Digital Interventions for Detection and Reduction of Moral Distress

Study Overview
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Brief Summary
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Stress, anxiety, distress and depression are exceptionally high among healthcare workers at the frontline of the COVID-19 pandemic. Factors underlying distress and resilience are unknown and there are no evidence based interventions to impact the mental wellbeing of frontline healthcare workers. This study will evaluate a novel virtual reality platform to gather the distress experience of frontline healthcare workers at Unity Health Toronto in real time during the ongoing COVID pandemic by developing and showing feasibility of digital technology (Virtual Reality (VR) and mobile app) as a digital platform to understand the causes and ultimately reduce the moral distress of healthcare providers during the COVID-19 pandemic. The project will develop innovations which can be used for future pandemics and other contexts prone to producing moral distress and injury.

Official Title
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Could Digital Interventions Help Understand And Flatten The Curve Of Distress Due To Moral Injury Among Health Care Workers During The COVID Pandemic?

Conditions
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Moral Injury, Distress, Emotional

Intervention / Treatment
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* Other: Educational moral injury video


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Staff or healthcare providers working at Unity Health Toronto 18 years of age or older Must own a mobile phone running Android Version 6.0 and higher, or an iPhone 6 running OS 14 and higher) Exclusion Criterion: - Non-Unity Health Toronto staff

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: Other
Intervention Model: Single Group Assignment
Interventional Model Description: Users will go through a VR experiment before and after a brief interventional informative video describing moral distress. The VR experiment is a simulation that will lead the participant through a stressful experience about moral distress during the COVID-19 pandemic. Before, during, and after the experiment, active and physiological data will be collected from the participant to monitor their level of acute distress and health, respectively. Following the experiment, active and passive data will be collected on each user through the investigators' mobile platform (DiiG) for longitudinal monitoring of moral distress and injury.
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Experimental Arm<br>VR simulation exercise with a digital follow-up component to help assess the physiological and psychological indicators of moral distress | Other: Educational moral injury video<br>* Educational video that addresses the identification of moral injury and distress in frontline healthcare workers during COVID-19; offers available interventions at the levels of individual, team and organization<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Feasibility evaluation of the virtual reality environment | The primary outcome measure will be a comparison of MIOS (Moral Injury Outcome Scale) and PSS (Perceived Stress Scale) scores before and after watching an educational video on moral injury; feasibility of this platform will be assessed based on a feasibility questionnaire and changes in score. | 60 minutes (during the intervention) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Feasibility evaluation of a mobile platform to understand the continuum of stress and moral distress. | Feasibility of the mobile platform will be measured based on dropout rate | Up to 8 weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Stress, Loneliness, Depression, Anxiety, Moral Injury, Moral Distress