CARE Study for Paramedics in Singapore

Cognitive Training And Resilience Education (CARE) for Paramedics on the Frontlines of the COVID-19 Epidemic: A Randomised Controlled Trial in Singapore

The purpose of this study is to compare the effectiveness of two different online education courses (Oxford-Online and Mind-Online) for preventing stress related conditions among paramedics who have been working during a period of COVID-19 occurrence in Singapore.

The study aims to:

• Compare the efficacy of a locally-adapted version of internet-delivered cognitive training for resilience (Oxford Online) to an existing educational online training (Mind Online) on depressive symptom severity
• Compare the efficacy of Oxford Online to Mind Online for improving posttraumatic stress symptoms, resilience, general psychological distress, anxiety symptoms, social support, work engagement, and health-related quality of life

Participants will:

• Complete an online battery of baseline questionnaires
• Be randomised to receive 6 modules of either Oxford Online or Mind Online, delivered once per week over a 6-week period
• Complete the same online questionnaire battery immediately following the intervention, and again at the 6-month and 12-month follow up

Aim 1 (Primary): To compare the efficacy of a locally-adapted version of internet-delivered cognitive training for resilience (Oxford Online) to an existing educational online training (Mind Online) on depressive symptom severity in a sample of paramedics recruited during the COVID-19 pandemic in Singapore.

Aim 2 (Secondary): To compare the efficacy of Oxford-Online to Mind-Online for improving posttraumatic stress symptoms, resilience, general psychological distress, anxiety symptoms, social support, work engagement, and health-related quality of life in a sample of paramedics recruited during the COVID-19 pandemic in Singapore.

Aim 3 (Economic): To evaluate the incremental cost and cost-effectiveness of Oxford Online in a sample of paramedics recruited during the COVID-19 pandemic in Singapore.

Inclusion Criteria:

• Age 21 and above
• English speaking
• Employed or subcontracted as paramedics by SCDF who have been working during the COVID-19 pandemic
• Able to provide informed consent and read study materials
• Willing to enter randomised trial

Exclusion Criteria:

• Non-English speaking
• Not working during COVID-19 outbreak (e.g. on medical or maternity leave)
• Working as trainees, conscripts, medics or ambulance drivers
• Unwilling or unable to complete study procedures
• Unwilling to enter randomised trial