A pilot trial of a mental health app for Emergency Service Workers: the Build Back Better app

This pilot study aims to explore the use and preferences of emergency service workers regarding potential uptake of a smartphone-based Mental Health (MH) intervention providing evidence-based prevention strategies for mental distress for Emergency Service Workers in Australia. The preliminary effectiveness for whether the smartphone-based MH intervention leads to any improvement in outcomes such as distress, wellbeing and common mental disorders will furthermore be explored. The smartphone application is intended to be used in a larger scale study aimed at promoting mental health and wellbeing within Emergency Service Workers (ESWs) and their families. A 3-month single-arm study design will be used in this pilot study to examine the feasibility and acceptability of this smartphone-based MH interventions among a sample of 63 Emergency Service Workers (ESWs) (18 years and older) in Australia. Baseline assessment will occur immediately after participants consent to participate in the study. Participants will then download the app and use it daily for approximately 21 days. Participant will be encouraged to use the app daily for a minimum of 15 minutes each day. Post-intervention assessment will occur 4 weeks (1 month) after baseline. This pilot study will involve two key phases: Phase 1 will focus on exploring the feasibility and acceptability of this novel, purpose-built smartphone app, which will include the administration of usability and user experience surveys and qualitative interviews. The secondary objectives of Phase 2 are to describe app usage patterns (i.e. number of logins, time spent using the app) to help identify patterns in how participants engage with the smartphone application, and provide preliminary evidence for participant reported clinical outcomes (such as alcohol and other drug use, self-reported recovery, and mental health), collected via user experience surveys, qualitative interviews and in -app. Usage Information which will be passively collected whilst users engage with the application (i.e. does not require any direct data collection). The Build Back Better app has been developed by researchers from Workplace Mental Health Team, Black Dog Institute, UNSW, and has been adapted from HeadGear, a smartphone application based on recognised and evidence-based psychological approaches including psychoeducation, behavioural activation, value-driven activity planning, goal-setting, and coping skill development and mindfulness. The Build Back Better app content and visual presentation has been modified to be suitable for Emergency Service Workers (ESWs) and their families, i.e. targeting depression, anxiety and Post Traumatic Stress Disorder (PTSD) complaints. The Build Back Better is designed for day -to- day use, and similar to HeadGear, the app content in Build Back Better is presented in the form of videos (and voiceovers), audio-recordings, and activities, providing the user with proven effective psychological approaches including problem solving, behavioural activation, mindfulness and grounding tasks, all designed to upskill users and promote wellbeing. In -app activities are including guided mindfulness exercises; value-driven activity planning, goal-setting and review; coping skill development (i.e. interactive role playing task regarding: problem solving, improving sleep, grounding methods, alcohol use, assertiveness, and training in thought managing/challenging) and also a mood monitoring widget. Different from Headgear, the app Build Back Better furthermore tailors functionalities and content based on user preferences; i.e. what complaints users are currently experiencing and what they would like to work on in this app.