TY - JOUR
T1 - Evaluation of the effectiveness and cost-effectiveness of psychological first aid (PFA) system based training for frontline health workers in emergency health services in China a study protocol of a cluster randomized controlled trial
AU - Peng, Min
AU - Xiao, Tao
AU - Carter, Ben
AU - Chen, Pan
AU - Shearer, James
N1 - Funding Information:
This work was supported by the National Natural Science Foundation of China (Grant No. 82173201). The Second Xiangya Hospital of Central South University is the study sponsor and responsible for the initiation of the project and data management.
Funding Information:
This work was supported by the National Natural Science Foundation of China (Grant No. 82173201). The Second Xiangya Hospital of Central South University is the study sponsor and responsible for the initiation of the project and data management.
Publisher Copyright:
Copyright © 2022 Peng, Xiao, Carter, Chen and Shearer.
PY - 2022/12/16
Y1 - 2022/12/16
N2 - Introduction: There is insufficient evidence on the effectiveness and cost-effectiveness of psychological interventions to enhance frontline responders’ mental health proficiency and competence in emergency settings. This paper describes the methods for the evaluation of the effectiveness and cost-effectiveness of Psychological First Aid training, to determine whether the intervention is effective and cost-effective as a mental health intervention in public health emergencies. A pilot to evaluate the acceptability of the PFA training found participants were either satisfied (55.6%) or extremely satisfied (44.4%) with the training program. Method: This paper describes the protocol for a cluster randomized two-arm controlled trial. A total of 1,399 non-specialist health care workers will be recruited in 42 hospitals and health care centers across six provinces in China. Participants will be assigned according to hospital or health care center site to one of two groups (n = 699 for intervention group and 709 for control group) to receive system based PFA training or PFA training as usual. Both groups will receive one-day of training, comprising six modules including PFA core concepts, knowledge, skills and practice. Their knowledge, skills, competency, self-efficacy, resilience, and professional quality of life will be assessed immediately after the training; and reassessed after 1 and 2 months. Analysis: For effectiveness outcomes, repeated measures will be used in a multi-level linear mixed model. The pooled standard deviations will be used to calculate the effect sizes (Cohen’s d) within and between groups. Appropriate statistical tests will be used to explore differences between intervention and control groups. For economic outcomes, a health service sector perspective will be adopted, with intervention costs and outcomes collected prospectively. Within-trial cost-effectiveness analysis (CEA) will quantify the incremental costs and PFA proficiency gains of the intervention compared with training as usual at 2 months post training. CEA will present results as cost per unit of mental health proficiency gained. A cost-utility analysis (CUA) model will extend the population to emergency health service users.in order to identify potential for incremental cost offsets attributable to mental health improvement arising from intervention. Intervention costs and effects will be extrapolated to the population of patients who receive the emergency health service in clinical wards and will be modeled over the cohort’s lifetime. Modeled CUA results will be calculated as quality-adjusted life-years saved and healthcare cost savings in preventing mental disorders. Ethics and dissemination: Ethics approval was obtained from the Second Xiangya Hospital, Central South University Clinical Research Ethics Committee (2021) Ethical Review [Clinical Research] #067). Data about the economic evaluation of the intervention will be stored in the KCL OneDrive at King’s College London, UK. The trial protocol was registered with the China Clinical Trials Registry: ChiCTR2200060464. Study findings will be disseminated through peer-reviewed academic papers, and participating hospitals.
AB - Introduction: There is insufficient evidence on the effectiveness and cost-effectiveness of psychological interventions to enhance frontline responders’ mental health proficiency and competence in emergency settings. This paper describes the methods for the evaluation of the effectiveness and cost-effectiveness of Psychological First Aid training, to determine whether the intervention is effective and cost-effective as a mental health intervention in public health emergencies. A pilot to evaluate the acceptability of the PFA training found participants were either satisfied (55.6%) or extremely satisfied (44.4%) with the training program. Method: This paper describes the protocol for a cluster randomized two-arm controlled trial. A total of 1,399 non-specialist health care workers will be recruited in 42 hospitals and health care centers across six provinces in China. Participants will be assigned according to hospital or health care center site to one of two groups (n = 699 for intervention group and 709 for control group) to receive system based PFA training or PFA training as usual. Both groups will receive one-day of training, comprising six modules including PFA core concepts, knowledge, skills and practice. Their knowledge, skills, competency, self-efficacy, resilience, and professional quality of life will be assessed immediately after the training; and reassessed after 1 and 2 months. Analysis: For effectiveness outcomes, repeated measures will be used in a multi-level linear mixed model. The pooled standard deviations will be used to calculate the effect sizes (Cohen’s d) within and between groups. Appropriate statistical tests will be used to explore differences between intervention and control groups. For economic outcomes, a health service sector perspective will be adopted, with intervention costs and outcomes collected prospectively. Within-trial cost-effectiveness analysis (CEA) will quantify the incremental costs and PFA proficiency gains of the intervention compared with training as usual at 2 months post training. CEA will present results as cost per unit of mental health proficiency gained. A cost-utility analysis (CUA) model will extend the population to emergency health service users.in order to identify potential for incremental cost offsets attributable to mental health improvement arising from intervention. Intervention costs and effects will be extrapolated to the population of patients who receive the emergency health service in clinical wards and will be modeled over the cohort’s lifetime. Modeled CUA results will be calculated as quality-adjusted life-years saved and healthcare cost savings in preventing mental disorders. Ethics and dissemination: Ethics approval was obtained from the Second Xiangya Hospital, Central South University Clinical Research Ethics Committee (2021) Ethical Review [Clinical Research] #067). Data about the economic evaluation of the intervention will be stored in the KCL OneDrive at King’s College London, UK. The trial protocol was registered with the China Clinical Trials Registry: ChiCTR2200060464. Study findings will be disseminated through peer-reviewed academic papers, and participating hospitals.
KW - effectiveness evaluation
KW - emergency health services
KW - frontline health workers
KW - psychological first aid training
KW - study protocol
KW - trial cost-effectiveness analysis
UR - http://www.scopus.com/inward/record.url?scp=85145366570&partnerID=8YFLogxK
U2 - 10.3389/fpsyt.2022.1044594
DO - 10.3389/fpsyt.2022.1044594
M3 - Article
AN - SCOPUS:85145366570
SN - 1664-0640
VL - 13
JO - Frontiers in Psychiatry
JF - Frontiers in Psychiatry
M1 - 1044594
ER -