A Mental Health–Informed Physical Activity Intervention for First Responders and Their Partners Delivered Using Facebook: Mixed Methods Pilot Study

Abstract

Background First responders (eg, police, firefighters, and paramedics) are at high risk of experiencing poor mental health. Physical activity interventions can help reduce symptoms and improve mental health in this group. More research is needed to evaluate accessible, low-cost methods of delivering programs. Social media may be a potential platform for delivering group-based physical activity interventions. Objective This study aims to examine the feasibility and acceptability of delivering a mental health–informed physical activity program for first responders and their self-nominated support partners. This study also aims to assess the feasibility of applying a novel multiple time series design and to explore the impact of the intervention on mental health symptoms, sleep quality, quality of life, and physical activity levels. Methods We co-designed a 10-week web-based physical activity program delivered via a private Facebook group. We provided education and motivation around different topics weekly (eg, goal setting, overcoming barriers to exercise, and reducing sedentary behavior) and provided participants with a Fitbit. A multiple time series design was applied to assess psychological distress levels, with participants acting as their own control before the intervention. Results In total, 24 participants (12 first responders and 12 nominated support partners) were recruited, and 21 (88%) completed the postassessment questionnaires. High acceptability was observed in the qualitative interviews. Exploratory analyses revealed significant reductions in psychological distress during the intervention. Preintervention and postintervention analysis showed significant improvements in quality of life (P=.001; Cohen d=0.60); total depression, anxiety, and stress scores (P=.047; Cohen d=0.35); and minutes of walking (P=.04; Cohen d=0.55). Changes in perceived social support from family (P=.07; Cohen d=0.37), friends (P=.10; Cohen d=0.38), and sleep quality (P=.28; Cohen d=0.19) were not significant. Conclusions The results provide preliminary support for the use of social media and a multiple time series design to deliver mental health–informed physical activity interventions for first responders and their support partners. Therefore, an adequately powered trial is required. Trial Registration Australian New Zealand Clinical Trials Registry (ACTRN): 12618001267246; https://anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12618001267246.

An online mental health informed physical activity intervention for emergency service workers and their families: A stepped-wedge trial

“…The study is reported in line with the CONSORT 2010 checklist extension for stepped wedge cluster randomised trials (32). The study protocol has been published elsewhere (33) and was informed by pilot work (34).…”

“…showed that a sample size of n=80 would be sufficient to achieve power of 80% with the P value set at 0.05 (34).…”

“…The same exclusion criteria for support partners were used. Monte Carlo simulations conducted in Mplus8 using our pilot data (psychological distress (Kessler-6)) showed that a sample size of n=80 would be sufficient to achieve power of 80% with the P value set at 0.05 (34).…”

“…The peer-facilitators were participants from previous clusters of the program who expressed interest to volunteer to take part in a subsequent cluster to help motivate and support other participants. Peer-facilitators in the first cluster were recruited from our pilot study (34). Participants who expressed interest were ‘graduated’ into the role of peer-facilitator for the subsequent cluster of the program and co-delivered the succeeding program with the exercise physiologists.…”

“…Peer-facilitators in the first cluster were recruited from our pilot study (34). Participants who expressed interest were 'graduated' into the role of peer-facilitator for the subsequent cluster of the program and co-delivered the succeeding program with the exercise physiologists.…”