Evaluation of Shift, a smartphone application for Junior Medical Officers in New South Wales during the COVID-19 epidemic.

The aim of this project is to conduct a preliminary (uncontrolled) quasi-experimental before and after study of a novel smartphone application designed to support the mental health and wellbeing of Junior Medical Officers across New South Wales. In response to the latest developments with regards to the coronavirus outbreak, the app will contain a dedicated session providing guidance for junior doctors who have pandemic-related anxieties and concerns. The Shift app's conceptual design was modelled after HeadGear, an evidence-informed app delivered by the Black Dog Institute that has been shown to alleviate mental health concerns in working populations (Deady et al., 2018). The prototype and the current version of the Shift app have been adjusted in close collaboration with medical doctors, NSW Health, external digital project designers, and in-house IT developers, user experience, digital learning, and marketing and communication experts within the Black Dog Institute. Initial pilot testing of the Shift app prototype [approved by the South Eastern Sydney Local Health District HREC protocol number 2019/ETH00318, N = 22] resulted in design, content, and user experience updates of the app. Shift is a smartphone application compatible with Apple and Android operating systems. Shift delivers its contents through text, audio, and video addressing topics such as depression, anxiety, traumatic stress, burnout, alcohol and drug use, sleep health, shift work, exams and interviews, work/life balance, diet, exercise, rural and regional placements, bullying, grief, calling for a consult, feeling inadequate, and anxieties related to the coronavirus pandemic. Shift incorporates general therapeutic elements from cognitive behavioural therapy such as thought evaluation (i.e., identification, evaluation, and modification of unhelpful thoughts) and engagement in valued action (i.e., values-consistent patterns of action). Shift further incorporates relaxation techniques (e.g., progressive muscle relaxation) based in mindfulness and stress-management practice that are intended to lessen the impact of stressful life events or daily stressors. Each of the 51 activities delivered in the app takes about 2 to 5 minutes to complete and users are able to set their own targets (between two to five activities per week). The app collects standard usage metrics such as number of logins, number of sessions completed, and time spent on the app. A minimum of 75 Junior Medical Officers working in New South Wales will be recruited to complete an app-based intervention. The proposed study will employ a pre-post design without a control group and will take place entirely online. The overall trial period is four weeks. Baseline and post-study measures assess participants' levels of depression, anxiety (general and COVID-19-specific), work and social functioning, and help-seeking behaviours. Participants will further be asked to indicate their user experience with the app at the post-study assessment.