Self-Reflection Resilience-Recovery Activity Promotion Training for Emergency Medical Service Clinicians: A Randomized Controlled Pilot Trial of a Novel Digital Intervention
Abstract
Emergency medical service clinicians face significant mental health risk. This randomized controlled pilot trial examined 1) feasibility, acceptability, and adoptability of Self-Reflection Resilience-Recovery Activity Promotion Training (SRR-RAPT); 2) SRR-RAPT's effect on hypothesized mechanisms of action (HMAs: meaning made from stressors, adaptive self-reflection, recovery activities, recovery experiences); and 3) SRR-RAPT's impact on mental health outcomes (MHOs: PTSD, anxiety, depression). Participants were ≥18 years with ≥1 shift scheduled within 8 days. Overall, 83/126 workers were eligible and randomized to intervention (n = 37) or control (n = 46). Most were White (89%) and male (51%). Both groups completed 8 daily assessments monitoring HMAs/MHOs. Intervention participants received 10 additional reflection questions on stressors, lessons learned, and recovery strategies. We recruited >80% of respondents within 3-weeks; 70/83 submitted ≥1 complete assessment (M = 6.07, SD = 2.20); SRR-RAPT was rated helpful, useful, and acceptable. The intervention group reported more meaning made across assessments (b = 1.46, 95% CI = 0.17, 2.75, p = .027) and higher levels on each subsequent assessment (b = 0.35, 95% CI = 0.16, 0.53, p < .001). Higher adherence predicted more meaning made across assessments (b = 1.53, 95% CI = 0.03, 1.02, p = .039) and higher levels on each subsequent assessment (b = 0.13, 95% CI = 0.06, 0.20, p < .001). No significant differences were detected on other HMAs or MHOs. Results support the intervention's feasibility and acceptability, but refinement is necessary to detect expected differences on all HMAs/MHOs before definitive trials.
Versions
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BibTeX
@misc{hruska2026selfreflection,
title = {{Self-Reflection Resilience-Recovery Activity Promotion Training for Emergency Medical Service Clinicians: A Randomized Controlled Pilot Trial of a Novel Digital Intervention}},
author = {Bryce Hruska and Bernard Appiah and Collins Annor and maria pacella and Marley S. Barduhn},
howpublished = {PsyArXiv},
year = {2026},
month = sep,
doi = {10.31234/osf.io/qfndj_v2},
url = {https://osf.io/preprints/psyarxiv/qfndj_v2/},
note = {CC BY 4.0},
}
RIS
TY - UNPB
TI - Self-Reflection Resilience-Recovery Activity Promotion Training for Emergency Medical Service Clinicians: A Randomized Controlled Pilot Trial of a Novel Digital Intervention
AU - Bryce Hruska
AU - Bernard Appiah
AU - Collins Annor
AU - maria pacella
AU - Marley S. Barduhn
PY - 2026
DA - 2026/09/09
PB - PsyArXiv
DO - 10.31234/osf.io/qfndj_v2
UR - https://osf.io/preprints/psyarxiv/qfndj_v2/
AB - Emergency medical service clinicians face significant mental health risk. This randomized controlled pilot trial examined 1) feasibility, acceptability, and adoptability of Self-Reflection Resilience-Recovery Activity Promotion Training (SRR-RAPT); 2) SRR-RAPT's effect on hypothesized mechanisms of action (HMAs: meaning made from stressors, adaptive self-reflection, recovery activities, recovery experiences); and 3) SRR-RAPT's impact on mental health outcomes (MHOs: PTSD, anxiety, depression). Participants were ≥18 years with ≥1 shift scheduled within 8 days. Overall, 83/126 workers were eligible and randomized to intervention (n = 37) or control (n = 46). Most were White (89%) and male (51%). Both groups completed 8 daily assessments monitoring HMAs/MHOs. Intervention participants received 10 additional reflection questions on stressors, lessons learned, and recovery strategies. We recruited >80% of respondents within 3-weeks; 70/83 submitted ≥1 complete assessment (M = 6.07, SD = 2.20); SRR-RAPT was rated helpful, useful, and acceptable. The intervention group reported more meaning made across assessments (b = 1.46, 95% CI = 0.17, 2.75, p = .027) and higher levels on each subsequent assessment (b = 0.35, 95% CI = 0.16, 0.53, p < .001). Higher adherence predicted more meaning made across assessments (b = 1.53, 95% CI = 0.03, 1.02, p = .039) and higher levels on each subsequent assessment (b = 0.13, 95% CI = 0.06, 0.20, p < .001). No significant differences were detected on other HMAs or MHOs. Results support the intervention's feasibility and acceptability, but refinement is necessary to detect expected differences on all HMAs/MHOs before definitive trials.
ER -