The goal of this clinical trial is to test how best to implement a mobile peer support app called PeerOnCall in Canadian fire services. The main questions it aims to answer are: 1. Do firefighters use the app more with a structured implementation compared to standard implementation? 2. Does using the app improve mental health and workplace outcomes? Researchers will compare a standard implementation approach with basic onboarding to more structured implementation with weekly reminders, new content, and feedback reports to see if these features encourage more consistent app use. Participants will: 1. Use the PeerOnCall app to access private peer support and wellness resources. 2. Participate in surveys, interviews, and focus groups about their app experience and workplace environment.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
DOUBLE
Enrollment
2,000
The structured implementation (intervention) group will follow a structured protocol designed to promote weekly app engagement. This includes regular updates to customized content, reminders to use the app, and feedback on use. Weekly content updates and push notifications will be provided through the app, and the research team will communicate monthly with organizational champions with feedback reports on app utilization to reinforce engagement.
The standard implementation (control) group will receive baseline support, allowing firefighters to use the app as they choose. The research team will provide an initial orientation for organizations and peer supporters, but the organizational champion will be responsible for communication and follow-up. The research team will respond to questions and prompt data collection.
20 Fire Service Organizations across Canada
Hamilton, Canada
Change from Baseline Score on the Mental Health Continuum at 1 year
Impact on mental health (primary) outcome - A 10-point visual analogue scale (VAS) will be used to measure mental health status as a continuous variable, aligning with the mental health continuum commonly used in the public safety community. The scale uses color coding from 0 (green/well) to 10 (red/crisis) with strong concurrent validity (r = .60 to .74) compared to other anxiety measures. Pilot research indicated that firefighters are resistant to lengthy psychological questionnaires, so this brief, intuitive, and widely accepted single-item scale was selected to optimize response rates. App users will receive monthly in-app notifications prompting them to complete the scale. Since the scale is integrated into the app, data can be directly linked to app utilization.
Time frame: From Baseline to the end of implementation at 1-year
App Engagement (App Opens)
App opens will be tracked as a binary variable, measuring whether an employee opens the app at least once during the 12-month study period. This initial adoption measure will be monitored using unique ID numbers to track the total number of app opens per user. A list of eligible employees will be established at the start of the intervention and monitored over time to assess engagement across the organization.
Time frame: From enrolment to the end of implementation at 1-year
App Engagement (Peer Support Outreach)
Peer support outreach will be measured by the number of text or phone interactions initiated with a peer support provider. Software analytics will track individual use patterns, including whether users reach out once or multiple times to peer support. Higher outreach frequency reflects greater engagement with the app.
Time frame: From enrolment to the end of implementation at 1-year
Change from Baseline Score on the WLQ-F at 1 year
The secondary outcome is firefighter work performance, measured using the 36-item Work Limitations Questionnaire for Firefighters (WLQ-F), which assesses physical, cognitive, social, emotional, and time-related work demands. Responses are scored on a 5-point Likert scale from 0% (not limited at all) to 100% (unable to do), with higher scores indicating greater limitations.
Time frame: From Baseline to the end of implementation at 1-year
Mental Health Absenteeism
Absenteeism, measured as the number of mental health related sick days will also be tracked in each organization. These productivity or performance measures provide important organizational impact data.
Time frame: From enrolment to the end of implementation at 1-year
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