{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T15:49:49Z","timestamp":1789487389863,"version":"build-2803163510"},"reference-count":65,"publisher":"BMJ","issue":"9","license":[{"start":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T00:00:00Z","timestamp":1789430400000},"content-version":"unspecified","delay-in-days":14,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"\u00c9tablissement Public de Sant\u00e9 Mentale Georges Daum\u00e9zon","award":["NA"],"award-info":[{"award-number":["NA"]}]},{"name":"Neurobiology of Receptors & Therapeutic Innovations team","award":["NA"],"award-info":[{"award-number":["NA"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,8,17]]},"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Work-related stress is a major public health concern affecting workers across various sectors. It may be associated with increased psychoactive substance use, primarily alcohol, tobacco and cannabis as well as psychoactive medications, which may represent coping mechanisms in response to occupational stress. Work-related stress is also associated with adverse outcomes such as burnout, depression, anxiety and sleep-related problems (excessive daytime sleepiness).<\/jats:p>\n                    <jats:p>This study focuses on three groups of early childhood professionals in France: \u2018ATSEMs\u2019 (preschool classroom assistants who support teachers, help maintain the classroom environment and work exclusively in nursery schools), \u2018animateurs\u2019 (staff supervising educational and extracurricular activities outside school hours) and \u2018agents d\u2019entretien\u2019 (cleaning and maintenance staff) working in nursery and elementary schools, the latter two work in both nursery and elementary schools. These professionals play a crucial role in the education, care and well-being of children but are exposed to high levels of occupational stress due to the emotionally demanding nature of their work, which may increase the risk of substance use, burnout, depression, anxiety and excessive daytime sleepiness. We hypothesise that professionals exposed to job strain (stressed work) will have higher odds of psychoactive substance and medication use, higher levels of substance-related risk or dependence and higher odds of burnout, symptoms of anxiety and depression and sleep-related problems compared with those not exposed to job strain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>\n                      This cross-sectional epidemiological study is being conducted among early childhood professionals working in nursery and elementary schools in participating territories across the Axe lig\u00e9rien in France. The study aims to investigate the association between work-related stress and the use of psychoactive substances and medications and to evaluate the associated levels of substance-related risk or dependence among \u2018ATSEMs\u2019, \u2018animateurs\u2019 and \u2018agents d\u2019entretien\u2019, as well as the association between work-related stress and burnout, depression, anxiety and excessive daytime sleepiness. Data are being collected anonymously using a self-administered online questionnaire, accessible via a QR code displayed on study posters placed in staff rooms and other shared areas in participating schools as well as on flyers distributed among staff containing the same study information and QR code. The QR code also provides access to an information sheet explaining that the study complies with ethical guidelines and that proceeding to the questionnaire indicates non-objection to participation. A sample size of 234 participants was estimated using BiostaTGV. Descriptive analyses will be conducted. Associations between work-related stress, operationalised as job strain and the study outcomes will be examined using Pearson\u2019s \u03c7\n                      <jats:sup>2<\/jats:sup>\n                      chi-square test or Fisher\u2019s exact test, followed by multivariable analyses according to the nature of the outcome variable. Results will be reported using appropriate measures of association with 95% CIs. Studying these associations is essential for informing the development of targeted interventions and preventive strategies.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>Ethical approval for this study was obtained from the Ethics Committee of the Centre Hospitalier Universitaire d\u2019Orl\u00e9ans (assigned reference number: CERO 2511-02). Participation is voluntary and anonymous. The findings of the study will be disseminated through peer-reviewed, open-access publications and scientific conferences.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2026-121614","type":"journal-article","created":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T14:00:41Z","timestamp":1789480841000},"page":"e121614","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Work-related stress and consumption of psychoactive substances and medications among early childhood professionals (TraPsyCOL): study protocol for a cross-sectional study"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-9817-0292","authenticated-orcid":false,"given":"Walaa","family":"Khazaal","sequence":"first","affiliation":[{"name":"Centre de Biophysique Mol\u00e9culaire (CBM), Centre National de la Recherche Scientifique (CNRS), Orl\u00e9ans, France"},{"name":"\u00c9tablissement Public de 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