Trial reportThe British journal of psychiatry : the journal of mental science2023
Multicentre, England-wide randomised controlled trial of the 'Foundations' smartphone application in improving mental health and well-being in a healthcare worker population.
Trial report in The British journal of psychiatry : the journal of mental science, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 6 of them syntheses that pooled it.
What it found
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
17 citing papers in PubMed, 6 syntheses or guidelines pooled it, 27 citations in OpenAlex.
- Optimizing Workplace Digital Mental Health Interventions: Systematic Review and Meta-Analysis.Journal of medical Internet research · 2025Pooled it
- Identifying the effective strategies in reducing the effects of mental health issues caused by COVID-19 pandemic in healthcare providers: a systematic review.BMC health services research · 2025Pooled it
- Mindfulness-Based Mobile Apps and Their Impact on Well-Being in Nonclinical Populations: Systematic Review of Randomized Controlled Trials.Journal of medical Internet research · 2023Pooled it
- Efficacy of stand-alone digital mental health applications for anxiety and depression: A meta-analysis of randomized controlled trials.Journal of psychiatric research · 2023Pooled it
- What are effective strategies to respond to the psychological impacts of working on the frontlines of a public health emergency?Frontiers in public health · 2023Pooled it
- Presenteeism and mental health of workers during the COVID-19 pandemic: a systematic review.Frontiers in public health · 2023Pooled it
- Reducing intrusive memories after trauma via an imagery-competing task intervention in COVID-19 intensive care staff: a randomised controlled trial.Translational psychiatry · 2023Trial
- Effectiveness of a mental health stepped-care programme for healthcare workers with psychological distress in crisis settings: a multicentre randomised controlled trial.BMJ mental health · 2023Trial
- Mental Health Apps Implemented in the Workplace: Scoping Review of Trends and Gaps in Evaluation Research.JMIR mHealth and uHealth · 2026Article
- The evolving field of digital mental health: current evidence and implementation issues for smartphone apps, generative artificial intelligence, and virtual reality.World psychiatry : official journal of the World Psychiatric Association (WPA) · 2025Article
- Article
- A stress-reduction eHealth intervention for healthcare workers in primary care settings: an implementation study.Frontiers in public health · 2025Article
- Testing the Effectiveness of a Mobile Smartphone App Designed to Improve the Mental Health of Junior Physicians: Protocol for a Randomized Controlled Trial.JMIR research protocols · 2024Article
- Mapping the needs of healthcare workers caring for COVID-19 patients using the socio-ecological framework: a rapid scoping review.Human resources for health · 2024Article
- Potential strategies for supporting mental health and mitigating the risk of burnout among healthcare professionals: insights from the COVID-19 pandemic.EClinicalMedicine · 2024Review
- Advantages and disadvantages of mobile applications for workplace health promotion: A scoping review.PloS one · 2024Article
- Protective and risk factors associated with substance use coping among healthcare workers during the COVID-19 pandemic.Frontiers in psychology · 2023Article
Corrections and comments
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Authors and funding
14 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundHealthcare workers (HCWs) have faced considerable pressures during the COVID-19 pandemic. For some, this has resulted in mental health distress and disorder. Although interventions have sought to support HCWs, few have been evaluated.
aimsWe aimed to determine the effectiveness of the 'Foundations' application (app) on general (non-psychotic) psychiatric morbidity.
methodWe conducted a multicentre randomised controlled trial of HCWs at 16 NHS trusts (trial registration number: EudraCT: 2021-001279-18). Participants were randomly assigned to the app or wait-list control group. Measures were assessed at baseline, after 4 and 8 weeks. The primary outcome was general psychiatric morbidity (using the General Health Questionnaire). Secondary outcomes included: well-being; presenteeism; anxiety; depression and insomnia. The primary analysis used mixed-effects multivariable regression, presented as adjusted mean differences (aMD).
resultsBetween 22 March and 3 June 2021, 1002 participants were randomised (500:502), and 894 (89.2%) followed-up. The sample was predominately women (754/894, 84.3%), with a mean age of 44⋅3 years (interquartile range (IQR) 34-53). Participants randomised to the app had a reduction in psychiatric morbidity symptoms (aMD = -1.39, 95% CI -2.05 to -0.74), improvement in well-being (aMD = 0⋅54, 95% CI 0⋅20 to 0⋅89) and reduction in insomnia (adjusted odds ratio (aOR) = 0⋅36, 95% CI 0⋅21 to 0⋅60). No other significant findings were found, or adverse events reported.
conclusionsThe app had an effect in reducing psychiatric morbidity symptoms in a sample of HCWs. Given it is scalable with no adverse effects, the app may be used as part of an organisation's tiered staff support package. Further evidence is needed on long-term effectiveness and cost-effectiveness.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.