Acceptability, Adaptive Self-reflection, Adoptability, Anxiety, Depression, Feasibility, Meaning Made, Post Traumatic Stress Disorder PTSD, Recovery Activities, Recovery Experiences
Conditions
Keywords
Emergency Medical Service Personnel, Psychological Resilience
Brief summary
Emergency medical service (EMS) workers (i.e., ambulance service providers) experience triple the risk for anxiety, depression, and posttraumatic stress disorder (PTSD) compared to the general U.S. population. These mental disorders impact health and well-being across the life course. Thus, there is a critical need for interventions targeting key risk factors that can reduce EMS workers' mental health risk. Chronic stress represents such a risk factor and is a routine feature of the EMS profession due to the demands of providing emergency medical care. Self-Reflective Resilience-Recovery Activity Promotion Training (SRR-RAPT) promotes finding positive meaning in stressors by building self-awareness of the coping and regulatory responses used to manage them; evaluating those responses; adapting them based upon their perceived effectiveness; and developing a plan for managing similar stressors in the future based on what can be learned from the current situation. In addition to prompting self-monitoring and active reflection on stressors and coping responses, SRR-RAPT encourages practicing recovery activities that permit a person's stressor induced strain level to return to baseline. The primary objective of the current study is to evaluate the feasibility, acceptability, and adoptability of SRR-RAPT among EMS personnel. A secondary objective was to examine the intervention's effect on hypothesized mechanisms of action predicted to vary in response to the intervention, as well as consider the intervention's ability to reduce mental health symptoms. It is hypothesized that the intervention will be associated with more positive meaning made, adaptive self-reflection, recovery activities, and recovery experiences, as well as lower levels of mental health symptoms.
Interventions
BEHAVIORALSelf-Reflective Resilience-Recovery Activity Promotion Training
Self-Reflective Resilience-Recovery Activity Promotion Training (SRR-RAPT) promotes finding positive meaning in stressors by building self-awareness of the coping and regulatory responses used to manage them; evaluating those responses; adapting them based upon their perceived effectiveness; and developing a plan for managing similar stressors in the future based on what can be learned from the current situation. In addition to prompting self-monitoring and active reflection on stressors and coping responses, SRR-RAPT encourages practicing recovery activities that permit a person's stressor induced strain level to return to baseline. SRR-RAPT is administered daily for 8 consecutive days.
Sponsors
Syracuse University
Study design
Allocation
RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
PREVENTION
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Full-time or part-time employee at an emergency medical service agency * ≥ 18 years of age * ≥ 1 emergency medical service shift scheduled in the next 8 days from recruitment date.
Exclusion criteria
* Not a full-time or part-time employee at an emergency medical service agency * \< 18 years of age * \< 1 emergency medical service shift scheduled in the next 8 days from recruitment date.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Time period required to achieve target sample size | From study initiation until at least 80 participants are recruited, up to 12 months | The number of months it takes to recruit the number of participants necessary to reach the target sample size. |
| Number of participants recruited and randomized each week of the study | From study initiation until at least 80 participants are recruited, up to 12 months | A count of the number of participants who are recruited and randomized each week that the study is taking place. |
| Acceptability | Day 8 of the intervention | Assessed with 3 items asking about respondents' perceptions that the intervention was helpful (I found that answering the questions about managing stressful experiences and practicing recovery behaviors was helpful); useful (I found that answering the questions about managing stressful experiences and practicing recovery behaviors was useful); and not burdensome (I found that answering the questions about managing stressful experiences and practicing recovery behaviors was not too burdensome). Respondents rated each item on a scale ranging from 1 (Strongly Disagree) to 5 (Strongly Agree). Ratings are summed to yield a total daily score. |
| Adoptability | Day 8 of the intervention | Assessed with 3 items asking about respondents intention to use what they had learned from the intervention in the future (I will keep using these questions to help manage stressful experiences and practice recovery activities in the future. I will try to use these questions in the future when managing stressful experiences and trying to practice recovery activities. I plan to use some of the approaches that I came up with in my responses to the questions about managing stressful experiences and practicing recovery behaviors in the future). Respondents rate each item on a scale ranging from 1 (Strongly Disagree) to 5 (Strongly Agree). Ratings are summed to yield a total daily score. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| PTSD Symptom Severity | Days 1 to 8 of the intervention | Short -form of the PTSD Checklist for DSM-5. Each day respondents rate how bothered they are by PTSD symptoms on a scale ranging from 0 (Not at all) to 4 (Extremely). Ratings are summed to yield a total daily score. |
| Meaning Made | Days 1 to 8 of the intervention | Assessed using 3 items with the highest factor loadings on the positive reframing, acceptance, and religion subscales of the Brief COPE plus one additional item representing growth (I identified lessons that I can learn from the challenge). Respondents rate how much they performed the strategy described in response to any stressful or challenging experiences they encountered today. Ratings are made on a scale ranging from 1 (Not at all) to 4 (I did this a lot). Ratings are summed to yield a total daily score. |
| Anxiety Symptom Severity | Days 1 to 8 of the intervention | PROMIS-anx-4a questionnaire. Each day respondents rate the extent they experienced anxiety symptoms on a scale ranging from 1 (Not at all) to 5 (All of the time). Ratings are summed to yield a total daily score. |
| Depression Symptom Severity | Days 1 to 8 of the intervention | PROMIS-dep-4a questionnaire. Each day respondents rate the extent they experienced depression symptoms on a scale ranging from 1 (Not at all) to 5 (All of the time). Ratings are summed to yield a total daily score. |
| Adaptive Self-Reflection | Days 1 to 8 of the intervention | Derived from 3 items used in prior research. Each day respondents rate how much they agree with the following statements describing how they reacted to challenging and stressful events they encountered today: I noticed the strategies that I used to cope with today's stress experiences, I considered how I approach stressful experiences in my life, and After attempting to deal with any of today's stressful experiences, I thought about how well my approach worked. Ratings are made on a scale ranging from 1 (Strongly Disagree) to 5 (Strongly Agree). Ratings are summed to yield a total daily score. |
| Recovery Activities | Days 1 to 8 of the intervention | Pittsburgh Enjoyable Activities Test. For each item, respondents indicate whether they did the activity described today when they were not working (Yes vs No). Endorsed items are summed to yield a total daily count. |
| Recovery Experiences | Days 1 to 8 of the intervention | Derived from 8 items with the highest factor loadings from the detachment, relaxation, mastery, and control subscales of the Recovery Experiences Questionnaire. Respondents report how much they agree with each statement describing what they did during their off-job time today on a scale ranging from 1 (Totally Disagree) to 5 (Totally Agree). Ratings are summed to yield a total daily score. |
Countries
United States
Outcome results
None listed