Stress and Recovery in Frontline COVID-19 Workers

Study Overview
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Brief Summary
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The novel coronavirus (COVID-19) pandemic has caused an unprecedented stress on healthcare systems in affected countries, and in particular, on the healthcare workers at the frontline working directly with COVID-19 positive patients. Numerous lines of evidence support the damaging impact of stress on our immune systems which increases susceptibility to infection. Yet, the accurate measurement of immediate stress responses in real time and in naturalistic settings has so far been a challenge, limiting our understanding of how different facets of acute or sustained stress increases susceptibility. This study utilizes wearable technologies including an Oura smart ring as well as semi-continuous passive and active biometric measurements carried out using individuals' own smartphones equipped with applications to track and transmit key data to measure frontline workers stress and recovery during a uniquely stressful and high-risk work environment.

Official Title
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Stress and Recovery in Frontline Healthcare COVID-19 Workers: A Feasibility Study Using Wearable and Smartphone Devices

Conditions
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Covid19, Stress, Wearables

Intervention / Treatment
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* Behavioral: Lifestyle (Meditation)
* Behavioral: Lifestyle (Exercise)


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Healthcare workers working directly with COVID-19 patients, or whose work routines have been shifted from COVID-19 Age over 18 years Able to speak, write and read English, given the app will be available only in English Able to provide informed consent Have a personal IOS mobile phone (OS11 and above). Own a personal wearable device including a Fitbit, Garmin, or Oura ring (BYOD arm only) Exclusion Criteria: - Prior COVID-19 infection

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Screening
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: All Interested and enrolled participants in the main Stress and Recovery were invited to participate in a lifestyle intervention arm. Participants were instructed to self-select into either a physical activity arm, or a meditation arm. Participants were excluded if they were already partaking in both regular physical exercise, and meditation.
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: Lifestyle Intervention Group (Exercisers)<br>All Interested and enrolled participants in the main Stress and Recovery were invited to participate in a lifestyle intervention arm. Participants were instructed to self-select into either a physical activity arm, or a meditation arm. Participants were excluded if they were already partaking in both regular physical exercise, and meditation. Those in the meditation arm (exercisers) were instructed to complete meditation sessions from the smartphone app, Headspace, 2 or more times a week for a duration of 4 weeks. | Behavioral: Lifestyle (Meditation)<br>* Those in the meditation arm (exercisers) were instructed to complete meditation sessions from the smartphone app, Headspace 2 or more times a week for a duration of 4 weeks.<br>|
| Other: Lifestyle Intervention Group (Meditators)<br>All Interested and enrolled participants in the main Stress and Recovery were invited to participate in a lifestyle intervention arm. Participants were instructed to self-select into either a physical activity arm, or a meditation arm. Participants were excluded if they were already partaking in both regular physical exercise, and meditation. Those in the physical activity arm (meditators) were instructed to complete 30 minutes to 1 hour of physical activity for 2 or more sessions per week for 4 weeks. | Behavioral: Lifestyle (Exercise)<br>* Those in the physical activity arm (meditators) were instructed to complete 30 minutes to 1 hour of physical activity for 2 or more sessions per week for 4 weeks.<br>|
| No Intervention: Garmin wearable arm<br>Existing stress and recovery participants were invited to participate in a Garmin wearable arm where they were provided a Garmin Vivoactive 4 smartwatch to wear continuously, and in particular, while they were on shift at work for a total of 4 consecutive weeks. | |
| No Intervention: Hair cortisol arm<br>Interested existing stress and recovery participants were invited to participate in a one time hair sample collection for cortisol analysis. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Study Retention | Proportion of participants completing the study | 4 months | 
| Daily survey/task adherence | Average completion of daily app-based surveys/tasks | 4 months | 
| Oura adherence | Average usage of the Oura smartring during study follow-up | 4 months | 
| Garmin adherence | Average usage of the Garmin smartwatch during study follow-up | 4 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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stress, frontliner, covid19, wearables