Mindful Attention Training Workshop for Firefighters (HAZMAT)

May 8, 2023 updated by: Anka A Vujanovic, University of Houston

Healthy Action Zone - Mindful Attention Training: A Mindfulness-Based Workshop for Firefighters

The overarching goal of this study is to demonstrate the efficacy, feasibility, and acceptability of Mindful Attention Training (MAT), a novel mindfulness-based intervention that is specifically developed for firefighters. This project is designed to improve the health of firefighters, an integral, essential component of our national and international communities. Moreover, the study aims to promote health service psychologists by enhancing our contributions to the mental healthcare of firefighters, an understudied and underserved segment of the population by virtue of their service to our communities. This study therefore has significant potential to identify, develop, and promote an effective model of quality, evidence-based mental health promotion and illness prevention by integrating health service psychology into the fire service.

Study Overview

Detailed Description

Firefighters are repeatedly exposed to traumatic and stressful situations, increasing their vulnerability for the development of various psychological symptoms and disorders. As many as 32.4% of firefighters meet criteria for posttraumatic stress disorder (PTSD) with significantly more experiencing significant subclinical PTSD symptoms. Approximately 22% of firefighters are also at risk for depression, 46.8% reported serious suicidal ideation, and 15.5% reported having made a suicide attempt during heir firefighter tenure6. Alcohol use disorder (AUD) among firefighters is estimated at approximately 50%, nearly twice that of the general population.

Given the chronically stressful and potentially traumatic nature of the firefighting profession and the high rates of psychological disturbances among firefighters, the development of specialized mental health promotion and illness prevention programs for this vulnerable population is a priority. Mindfulness, generally defined as bringing one's full attention to the present moment and taking a stance of nonjudgmental acceptance to the ongoing flow of sensations, thoughts, and/or emotional states, has significant clinical relevance to the prevention and treatment of various psychological conditions. Mindfulness-based interventions have demonstrated efficacy with regard to various psychological symptoms, including PTSD, depression, and alcohol use. In a military context, mindful attention training has shown promise in terms of reducing the impact of combat on psychological health. However, no specialized mindfulness-based interventions exist for firefighters.

The overarching goal of this study is to demonstrate the efficacy, feasibility, and acceptability of Mindful Attention Training (MAT), a novel mindfulness-based intervention that is specifically developed for firefighters. This project is designed to improve the health of firefighters, an integral, essential component of our national and international communities. Moreover, the study aims to promote health service psychologists by enhancing our contributions to the mental healthcare of firefighters, an understudied and underserved segment of the population by virtue of their service to our communities. This study therefore has significant potential to identify, develop, and promote an effective model of quality, evidence-based mental health promotion and illness prevention by integrating health service psychology into the fire service.

Aim 1: To evaluate the efficacy of the Mindful Attention Training (MAT) workshop, as compared to waitlist comparison ("as usual" condition), on mental health promotion among firefighters, as defined by: self-reported levels of (1a) mindful attention and awareness, (1b) nonjudgmental acceptance, and (1c) nonreactivity at each time point.

Aim 2: To evaluate the efficacy of the MAT workshop, as compared to waitlist, on psychological 'illness' prevention among firefighters, as defined by: self-reported symptom severity of PTSD, depression, anxiety, suicidal ideation, and alcohol use at each time point.

Aim 3: To evaluate the feasibility and acceptability of the MAT workshop, as compared to waitlist, as defined by: (1) firefighters' self-reported helpfulness of the workshop and (2) firefighters' self-reported satisfaction ratings of the workshop.

Study Type

Interventional

Enrollment (Actual)

82

Phase

  • 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 Contact

Study Contact Backup

  • Name: Antoine M Lebeaut, M.A.
  • Phone Number: 713-743-3241
  • Email: amlebeaut@uh.edu

Study Locations

    • Texas
      • Houston, Texas, United States, 77204
        • Trauma and Stress Studies Center

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

Ages Eligible for Study

18 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • ≥ 18 years of age
  • Current employment as a firefighter with the Houston Fire Department

Exclusion Criteria:

  • Persons who are not actively employed in the Houston Fire Department (e.g. former firefighters, retired firefighters)
  • Current imminent risk of suicidality and/or homicidality (i.e., past month ideation with intent or plan)
  • Inability to provide verbal or written consent
  • Study personnel will not recruit or screen for individuals who fall into the following categories: pregnant women, prisoners, students for whom study personnel have direct access to/influence on grades, or economically and/or educationally disadvantaged persons

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: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Mindful Attention Workshop
50 participants will be randomized to the Mindful Attention Training (MAT) workshop. The 90-minute workshop will be conducted in group, online format.
The 90-minute workshop will include a 15-minute break and include up to 15 participants. The workshop will be led by peer support staff, fire department psychologists, and/or fire department doctoral psychology practicum students. Each workshop will be facilitate by up to 3 workshop leaders. The workshop will provide (1) psychoeducation regarding common mental health concerns among firefighters, (2) introduction to the concept of mindful attention, why it is relevant to firefighters, and how it can prevent or decrease mental health symptoms, (3) 5 experiential mindful attention training exercises, and (4) discussion. Workshop co-leaders will teach 5 mindful attention exercises, and firefighters will practice each exercise and then engage in discussion about their experiences and provide feedback regarding the utility of the exercise for them personally and for firefighters, generally.
No Intervention: Waitlist Control
50 participants will be randomized to the waitlist control condition ("as usual" condition).

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Changes in mindfulness
Time Frame: Administered at each of the following timepoints: baseline, 1-week follow-up, 2-week follow-up, 1-month follow-up, 3-month follow-up, and 6-month follow-up

To evaluate the efficacy of the Mindful Attention Training (MAT) workshop by examining self-reported levels of (1) nonjudgmental acceptance, (2) nonreactivity as well as (3) psychological resilience and (4) self-compassion at each time point using the following measure:

- Five Facet Mindfulness Questionnaire (FFMQ; Baer et al., 2006): 39-item measure that assesses a participant's capacity for the following five factors: observing, describing, acting with awareness, non-judging of inner experience, and non-reactivity to inner experience.

Administered at each of the following timepoints: baseline, 1-week follow-up, 2-week follow-up, 1-month follow-up, 3-month follow-up, and 6-month follow-up
Changes in mindful attention
Time Frame: Administered at each of the following timepoints: baseline, 1-week follow-up, 2-week follow-up, 1-month follow-up, 3-month follow-up, and 6-month follow-up

To evaluate the efficacy of the Mindful Attention Training (MAT) workshop by examining self-reported levels of mindful attention and awareness at each time point using the following measure:

- Mindful Attention Awareness Scale (MAAS; Brown & Ryan, 2003): 15-item scale assessing a participant's capacity for mindful attention, a key component of mindfulness.

Administered at each of the following timepoints: baseline, 1-week follow-up, 2-week follow-up, 1-month follow-up, 3-month follow-up, and 6-month follow-up
Changes in PTSD symptom severity
Time Frame: Administered at each of the following timepoints: baseline, 1-week follow-up, 2-week follow-up, 1-month follow-up, 3-month follow-up, and 6-month follow-up

To evaluate the efficacy of the Mindful Attention Training (MAT) workshop on the symptom severity of PTSD at each time point using the following measure:

- Posttraumatic Stress Disorder Checklist for the Diagnostic and Statistical Manual of Mental Disorders (PCL-5): 20-item self-report measure that assesses the 20 Diagnostic and Statistical Manual of Mental Disorders (DSM-5) symptoms of PTSD over the past month.

Administered at each of the following timepoints: baseline, 1-week follow-up, 2-week follow-up, 1-month follow-up, 3-month follow-up, and 6-month follow-up
Changes in hazardous drinking patterns
Time Frame: Administered at each of the following timepoints: baseline, 1-week follow-up, 2-week follow-up, 1-month follow-up, 3-month follow-up, and 6-month follow-up

To evaluate the efficacy of the Mindful Attention Training (MAT) workshop on the alcohol use and alcohol use severity at each time point using the following measure:

- Alcohol Use Disorders Identification Test (AUDIT): 10-item screening measurement to assess any hazardous and harmful alcohol consumption during the past year.

Administered at each of the following timepoints: baseline, 1-week follow-up, 2-week follow-up, 1-month follow-up, 3-month follow-up, and 6-month follow-up
Changes in depressive symptoms
Time Frame: Administered at each of the following timepoints: baseline, 1-week follow-up, 2-week follow-up, 1-month follow-up, 3-month follow-up, and 6-month follow-up

To evaluate the efficacy of the Mindful Attention Training (MAT) workshop on the symptom severity of depression at each time point using the following measure:

- Overall Depression Severity and Impairment Scale (ODSIS): 5 item measure assessing for past week depression-related symptoms.

Administered at each of the following timepoints: baseline, 1-week follow-up, 2-week follow-up, 1-month follow-up, 3-month follow-up, and 6-month follow-up
Changes in suicidal thoughts
Time Frame: Administered at each of the following timepoints: baseline, 1-week follow-up, 2-week follow-up, 1-month follow-up, 3-month follow-up, and 6-month follow-up

To evaluate the efficacy of the Mindful Attention Training (MAT) workshop on the severity and presence of suicidal thoughts at each time point using the following measure:

- Beck Suicide Scale-5 (BSS-5): 5-item measure assessing the presence and intensity of suicidal thoughts.

Administered at each of the following timepoints: baseline, 1-week follow-up, 2-week follow-up, 1-month follow-up, 3-month follow-up, and 6-month follow-up
Evaluate the feasibility and acceptability of the Mindful Attention Training (MAT) workshop
Time Frame: Administered at 1-week follow-up

To evaluate the feasibility and acceptability of the MAT workshop, as compared to waitlist, as defined by: (1) firefighters' self-reported helpfulness of the workshop and (2) firefighters' self-reported efficacy ratings of the workshop using the following measure:

- Post-MAT Workshop Questionnaire (Post-MAT): 10-item questionnaire assessing the degree to which participants found the workshop helpful and tolerable.

Administered at 1-week follow-up
Changes in anxiety symptoms
Time Frame: Administered at each of the following timepoints: baseline, 1-week follow-up, 2-week follow-up, 1-month follow-up, 3-month follow-up, and 6-month follow-up

To evaluate the efficacy of the Mindful Attention Training (MAT) workshop on the symptom severity of anxiety at each time point using the following measure:

- Overall Anxiety Severity and Impairment Scale (OASIS): 5 item measure assessing for past week anxiety-related symptoms.

Administered at each of the following timepoints: baseline, 1-week follow-up, 2-week follow-up, 1-month follow-up, 3-month follow-up, and 6-month follow-up

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Evaluate group dynamics
Time Frame: Administered at 1-week follow-up

To evaluate the group dynamics of the MAT workshop using the following measure:

- Group Evaluation Scale (GES; Joyce, 2005): 7-item measure assessing how the participant felt while participating in the group, particularly comfortability and sense of being understood by other group members.

Administered at 1-week follow-up
Evaluate group cohesion
Time Frame: Administered at 1-week follow-up

To evaluate the cohesion of each group in the MAT workshop using the following measure:

- Group Cohesion Questionnaire (GCQ; MacKenzie, 1983): 12-item measure assessing a participant's view of the cohesion of the group and the quality of the group dynamic.

Administered at 1-week follow-up
Evaluate occupational stress
Time Frame: Administered at each of the following timepoints: baseline, 1-week follow-up, 2-week follow-up, 1-month follow-up, 3-month follow-up, and 6-month follow-up

To evaluate the influence of the Mindful Attention Training (MAT) workshop on self-reported occupational stress levels at each time point using the following measure:

- The Sources of Occupational Stress (SOOS-14): 14-item self-report measure used to assess levels of occupational stress (i.e., harmful physical and psychological responses that occur when job requirements do not align with the worker's abilities, resources, and/or needs) among firefighters.

Administered at each of the following timepoints: baseline, 1-week follow-up, 2-week follow-up, 1-month follow-up, 3-month follow-up, and 6-month follow-up

Collaborators and Investigators

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

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)

May 5, 2021

Primary Completion (Actual)

April 14, 2023

Study Completion (Actual)

April 14, 2023

Study Registration Dates

First Submitted

May 19, 2021

First Submitted That Met QC Criteria

May 24, 2021

First Posted (Actual)

June 1, 2021

Study Record Updates

Last Update Posted (Actual)

May 9, 2023

Last Update Submitted That Met QC Criteria

May 8, 2023

Last Verified

May 1, 2023

More Information

Terms related to this study

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

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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