Feasibility of Implementing the Internet-Delivered Stress Recovery Intervention FOREST for Healthcare Staff in a Real-World Healthcare Setting (FOREST-IN)

September 1, 2026 updated by: Austeja Dumarkaite, Vilnius University
The aim of the study is to assess the feasibility of implementing the internet-delivered stress recovery intervention FOREST for healthcare staff in a real-world healthcare setting and to obtain preliminary estimates of changes in stress recovery and mental health outcomes.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Detailed Description

The feasibility of implementing the evidence-based, internet-delivered stress recovery intervention FOREST for healthcare staff in a real-world healthcare setting will be evaluated using a single-arm pre-post study design. The study aims to assess the feasibility of implementing the intervention within a hospital setting and to obtain preliminary estimates of changes in stress recovery and mental health outcomes to inform broader implementation across healthcare settings. Information about the intervention and the study will be disseminated within participating healthcare settings. Interested healthcare staff will complete an online eligibility screening. Individuals who meet the inclusion criteria will be invited to provide informed consent and complete the baseline assessment before being enrolled in and granted access to the FOREST intervention.

The FOREST intervention consists of six sessions (Introduction, Psychological Detachment, Distancing, Mastery, Control, and Keeping the Change Alive) delivered over a four-week period. Each session includes psychoeducational content presented through text and video materials, as well as practical stress recovery exercises. Participants will also have access to support from a trained psychologist on demand throughout the intervention.

Assessments will be conducted at baseline, immediately after the four-week intervention, and at a 12-week follow-up after baseline. The study's primary outcomes will assess implementation at the individual level, guided by Proctor et al.'s Implementation Outcomes Framework to evaluate acceptability and appropriateness, alongside intervention uptake (initiation), and complemented by feasibility and process indicators capturing reach, recruitment, engagement, and retention. Secondary outcomes will provide preliminary estimates of changes in stress recovery and other mental health outcomes.

Study Type

Interventional

Enrollment (Estimated)

300

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

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

  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • being at least 18 years old
  • working in a healthcare setting;
  • understanding Lithuanian;
  • living in Lithuania;
  • having access to an internet-enabled device.

Exclusion Criteria: No additional exclusion criteria will be applied in order to maximize inclusiveness and reflect real-world implementation.

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: N/A
  • Interventional Model: Single Group Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Intervention group
The intervention group will get a four-week internet-delivered stress recovery intervention FOREST.
Behavioral: FOREST
The internet-delivered stress recovery intervention FOREST consists of six sessions (Introduction, Psychological Detachment, Distancing, Mastery, Control, and Keeping the Change Alive) delivered over a four-week period. Each session includes psychoeducational content presented through text and video materials, as well as practical stress recovery exercises. Participants also have access to support from a trained psychologist on demand throughout the intervention.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Reach
Time Frame: Through completion of recruitment, up to 9 months.

Measurement: study recruitment records.

Reach will be assessed as the proportion of the target healthcare workforce that enrolls in the intervention. It will be calculated as the number of enrolled participants divided by the estimated number of healthcare staff in the target workforce, expressed as a percentage.
Through completion of recruitment, up to 9 months.
Recruitment
Time Frame: Through completion of recruitment, up to 9 months.

Measurement: Study screening, eligibility, and informed consent records.

Recruitment will be assessed as the number and proportion of eligible healthcare staff who provide informed consent and enroll in the study.
Through completion of recruitment, up to 9 months.
Intervention uptake
Time Frame: Through completion of the intervention period, up to 10 months.

Measurement: FOREST intervention platform usage records.

Intervention uptake will be assessed as the number and proportion of enrolled participants who initiate the intervention by completing the first FOREST session.
Through completion of the intervention period, up to 10 months.
Number of intervention sessions completed
Time Frame: Through completion of the intervention period, up to 10 months.
Number of intervention sessions completed will be assessed using FOREST intervention platform usage records. The number of FOREST intervention sessions completed by each participant will be recorded.
Through completion of the intervention period, up to 10 months.
Percentage of participants completing all six intervention sessions
Time Frame: Through completion of the intervention period, up to 10 months.
Percentage of participants completing all six FOREST intervention sessions will be assessed using FOREST intervention platform usage records. The percentage of participants who complete all six FOREST intervention sessions will be calculated as the number of participants completing all six sessions divided by the total number of participants who initiated the intervention, multiplied by 100.
Through completion of the intervention period, up to 10 months.
Retention
Time Frame: Through completion of the 12-week follow-up, up to 12 months.

Measurement: Study assessment completion records.

Retention will be assessed as the number and proportion of enrolled participants who complete the post-intervention assessment and the 12-week follow-up assessment.

Unit of Measure: Number and percentage of participants completing each assessment time point.
Through completion of the 12-week follow-up, up to 12 months.
Intervention acceptability
Time Frame: Through completion of the post-intervention assessment period, up to 10 months.

Measurement: Post-intervention acceptability questions developed by study researchers.

Acceptability will be assessed using post-intervention participant questions evaluating satisfaction with the FOREST intervention, perceived usefulness, and likelihood of recommending the intervention to colleagues. Each item will be reported according to its response scale, with descriptive summary statistics presented for participant responses. Higher scores indicate more pronounced acceptability.
Through completion of the post-intervention assessment period, up to 10 months.
Intervention appropriateness
Time Frame: Post-intervention assessment, up to 10 months.

Measurement: Post-intervention appropriateness question developed by study researchers.

Appropriateness will be assessed using a post-intervention participant question evaluating participants' perceptions of whether the FOREST intervention is relevant and suitable for healthcare staff working in a hospital setting. The item will be reported according to its response scale, with descriptive summary statistics presented for participant responses. A higher score indicates more pronounced appropriateness.
Post-intervention assessment, up to 10 months.

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Changes in stress recovery
Time Frame: Baseline, post-test after four weeks, follow-up after 12 weeks
Changes in stress recovery are measured. The Recovery Experiences Questionnaire (Sonnentag & Fritz, 2007) is a self-report measure consisting of 16 questions. All items are answered on a 5-point Likert scale ranging from 1 (Totally disagree) to 5 (Totally agree). A higher score indicates more pronounced stress recovery.
Baseline, post-test after four weeks, follow-up after 12 weeks
Changes in perceived stress
Time Frame: Baseline, post-test after four weeks, follow-up after 12 weeks
Changes in perceived stress are measured. Perceived Stress Scale (PSS-4, Cohen et al., 1983) is a self-report measure consisting of four questions. All items are answered on a 5-point Likert scale ranging from 0 (Never) to 4 (Very often). A higher score indicates more pronounced perceived stress.
Baseline, post-test after four weeks, follow-up after 12 weeks
Changes in symptoms of anxiety and depression
Time Frame: Baseline, post-test after four weeks, follow-up after 12 weeks
Changes in symptoms of anxiety and depression are measured. The Patient Health Questionnaire-4 (PHQ-4; Kroenke et al., 2009) is a self-report measure consisting of four questions. All items are answered on a 4-point Likert scale ranging from 0 (Not at all) to 3 (Nearly every day). A higher score indicates more pronounced symptoms of anxiety and depression.
Baseline, post-test after four weeks, follow-up after 12 weeks
Changes in mental well-being
Time Frame: Baseline, post-test after four weeks, follow-up after 12 weeks
Changes in mental well-being are measured. Well-being Index (WHO-5, Bech, 2004) is a self-report measure consisting of five questions. All items are answered on a 6-point Likert scale ranging from 0 (At no time) to 5 (All of the time). A higher score indicates more pronounced mental well-being.
Baseline, post-test after four weeks, follow-up after 12 weeks

Collaborators and Investigators

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

Sponsor

Vilnius University

Investigators

  • Principal Investigator: Austeja Dumarkaite, PhD, Vilnius University

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 (Estimated)

October 1, 2026

Primary Completion (Estimated)

September 1, 2027

Study Completion (Estimated)

September 1, 2027

Study Registration Dates

First Submitted

August 24, 2026

First Submitted That Met QC Criteria

September 1, 2026

First Posted (Actual)

September 9, 2026

Study Record Updates

Last Update Posted (Actual)

September 9, 2026

Last Update Submitted That Met QC Criteria

September 1, 2026

Last Verified

September 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 3.7 E-10000-KT-2858

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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