Anxiety Disorders and Symptoms, Burnout, Depression, Post Traumatic Stress Disorder, Psychological Distress
Conditions
Brief summary
The purpose of this study is to compare the effectiveness of two different online education courses (Oxford-Online and Mind-Online) for preventing stress related conditions among paramedics who have been working during a period of COVID-19 occurrence in Singapore. The study aims to: * Compare the efficacy of a locally-adapted version of internet-delivered cognitive training for resilience (Oxford Online) to an existing educational online training (Mind Online) on depressive symptom severity * Compare the efficacy of Oxford Online to Mind Online for improving posttraumatic stress symptoms, resilience, general psychological distress, anxiety symptoms, social support, work engagement, and health-related quality of life Participants will: * Complete an online battery of baseline questionnaires * Be randomised to receive 6 modules of either Oxford Online or Mind Online, delivered once per week over a 6-week period * Complete the same online questionnaire battery immediately following the intervention, and again at the 6-month and 12-month follow up
Detailed description
Aim 1 (Primary): To compare the efficacy of a locally-adapted version of internet-delivered cognitive training for resilience (Oxford Online) to an existing educational online training (Mind Online) on depressive symptom severity in a sample of paramedics recruited during the COVID-19 pandemic in Singapore. Aim 2 (Secondary): To compare the efficacy of Oxford-Online to Mind-Online for improving posttraumatic stress symptoms, resilience, general psychological distress, anxiety symptoms, social support, work engagement, and health-related quality of life in a sample of paramedics recruited during the COVID-19 pandemic in Singapore. Aim 3 (Economic): To evaluate the incremental cost and cost-effectiveness of Oxford Online in a sample of paramedics recruited during the COVID-19 pandemic in Singapore.
Interventions
BEHAVIORALOxford-Online
The Oxford Online programme targets cognitive predictors of depression and posttraumatic stress disorder. The core information is delivered in six 20-minute modules over a 6-week period. The modules include whiteboard videos to explain concepts, audio files for practicing concrete thinking, video testimonies and footage of paramedics on-call for use in experiential exercises. A trained online wellbeing coordinator will provide individual email feedback on participants' responses and send brief automated message reminders.
BEHAVIORALMind-Online
Mind Online is a series of six modules available online where participants read information and advice about stress, depression, posttraumatic stress, sleep problems, anger, and mindfulness. A trained online wellbeing coordinator will provide individual email feedback on participants' responses and send brief automated message reminders.
Sponsors
Singapore General Hospital
Duke-NUS Graduate Medical School
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE
Intervention model description
Parallel group block RCT design
Eligibility
Sex/Gender
ALL
Age
21 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Age 21 and above * English speaking * Employed or subcontracted as paramedics by SCDF who have been working during the COVID-19 pandemic * Able to provide informed consent and read study materials * Willing to enter randomised trial
Exclusion criteria
* Non-English speaking * Not working during COVID-19 outbreak (e.g. on medical or maternity leave) * Working as trainees, conscripts, medics or ambulance drivers * Unwilling or unable to complete study procedures * Unwilling to enter randomised trial
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Depression Symptoms | Change from baseline at post-intervention (6-8 weeks after baseline), 6 months and 12 months post-intervention | Patient Health Questionnaire 9 (PHQ-9) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in Posttraumatic Stress Symptoms | Change from baseline at post-intervention (6-8 weeks after baseline), 6 months and 12 months post-intervention | Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5) |
| Change in Resilience | Change from baseline at post-intervention (6-8 weeks after baseline), 6 months and 12 months post-intervention | Connor-Davidson Resilience Scale (CD-RISC) |
| Change in Rumination | Change from baseline at post-intervention (6-8 weeks after baseline), 6 months and 12 months post-intervention | Response to Intrusions Questionnaire (RIQ-s) |
| Change in Anxiety Symptoms | Change from baseline at post-intervention (6-8 weeks after baseline), 6 months and 12 months post-intervention | Generalized Anxiety Disorder seven item scale (GAD-7) |
| Change in Psychological Distress | Change from baseline at post-intervention (6-8 weeks after baseline), 6 months and 12 months post-intervention | General Health Questionnaire (GHQ) |
| Change in Burnout | Change from baseline at post-intervention (6-8 weeks after baseline), 6 months and 12 months post-intervention | Physician Work-Life Study's Single Item (PWLS) |
| Change in Social Support | Change from baseline at post-intervention (6-8 weeks after baseline), 6 months and 12 months post-intervention | Multidimensional Scale of Perceived Social Support (MSPSS) |
| Change in Work Engagement | Change from baseline at post-intervention (6-8 weeks after baseline), 6 months and 12 months post-intervention | Utrecht Work Engagement Scale (UWES) |
| Change in Health-related Quality of Life | Change from baseline at post-intervention (6-8 weeks after baseline), 6 months and 12 months post-intervention | EuroQol 5 Dimensions Questionnaire (EQ-5D5L) |
| Change in Posttraumatic Growth | Change from baseline at 6 months and 12 months post-intervention (intervention completed 6-8 weeks after baseline). | Posttraumatic Growth Inventory (PTGI-SF) |
Countries
Singapore
Contacts
PRINCIPAL_INVESTIGATORGayathri Devi Nadarajan
SGH
Outcome results
None listed