A Digital Resilience Intervention for Emergency Medical Service Workers

March 5, 2025 updated by: Bryce Hruska, Syracuse University

Self-Reflective Resilience-Recovery Activity Promotion Training for Emergency Medical Service Personnel

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.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Completed

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Actual)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
83

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • United States
    • New York
      • Syracuse, New York, United States, 13244
        • Syracuse University

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Description

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.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Prevention
  • Allocation: Randomized
  • Interventional Model: Crossover Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Experimental: Self-Reflective Resilience-Recovery Activity Promotion Training (SRR-RAPT)
Receives Self-Reflective Resilience-Recovery Activity Promotion Training (SRR-RAPT)
Behavioral: Self-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.
No Intervention: Usual Care
Does not receive SRR-RAPT.

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Time period required to achieve target sample size
Time Frame: 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.
From study initiation until at least 80 participants are recruited, up to 12 months
Number of participants recruited and randomized each week of the study
Time Frame: 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.
From study initiation until at least 80 participants are recruited, up to 12 months
Acceptability
Time Frame: 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.
Day 8 of the intervention
Adoptability
Time Frame: 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.
Day 8 of the intervention

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Meaning Made
Time Frame: 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.
Days 1 to 8 of the intervention
Adaptive Self-Reflection
Time Frame: 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.
Days 1 to 8 of the intervention
Recovery Activities
Time Frame: 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.
Days 1 to 8 of the intervention
Recovery Experiences
Time Frame: 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.
Days 1 to 8 of the intervention
PTSD Symptom Severity
Time Frame: 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.
Days 1 to 8 of the intervention
Depression Symptom Severity
Time Frame: 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.
Days 1 to 8 of the intervention
Anxiety Symptom Severity
Time Frame: 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.
Days 1 to 8 of the intervention

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Syracuse University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
June 28, 2023

Primary Completion (Actual)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
December 20, 2023

Study Completion (Actual)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
December 20, 2023

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
February 24, 2025

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
February 28, 2025

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
March 25, 2025

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
March 25, 2025

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
March 5, 2025

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
March 1, 2025

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • 11-3278-2022

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

product manufactured in and exported from the U.S.

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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Sponsors and Collaborators

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Drug Interventions

Conditions

Rare Diseases

Drug Interventions

Dietary Supplements

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