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High levels of chronic and recurrent workplace stress can profoundly impact the physical, mental, and emotional health of first responders. A multi-modal evidence-based mindfulness intervention was delivered to cohorts of first responders to evaluate effects on perceived stress, resilience, work engagement, and musculoskeletal pain.
The occupational stress experienced by first responders can result in decreased quality and safety of patient care, increased risk of first responder injury, and decreased organizational performance. Worksite mindfulness interventions have been shown to support decreases in occupational stress, as well as improved resilience and work engagement for other high stress professions. Mindfulness in Motion (MIM), an evidence-based mindfulness intervention, was adapted to target the specific occupational needs of first responders in a format that could be easily integrated into their workdays. Three cohorts of first responders received eight weekly synchronous mindfulness sessions with full access to the companion smartphone MIM app for six months after the core eight-week sessions were completed. Adaptations to the MIM content and experiential practices were informed by first responder feedback prior to the study. Self-report surveys to assess perceived stress, resilience, work engagement, and musculoskeletal pain were completed by first responder participants before participation in the intervention, at the end of the eight week intervention, and again six months after the intervention was completed.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Intervention Group | Experimental | First responders participate in an eight-week, synchronous virtual mindfulness intervention, during work hours, with access to companion smartphone app to reinforce virtually presented content and support individual mindfulness practices. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Mindfulness in Motion for First Responders | Behavioral | Mindfulness in Motion (MIM) is an eight-week, evidence-based workplace intervention designed to provide participants with practical strategies to reduce stress and burnout, and improve resilience. Offered virtually, MIM was adapted to support first responders relative to their occupational stressors and unique work characteristics. A companion smartphone app supplemented the eight weekly synchronous sessions and offered content informed by first responders and experiential practices that were modeled by first responders. |
| Measure | Description | Time Frame |
|---|---|---|
| Perceived Stress Scale (PSS-10) | The Perceived Stress Scale-10 is a self-report measure of perceived stress that measures the degree to which situations in one's life over the past month are appraised as stressful. The 4-point Likert scale responses are 0=Never, 1=Almost Never, 2=Sometimes, 3=Fairly Often, and 4=Very Often. Individual scores are summed and range from 0 to 40 with higher scores indicating higher perceived stress. | Baseline, immediately after the 8 week intervention, and 6 months after the completion of the 8-week intervention |
| Connor-Davidson Resilience Scale-10 (CD-RISC-10) | The Connor Davidson-Resilience Scale-10 is a 10-item self-report assessment of a person's ability to bounce back after adversity. A 5-point Likert scale for each statement ranges from 0=Not true at all to 4=True nearly all of the time. A respondents's total sum score can range from 0-40 with higher scores indicating higher resilience. | Baseline, immediately after the 8 week intervention, and 6 months after the completion of the 8-week intervention |
| Utrecht Work Engagement Scale-0 (UWES-9) | A 9-item assessment of attitudes towards one's job. The Utrecht Work Engagement Scale-9 measures three dimensions: dedication, vigor, and absorption. All items are rated on a 7-point Likert scale ranging from 0=Never, 1=Almost Never, 2=Rarely, 3=Sometimes, 4=Often, 5=Very Often, and 6=Always. Each sub scale time is summed and ranges from 0-18. Higher scores for each sub scale indicate higher dedication, vigor, and absorption with work. | Baseline, immediately after the 8 week intervention, and 6 months after the completion of the 8-week intervention |
| Measure | Description | Time Frame |
|---|---|---|
| Modified Nordic Musculoskeletal Questionnaire (mNMQ) | The Modified Nordic Musculoskeletal Questionnaire is a standardized 14-item tool assessing musculoskeletal symptoms, over the past 12 months and past 7 days, across multiple body regions. Q. 1 asks about musculoskeletal pain in 9 anatomical areas include the neck, shoulders, upper back, elbows, lower back, wrists/hands, hips/thighs, knees, and ankles/feet--yes/no are responses. Q. 2 asks frequency of musculoskeletal issues in the 9 anatomical areas over the past 30 days with Q. 3 asking about length of time related to the musculoskeletal pain and Q. 4 about intensity of the pain that was indicated. With yes/no responses, Q. 5 & 6 asks if pain has interfered with usual activities; question 7 asks if a healthcare provider was seen. Q. 9, 10, 11 asks if work activities have been disrupted and if a formal diagnosis was determined. Q. 12, 13, and 14 asks about related symptoms. The tool uses a structured, forced-choice format supported by a body map. There is no minimum or maximum score. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Maryanna Klatt, PhD | Ohio State University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| The Ohio State University | Columbus | Ohio | 43210 | United States |
The de-identified data and analysis code will be submitted to the Dryad repository. Human subjects demographics will be limited to three de-identified descriptors. MIM app usage will be submitted as de-identified usage frequencies. Paired t-test and ANOVA analysis for perceived stress, resilience, and work engagement will be submitted as de-identified, cohort data-comparison on means. nNMQ data will be submitted as frequency and comparison of means.
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot_SAP | Yes | Yes | No | Study Protocol and Statistical Analysis Plan | Sep 8, 2022 |
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| Baseline, immediately after the 8 week intervention, and 6 months after the completion of the 8-week intervention |
| Mindfulness in Motion smartphone app usage | App usage data in time per participant | Immediately after completion of the 8-week intervention |
| Mindfulness in Motion videos watched | Frequency of videos watched by the overall participant sample on the smartphone app | immediately after completion of the 8-week intervention |
| Jun 14, 2026 |
| Prot_SAP_000.pdf |
| ICF | No | No | Yes | Informed Consent Form | Sep 8, 2022 | Jun 14, 2026 | ICF_001.pdf |
| ID | Term |
|---|---|
| D000073397 | Occupational Stress |
| D000092862 | Psychological Well-Being |
| ID | Term |
|---|---|
| D009784 | Occupational Diseases |
| D013315 | Stress, Psychological |
| D001526 | Behavioral Symptoms |
| D001519 | Behavior |
| D010549 | Personal Satisfaction |
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| ID | Term |
|---|---|
| D064866 | Mindfulness |
| D009038 | Motion |
| ID | Term |
|---|---|
| D015928 | Cognitive Behavioral Therapy |
| D001521 | Behavior Therapy |
| D011613 | Psychotherapy |
| D004191 | Behavioral Disciplines and Activities |
| D055585 | Physical Phenomena |
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