Background: Health and social care staff are at high risk of experiencing adverse mental health (MH) outcomes during the COVID-19 pandemic. Hence, there is a need to prioritize and identify ways to effectively support their psychological well-being (PWB). Compared to traditional psychological interventions, digital psychological interventions are cost-effective treatment options that allow for large-scale dissemination and transcend social distancing, overcome rurality, and minimize clinician time. Objective: This study reports MH outcomes of a Consolidated Standards of Reporting Trials (CONSORT)-compliant parallel-arm pilot randomized controlled trial (RCT) examining the potential usefulness of an existing and a novel digital psychological intervention aimed at supporting psychological health among National Health Service (NHS) staff working through the COVID-19 pandemic. Methods: NHS Highland (NHSH) frontline staff volunteers (N=169) were randomly assigned to the newly developed NHSH Staff Wellbeing Project (NHSWBP), an established digital intervention (My Possible Self [MPS]), or a waitlist (WL) group for 4 weeks. Attempts were made to blind participants to which digital intervention they were allocated. The interventions were fully automated, without any human input or guidance. We measured 5 self-reported psychological outcomes over 3 time points: before (baseline), in the middle of (after 2 weeks), and after treatment (4 weeks). The primary outcomes were anxiety (7-item General Anxiety Disorder), depression (Patient Health Questionnaire), and mental well-being (Warwick-Edinburgh Mental Well-being Scale). The secondary outcomes included mental toughness (Mental Toughness Index) and gratitude (Gratitude Questionnaire-6). Results: Retention rates mid- and postintervention were 77% (n=130) and 63.3% (n=107), respectively. Postintervention, small differences were noted between the WL and the 2 treatment groups on anxiety (vs MPS: Cohen d=0.07, 95% CI –0.20 to 0.33; vs NHSWBP: Cohen d=0.06, 95% CI –0.19 to 0.31), depression (vs MPS: Cohen d=0.37, 95% CI 0.07-0.66; vs NHSWBP: Cohen d=0.18, 95% CI –0.11 to 0.46), and mental well-being (vs MPS: Cohen d=–0.04, 95% CI –0.62 to –0.08; vs NHSWBP: Cohen d=–0.15, 95% CI –0.41 to 0.10). A similar pattern of between-group differences was found for the secondary outcomes. The NHSWBP group generally had larger within-group effects than the other groups and displayed a greater rate of change compared to the other groups on all outcomes, except for gratitude, where the rate of change was greatest for the MPS group. Conclusions: Our analyses provided encouraging results for the use of brief digital psychological interventions in improving PWB among health and social care workers. Future multisite RCTs, with power to reliably detect differences, are needed to determine the efficacy of contextualized interventions relative to existing digital treatments. Trial Registration: ISRCTN Registry (ISRCTN) ISRCTN18107122; https://www.isrctn.com/ISRCTN18107122

中文翻译：

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在 COVID-19 大流行期间支持 NHS 工作人员心理健康的简短数字干预：3 臂试点随机对照试验

背景：在 COVID-19 大流行期间，卫生和社会护理人员面临心理健康 (MH) 不良后果的高风险。因此，需要优先考虑和确定有效支持他们的心理健康（PWB）的方法。与传统的心理干预相比，数字心理干预是具有成本效益的治疗选择，可以进行大规模传播并超越社会距离，克服农村，并最大限度地减少临床医生的时间。客观的：本研究报告了符合综合报告试验标准 (CONSORT) 的平行试验随机对照试验 (RCT) 的 MH 结果，该试验检验了旨在支持国民健康服务中心理健康的现有和新型数字心理干预的潜在用途。 NHS) 工作人员应对 COVID-19 大流行。方法：NHS 高地 (NHSH) 一线员工志愿者 (N=169) 被随机分配到新开发的 NHSH 员工福利项目 (NHSWBP)、已建立的数字干预 (我可能的自我 [MPS]) 或 4 人的候补名单 (WL) 组周。尝试使参与者失明，他们被分配到哪些数字干预。干预是完全自动化的，无需任何人工输入或指导。我们在 3 个时间点测量了 5 个自我报告的心理结果：治疗前（基线）、治疗中（2 周后）和治疗后（4 周）。主要结果是焦虑（7 项一般焦虑障碍）、抑郁（患者健康问卷）和心理健康（Warwick-Edinburgh 心理健康量表）。次要结果包括心理韧性（Mental Toughness Index）和感恩（Gratitude Questionnaire-6）。结果：干预中期和干预后的保留率分别为 77% (n=130) 和 63.3% (n=107)。干预后，WL 和 2 个治疗组在焦虑方面的差异很小（vs MPS：Cohen d = 0.07, 95% CI –0.20 至 0.33；vs NHSWBP：Cohen d =0.06, 95% CI –0.19 至 0.31），抑郁症（相对于 MPS：Cohen d =0.37, 95% CI 0.07-0.66；相对于 NHSWBP：Cohen d =0.18, 95% CI –0.11 至 0.46）和心理健康（相对于 MPS：Cohen d =–0.04, 95 % CI –0.62 至 –0.08；对比 NHSWBP：Cohen d=–0.15, 95% CI –0.41 至 0.10)。对于次要结果，发现了类似的组间差异模式。NHSWBP 组通常比其他组具有更大的组内效应，并且与其他组相比，在所有结果上显示出更大的变化率，除了感恩，其中 MPS 组的变化率最大。结论：我们的分析为使用简短的数字心理干预改善卫生和社会护理工作者的 PWB 提供了令人鼓舞的结果。未来的多中心 RCT 需要能够可靠地检测差异，以确定情境化干预相对于现有数字治疗的有效性。试用注册：ISRCTN 注册中心 (ISRCTN) ISRCTN18107122；https://www.isrctn.com/ISRCTN18107122