Mental Health in First Responders and Military Personnel: Is Physical Activity A Viable Option?

UNSTRUCTURED First-responders (e.g. police, firefighters, paramedics) are at high risk of experiencing poor mental health. Physical activity interventions can help reduce symptoms and improve mental health in this group. More research is however needed to evaluate accessible, low cost ways of delivering programs. Social media may be a potential platform for delivering group-based physical activity interventions. We co-designed a 10-week online physical activity program delivered via a private Facebook group. We provided education and motivation around different weekly topics (e.g. goal setting and reducing sedentary behaviour) and provided participants with a Fitbit. We aimed to examine the feasibility and acceptability of the program for first-responders and a nominated informal caregiver to participate with them. We also explored the impact on mental health symptoms, sleep quality, quality of life and physical activity levels. A multiple time series design was applied to assess levels of psychological distress, with participants acting as their own control prior to the intervention. Twenty-four participants (n=12 first responders and n=12 nominated support partners) were recruited and 88% (n=21) completed the post assessment questionnaires. High acceptability was observed in the qualitative interviews. Exploratory analyses found significant reductions in psychological distress across the intervention. Pre and post analysis showed significant improvements in quality of life (Cohen’s d=0.603), total depression, anxiety and stress scores (d=0.354) and minutes of walking (d=0.549). Changes in perceived social support to exercise and sleep quality were not significant. The results provide preliminary support for the use of social media and a multiple-time series design to deliver mental health informed physical activity interventions for first-responders and their informal caregivers.

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Supplemental Material for Association Between Physical Activity and Mental Health Among First Responders With Different Service Roles

Psychological Trauma Theory Research Practice and Policy ◽

10.1037/tra0000971.supp ◽

2020 ◽

Keyword(s):

Mental Health ◽

Physical Activity ◽

First Responders

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Mental health informed physical activity for first responders and their support partner: a protocol for a stepped-wedge evaluation of an online, codesigned intervention

BMJ Open ◽

10.1136/bmjopen-2019-030668 ◽

2019 ◽

Vol 9 (9) ◽

pp. e030668 ◽

Cited By ~ 2

Author(s):

Grace McKeon ◽

Zachary Steel ◽

Ruth Wells ◽

Jill M Newby ◽

Dusan Hadzi-Pavlovic ◽

...

Keyword(s):

Quality Of Life ◽

Mental Health ◽

Physical Activity ◽

Post Traumatic Stress Disorder ◽

Traumatic Stress ◽

Stress Disorder ◽

First Responders ◽

Post Traumatic Stress ◽

Post Traumatic

BackgroundFirst responders (police, fire and ambulance officers) are at a significantly increased risk of experiencing poor mental health, including depression and post-traumatic stress disorder. These conditions are associated with high rates of cardiovascular disease, in part due to low levels of physical activity (PA) and high levels of sedentary behaviour. Using a person’s social support system may be an effective solution to help increase PA levels to improve mental and physical health outcomes. We will examine the efficacy of a group-based online intervention in increasing PA in first responders and their support partners, iteratively codesigned with advisors with lived experience of mental illness among first responders.MethodsThis study will recruit a convenience sample of self-identified sedentary first responders and their self-selected support partners to a 10-week PA programme delivered through a private Facebook group. We will deliver education on predetermined topics related to PA and diet and provide participants with an activity tracker (Fitbit). A stepped-wedged design will be applied to compare multiple baselines to intervention and follow-up phases within subjects. Five cohorts of n=20 will be recruited, with each cohort randomised to a different baseline length. Our primary outcome will be psychological distress (Kessler-6). Secondary outcomes include feasibility, self-report and objective PA data (Simple Physical Activity Questionnaire and Fitbit accelerometry), depression and anxiety (Depression Anxiety and Stress Scale-21 items), post-traumatic stress disorder symptoms (PTSD Checklist for DSM-5), quality of life Assessment of Quality of Life-6 dimensions, sleep quality (The Pittsburgh Sleep Quality Index), suicidal ideation (Suicidal Ideation Attributes Scale) and social support for exercise. The mobile data collection platform MetricWire will be used.Ethics and disseminationEthical approval was obtained from the University of New South Wales, Deupty Vice-Chancellor Research, Human Research Ethics Committee on 3 June 2019, HC180561. Findings will be published in peer-reviewed journals and disseminated at national conferences.Trial registration numberACTRN12619000877189.

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A Mental Health–Informed Physical Activity Intervention for First Responders and Their Partners Delivered Using Facebook: Mixed Methods Pilot Study

JMIR Formative Research ◽

10.2196/23432 ◽

2021 ◽

Vol 5 (4) ◽

pp. e23432

Author(s):

Grace McKeon ◽

Zachary Steel ◽

Ruth Wells ◽

Jill Newby ◽

Dusan Hadzi-Pavlovic ◽

...

Keyword(s):

Mental Health ◽

Physical Activity ◽

Time Series ◽

First Responders ◽

Multiple Time ◽

Multiple Time Series ◽

Physical Activity Interventions ◽

Series Design ◽

Time Series Design

Background First responders (eg, police, firefighters, and paramedics) are at high risk of experiencing poor mental health. Physical activity interventions can help reduce symptoms and improve mental health in this group. More research is needed to evaluate accessible, low-cost methods of delivering programs. Social media may be a potential platform for delivering group-based physical activity interventions. Objective This study aims to examine the feasibility and acceptability of delivering a mental health–informed physical activity program for first responders and their self-nominated support partners. This study also aims to assess the feasibility of applying a novel multiple time series design and to explore the impact of the intervention on mental health symptoms, sleep quality, quality of life, and physical activity levels. Methods We co-designed a 10-week web-based physical activity program delivered via a private Facebook group. We provided education and motivation around different topics weekly (eg, goal setting, overcoming barriers to exercise, and reducing sedentary behavior) and provided participants with a Fitbit. A multiple time series design was applied to assess psychological distress levels, with participants acting as their own control before the intervention. Results In total, 24 participants (12 first responders and 12 nominated support partners) were recruited, and 21 (88%) completed the postassessment questionnaires. High acceptability was observed in the qualitative interviews. Exploratory analyses revealed significant reductions in psychological distress during the intervention. Preintervention and postintervention analysis showed significant improvements in quality of life (P=.001; Cohen d=0.60); total depression, anxiety, and stress scores (P=.047; Cohen d=0.35); and minutes of walking (P=.04; Cohen d=0.55). Changes in perceived social support from family (P=.07; Cohen d=0.37), friends (P=.10; Cohen d=0.38), and sleep quality (P=.28; Cohen d=0.19) were not significant. Conclusions The results provide preliminary support for the use of social media and a multiple time series design to deliver mental health–informed physical activity interventions for first responders and their support partners. Therefore, an adequately powered trial is required. Trial Registration Australian New Zealand Clinical Trials Registry (ACTRN): 12618001267246; https://anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12618001267246.

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