Alavi Nazanin, Stephenson Callum, Omrani Mohsen, Gerritsen Cory, Martin Michael S, Knyahnytskyi Alex, Zhu Yiran, Kumar Anchan, Jagayat Jasleen, Shirazi Amirhossein, Moghimi Elnaz, Patel Charmy, Knyahnytska Yuliya, Simpson Alexander I F, Zaheer Juveria, Andersen Judith, Munshi Alpna, Groll Dianne
Department of Psychiatry, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada.
Centre for Neuroscience Studies, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada.
JMIR Res Protoc. 2021 Jul 22;10(7):e30845. doi: 10.2196/30845.
Public safety personnel have regular and often intense exposure to potentially traumatic events at work, especially workplace violence in the case of correctional workers. Subsequently, correctional workers are at higher risk of developing mental health problems such as posttraumatic stress disorder. Public safety personnel are up to 4 times more likely to experience suicidal ideation, suicidal attempts, and death by suicide compared to the general population. Despite this high prevalence, help-seeking behaviors from public safety personnel are low due to stigma and irregular work hours limiting access to care. Innovative treatments are needed to address these challenges.
This study will investigate the efficacy of an electronically delivered cognitive behavioral therapy (e-CBT) program tailored to correctional workers' mental health problems.
This study is composed of 4 phases. In phase 1, we will interview correctional workers individually and in focus groups to identify personal, social, and cultural factors affecting their mental health and barriers to care. Phase 2 will use the information gathered from the interviews to develop gender- and diagnosis-specific e-CBT modules. These will be presented to a new group of participants who will provide further feedback on their usability and accessibility. In phase 3, we will randomly assign participants to either an e-CBT or treatment as usual arm. The program will be evaluated with validated symptomatology questionnaires and interviews. Phase 4 will use this additional information to fine-tune the e-CBT modules for a larger-scale randomized controlled trial design comparing the e-CBT program to in-person CBT. All e-CBT modules will be delivered through a secure online platform.
The study received ethics approval in December 2020, and participant recruitment began in March 2021. Participant recruitment has been conducted through targeted advertisements and physician referrals. To date, there have been 15 participants recruited for Phase 1, and it is expected to conclude in July 2021, with phase 2 beginning in September 2021. Complete data collection and analysis from all phases are expected to conclude by July 2023. Linear and binomial regression (for continuous and categorical outcomes, respectively) will be conducted along with interpretive qualitative methods.
If proven efficacious and feasible, this e-CBT program can provide a high-quality and clinically validated resource to address the mental health problems of correctional workers. Additionally, findings can contribute to the development of innovative treatments for other public safety professions.
ClinicalTrials.gov NCT04666974; https://www.clinicaltrials.gov/ct2/show/NCT04666974.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/30845.
公共安全人员在工作中经常且频繁地接触潜在的创伤性事件，尤其是惩教人员会遭遇工作场所暴力。随后，惩教人员出现心理健康问题（如创伤后应激障碍）的风险更高。与普通人群相比，公共安全人员出现自杀意念、自杀未遂和自杀死亡的可能性高出四倍。尽管患病率如此之高，但由于耻辱感以及工作时间不规律限制了获得护理的机会，公共安全人员寻求帮助的行为较少。需要创新治疗方法来应对这些挑战。
本研究将调查一种针对惩教人员心理健康问题量身定制的电子认知行为疗法（e-CBT）项目的疗效。
本研究由四个阶段组成。在第一阶段，我们将分别与惩教人员进行个体访谈并组织焦点小组讨论，以确定影响他们心理健康的个人、社会和文化因素以及护理障碍。第二阶段将利用访谈收集的信息开发针对性别和诊断的e-CBT模块。这些模块将展示给一组新的参与者，他们将对其可用性和可及性提供进一步反馈。在第三阶段，我们将随机将参与者分配到e-CBT组或常规治疗组。该项目将通过经过验证的症状问卷和访谈进行评估。第四阶段将利用这些额外信息对e-CBT模块进行微调，以用于更大规模的随机对照试验设计，将e-CBT项目与面对面的认知行为疗法进行比较。所有e-CBT模块都将通过安全的在线平台提供。
该研究于2020年12月获得伦理批准，参与者招募于2021年3月开始。参与者招募通过定向广告和医生推荐进行。截至目前，已有15名参与者被招募到第一阶段，预计将于2021年7月结束，并于2021年9月开始第二阶段。预计所有阶段的完整数据收集和分析将于2023年7月结束。将进行线性和二项式回归（分别用于连续和分类结果）以及解释性定性方法。
如果被证明有效且可行，这种e-CBT项目可以提供一种高质量且经过临床验证的资源，以解决惩教人员的心理健康问题。此外，研究结果可为其他公共安全职业的创新治疗方法的开发做出贡献。
ClinicalTrials.gov NCT04666974；https://www.clinicaltrials.gov/ct2/show/NCT04666974。
国际注册报告识别码（IRRID）：DERR1-10.2196/30845。
