Effectiveness of the fordyce happiness programme on occupational stress, job burnout, and happiness among emergency medical services personnel in Chalus, Abbasabad and Nowshahr, Iran: a quasi-experimental study

Emergency Medical Services (EMS) personnel experience high occupational stress, yet evidence for culturally adapted interventions in Middle Eastern prehospital settings remains limited. This study evaluated the Fordyce Happiness Program on occupational stress, job burnout, and happiness among Iranian EMS personnel. A quasi-experimental pretest-posttest design with 2-month follow-up and non-equivalent control group was conducted from September to December 2025. Seventy EMS personnel completed the study (intervention = 35, control = 35). Participants were allocated using matched allocation based on age and work experience. The intervention group received eight weekly 90-minute Fordyce Program sessions. Outcomes were assessed using validated instruments at three time points. Mixed-design ANOVA with Greenhouse-Geisser correction was used for analysis. The intervention group showed significant improvements in occupational stress (F(1.74, 118.32) = 15.34, p < .001, η² p = .21) and happiness (F(1.82, 123.76) = 22.56, p < .001, η² p = .28) with large effect sizes. No significant reduction was observed for job burnout (F(1.81, 123.1) = 1.45, p = .241, η² p = .021), indicating dissociation between stress/happiness and burnout. Within-group analyses revealed significant pre-to-post improvements in both stress and happiness ( p < .001), sustained at 2-month follow-up. The Fordyce Program effectively reduced stress and increased happiness but did not reduce burnout, suggesting burnout is distinct from stress and requires organizational-level interventions. The program should be a complementary well-being strategy, not a standalone burnout intervention. Due to the quasi-experimental design, causal conclusions cannot be drawn; randomized controlled trials are needed.