A randomized controlled trial of a trauma-informed smartphone application in reducing firefighters’ mental health symptoms

Many workforces are exposed to traumatic events which can precipitate the development of depression, anxiety and posttraumatic stress symptoms. This randomized controlled trial aimed to evaluate if an app-based version of the Skills for Life Adjustment and Resilience program (SOLAR-m) was superior to an active mood monitoring control app in reducing symptoms of depression and anxiety (Hospital Anxiety Depression Scale) at 8-weeks post baseline (primary) and 3-months post intervention in firefighters. Firefighters (N = 163) experiencing distress were randomized 1:1 to SOLAR-m or control. Secondary outcomes included posttraumatic stress symptoms and work-related outcomes. Longitudinal analysis on an intention-to-treat basis showed a greater decrease in depression and anxiety at 8-weeks for SOLAR-m (mean difference -2.64, 95% CI: -4.64, -0.63; p = 0.01), and each of depression, anxiety and posttraumatic stress symptoms. Only depression showed a between-group difference at 3-months. SOLAR-m was efficacious in reducing symptoms of depression, anxiety and posttraumatic stress among firefighters. (Trial registration: ANZCTRN12621001141831; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=382298&isReview=true ).