Evidence map›Paper›PMID 41642859›Full record

Trial reportPloS one2026

Efficacy of a smartphone app to improve mental health among emergency service workers: A randomised controlled trial.

Mark Deady, Mikayla Gregory, Quincy J J Wong, Denise Meuldijk, Daniel A J Collins, Lasse B Sander, Richard Bryant, Samuel B Harvey

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in PloS one, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Mark DeadyBlack Dog Institute, Faculty of Medicine & Health, University of New South Wales, Sydney, New South Wales, Australia.ORCID https://orcid.org/0000-0002-5230-2401
Mikayla GregoryBlack Dog Institute, Faculty of Medicine & Health, University of New South Wales, Sydney, New South Wales, Australia.
Quincy J J WongSchool of Psychology, Western Sydney University, Sydney, New South Wales, Australia.
Denise MeuldijkBlack Dog Institute, Faculty of Medicine & Health, University of New South Wales, Sydney, New South Wales, Australia.ORCID https://orcid.org/0000-0002-4895-8969
Daniel A J CollinsBlack Dog Institute, Faculty of Medicine & Health, University of New South Wales, Sydney, New South Wales, Australia.ORCID https://orcid.org/0000-0003-2195-9037
Lasse B SanderMedical Psychology and Medical Sociology, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany.
Richard BryantSchool of Psychology, University of New South Wales, Sydney, New South Wales, Australia.ORCID https://orcid.org/0000-0002-9607-819X
Samuel B HarveyBlack Dog Institute, Faculty of Medicine & Health, University of New South Wales, Sydney, New South Wales, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEmergency service workers (ESWs) are routinely exposed to highly stressful and potentially traumatic events leading to high rates of psychological distress. Early intervention is vital to prevent chronic impairment and/or psychiatric disorders, with digital health innovations (e.g., smartphone apps) offering a potential means of scaling such intervention while overcoming barriers to help-seeking in this population. This study aims to evaluate the efficacy of an app designed to reduce psychological distress and related outcomes in ESWs.

methodsWe conducted a randomised controlled trial with ESWs experiencing psychological distress (Kessler Psychological Distress Scale; K10) score >15. Participants were assigned to the intervention group, a full version of the Build Back Better app (including mindfulness, behavioural activation, trauma-focused cognitive therapy skills, activity and mood monitoring, and healthy coping strategies) or a mood/activity tracking-only version of the same app. Assessment occurred via online self-report questionnaires at baseline (T0) and at 1- and 3-month post-baseline (T1, T2) timepoints. The primary outcome was the K10 score at T2. Linear mixed model analyses were conducted based on the intention-to-treat principle.

resultsN = 880 ESWs were randomized to the full (n = 440) or tracking-only (n = 440) condition. There was no Time x Condition effect for K10 scores, with both conditions showing similar improvements from baseline to 1-month (all ps < .001), and 3-month follow-up (all ps < .001). Exploratory analyses of moderators (engagement; baseline severity) found generally no significant differences in K10 score decreases across different levels of engagement in the full-app condition, however, app use was markedly low overall. At higher baseline psychological distress levels, there was a significant decrease in posttraumatic stress disorder symptoms from baseline to 1-month for the full-app group but not the tracking-only group (p = .002, d = -1.43).

conclusionDespite consistent improvement across both app conditions, the minimal between group differences found here highlight the difficulties in developing effective, scalable resources for ESWs and the limitations of unguided digital programs more broadly.

trial registrationAustralian New Zealand Clinical Trials Registry ACTRN12622001324707.

Indexed as

Mental HealthMobile ApplicationsSmartphoneStress, PsychologicalAdultCoping SkillsFemaleHumansMaleMiddle AgedSurveys and Questionnaires

Identifiers

PMID41642859
PMCPMC12875461

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.