Reflective Resilience-Recovery Activity Promotion Training

Behavioral

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. SRR-RAPT is administered daily for 8 consecutive days.

Primary outcomes

  1. Time period required to achieve target sample size

    Time frame: 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.

  2. Number of participants recruited and randomized each week of the study

    Time frame: 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.

  3. Acceptability

    Time frame: 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.

  4. Adoptability

    Time frame: 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 outcomes

  1. Meaning Made

    Time frame: 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.

  2. Adaptive Self-Reflection

    Time frame: 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.

  3. Recovery Activities

    Time frame: 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.

  4. Recovery Experiences

    Time frame: 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.

  5. PTSD Symptom Severity

    Time frame: 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.

  6. Depression Symptom Severity

    Time frame: 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.

  7. Anxiety Symptom Severity

    Time frame: 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.

Sponsors and collaborators

Lead sponsor

Syracuse University

Other

Registry information

Official study title

Self-Reflective Resilience-Recovery Activity Promotion Training for Emergency Medical Service Personnel

Important dates

Study start
2023
Primary completion
2023
Study completion
2023
First posted
Mar 6, 2025
Registry last updated
Mar 10, 2025

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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