An Impact Evaluation protocol for the rapid design and delivery of an experience-based co-designed mobile app to support the mental health needs of healthcare workers impacted by COVID-19 (Preprint)

An Impact Evaluation protocol for the rapid design and delivery of an experience-based co-designed mobile app to support the mental health needs of healthcare workers impacted by COVID-19. (Preprint)

10.2196/preprints.26168 ◽

2020 ◽

Author(s):

Matthew Lewis ◽

Victoria J Palmer ◽

Aneta Kotevski ◽

Konstancja Densley ◽

Meaghan L O'Donnell ◽

...

Keyword(s):

Mental Health ◽

Impact Evaluation ◽

Qualitative Data ◽

Outcome Data ◽

Mobile App ◽

Design Development ◽

Structured Interviews ◽

Rapid Design ◽

Patient Health ◽

The Impact

BACKGROUND The COVID-19 pandemic has highlighted the central importance of health care workers’ (HCWs) mental health and wellbeing for the successful function of the health care system. Few targeted digital tools exist to support HCWs’ mental health and none appear to have been co-designed with end users. OBJECTIVE RMHive is being developed as a mobile app to support the mental health challenges being posed by COVID-19 to HCWs using experience-based co-design (EBCD) processes. We present the Impact Evaluation protocol for the rapid design and delivery of the RMHive mobile app. METHODS The Impact Evaluation will adopt a mixed-methods approach. Qualitative data from photo interviews undertaken with HCWs exploring needs and experiences, and semi-structured interviews conducted with governance stakeholders during design development and implementation will be integrated with quantitative user analytics data and user generated demographic and mental health data entered into the app. Analyses will address three evaluation questions related to: (1) engagement with and use of the mobile app; (2) implementation and integration; and (3) the quantifiable and qualitative impacts on individual mental health. The mobile app design and development will be described using the mobile health (mHealth) evidence reporting and assessment (mERA) guidelines. Implementation of the app will be evaluated using Normalisation Process Theory (NPT) as a framework to analyse qualitative data combined with text and video analysis from semi-structured interviews. Mental health impacts will be assessed using the Patient Health Questionnaire (PHQ4) total score and subscale scores for the Patient Health Questionnaire (PHQ2) for depression and Generalised Anxiety Scale (GAD2) for anxiety. The PHQ4 will be completed at download (baseline), then at 14 and 28 days. RESULTS The anticipated use period of the app is an average of 30 days. The rapid design will occur over four months using EBCD approaches to collect qualitative data and develop app content. The Impact Evaluation will monitor outcome data for up to 12 weeks following the Minimal Viable Product release. The study received funding and institutional ethics approvals in June, 2020. Outcome data is expected to be available in March, 2021 and the Impact Evaluation published mid 2021. CONCLUSIONS The Impact Evaluation will examine the rapid design, development and implementation of the RMHive app and the mental health and wellbeing outcomes for HCWs. Evaluation outcomes will provide guidance for the integration of EBCD in rapid design and implementation processes. Outcomes will inform future development and roll out of the app programmatically to support the mental health needs of HCWs more widely.

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COVID-19 pandemic: Prevalence of Perceived Stress, Anxiety, Depression, and Obsessive-Compulsive Symptoms vary among Healthcare and non-Healthcare Workers in Alberta (Preprint)

10.2196/preprints.20041 ◽

2020 ◽

Cited By ~ 1

Author(s):

Kelly Mrklas ◽

Reham Shalaby ◽

Marianne Hrabok ◽

April Gusnowski ◽

Wesley Vuong ◽

...

Keyword(s):

Mental Health ◽

Healthcare Workers ◽

High Stress ◽

Health Needs ◽

Mitigation Measures ◽

Depression Symptoms ◽

Mental Health Needs ◽

Obsessive Compulsive ◽

Obsessive Compulsive Symptoms ◽

Anxiety Depression

BACKGROUND During pandemic disease episodes, effective containment and mitigation measures that limit the disease spread, may also negatively influence psychological stability. As knowledge about the novel SARS-CoV2 and COVID-19 disease rapidly evolves, global implementation of containment and mitigation measures has varied greatly, as have the impacts on mental wellness. Assessing relevant impacts of COVID-19 on healthcare and non-healthcare workers’ mental health needs may enable us to more effectively limit or mitigate mental health impact. OBJECTIVE This study assessed the prevalence of stress, anxiety, depression and obsessive-compulsive symptoms in healthcare and non-healthcare workers subscribing to Text4Help, an evidence-based, text message service supporting Alberta residents’ mental health, during the COVID-19 pandemic. METHODS An online cross-sectional survey was used to gather demographic (age, sex, ethnicity, education, relationship, housing and employment status, employment type, and isolation status) and clinical characteristics using validated tools (self-reported stress, anxiety, depression and contamination/hand hygiene associated obsessive-compulsive symptoms). Descriptive statistics summarized respondent demographics. Chi square analysis was used to compare healthcare to non-healthcare workers’ clinical characteristics. Post hoc analysis was conducted on variables with >3 response categories using adjusted residuals. We performed correlation analysis prior to logistic regression to determine the association between worker type and likelihood of respondent moderate to high stress, likely GAD and MDD, while controlling for other variables. RESULTS Overall, 8 267 surveys were submitted by 44 992 Text4Hope subscribers (19.39%). Of 5 990 employed respondents (72.5%), 958 (11.6 reported being unemployed, 454 (5.5%) were students, 559 (6.8%) were retired and 72 (0.9%) did not indicate their employment status. Most survey respondents in the employed category were female (86.2%, n=4 621). Six-week prevalence in the general sample for moderate/severe stress, anxiety, and depression symptoms was 85.6%, 47.0%, 44.0%, respectively. Self-reported moderate/high stress, anxiety and depression symptoms were all statistically significantly higher in non-healthcare than healthcare workers (p<0.001). The prevalence of obsessive-compulsive characteristics (worry about contamination and compulsive handwashing behavior) after pandemic onset was statistically significantly higher in non-healthcare than healthcare workers (p<0.001); however, the prevalence of healthcare worker worry about contamination and handwashing was statistically significantly higher than non-healthcare workers before the COVID-19 pandemic began (p<0.001). CONCLUSIONS Measurement of prevalent stress, anxiety, depression and obsessive-compulsive symptoms in healthcare and non-healthcare workers may enhance our understanding of mental health needs in the COVID-19 pandemic. Further investigation will be necessary to understand more fully the relationship between worker type, outbreak phase, work context, and mental health changes over time. Findings underscore the importance of anticipating and mitigating mental health effects using integrated confinement/mitigation implementation strategies, and demonstrate the ease of safely and rapidly assessing mental health needs using a voluntary participation text messaging platform, during a pandemic.

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Recommended Modifications and Applications of the Hospital Emergency Incident Command System for Hospital Emergency Management

Prehospital and Disaster Medicine ◽

10.1017/s1049023x00002740 ◽

2005 ◽

Vol 20 (5) ◽

pp. 290-300 ◽

Cited By ~ 25

Author(s):

Jeffrey L. Arnold ◽

Louise-Marie Dembry ◽

Ming-Che Tsai ◽

Nicholas Dainiak ◽

Ülküen Rodoplu ◽

...

Keyword(s):

Mental Health ◽

Information Technology ◽

Emergency Management ◽

Emergency Response ◽

Healthcare Workers ◽

Health Needs ◽

Mental Health Needs ◽

Hospital Emergency ◽

Incident Command System ◽

Incident Command

AbstractThe Hospital Emergency Incident Command System (Hospital Emergency Incident Command System), nowin its third edition, has emerged asa popular incident command system model for hospital emergency response in the United States and other countries. Since the inception of the Hospital Emergency Incident Command System in 1991, several events have transformed the requirements of hospital emergency management, including the 1995 Tokyo Subway sarin attack, the 2001 US anthrax letter attacks, and the 2003 Severe Acute Respiratory Syndrome (Severe Acute Respiratory Syndrome) outbreaks in eastern Asia and Toronto, Canada.Several modifications of the Hospital Emergency Incident Command System are suggested to match the needs of hospital emergency management today, including: (1) an Incident Consultant in the Administrative Section of the Hospital Emergency Incident Command System to provide expert advice directly to the Incident Commander in chemical, biological, radiological, nuclear (CBRN) emergencies as needed, as well as consultation on mental health needs; (2) new unit leaders in the Operations Section to coordinate the management of contaminated or infectious patients in chemical, biological, radiological, nuclear emergencies; (3) new unit leaders in theOperations Section to coordinate mental health support for patients, guests, healthcare workers, volunteers, anddependents in terrorismrelated emergencies or events that produce significant mental health needs; (4) a new Decedent/Expectant Unit Leader in the Operations Section to coordinate the management of both types ofpatients together; and (5) a new Information Technology Unit Leader in the Logistics Section to coordinate the management of information technology and systems.New uses of the Hospital Emergency Incident Command System in hospital emergency management also are recommended, including: (1) the adoption of the Hospital Emergency Incident Command System as the conceptual framework for organizing all phases of hospital emergency management, including mitigation, preparedness, response, and recovery; and (2) the application of the Hospital Emergency Incident Command System not only to healthcare facilities, but also to healthcare systems.Finally, three levels of healthcare worker competencies in the Hospital Emergency Incident Command Systemare suggested: (1) basic understanding of the Hospital Emergency Incident Command System for all hospital healthcare workers; (2) advanced understanding and proficiency in the Hospital Emergency Incident Command Systemfor hospital healthcare workers likely to assume leadership roles in hospital emergency response; and (3) special proficiency in constituting the Hospital Emergency Incident Command System ad hoc from existing healthcare workers in resource-deficient settings. The Hospital Emergency Incident Command System should be viewed asa work in progress that will mature as additional challenges arise and ashospitals gain further experience with its use.

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