Accepted for/Published in: JMIR Research Protocols
Date Submitted: Mar 13, 2024
Date Accepted: Jul 15, 2024
Testing the Effectiveness of a Mobile Smartphone Application Designed to Improve the Mental Health of Junior Physicians: Protocol for a Randomised Controlled Trial
ABSTRACT
Background:
Shift, a mobile health smartphone application (mHealth app), is the first app-based intervention created specifically to support the mental health and wellbeing of junior physicians. While it has been found that junior physicians experience high levels of psychological distress and burnout, few interventions have been developed for them. Junior physicians are time-poor, work irregular hours, and are often reluctant to seek help due to concerns regarding confidentiality and potential career impacts. The confidentiality and ease of access of digital interventions may be particularly suited to address these concerns. The Shift app provides therapeutic, psychoeducational content, and strategies contextualised for the specific needs of doctors in training. Content includes information on mental health, help-seeking, practical information about managing the hospital work environment, mindfulness, and other topics designed to provide support for concerns faced by junior physicians.
Objective:
The aim of this study is to test, at scale, the effectiveness of Shift among junior physicians working in Australia, using a randomised controlled trial design. The primary aim is to examine whether junior physicians using Shift experience a significant reduction in depressive symptoms compared to a waitlist control group. The secondary aim is to examine whether the app intervention group experience significant improvements in anxiety, work and social functioning, help-seeking, quality of life, and burnout, compared to controls.
Methods:
A total of 778 junior physicians will be recruited online through government and non-government medical organisations across Australia, as well as through paid social media advertisements. They will be randomly allocated to one of two groups: (1) the intervention group, who will be asked to use the Shift app for a period of 30 days; or (2) the waitlist control group, who will be placed on a waitlist to use the app after 3 months. Participants will complete psychometric measures self-assessing mental health and wellbeing outcomes with assessments at baseline, one-month post-baseline, and three months post-baseline. The waitlist control group will be asked to complete an additional online questionnaire one month after receiving access to the app, or four months post-baseline. Study participation will occur online, and is fully automated.
Results:
Recruitment is underway: as of March 2024, over 600 participants had registered for the study. Effectiveness of the mHealth intervention will be estimated on an intention-to-treat basis, using mixed-model repeated measures analysis.
Conclusions:
This is the first RCT to examine the effectiveness of a mHealth app specifically designed to support the mental health of junior physicians. The study will inform the development of other cost-effective and easily accessible app-based interventions for early-career physicians. Clinical Trial: Australian and New Zealand Clinical Trials Registry ACTRN12623000664640; https://www.anzctr.org.au/ACTRN12623000664640.aspx
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