Trial reportBMJ mental health2023
Effectiveness of a mental health stepped-care programme for healthcare workers with psychological distress in crisis settings: a multicentre randomised controlled trial.
Trial report in BMJ mental health, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04980326 (A Scalable Low-intensity Psychological Intervention to Reduce Psychological Distress Among Healthcare Workers Involved in the First COVID-19 Outbreak in Spain), which is not on this map. Cited by 35 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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.
A Scalable Low-intensity Psychological Intervention to Reduce Psychological Distress Among Healthcare Workers Involved in the First COVID-19 Outbreak in Spain: a Randomized Trial
Who cites it
35 citing papers in PubMed, 1 synthesis or guideline pooled it, 36 citations in OpenAlex.
- Workplace Mental Health Programs for Healthcare Workers: A Systematic Review.International journal of environmental research and public health · 2026Pooled it
- Trial
- A Randomized Controlled Trial of a Digital Stepped-Care Program to Reduce Anxiety and Depressive Symptoms Among Long-Term Care Workers With Psychological Distress: The REPICAL Study.Depression and anxiety · 2026Trial
- Mindfulness-Based Interventions for Mental Health Outcomes in Frontline Healthcare Workers During the COVID-19 Pandemic: A Randomized Controlled Trial.Journal of general internal medicine · 2025Trial
- Trial
- Salutogenic Principles in Workplace Health Promotion Interventions: A Scoping Review.Journal of prevention (2022) · 2026Article
- Working conditions and mental health among doctors and nurses in the European Union, Iceland, and Norway: a cross-sectional survey.The Lancet regional health. Europe · 2026Article
- Psychiatrists' role in disaster situations: A narrative review of empirical evidence.The Australian and New Zealand journal of psychiatry · 2026Review
- Article
- Implementing Problem Management Plus (PM+) in Haiti: qualitative study.BJPsych open · 2026Article
- Bending or breaking? Examining the relationship between psychological inflexibility, resilience, professional fulfilment and burnout among cancer care professionals in Ireland.Frontiers in psychology · 2026Article
- Psychosocial problems, daily functioning and help-seeking behaviour of international migrant workers in the Netherlands: A qualitative study to inform the adaptation of a scalable stepped-care intervention.Global mental health (Cambridge, England) · 2026Article
- Implementing scalable face-to-face and digital interventions among forcibly displaced persons from Ukraine in Europe: protocol of The U-RISE Project.European journal of psychotraumatology · 2025Article
- Positive appraisal style predicts long-term stress resilience and mediates the effect of a pro-resilience intervention.Nature communications · 2025Observational
- Unguided self-help to bridge waiting time for face-to-face therapy in a university student mental health service: interrupted time series analysis.BJPsych open · 2025Article
- Evidenced Interventions Supporting the Psychological Wellbeing of Disaster Workers: A Rapid Literature Review.International journal of environmental research and public health · 2025Review
- Chatbot-Based Version of a World Health Organization-Validated Intervention for Stress Management in Patients With Breast Cancer (Self-Help Plus): Protocol for a Pilot Feasibility Study.JMIR research protocols · 2025Article
- Effectiveness of a Self-Guided Digital Intervention for Mental Health and Psychological Well-Being in University Students: Pre- and Postintervention Study.Journal of medical Internet research · 2025Article
- Factors influencing the implementation of interventions for symptoms of posttraumatic stress disorder among hospital-based nurses and physicians during the COVID-19 pandemic: a scoping review.BMC health services research · 2025Article
- World Health Organization Evidence-Based Self-Help Plus Intervention for Stress Management via Chatbot: Protocol for Adaptation to a Tech-Enabled Model.JMIR research protocols · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
27 authors at 11 institutions in 8 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEvidence-based mental health interventions to support healthcare workers (HCWs) in crisis settings are scarce.
objectiveTo evaluate the capacity of a mental health intervention in reducing anxiety and depression symptoms in HCWs, relative to enhanced care as usual (eCAU), amidst the COVID-19 pandemic.
methodsWe conducted an analyst-blind, parallel, multicentre, randomised controlled trial. We recruited HCWs with psychological distress from Madrid and Catalonia (Spain). The intervention arm received a stepped-care programme consisting of two WHO-developed interventions adapted for HCWs: Doing What Matters in Times of Stress (DWM) and Problem Management Plus (PM+). Each intervention lasted 5 weeks and was delivered remotely by non-specialist mental health providers. HCWs reporting psychological distress after DWM completion were invited to continue to PM+. The primary endpoint was self-reported anxiety/depression symptoms (Patient Health Questionnaire-Anxiety and Depression Scale) at week 21.
findingsBetween 3 November 2021 and 31 March 2022, 115 participants were randomised to stepped care and 117 to eCAU (86% women, mean age 37.5). The intervention showed a greater decrease in anxiety/depression symptoms compared with eCAU at the primary endpoint (baseline-adjusted difference 4.4, 95% CI 2.1 to 6.7; standardised effect size 0.8, 95% CI 0.4 to 1.2). No serious adverse events occurred.
conclusionsBrief stepped-care psychological interventions reduce anxiety and depression during a period of stress among HCWs. CLINICAL IMPLICATIONS: Our results can inform policies and actions to protect the mental health of HCWs during major health crises and are potentially rapidly replicable in other settings where workers are affected by global emergencies. TRIAL REGISTRATION NUMBER: NCT04980326.
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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.