Expressive Writing for COVID-19 Resilience

Study Overview
=================
Brief Summary
-----------------
The purpose of this study is to determine the impact of a 6-week, virtually-delivered expressive writing intervention on resilience in a cohort of individuals currently navigating the COVID-19 pandemic during spring 2020.

Detailed Description
-----------------
The purpose of this study is to determine the impact of a 6-week, virtually-delivered expressive writing intervention on resilience in a cohort of individuals currently navigating the COVID-19 pandemic during spring 2020. Eligible subjects will be adults who are able to read and write in English and are cognitively able to provide informed consent. Potential subjects will be recruited through the Duke Health & Well-Being email lists. The entirely virtual 6-week expressive writing intervention will be delivered via Zoom, REDCap, and email, and subjects will complete measures at baseline, 6 weeks, and 10 weeks (1 month post-intervention). Each week of the intervention will invite participants to complete a series of expressive writing assignments designed to support emotional expression and cultivate resilience, and the assignments will take approximately 60-90 minutes each week to complete. The primary outcome is the 25-item Connor-Davidson Resilience Scale (CD-RISC). Other measures will include a basic demographics survey, questions about COVID-19 impact, post-writing surveys collected after the writing assignments, the 10-item Perceived Stress Scale (PSS), the Center for Epidemiologic Studies Depression Scale-Revised, and the 21-item Post -Traumatic Growth Inventory (PTGI). Participants will also have the option to share the content of their writing assignments with the research team if they choose. The risks of participation in this study are minimal and include the risk of mild sadness after the writing assignments and the risk of loss of confidentiality.

Official Title
-----------------
Expressive Writing for COVID-19 Resilience

Conditions
-----------------
Distress Due to COVID-19

Intervention / Treatment
-----------------
* Behavioral: Expressive writing


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Potential subjects will be considered eligible if they feel they have been personally impacted by circumstances surrounding COVID-19. Other eligibility criteria include: Able to speak, read, write, and understand English Cognitively able to provide consent Ability to participate in a 6-week intervention delivered via Zoom, REDCap, and email

Ages Eligible for Study
-----------------
Minimum Age: 18 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
Accepts Healthy Volunteers

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Supportive Care
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Expressive writing<br>The expressive writing intervention consists of a 6-week, virtually-delivered writing program. Each week, participants meet for 90 minutes via Zoom and will be guided through writing prompts designed to encourage emotional expression and enhance personal resilience. The progression of writing exercises flows as follows: Week 1: Writing to expressive difficult emotions Week 2: Writing to release & integrate difficult emotions Week 3: Writing to nurture gratitude Week 4: Writing to enhance strengths & resources Week 5: Writing to cultivate positive meaning & savor goodness Week 6: Writing to invite insight, perspective, & growth | Behavioral: Expressive writing<br>* The expressive writing intervention consists of a 6-week, virtually-delivered writing program. Each week, participants meet for 90 minutes via Zoom and will be guided through writing prompts designed to encourage emotional expression and enhance personal resilience. The progression of writing exercises flows as follows: Week 1: Writing to expressive difficult emotions Week 2: Writing to release & integrate difficult emotions Week 3: Writing to nurture gratitude Week 4: Writing to enhance strengths & resources Week 5: Writing to cultivate positive meaning & savor goodness Week 6: Writing to invite insight, perspective, & growth<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Resilience | Connor-Davidson Resilience Scale (CD-RISC) | 3 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Perceived stress | Perceived Stress Scale-10 (PSS10) | 3 months | 
| Depression symptoms | Center for Epidemiologic Studies Scale - Revised (CESDR) | 3 months | 
| Post-traumatic growth | Post Traumatic Growth Inventory (PTGI) | 3 months |