TY - JOUR
T1 - Multicentre, England-wide randomised controlled trial of the 'Foundations' smartphone application in improving mental health and well-being in a healthcare worker population
AU - Gnanapragasam, Sam N.
AU - Tinch-Taylor, Rose
AU - Scott, Hannah R.
AU - Hegarty, Siobhan
AU - Souliou, Emilia
AU - Bhundia, Rupa
AU - Lamb, Danielle
AU - Weston, Danny
AU - Greenberg, Neil
AU - Madan, Ira
AU - Stevelink, Sharon
AU - Raine, Rosalind
AU - Carter, Ben
AU - Wessely, Simon
N1 - Funding of this RCT: KOA HEALTH B.V (company number 78707838). The funder of the study had no role in study design, data collection, analysis, interpretation or writing of the report. The study was conducted by an independent research team. Funding for main NHS CHECK cohort was received from the following sources: Medical Research Council (MR/V034405/1); UCL/Wellcome (ISSF3/ H17RCO/C3); Rosetrees (M952); Economic and Social Research Council (ES/V009931/1); NHS England and NHS Improvement; as well as seed funding from National Institute for Health Research Maudsley Biomedical Research Centre, King's College London, National Institute for Health Research Health Protection Research Unit in Emergency Preparedness and Response at King's College London. This paper represents independent research part funded by Koa Health B.V, Medical Research Council and other sources noted above. The views expressed are those of the authors and not those of Koa Health B.V, the NHS, the NIHR or the Department of Health and Social Care.
Publisher Copyright:
Copyright © The Author(s), 2022. Published by Cambridge University Press on behalf of the Royal College of Psychiatrists.
PY - 2023/2/11
Y1 - 2023/2/11
N2 - Background: Healthcare workers (HCWs) have faced considerable pressures during the COVID-19 pandemic. For some, this has resulted in mental health distress and disorder. Although interventions have sought to support HCWs, few have been evaluated. Aims: We aimed to determine the effectiveness of the 'Foundations' application (app) on general (non-psychotic) psychiatric morbidity. Method: We conducted a multicentre randomised controlled trial of HCWs at 16 NHS trusts (trial registration number: EudraCT: 2021-001279-18). Participants were randomly assigned to the app or wait-list control group. Measures were assessed at baseline, after 4 and 8 weeks. The primary outcome was general psychiatric morbidity (using the General Health Questionnaire). Secondary outcomes included: well-being; presenteeism; anxiety; depression and insomnia. The primary analysis used mixed-effects multivariable regression, presented as adjusted mean differences (aMD). Results: Between 22 March and 3 June 2021, 1002 participants were randomised (500:502), and 894 (89.2%) followed-up. The sample was predominately women (754/894, 84.3%), with a mean age of 44.3 years (interquartile range (IQR) 34-53). Participants randomised to the app had a reduction in psychiatric morbidity symptoms (aMD = -1.39, 95% CI -2.05 to -0.74), improvement in well-being (aMD = 0.54, 95% CI 0.20 to 0.89) and reduction in insomnia (adjusted odds ratio (aOR) = 0.36, 95% CI 0.21 to 0.60). No other significant findings were found, or adverse events reported. Conclusions: The app had an effect in reducing psychiatric morbidity symptoms in a sample of HCWs. Given it is scalable with no adverse effects, the app may be used as part of an organisation's tiered staff support package. Further evidence is needed on long-term effectiveness and cost-effectiveness.
AB - Background: Healthcare workers (HCWs) have faced considerable pressures during the COVID-19 pandemic. For some, this has resulted in mental health distress and disorder. Although interventions have sought to support HCWs, few have been evaluated. Aims: We aimed to determine the effectiveness of the 'Foundations' application (app) on general (non-psychotic) psychiatric morbidity. Method: We conducted a multicentre randomised controlled trial of HCWs at 16 NHS trusts (trial registration number: EudraCT: 2021-001279-18). Participants were randomly assigned to the app or wait-list control group. Measures were assessed at baseline, after 4 and 8 weeks. The primary outcome was general psychiatric morbidity (using the General Health Questionnaire). Secondary outcomes included: well-being; presenteeism; anxiety; depression and insomnia. The primary analysis used mixed-effects multivariable regression, presented as adjusted mean differences (aMD). Results: Between 22 March and 3 June 2021, 1002 participants were randomised (500:502), and 894 (89.2%) followed-up. The sample was predominately women (754/894, 84.3%), with a mean age of 44.3 years (interquartile range (IQR) 34-53). Participants randomised to the app had a reduction in psychiatric morbidity symptoms (aMD = -1.39, 95% CI -2.05 to -0.74), improvement in well-being (aMD = 0.54, 95% CI 0.20 to 0.89) and reduction in insomnia (adjusted odds ratio (aOR) = 0.36, 95% CI 0.21 to 0.60). No other significant findings were found, or adverse events reported. Conclusions: The app had an effect in reducing psychiatric morbidity symptoms in a sample of HCWs. Given it is scalable with no adverse effects, the app may be used as part of an organisation's tiered staff support package. Further evidence is needed on long-term effectiveness and cost-effectiveness.
KW - epidemiology
KW - information technologies
KW - outcome studies
KW - psychosocial interventions
KW - Randomised controlled trial
UR - http://www.scopus.com/inward/record.url?scp=85147095168&partnerID=8YFLogxK
U2 - 10.1192/bjp.2022.103
DO - 10.1192/bjp.2022.103
M3 - Article
C2 - 36040419
AN - SCOPUS:85147095168
SN - 0007-1250
VL - 222
SP - 58
EP - 66
JO - British Journal of Psychiatry
JF - British Journal of Psychiatry
IS - 2
ER -