A randomised controlled trial of SOLAR-m: A low-intensity, brief, psychosocial intervention for firefighters delivered via smartphone

INTERVENTION: The Skills For Life Adjustment and Resilience (SOLAR) program is a brief, psychosocial, skills based intervention designed to promote recovery and maintain wellbeing following stressful events. SOLAR is typically delivered face‐to‐face by non‐mental health professionals. The aim of this project is to conduct a randomised controlled trial to assess whether a smartphone‐based version of the SOLAR intervention, known as SOLAR‐m, is more effective than a control app comparator. The SOLAR mobile (SOLAR‐m) app has been culturally adapted for firefighters, and participants in this RCT will be firefighters experiencing distress. The intervention period will last for five weeks, both active and control interventions will be self‐paced and will be carried out at a location(s) of each participant’s choosing, as they will be delivered entirely via smartphone app and telephone calls. Participants randomised to the Skills For Life Adjustment and Resilience (SOLAR) intervention will receive access to the SOLAR smartphone app (SOLAR‐m). SOLAR‐m consists of eight modules delivered in animations, videos, activities, and notifications, that participants can self‐complete at their own pace. The SOLAR program comprises elements drawn from evidence‐based treatments for individuals experiencing trauma‐related mental health problems. Most are focused on behavioural skill development or psychoeducation, with one module on cognitive strategies. These elements include components on psychoeducation about healthy living, information about keeping relationships healthy, values‐based behavioural activation, arousal and affective management, expressive writing to reduce arousal associated with stress or trauma, and dealing with worry and rumination. The specific contents of each module are as follows. CONDITION: Anxiety symptoms;Depression symptoms;PTSD symptoms;Work‐related performance and work‐family conflict; ; Anxiety symptoms ; Depression symptoms ; PTSD symptoms ; Work‐related performance and work‐family conflict Mental Health ‐ Anxiety Mental Health ‐ Depression Mental Health ‐ Other mental health disorders INCLUSION CRITERIA: To be eligible for the study, participants need to be a current retained (volunteer) or full‐time firefighter with Fire & Rescue NSW, aged over 18, own an internet connected smartphone and be willing to download and use an app for the duration of the study. They must also be experiencing mild to moderate distress, as assessed by the 6‐item Kessler Psychological Distress Scale (K6). If participants score between 7 and 18 on the K6 they are eligible for this study. If participants score greater than or equal to 19 on the screener, they will be eligible to participate in the SOLAR‐m trial however, they will first be offered a more structured form of clinical treatment. PRIMARY OUTCOME: Change in anxiety subscore of the Hospital Anxiety and Depression Scale (HADS) (measuring anxiety symptoms) from pre‐ (T1) to post‐intervention (T2 and T3) in the intervention group compared to the control group[At commencement of the intervention period (Time 1), 2‐4 weeks following completion of the intervention (Time 2 ‐ primary timepoint), 3 months after the intervention (Time 3)] Change in depression subscore of the Hospital Anxiety and Depression Scale (HADS) (measuring depression symptoms) from pre‐ (T1) to post‐intervention (T2 and T3) in the intervention group compared to the control group[At commencement of the intervention period (Time 1), 2‐4 weeks following completion of the intervention (Time 2 ‐ primary timepoint), 3 months after the intervention (Time 3)] Change in PTSD Checklist for DSM‐5 (PCL‐5) score (measuring PTSD symptoms) from pre‐ (T1) to post‐intervention (T2 and T3) in the intervention group compared to the control group[At commencement of the intervention period (Time 1), 2‐4 weeks following completion of the intervention (Time 2 ‐ primary timepoint), 3 months after the intervention (Time 3)] SECONDARY OUTCOME: Change in Health and Work Performance Questionnaire (HPQ) score (measuring the workplace cost of health problems) from pre‐ (T1) to post‐intervention (T2 and T3) in the intervention group compared to the control group[At commencement of the intervention period (Time 1), 2‐4 weeks following completion of the intervention (Time 2), 3 months after the intervention (Time 3)] Change in Work Family Conflict (WFC) score (measuring work‐family conflict) from pre‐ (T1) to post‐intervention (T2 and T3) in the intervention group compared to the control group[At commencement of the intervention period (Time 1), 2‐4 weeks following completion of the intervention (Time 2), 3 months after the intervention (Time 3)] Credibility Expectancy Questionnaire (CEQ‐II) score (measuring treatment expectations) in the intervention group compared to the control group[At commencement of the intervention period (Time 1)]