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

实验性的：Intervention group

The intervention group will get a four-week internet-delivered stress recovery intervention FOREST.

行为的：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.

Reach

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.

Recruitment

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.

Intervention uptake

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.

Number of intervention sessions completed

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.

Percentage of participants completing all six intervention sessions

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.

Retention

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.

Intervention acceptability

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.

Intervention appropriateness

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.

Changes in stress recovery

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.

Changes in perceived stress

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.

Changes in symptoms of anxiety and depression

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.

Changes in mental well-being

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.