An E-Mental Health Solution to Prevent and Manage Posttraumatic Stress Injuries Among First Responders in Alberta: Protocol for the Implementation and Evaluation of Text Messaging Services (Text4PTSI and Text4Wellbeing)

Background: First responders are confronted with traumatic events in their work that has a substantial toll on their psychological health and may contribute to or result in posttraumatic stress injuries (PTSIs) for many responders. Persons with a PTSI usually seek management therapies. Evidence indicates that digital delivery of these therapies is an innovative, efficient, and effective way to improve PTSI symptoms as an adjunct to in-person delivery. Objective: This project aims to implement and provide accessible, convenient, and economical SMS text messaging services, known as Text4PTSI and Text4Wellbeing, to first responders in Alberta, Canada; to prevent and improve the symptoms of PTSI among first responders; and to improve their overall quality of life. We will evaluate posttraumatic symptoms and the impact of Text4PTSI and Text4Wellbeing on stress, anxiety, and depression in relation to the correspondents' demographic backgrounds. Methods: First responders who subscribe to Text4PTSI or Text4Wellbeing receive daily supportive and psychoeducational SMS text messages for 6 months. The SMS text messages are preprogrammed into an online software program that delivers messages to subscribers. Baseline and follow-up data are collected through online questionnaires using validated scales at enrollment, 6 weeks, 12 weeks, and 24 weeks (end point). In-depth interviews will be conducted to assess satisfaction with the text-based intervention. Results: We hypothesize that participants who enroll in this program will have improved PTSI symptoms; increased or improved quality of life; and significant reduction in associated stress, depression, and anxiety symptoms, among other psychological concerns. Improvement will be determined in comparison to established baseline parameters. Conclusions: This research will be beneficial for practitioners and will inform policy-making and decision-making regarding psychological interventions for PTSI. Lessons from this study will inform the scale-up of the intervention, a cost-effective, zero contact therapeutic option to manage PTSI.