DOI: 10.3886/icpsr38816.v1
title: Protecting the Mental and Physical Well-Being of Frontline Healthcare Workers During COVID-19, United States, 2021-2022
title: Version 1

description: This study sought to test whether Stress First Aid Sites (SFA) improves the well-being of health care workers (HCWs) compared with care as usual for HCWs who deliver care in hospital and ambulatory health center settings. Researchers conducted interviews with site leadership, site champions, and HCWs to describe the experiences of HCWs receiving the training, as well as to understand the resources available in usual care and how SFA was implemented.
description: The goal of this study was to support the mental and physical well-being of United States health care workers (HCWs) during the COVID-19 pandemic to ensure high-quality care for patients with the use of Stress First Aid Sites (SFA). The study also sought to establish the effectiveness of a tailored SFA intervention, compared with usual care (UC). Its three specific aims were to:

Test the effect of SFA versus UC (i.e., psychosocial support the hospitals/health centers already provide) on mental and physical well-being (quantitative)
Understand and document any UC activities to support HCW well-being prior to implementing SFA across sites (qualitative)
Assess the experiences of HCWs with SFA (e.g., acceptability, likelihood of uptake, lessons learned) and impact on HCW well-being (qualitative)
description: Researchers used a mixed methods approach that included a quantitative component designed as a cluster randomized controlled trial (cRCT) and a qualitative component designed as a complementary descriptive study. The cRCT was comprised of three cohorts of matched pairs representing diverse health care sites (hospitals and health centers) to determine whether Stress First Aid (SFA) for frontline health care workers (HCWs) improves mental and physical well-being compared to usual care (UC). Sequential roll-out of the intervention to three cohorts allowed researchers to incorporate lessons learned between cohorts and stakeholder feedback from each iteration into subsequent trainings, and to share actionable findings with site leadership given the urgency of the psychosocial effects of the ongoing pandemic. Each recruited site involved leadership and HCWs. Intervention sites implementing SFA identified a site champion or multiple champions who trained their peers using a train-the-trainer approach.


The quantitative component included an assessment of the primary outcomes (general psychological distress and post-traumatic stress disorder (PTSD)), based on established survey questions, as well as secondary outcomes (depression, anxiety, fatigue, sleep impairment, and social roles/activities), captured by a HCW survey at both the SFA and UC sites before and after the intervention period. Researchers also collected some patient mortality, quality, and safety measures from hospitals at the aggregate level.


The user guide included in this study indicates qualitative data were collected. These data were not made available for archiving, and it is not known when these data might be made available.
description: Data file 3 (Outcome Variables - Weighted) contains the variable <strong>W</strong> (Nonresponse Weight).
description: Presence of Common Scales: 
Kessler 6 (K-6)


Post-Traumatic Stress Disorder (PTSD) Checklist (PCL-5)


Patient-Reported Outcomes Information Measurement System (PROMIS)-29 subscale


American Psychological Association's Stress in the Workplace Survey


Dolan Single Item Burnout Inventory


Brief version of the Connor-Davidson Resilience Scale (CD-RISC-2)


Moral Distress Thermometer


COVID-19 Experience


Demographics


Professional Characteristics


Patient Quality and Safety Measures


Hospital Consumer Assessment of Health Providers and Systems (HCAHPS) 9 for hospitals and Clinician and Group Consumer Assessment of Health Providers and Systems (CGCAHPS)
description: Researchers partnered with Vizient and Clinical Directors Network (CDN) to recruit and engage sites in the study. Vizient recruited eight pairs of hospitals, and CDN recruited six pairs of health centers. Vizient recruited members from their organization using targeted emails, supplemented by a live webinar (which was recorded and posted for members). CDN reached out to health centers and also used a listserv. Both organizations had access to a one-page description of the study and slide set developed for this project, which contained the same content but were tailored for each organization. Each recruited site was asked to identify leaders, site champions, and ultimately health care workers (HCWs).


Recruitment started in Fall 2020 and continued until the third wave began in October 2021. Interested sites were eligible for any of the three waves, depending on the project needs to ensure balance across region and by other characteristics (e.g., academic status, size) and site preference given other competing demands. For example, some sites were initially interested during recruitment but requested delaying to a later cohort if they did not have bandwidth due to pandemic surges. While there was no formal stratification by region or other characteristics, recruitment in later waves was purposive to ensure some geographic and academic status diversity.


Sites recruited by CDN were paid $10,000 for participation, which is consistent with prior project approaches (including Patient-Centered Outcomes Research Institute (PCORI)-funded projects). This amount was paid regardless of whether the health center was recruited to Stress First Aid (SFA) or usual care (UC). Sites recruited by Vizient were not paid an honorarium. In addition, Vizient and CDN arranged for continuing medical education (CME)/continuing nursing education (CNE) credit as an incentive for all site champions and HCWs participating in the training workshop at the SFA sites. This amounted to two credits for site champions who participated in a two-hour train-the-trainer workshop and one credit for HCWs who participated in the one-hour local workshop provided by the site champions. HCWs at UC sites did not receive SFA or CME/CNE, unless they opted to adopt training after the intervention was completed. All UC sites were invited to a post-study period training for SFA; HCWs from seven hospitals and four health centers attended.
description: Datasets: 
DS0: Study-Level Files
DS1: Pre-Intervention Survey and Post-Intervention Survey Data
DS2: Outcome Variables
DS3: Outcome Variables - Weighted
DS4: Exposure Variables From Attendance Data
description: Health care workers in the United States.
description: computer-assisted personal interview (CAPI)The user guide included in this study indicates qualitative data were collected. These data were not made available for archiving, and it is not known when these data might be made available.