Reducing Psychological Distress in Fire Fighters with an Asynchronous App-based Meditation Intervention

通过基于应用程序的异步冥想干预减少消防员的心理困扰

• 批准号: 10590943
• 负责人: THADDEUS PACE
• 金额: $ 22.7万
• 依托单位: UNIVERSITY OF ARIZONA
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-01 至 2025-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10590943
• 关键词: Reducing; Psychological; Distress; Fire; Fighters

ABSTRACT More than one million firefighters in the United States provide critical emergency medical services in communities they serve and have been on the front lines of healthcare delivery, including throughout the COVID-19 pandemic. As a result of exposure to occupational stressors, a high proportion of firefighters experience considerable stress-related illness burden, including chronic pain, psychological distress (i.e., anxiety and depression), and posttraumatic stress disorder. Although interventions have been developed to address this high need of reducing effects of occupational stress exposure in order to improve firefighter well- being (e.g., cognitive-behavioral therapy, resilience training), not all of these modalities appeal to all firefighters, nor are they easily implemented without direct, in-person contact. One modality that has shown promise to reduce distress in various populations is meditation, including meditation delivered by smartphone apps. To the best of our knowledge, no smartphone-based meditation interventions designed to cultivate both mindfulness and feelings of social connection to others have been tested with firefighters. This study will therefore test the efficacy of a 10-day, smartphone-based meditation app intervention among N=192 career firefighters. The app was developed by Health Minds Innovations (HMI, Madison, WI) and is designed to enhance both mindfulness (awareness) and social connection to others in order to reduce anxiety. Our group recently piloted tested this app and found that firefighters exhibited reduced anxiety (a key component of psychological distress) and burnout, as well as improved function of the stress hormone, cortisol, from before to after use of the app. Although these encouraging results suggest a low-cost, scalable smartphone-based meditation app may be effective to improve firefighter well-being, our pilot study lacked an attention control comparison needed to establish intervention efficacy. Therefore, in collaboration with 3 metropolitan fire departments in the United States, we will test the efficacy of the HMI meditation app to reduce psychological distress compared to a rigorous active attention control (i.e., a Health Education app, based on our prior work)(Aim 1). We will also determine whether the effect of the HMI meditation app of psychological distress is mediated by mindfulness and perceived social connection (Aim 2). The proposed research will provide important evidence of efficacy about a smartphone-based meditation app intervention, with likely high impact, that cultivates both mindfulness and social connection in order to reduce psychological distress in frontline workers in the fire service. This research supports NIOSH's Strategic Goal 7 / Activity Goal 7.14.1 (to develop interventions that integrate protection from work-related health hazards with promotion of prevention to advance worker well-being) and NORA Objective 6 (promote healthy work design and well-being).

抽象的 美国超过一百万消防员在以下地区提供重要的紧急医疗服务 他们所服务的社区，一直处于医疗保健服务的第一线，包括整个社区 2019冠状病毒病大流行。由于承受职业压力，很大比例的消防员 经历相当大的与压力相关的疾病负担，包括慢性疼痛、心理困扰（即 焦虑和抑郁）和创伤后应激障碍。尽管已经制定了干预措施 满足减少职业压力暴露影响的迫切需要，以提高消防员的健康水平 是（例如，认知行为疗法、复原力训练），并非所有这些方式都对所有人有吸引力 消防员，如果没有直接的面对面接触，这些措施也不容易实施。已显示的一种模式 冥想有望减少不同人群的痛苦，包括通过智能手机提供的冥想 应用程序。据我们所知，目前还没有基于智能手机的冥想干预措施能够同时培养这两种能力。 消防员对正念和与他人的社会联系的感觉进行了测试。这项研究将 因此，我们在 N=192 名职业人士中测试了为期 10 天、基于智能手机的冥想应用程序干预的效果 消防员。该应用程序由 Health Minds Innovations（HMI，麦迪逊，威斯康星州）开发，旨在 增强正念（意识）和与他人的社会联系，以减少焦虑。我们组 最近对这个应用程序进行了试点测试，发现消防员的焦虑程度有所减轻（焦虑的一个关键组成部分） 心理困扰）和倦怠，以及压力荷尔蒙皮质醇的功能比以前有所改善 使用该应用程序后。尽管这些令人鼓舞的结果表明低成本、可扩展的基于智能手机的 冥想应用程序可能有效改善消防员的健康，我们的试点研究缺乏注意力控制 需要进行比较才能确定干预效果。因此，与3个都市消防局合作 在美国的部门，我们将测试HMI冥想应用程序减少心理的功效 与严格的主动注意力控制（即健康教育应用程序，基于我们之前的研究）相比，痛苦 工作）（目标 1）。我们还将确定 HMI 冥想应用程序是否对心理产生影响 痛苦是通过正念和感知的社会联系来调节的（目标 2）。拟议的研究将 提供有关基于智能手机的冥想应用程序干预效果的重要证据，可能 高影响力，培养正念和社会联系，以减少心理压力 消防一线工作人员的痛苦。这项研究支持 NIOSH 的战略目标 7/活动 目标 7.14.1（制定干预措施，将预防与工作相关的健康危害与 促进预防以提高工人福祉）和 NORA 目标 6（促进健康工作） 设计和福祉）。