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Completed

NCT Number: NCT07457801

CARE Study for Paramedics in Singapore

The purpose of this study is to compare the effectiveness of two different online education courses (Oxford-Online and Mind-Online) for preventing stress related conditions among paramedics who have been working during a period of COVID-19 occurrence in Singapore.

The study aims to:

* Compare the efficacy of a locally-adapted version of internet-delivered cognitive training for resilience (Oxford Online) to an existing educational online training (Mind Online) on depressive symptom severity * Compare the efficacy of Oxford Online to Mind Online for improving posttraumatic stress symptoms, resilience, general psychological distress, anxiety symptoms, social support, work engagement, and health-related quality of life

Participants will:

* Complete an online battery of baseline questionnaires * Be randomised to receive 6 modules of either Oxford Online or Mind Online, delivered once per week over a 6-week period * Complete the same online questionnaire battery immediately following the intervention, and again at the 6-month and 12-month follow up

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Key information

Conditions

Post Traumatic Stress Disorder Anxiety Disorders Anxiety Disorders and Symptoms Behavior Behavioral Symptoms Burnout Burnout, Psychological Depression Mental Disorders Psychological Distress Stress Disorders, Post-Traumatic Stress Disorders, Traumatic Stress, Psychological Trauma and Stressor Related Disorders

Age range

21 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Duke-NUS Medical School

Singapore, 169857

About this study

Aim 1 (Primary): To compare the efficacy of a locally-adapted version of internet-delivered cognitive training for resilience (Oxford Online) to an existing educational online training (Mind Online) on depressive symptom severity in a sample of paramedics recruited during the COVID-19 pandemic in Singapore.

Aim 2 (Secondary): To compare the efficacy of Oxford-Online to Mind-Online for improving posttraumatic stress symptoms, resilience, general psychological distress, anxiety symptoms, social support, work engagement, and health-related quality of life in a sample of paramedics recruited during the COVID-19 pandemic in Singapore.

Aim 3 (Economic): To evaluate the incremental cost and cost-effectiveness of Oxford Online in a sample of paramedics recruited during the COVID-19 pandemic in Singapore.

Who can participate

Healthy volunteers accepted: Yes

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

Inclusion criteria

  • Age 21 and above
  • English speaking
  • Employed or subcontracted as paramedics by SCDF who have been working during the COVID-19 pandemic
  • Able to provide informed consent and read study materials
  • Willing to enter randomised trial

Exclusion criteria

  • Non-English speaking
  • Not working during COVID-19 outbreak (e.g. on medical or maternity leave)
  • Working as trainees, conscripts, medics or ambulance drivers
  • Unwilling or unable to complete study procedures
  • Unwilling to enter randomised trial

Treatment and study plan

Oxford-Online

Behavioral

The Oxford Online programme targets cognitive predictors of depression and posttraumatic stress disorder. The core information is delivered in six 20-minute modules over a 6-week period. The modules include whiteboard videos to explain concepts, audio files for practicing concrete thinking, video testimonies and footage of paramedics on-call for use in experiential exercises. A trained online wellbeing coordinator will provide individual email feedback on participants' responses and send brief automated message reminders.

Mind-Online

Behavioral

Mind Online is a series of six modules available online where participants read information and advice about stress, depression, posttraumatic stress, sleep problems, anger, and mindfulness. A trained online wellbeing coordinator will provide individual email feedback on participants' responses and send brief automated message reminders.

Primary outcomes

  1. Change in Depression Symptoms

    Time frame: Change from baseline at post-intervention (6-8 weeks after baseline), 6 months and 12 months post-intervention

    Patient Health Questionnaire 9 (PHQ-9)

Secondary outcomes

  1. Change in Posttraumatic Stress Symptoms

    Time frame: Change from baseline at post-intervention (6-8 weeks after baseline), 6 months and 12 months post-intervention

    Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5)

  2. Change in Resilience

    Time frame: Change from baseline at post-intervention (6-8 weeks after baseline), 6 months and 12 months post-intervention

    Connor-Davidson Resilience Scale (CD-RISC)

  3. Change in Rumination

    Time frame: Change from baseline at post-intervention (6-8 weeks after baseline), 6 months and 12 months post-intervention

    Response to Intrusions Questionnaire (RIQ-s)

  4. Change in Anxiety Symptoms

    Time frame: Change from baseline at post-intervention (6-8 weeks after baseline), 6 months and 12 months post-intervention

    Generalized Anxiety Disorder seven item scale (GAD-7)

  5. Change in Psychological Distress

    Time frame: Change from baseline at post-intervention (6-8 weeks after baseline), 6 months and 12 months post-intervention

    General Health Questionnaire (GHQ)

  6. Change in Burnout

    Time frame: Change from baseline at post-intervention (6-8 weeks after baseline), 6 months and 12 months post-intervention

    Physician Work-Life Study's Single Item (PWLS)

  7. Change in Social Support

    Time frame: Change from baseline at post-intervention (6-8 weeks after baseline), 6 months and 12 months post-intervention

    Multidimensional Scale of Perceived Social Support (MSPSS)

  8. Change in Work Engagement

    Time frame: Change from baseline at post-intervention (6-8 weeks after baseline), 6 months and 12 months post-intervention

    Utrecht Work Engagement Scale (UWES)

  9. Change in Health-related Quality of Life

    Time frame: Change from baseline at post-intervention (6-8 weeks after baseline), 6 months and 12 months post-intervention

    EuroQol 5 Dimensions Questionnaire (EQ-5D5L)

  10. Change in Posttraumatic Growth

    Time frame: Change from baseline at 6 months and 12 months post-intervention (intervention completed 6-8 weeks after baseline).

    Posttraumatic Growth Inventory (PTGI-SF)

Sponsors and collaborators

Lead sponsor

Singapore General Hospital

Other

Collaborators

  • Duke-NUS Graduate Medical School

Registry information

Official study title

Cognitive Training And Resilience Education (CARE) for Paramedics on the Frontlines of the COVID-19 Epidemic: A Randomised Controlled Trial in Singapore

Important dates

Study start
2020
Primary completion
2025
Study completion
2025
First posted
Mar 9, 2026
Registry last updated
Mar 9, 2026

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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