Usability, feasibility and acceptability of a smartphone application to support the mental health of Junior Medical Officers in NSW: A pilot trial

The pilot trial will examine the usability, acceptability and feasibility of a smartphone application (“Shift”) that aims to support the mental health and well-being of Junior Medical Officers (JMOs) in NSW. Due to doctors’ job demands and their specific work environment, evidence suggests that doctors are at risk of developing mental health problems, avoiding seeking help for these problems, and suicide. JMOs in particular report high levels of distress and stressors such as long working hours, sleep difficulties and the pressure to pass exams. In response to the mental health needs of JMOs, the NSW Ministry of Health has partnered with the Black Dog Institute's Workplace Mental Health team lead by A/Prof and Chief Psychiatrist Dr Samuel Harvey to develop Shift to support the mental health and wellbeing of JMOs. This project is an initiative of the NSW Health JMO Wellbeing and Support Plan (https://www.health.nsw.gov.au/workforce/culture/Pages/jmo-support-plan.aspx). Shift is designed for self-guided use by JMOs on Android or Apple smartphone devices. The app is modeled after a previously evaluated workplace mental health app called “HeadGear”, which follows a 30-day intervention format. The principal components of HeadGear were modified following one-on-one interviews with JMOs who identified their specific needs to overcome work-related stressors. At its core, Shift contains 30 "challenges" featuring evidence-based therapeutic techniques such as cognitive restructuring and mindfulness. Other components provide psycho-educational contents such as adjusting to shift work and adjusting to placements in remote or rural areas. Participants are asked to use Shift daily for approximately 5-10 minutes for the duration of 4 weeks. Each day, participants can complete a new exercise. These include generating lists of values and goals, watching short instructional videos, or listening to mindfulness audios. Basic usage statistics are being collected such as number of days the app was accessed and the number of challenges completed. It is hoped that delivering mental health support directly to JMOs via an app will overcome some of the barriers to help-seeking, such as time constraints and concerns about confidentiality. Up to 30 JMOs will be recruited from two NSW Local Health Districts to complete an app-based intervention for 1 month. This study will use a pre-post intervention design with no control group. The app will be evaluated by baseline and follow-up measures assessing usability and acceptability and app usage data (e.g., number of days accessed). As a secondary outcome of interest, depression and anxiety will be assessed for within-group changes in effect size. The results of this study will inform any modifications to the app, prior to a randomised controlled trial to evaluate the effectiveness of the app-based intervention in a larger sample of JMOs.