{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T16:02:08Z","timestamp":1792598528078,"version":"4.5.0"},"reference-count":63,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2022,1,1]],"date-time":"2022-01-01T00:00:00Z","timestamp":1640995200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100010677","name":"H2020 Health","doi-asserted-by":"publisher","award":["No 101016127"],"award-info":[{"award-number":["No 101016127"]}],"id":[{"id":"10.13039\/100010677","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["DIGITAL HEALTH"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background and aims<\/jats:title>\n                    <jats:p>The coronavirus disease 2019 pandemic has challenged health services worldwide, with a worsening of healthcare workers\u2019 mental health within initial pandemic hotspots. In early 2022, the Omicron variant is spreading rapidly around the world. This study explores the effectiveness and cost-effectiveness of a stepped-care programme of scalable, internet-based psychological interventions for distressed health workers on self-reported anxiety and depression symptoms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We present the study protocol for a multicentre (two sites), parallel-group (1:1 allocation ratio), analyst-blinded, superiority, randomised controlled trial. Healthcare workers with psychological distress will be allocated either to care as usual only or to care as usual plus a stepped-care programme that includes two scalable psychological interventions developed by the World Health Organization: A guided self-help stress management guide (Doing What Matters in Times of Stress) and a five-session cognitive behavioural intervention (Problem Management Plus). All participants will receive a single-session emotional support intervention, namely psychological first aid. We will include 212 participants. An intention-to-treat analysis using linear mixed models will be conducted to explore the programme's effect on anxiety and depression symptoms, as measured by the Patient Health Questionnaire \u2013 Anxiety and Depression Scale summary score at 21 weeks from baseline. Secondary outcomes include post-traumatic stress disorder symptoms, resilience, quality of life, cost impact and cost-effectiveness.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study is the first randomised trial that combines two World Health Organization psychological interventions tailored for health workers into one stepped-care programme. Results will inform occupational and mental health prevention, treatment, and recovery strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Registration details<\/jats:title>\n                    <jats:p>ClinicalTrials.gov Identifier: NCT04980326.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/20552076221129084","type":"journal-article","created":{"date-parts":[[2022,10,5]],"date-time":"2022-10-05T14:10:20Z","timestamp":1664979020000},"page":"205520762211290","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":22,"title":["Effectiveness of a stepped-care programme of internet-based psychological interventions for healthcare workers with psychological distress: Study protocol for the RESPOND healthcare workers randomised controlled 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Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Underhill","sequence":"additional","affiliation":[{"name":"Research consultant, Brighton, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard A.","family":"Bryant","sequence":"additional","affiliation":[{"name":"School of Psychology, University of New South Wales, Sydney, NSW, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josep Maria","family":"Haro","sequence":"additional","affiliation":[{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain"},{"name":"Research and Development Unit, Parc Sanitari Sant Joan de D\u00e9u, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Luis","family":"Ayuso-Mateos","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Universidad Aut\u00f3noma de Madrid (UAM), Madrid, Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain"},{"name":"Department of Psychiatry, La Princesa University Hospital, Instituto de Investigaci\u00f3n Sanitaria Princesa (IIS-Princesa), Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"on behalf of the RESPOND Consortium","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2022,10,5]]},"reference":[{"key":"bibr1-20552076221129084","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-2667(20)30074-8"},{"key":"bibr2-20552076221129084","first-page":"922","volume":"395","author":"The Lancet","year":"2020","journal-title":"Lancet"},{"key":"bibr3-20552076221129084","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)31713-X"},{"key":"bibr4-20552076221129084","author":"Mediavilla R","journal-title":"Revista de Psiquiatr\u00eda 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