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Enrolling by Invitation

NCT Number: NCT07247149

Testing a Novel Attention Based Training Prevention Strategy for First Responders: FirstFocus a Mobile App

First responders are frequently exposed to high-stress and traumatic events, putting them at increased risk for mental health challenges such as posttraumatic stress disorder, anxiety, and depression. Access to traditional mental health services is often hindered by stigma, time constraints, and a lack of tailored resources. Mobile app-based interventions offer a promising solution due to their accessibility and potential to address mental health proactively and in a time sensitive way. Attention training has emerged as a simple way to prevent distress and the emergence of future mental health concerns. The proposed research will test a mobile app: FirstFocus which will leverage targeted attention training to prevent stress/distress during shifts and enhance the wellbeing of rural first responders. The specific aims are to (1) test the feasibility and acceptability of FirstFocus as an intervention for rural first responders; (2) to test the short-term preventative efficacy of attention training on state stress/distress and its longer-term efficacy for improving professional quality of life and reducing symptoms of anxiety and depression.

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Key information

Conditions

Wellbeing

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Palo Alto University

Palo Alto, California, 94304, United States

Who can participate

Healthy volunteers accepted: Yes

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

Inclusion criteria

  • Age 18 or older
  • Employed as an Active First Responder
  • iPhone mobile device
  • Located in a rural part of the US

Exclusion criteria

  • Works less than 20 hours/week on average

Treatment and study plan

Attention Bias Modification

Behavioral

Attention training involves 80 training trials. The task uses words developed specifically for this study with fear words such as "crash" and "car" and neutral words such as "couch" and "can" that are balanced for length and frequency. Additionally, on every trial the location of the probe is the same as the location of the fear word. Participants press the button corresponding to the direction of the probe. The training takes approximately 5 minutes to complete.

Primary outcomes

  1. Client Satisfaction Questionnaire

    Time frame: From enrollment to the end of treatment at 8 weeks.

    The Client Satisfaction Questionnaire - 8 item version (CSQ-8; Nguyen et al., 1983) will assess participant satisfaction with the FirstFocus app at the 60-day assessment. The CSQ-8 yields a total score ranging from 8 to 32, with higher scores indicating greater satisfaction.

Secondary outcomes

  1. Stress Reduction (visual analogue scale)

    Time frame: From enrollment to the end of treatment at 8 weeks.

    Current stress will be assessed using a Visual Analogue Scale for Stress, administered daily before and after each shift. Participants rate their stress on a 0-100 scale, where 0 = no stress and 100 = extreme stress. Higher scores indicate greater stress.

  2. Professional Quality of Life

    Time frame: From enrollment to the end of treatment at 8 weeks

    The Professional Quality of Life Scale, Version 5 (ProQOL-5) assesses compassion satisfaction, burnout, and secondary traumatic stress. Each subscale yields a score from 10 to 50, with higher Compassion Satisfaction scores reflecting better outcomes, and higher Burnout or Secondary Traumatic Stress scores reflecting worse outcomes. Administered weekly on login.

  3. Symptoms of depression

    Time frame: From enrollment to the end of treatment at 8 weeks

    The Patient Health Questionnaire-9 (PHQ-9; Kroenke et al., 2001) assesses depressive symptoms over the past week. Total scores range from 0 to 27, with higher scores indicating more severe depressive symptoms. Administered monthly on login.

  4. Symptoms of anxiety

    Time frame: From enrollment to the end of treatment at 8 weeks

    The Generalized Anxiety Disorder-7 (GAD-7; Spitzer et al., 2006) assesses anxiety symptoms over the past week. Total scores range from 0 to 21, with higher scores indicating more severe anxiety. Administered monthly on login.

  5. Stress

    Time frame: From enrollment to the end of treatment at 8 weeks

    The Perceived Stress Scale - 10 item version (PSS-10; Cohen et al., 1983) assesses perceived stress over the past week. Total scores range from 0 to 40, with higher scores indicating higher perceived stress levels. Administered monthly on login.

Other outcomes

  1. Qualitative Evaluation of Acceptability.

    Time frame: From enrollment to the end of treatment at 8 weeks

    Qualitative feedback will be collected via a single open-ended item each week, along with multiple open-ended acceptability questions at the 60-day assessment. As a qualitative measure, no numerical scale or score range applies. This approach allows for detailed feedback on usability, acceptability, and alignment with first responder needs.

Sponsors and collaborators

Lead sponsor

Palo Alto University

Other

Registry information

Official study title

Testing a Novel Attention Based Training Prevention Strategy for First Responders: FirstFocus a Mobile Appt

Important dates

Study start
2025
Primary completion
2026
Study completion
2026
First posted
Nov 25, 2025
Registry last updated
Dec 5, 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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