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Completed

NCT Number: NCT04909216

Mindful Attention Training Workshop for Firefighters

The overarching goal of this study is to demonstrate the efficacy, feasibility, and acceptability of Mindful Attention Training (MAT), a novel mindfulness-based intervention that is specifically developed for firefighters. This project is designed to improve the health of firefighters, an integral, essential component of our national and international communities. Moreover, the study aims to promote health service psychologists by enhancing our contributions to the mental healthcare of firefighters, an understudied and underserved segment of the population by virtue of their service to our communities. This study therefore has significant potential to identify, develop, and promote an effective model of quality, evidence-based mental health promotion and illness prevention by integrating health service psychology into the fire service.

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Key information

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Trauma and Stress Studies Center

Houston, Texas, 77204, United States

About this study

Firefighters are repeatedly exposed to traumatic and stressful situations, increasing their vulnerability for the development of various psychological symptoms and disorders. As many as 32.4% of firefighters meet criteria for posttraumatic stress disorder (PTSD) with significantly more experiencing significant subclinical PTSD symptoms. Approximately 22% of firefighters are also at risk for depression, 46.8% reported serious suicidal ideation, and 15.5% reported having made a suicide attempt during heir firefighter tenure6. Alcohol use disorder (AUD) among firefighters is estimated at approximately 50%, nearly twice that of the general population.

Given the chronically stressful and potentially traumatic nature of the firefighting profession and the high rates of psychological disturbances among firefighters, the development of specialized mental health promotion and illness prevention programs for this vulnerable population is a priority. Mindfulness, generally defined as bringing one's full attention to the present moment and taking a stance of nonjudgmental acceptance to the ongoing flow of sensations, thoughts, and/or emotional states, has significant clinical relevance to the prevention and treatment of various psychological conditions. Mindfulness-based interventions have demonstrated efficacy with regard to various psychological symptoms, including PTSD, depression, and alcohol use. In a military context, mindful attention training has shown promise in terms of reducing the impact of combat on psychological health. However, no specialized mindfulness-based interventions exist for firefighters.

The overarching goal of this study is to demonstrate the efficacy, feasibility, and acceptability of Mindful Attention Training (MAT), a novel mindfulness-based intervention that is specifically developed for firefighters. This project is designed to improve the health of firefighters, an integral, essential component of our national and international communities. Moreover, the study aims to promote health service psychologists by enhancing our contributions to the mental healthcare of firefighters, an understudied and underserved segment of the population by virtue of their service to our communities. This study therefore has significant potential to identify, develop, and promote an effective model of quality, evidence-based mental health promotion and illness prevention by integrating health service psychology into the fire service.

Aim 1: To evaluate the efficacy of the Mindful Attention Training (MAT) workshop, as compared to waitlist comparison ("as usual" condition), on mental health promotion among firefighters, as defined by: self-reported levels of (1a) mindful attention and awareness, (1b) nonjudgmental acceptance, and (1c) nonreactivity at each time point.

Aim 2: To evaluate the efficacy of the MAT workshop, as compared to waitlist, on psychological 'illness' prevention among firefighters, as defined by: self-reported symptom severity of PTSD, depression, anxiety, suicidal ideation, and alcohol use at each time point.

Aim 3: To evaluate the feasibility and acceptability of the MAT workshop, as compared to waitlist, as defined by: (1) firefighters' self-reported helpfulness of the workshop and (2) firefighters' self-reported satisfaction ratings of the workshop.

Who can participate

Healthy volunteers accepted: Yes

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

Inclusion criteria

  • ≥ 18 years of age
  • Current employment as a firefighter with the Houston Fire Department

Exclusion criteria

  • Persons who are not actively employed in the Houston Fire Department (e.g. former firefighters, retired firefighters)
  • Current imminent risk of suicidality and/or homicidality (i.e., past month ideation with intent or plan)
  • Inability to provide verbal or written consent
  • Study personnel will not recruit or screen for individuals who fall into the following categories: pregnant women, prisoners, students for whom study personnel have direct access to/influence on grades, or economically and/or educationally disadvantaged persons

Treatment and study plan

Mindful Attention Workshop

Other

The 90-minute workshop will include a 15-minute break and include up to 15 participants. The workshop will be led by peer support staff, fire department psychologists, and/or fire department doctoral psychology practicum students. Each workshop will be facilitate by up to 3 workshop leaders. The workshop will provide (1) psychoeducation regarding common mental health concerns among firefighters, (2) introduction to the concept of mindful attention, why it is relevant to firefighters, and how it can prevent or decrease mental health symptoms, (3) 5 experiential mindful attention training exercises, and (4) discussion. Workshop co-leaders will teach 5 mindful attention exercises, and firefighters will practice each exercise and then engage in discussion about their experiences and provide feedback regarding the utility of the exercise for them personally and for firefighters, generally.

Primary outcomes

  1. Changes in mindfulness

    Time frame: Administered at each of the following timepoints: baseline, 1-week follow-up, 2-week follow-up, 1-month follow-up, 3-month follow-up, and 6-month follow-up

    To evaluate the efficacy of the Mindful Attention Training (MAT) workshop by examining self-reported levels of (1) nonjudgmental acceptance, (2) nonreactivity as well as (3) psychological resilience and (4) self-compassion at each time point using the following measure:

    • Five Facet Mindfulness Questionnaire (FFMQ; Baer et al., 2006): 39-item measure that assesses a participant's capacity for the following five factors: observing, describing, acting with awareness, non-judging of inner experience, and non-reactivity to inner experience.
  2. Changes in mindful attention

    Time frame: Administered at each of the following timepoints: baseline, 1-week follow-up, 2-week follow-up, 1-month follow-up, 3-month follow-up, and 6-month follow-up

    To evaluate the efficacy of the Mindful Attention Training (MAT) workshop by examining self-reported levels of mindful attention and awareness at each time point using the following measure:

    • Mindful Attention Awareness Scale (MAAS; Brown & Ryan, 2003): 15-item scale assessing a participant's capacity for mindful attention, a key component of mindfulness.
  3. Changes in PTSD symptom severity

    Time frame: Administered at each of the following timepoints: baseline, 1-week follow-up, 2-week follow-up, 1-month follow-up, 3-month follow-up, and 6-month follow-up

    To evaluate the efficacy of the Mindful Attention Training (MAT) workshop on the symptom severity of PTSD at each time point using the following measure:

    • Posttraumatic Stress Disorder Checklist for the Diagnostic and Statistical Manual of Mental Disorders (PCL-5): 20-item self-report measure that assesses the 20 Diagnostic and Statistical Manual of Mental Disorders (DSM-5) symptoms of PTSD over the past month.
  4. Changes in hazardous drinking patterns

    Time frame: Administered at each of the following timepoints: baseline, 1-week follow-up, 2-week follow-up, 1-month follow-up, 3-month follow-up, and 6-month follow-up

    To evaluate the efficacy of the Mindful Attention Training (MAT) workshop on the alcohol use and alcohol use severity at each time point using the following measure:

    • Alcohol Use Disorders Identification Test (AUDIT): 10-item screening measurement to assess any hazardous and harmful alcohol consumption during the past year.
  5. Changes in depressive symptoms

    Time frame: Administered at each of the following timepoints: baseline, 1-week follow-up, 2-week follow-up, 1-month follow-up, 3-month follow-up, and 6-month follow-up

    To evaluate the efficacy of the Mindful Attention Training (MAT) workshop on the symptom severity of depression at each time point using the following measure:

    • Overall Depression Severity and Impairment Scale (ODSIS): 5 item measure assessing for past week depression-related symptoms.
  6. Changes in suicidal thoughts

    Time frame: Administered at each of the following timepoints: baseline, 1-week follow-up, 2-week follow-up, 1-month follow-up, 3-month follow-up, and 6-month follow-up

    To evaluate the efficacy of the Mindful Attention Training (MAT) workshop on the severity and presence of suicidal thoughts at each time point using the following measure:

    • Beck Suicide Scale-5 (BSS-5): 5-item measure assessing the presence and intensity of suicidal thoughts.
  7. Evaluate the feasibility and acceptability of the Mindful Attention Training (MAT) workshop

    Time frame: Administered at 1-week follow-up

    To evaluate the feasibility and acceptability of the MAT workshop, as compared to waitlist, as defined by: (1) firefighters' self-reported helpfulness of the workshop and (2) firefighters' self-reported efficacy ratings of the workshop using the following measure:

    • Post-MAT Workshop Questionnaire (Post-MAT): 10-item questionnaire assessing the degree to which participants found the workshop helpful and tolerable.
  8. Changes in anxiety symptoms

    Time frame: Administered at each of the following timepoints: baseline, 1-week follow-up, 2-week follow-up, 1-month follow-up, 3-month follow-up, and 6-month follow-up

    To evaluate the efficacy of the Mindful Attention Training (MAT) workshop on the symptom severity of anxiety at each time point using the following measure:

    • Overall Anxiety Severity and Impairment Scale (OASIS): 5 item measure assessing for past week anxiety-related symptoms.

Secondary outcomes

  1. Evaluate group dynamics

    Time frame: Administered at 1-week follow-up

    To evaluate the group dynamics of the MAT workshop using the following measure:

    • Group Evaluation Scale (GES; Joyce, 2005): 7-item measure assessing how the participant felt while participating in the group, particularly comfortability and sense of being understood by other group members.
  2. Evaluate group cohesion

    Time frame: Administered at 1-week follow-up

    To evaluate the cohesion of each group in the MAT workshop using the following measure:

    • Group Cohesion Questionnaire (GCQ; MacKenzie, 1983): 12-item measure assessing a participant's view of the cohesion of the group and the quality of the group dynamic.
  3. Evaluate occupational stress

    Time frame: Administered at each of the following timepoints: baseline, 1-week follow-up, 2-week follow-up, 1-month follow-up, 3-month follow-up, and 6-month follow-up

    To evaluate the influence of the Mindful Attention Training (MAT) workshop on self-reported occupational stress levels at each time point using the following measure:

    • The Sources of Occupational Stress (SOOS-14): 14-item self-report measure used to assess levels of occupational stress (i.e., harmful physical and psychological responses that occur when job requirements do not align with the worker's abilities, resources, and/or needs) among firefighters.

Sponsors and collaborators

Lead sponsor

University of Houston

Other

Registry information

Official study title

Healthy Action Zone - Mindful Attention Training: A Mindfulness-Based Workshop for Firefighters

Acronym: HAZMAT

Important dates

Study start
2021
Primary completion
2023
Study completion
2023
First posted
Jun 1, 2021
Registry last updated
May 9, 2023

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

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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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