A Mobile Phone-Based Intervention to Reduce Mental Health Problems in Health Care Workers During the COVID-19 Pandemic (PsyCovidApp): Randomized Controlled Trial.

Autor:	Fiol-DeRoque MA; Health Research Institute of the Balearic Islands, Palma de Mallorca, Spain.; Primary Care Research Unit of Mallorca, Balearic Islands Health Services, Palma de Mallorca, Spain., Serrano-Ripoll MJ; Health Research Institute of the Balearic Islands, Palma de Mallorca, Spain.; Primary Care Research Unit of Mallorca, Balearic Islands Health Services, Palma de Mallorca, Spain.; Department of Psychology, University of the Balearic Islands (UIB), Palma de Mallorca, Spain., Jiménez R; Health Research Institute of the Balearic Islands, Palma de Mallorca, Spain.; Department of Psychology, University of the Balearic Islands (UIB), Palma de Mallorca, Spain., Zamanillo-Campos R; Health Research Institute of the Balearic Islands, Palma de Mallorca, Spain.; Primary Care Research Unit of Mallorca, Balearic Islands Health Services, Palma de Mallorca, Spain.; Department of Health, Valencian International University (VIU), Valencia, Spain., Yáñez-Juan AM; Health Research Institute of the Balearic Islands, Palma de Mallorca, Spain.; Research Group on Global Health & Human Development, University of the Balearic Islands, Palma de Mallorca, Spain., Bennasar-Veny M; Health Research Institute of the Balearic Islands, Palma de Mallorca, Spain.; Department of Nursing and Physiotherapy, University of the Balearic Islands, Palma de Mallorca, Spain., Leiva A; Health Research Institute of the Balearic Islands, Palma de Mallorca, Spain.; Primary Care Research Unit of Mallorca, Balearic Islands Health Services, Palma de Mallorca, Spain.; Primary Care Prevention and Health Promotion Research Network, Madrid, Spain., Gervilla E; Health Research Institute of the Balearic Islands, Palma de Mallorca, Spain.; Department of Psychology, University of the Balearic Islands (UIB), Palma de Mallorca, Spain., García-Buades ME; Department of Psychology, University of the Balearic Islands (UIB), Palma de Mallorca, Spain., García-Toro M; Health Research Institute of the Balearic Islands, Palma de Mallorca, Spain., Alonso-Coello P; CIBER de Epidemiología y Salud Pública, Madrid, Spain.; Department of Clinical Epidemiology and Public Health, Biomedical Research Institute Sant Pau, Iberoamerican Cochrane Centre, Barcelona, Spain., Pastor-Moreno G; CIBER de Epidemiología y Salud Pública, Madrid, Spain.; Andalusian School of Public Health, Granada, Spain., Ruiz-Pérez I; CIBER de Epidemiología y Salud Pública, Madrid, Spain.; Andalusian School of Public Health, Granada, Spain., Sitges C; Health Research Institute of the Balearic Islands, Palma de Mallorca, Spain.; Department of Psychology, University of the Balearic Islands (UIB), Palma de Mallorca, Spain.; Department of Psychology, Research Institute of Health Sciences, Palma de Mallorca, Spain., García-Campayo J; Primary Care Prevention and Health Promotion Research Network, Madrid, Spain.; Aragon Institute for Health Research, Miguel Servet University Hospital, Zaragoza, Spain., Llobera-Cánaves J; Health Research Institute of the Balearic Islands, Palma de Mallorca, Spain.; Primary Care Research Unit of Mallorca, Balearic Islands Health Services, Palma de Mallorca, Spain.; Primary Care Prevention and Health Promotion Research Network, Madrid, Spain., Ricci-Cabello I; Health Research Institute of the Balearic Islands, Palma de Mallorca, Spain.; Primary Care Research Unit of Mallorca, Balearic Islands Health Services, Palma de Mallorca, Spain.; CIBER de Epidemiología y Salud Pública, Madrid, Spain.
Jazyk:	angličtina
Zdroj:	JMIR mHealth and uHealth [JMIR Mhealth Uhealth] 2021 May 18; Vol. 9 (5), pp. e27039. Date of Electronic Publication: 2021 May 18.
DOI:	10.2196/27039
Abstrakt:	Background: The global health emergency generated by the COVID-19 pandemic is posing an unprecedented challenge to health care workers, who are facing heavy workloads under psychologically difficult situations. Mental mobile Health (mHealth) interventions are now being widely deployed due to their attractive implementation features, despite the lack of evidence about their efficacy in this specific population and context. Objective: The aim of this trial is to evaluate the effectiveness of a psychoeducational, mindfulness-based mHealth intervention to reduce mental health problems in health care workers during the COVID-19 pandemic. Methods: We conducted a blinded, parallel-group, controlled trial in Spain. Health care workers providing face-to-face health care to patients with COVID-19 were randomly assigned (1:1) to receive the PsyCovidApp intervention (an app targeting emotional skills, healthy lifestyle behavior, burnout, and social support) or a control app (general recommendations about mental health care) for 2 weeks. The participants were blinded to their group allocation. Data were collected telephonically at baseline and after 2 weeks by trained health psychologists. The primary outcome was a composite of depression, anxiety, and stress (overall score on the Depression Anxiety Stress Scale-21 [DASS-21]). Secondary outcomes were insomnia (Insomnia Severity Index), burnout (Maslach Burnout Inventory Human Services Survey), posttraumatic stress (Davidson Trauma Scale), self-efficacy (General Self-Efficacy Scale), and DASS-21 individual scale scores. Differences between groups were analyzed using general linear modeling according to an intention-to-treat protocol. Additionally, we measured the usability of the PsyCovidApp (System Usability Scale). The outcome data collectors and trial statisticians were unaware of the treatment allocation. Results: Between May 14 and July 25, 2020, 482 health care workers were recruited and randomly assigned to PsyCovidApp (n=248) or the control app (n=234). At 2 weeks, complete outcome data were available for 436/482 participants (90.5%). No significant differences were observed between the groups at 2 weeks in the primary outcome (standardized mean difference -0.04; 95% CI -0.11 to 0.04; P=.15) or in the other outcomes. In our prespecified subgroup analyses, we observed significant improvements among health care workers consuming psychotropic medications (n=79) in the primary outcome (-0.29; 95% CI -0.48 to -0.09; P=.004), and in posttraumatic stress, insomnia, anxiety, and stress. Similarly, among health care workers receiving psychotherapy (n=43), we observed improvements in the primary outcome (-0.25; 95% CI -0.49 to -0.02; P=.02), and in insomnia, anxiety, and stress. The mean usability score of PsyCovidApp was high (87.21/100, SD 12.65). After the trial, 208/221 participants in the intervention group (94.1%) asked to regain access to PsyCovidApp, indicating high acceptability. Conclusions: In health care workers assisting patients with COVID-19 in Spain, PsyCovidApp, compared with a control app, reduced mental health problems at 2 weeks only among health care workers receiving psychotherapy or psychotropic medications. Trial Registration: ClinicalTrials.gov NCT04393818; https://clinicaltrials.gov/ct2/show/NCT04393818. (©Maria Antònia Fiol-DeRoque, Maria Jesús Serrano-Ripoll, Rafael Jiménez, Rocío Zamanillo-Campos, Aina María Yáñez-Juan, Miquel Bennasar-Veny, Alfonso Leiva, Elena Gervilla, M Esther García-Buades, Mauro García-Toro, Pablo Alonso-Coello, Guadalupe Pastor-Moreno, Isabel Ruiz-Pérez, Carolina Sitges, Javier García-Campayo, Joan Llobera-Cánaves, Ignacio Ricci-Cabello. Originally published in JMIR mHealth and uHealth (https://mhealth.jmir.org), 18.05.2021.)
Databáze:	MEDLINE
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