A digital intervention to improve mental wellbeing and resilience in first responders : protocol for a nonrandomised feasibility trial and nested qualitative study

Cogan, Nicola and Kirk, Alison and Graf, Christoph (2023) A digital intervention to improve mental wellbeing and resilience in first responders : protocol for a nonrandomised feasibility trial and nested qualitative study. In: Trauma and Justice : An Interdisciplinary Approach, 2023-06-16 - 2023-06-16, England.

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Abstract

BACKGROUND: Limited evidence-based support has been offered to first responders (FRs) who have experienced occupational trauma. Challenges in accessing face to face, routine interventions aimed at improving mental wellbeing and processing trauma are evident. A digital intervention aimed at improving mental wellbeing in FRs who have experienced occupational trauma may reduce the risk of poor mental health outcomes and help FRs to process distress resulting from work related stressors and traumatic experiences. OBJECTIVE: We describe a protocol for determining the feasibility of the Sentinel trial and the acceptability, safety, and usability of the digital intervention (Sentinel app) and explore how to best integrate Sentinel into existing routine care pathways for FRs. METHODS: This is a mixed methods non-randomized study aimed to determine the feasibility, acceptability, safety, and usability of the Sentinel intervention. Participants aged 18 years and older who report distress associated exposure to work related trauma(s) will be recruited from the United Kingdom from the National Health Service (NHS) and FR organisations. All participants will receive the Sentinel app for 6 weeks. Coproduced with FRs and a range of stakeholders, the Sentinel app focuses on 10 main evidence based topics: education of stress and trauma, post-traumatic growth, increasing body and emotional awareness, coping with stress, improving mood, improving sleep, improving social connectedness, increasing physical activity, reducing sedentary behaviour and improving resilience: Daily nudges will encourage FRs to use the app, which is designed to be used in a stand-alone manner alongside routine care. We will follow participants up after the intervention and conduct interviews with stakeholders to explore the acceptability of the app and trial procedures and identify areas for improvement. Informed by the polyvagal theory, we will examine barriers and enablers relevant to the future integration of the intervention into existing care pathways, including traditional clinic-based NHS and e-therapy providers. RESULTS:: We expect data to be collected from up to 50 FRs. We expect to conduct approximately 20 qualitative interviews with FR participants and 20 health and social care professionals who referred FRs to the study. CONCLUSIONS: This study will provide preliminary evidence on the feasibility of recruiting FRs to a trial of this nature and on the acceptability, safety, and usability of the Sentinel app, including how to best integrate it into existing routine care. The findings will inform the decision to proceed with a powered efficacy trial.

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