Accepted for/Published in: JMIR Research Protocols
Date Submitted: Mar 19, 2026
Open Peer Review Period: Mar 23, 2026 - Apr 28, 2026
Date Accepted: May 8, 2026
(closed for review but you can still tweet)
Clinician-Supported Mobile Application to Reduce Mental Health Symptoms Among World Trade Center Responders in Florida: Protocol for a Randomized Controlled Trial
ABSTRACT
Background:
World Trade Center (WTC) General Responders (GRs) continue to experience long‑term mental health conditions, including posttraumatic stress disorder (PTSD), depression, anxiety, and sleep disturbance. A growing number of GRs reside in Florida, where barriers such as stigma, limited access to specialty care, and age‑related limitations contribute to persistent unmet mental health needs. PTSD Coach, a mobile application originally developed for trauma‑exposed veterans, has shown promise but has not been evaluated with WTC GRs or adapted for Spanish‑speaking responders.
Methods:
This study is a three‑arm randomized controlled trial comparing Clinician‑Supported (CS) PTSD Coach, Self‑Managed (SM) PTSD Coach, and a wait‑list control for reducing PTSD, depression, anxiety, and sleep disturbance among English‑ and Spanish‑speaking WTC GRs living in Florida. A total of 120 participants are randomized and assessed at baseline, 8 weeks, and 12‑week follow‑up. CS PTSD Coach includes four clinician‑guided sessions integrated with app‑based activities, whereas SM PTSD Coach includes a single orientation session. Outcomes include PTSD symptoms (PTSD Checklist for DSM‑5), depression (Patient Health Questionnaire‑9), anxiety (Generalized Anxiety Disorder‑7), and sleep disturbance (Insomnia Severity Index). Feasibility and acceptability are assessed using app usage data, satisfaction ratings, and usability measures.
Results:
The notice of award was received in September 2024, and Institutional Review Board approval, including amendments, was granted in January 2025. Recruitment began in February 2025, with data collection initiated in March 2025. As of March 2026, 55 participants have been enrolled, and outcome data collection is ongoing. Data analysis will commence following completion of follow‑up assessments, with results expected to be disseminated in Spring 2027.
Conclusions:
This trial will provide the first randomized controlled evaluation of a clinician‑supported mobile PTSD intervention for WTC responders, including Spanish‑speaking GRs. Findings will inform the feasibility, acceptability, and potential scalability of supported digital mental health interventions for aging, geographically dispersed disaster‑exposed populations.
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