Tan Leona, Deady Mark, Mead Olivia, Foright Rebecca M, Brenneman Eric M, Yeager Jamie R, Bryant Richard A, Harvey Samuel B
School of Psychiatry, University of New South Wales, Sydney, Australia.
Black Dog Institute, University of New South Wales, Randwick, Australia.
JMIR Form Res. 2023 Feb 1;7:e40145. doi: 10.2196/40145.
First responders report elevated rates of mental disorders, including posttraumatic stress disorder (PTSD), yet many are reluctant to seek care. Preventative resilience training programs attempt to proactively address this issue, and there is evidence showing promise for programs targeting cognitive processes. However, these programs rarely address the physical health conditions associated with PTSD. There is emerging evidence of mind-body exercise training improving PTSD symptoms as well as its associated physical health symptoms. However, the feasibility and acceptability of delivering a web-based mind-body resilience training among first responders are not yet known.
This study aimed to evaluate the feasibility, usability, and acceptability of a web-based mind-body tactical resilience training program designed for first responders. In addition, we explored the preliminary effectiveness of the training program on mental health outcomes, adaptive cognitive strategies, and work productivity.
A total of 42 first responders based in the United States enrolled in the web-based training program. Participants were administered web-based surveys before enrolling in the 6-week web-based program and at the end of the program. The primary outcomes of feasibility were measured using the number of training hours, program adherence rates, and self-reported data on frequency of practice. Acceptability and usability were measured using self-reported data. Secondary outcomes were symptoms of PTSD, psychological distress, emotion regulation, stress mindset, psychological preparedness, and work performance.
Overall, the training program was feasible based on the median number of training hours spent on the web-based program (7.57 hours out of an expected total of 6 to 9 hours), and 55% (23/42) of the enrolled participants completed more than half of the program. Although acceptability, usability, and frequency of practice were rated as high, this was based on only 29% (12/42) of the respondents who provided follow-up data. Secondary outcomes showed a significant improvement in the adaptive cognitive strategy of the stress mindset, with a mean difference of -5.42 (SD 4.81; 95% CI -8.475 to -2.358; t=-3.898; P=.002). All other secondary outcomes were not significant. However, the secondary outcomes were exploratory only, and this study was neither designed nor powered to adequately assess efficacy.
These findings suggest that a mind-body tactical resilience training program delivered in a web-based format is feasible and acceptable among first responders; however, further refinements may be required to improve adherence rates. Further research using a larger, more rigorous trial design is warranted to examine the effectiveness of this type of training as a possible prevention or treatment strategy for this population.
急救人员报告称精神障碍发病率升高，包括创伤后应激障碍（PTSD），但许多人不愿寻求治疗。预防性恢复力训练项目试图积极解决这一问题，有证据表明针对认知过程的项目有前景。然而，这些项目很少涉及与PTSD相关的身体健康状况。有新证据表明身心锻炼训练可改善PTSD症状及其相关的身体健康症状。然而，在急救人员中开展基于网络的身心恢复力训练的可行性和可接受性尚不清楚。
本研究旨在评估为急救人员设计的基于网络的身心战术恢复力训练项目的可行性、可用性和可接受性。此外，我们探讨了该训练项目对心理健康结果、适应性认知策略和工作效率的初步效果。
共有42名美国急救人员参加了基于网络的训练项目。参与者在参加为期6周的网络项目之前和项目结束时接受了基于网络的调查。可行性的主要指标通过训练小时数、项目依从率以及自我报告的练习频率数据来衡量。可接受性和可用性通过自我报告数据来衡量。次要指标包括PTSD症状、心理困扰、情绪调节、压力心态、心理准备和工作表现。
总体而言，基于网络项目花费的训练小时数中位数（预期总共6至9小时中的7.57小时）表明该训练项目是可行的，55%（23/42）的登记参与者完成了超过一半的项目。尽管可接受性、可用性和练习频率的评分较高，但这仅基于提供后续数据的29%（12/42）的受访者。次要指标显示压力心态的适应性认知策略有显著改善，平均差异为-5.42（标准差4.81；95%置信区间-8.475至-2.358；t=-3.898；P=.002）。所有其他次要指标均无显著差异。然而，次要指标仅为探索性的，本研究既未设计也无足够能力充分评估疗效。
这些发现表明，以网络形式提供的身心战术恢复力训练项目在急救人员中是可行且可接受的；然而，可能需要进一步改进以提高依从率。有必要进行更大规模、更严格试验设计的进一步研究，以检验这种训练作为该人群可能的预防或治疗策略的有效性。
