{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T09:55:41Z","timestamp":1770371741958,"version":"3.49.0"},"reference-count":88,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T00:00:00Z","timestamp":1770249600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003921","name":"Department of Health and Aged Care, Australian Government","doi-asserted-by":"publisher","award":["4-IHO1Z4B"],"award-info":[{"award-number":["4-IHO1Z4B"]}],"id":[{"id":"10.13039\/501100003921","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["1178666"],"award-info":[{"award-number":["1178666"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["1173921"],"award-info":[{"award-number":["1173921"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Emergency service workers (ESWs) are routinely exposed to highly stressful and potentially traumatic events leading to high rates of psychological distress. Early intervention is vital to prevent chronic impairment and\/or psychiatric disorders, with digital health innovations (e.g., smartphone apps) offering a potential means of scaling such intervention while overcoming barriers to help-seeking in this population. This study aims to evaluate the efficacy of an app designed to reduce psychological distress and related outcomes in ESWs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We conducted a randomised controlled trial with ESWs experiencing psychological distress (Kessler Psychological Distress Scale; K10) score &gt;15. Participants were assigned to the intervention group, a full version of the\n                      <jats:italic>Build Back Better<\/jats:italic>\n                      app (including mindfulness, behavioural activation, trauma-focused cognitive therapy skills, activity and mood monitoring, and healthy coping strategies) or a mood\/activity tracking-only version of the same app. Assessment occurred via online self-report questionnaires at baseline (T0) and at 1- and 3-month post-baseline (T1, T2) timepoints. The primary outcome was the K10 score at T2. Linear mixed model analyses were conducted based on the intention-to-treat principle.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      N\u2009=\u2009880 ESWs were randomized to the full (n\u2009=\u2009440) or tracking-only (n\u2009=\u2009440) condition. There was no Time x Condition effect for K10 scores, with both conditions showing similar improvements from baseline to 1-month (all\n                      <jats:italic>p<\/jats:italic>\n                      s\u2009&lt;\u2009.001), and 3-month follow-up (all\n                      <jats:italic>p<\/jats:italic>\n                      s\u2009&lt;\u2009.001). Exploratory analyses of moderators (engagement; baseline severity) found generally no significant differences in K10 score decreases across different levels of engagement in the full-app condition, however, app use was markedly low overall. At higher baseline psychological distress levels, there was a significant decrease in posttraumatic stress disorder symptoms from baseline to 1-month for the full-app group but not the tracking-only group (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.002, d\u2009=\u2009\u22121.43).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Despite consistent improvement across both app conditions, the minimal between group differences found here highlight the difficulties in developing effective, scalable resources for ESWs and the limitations of unguided digital programs more broadly.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec005\">\n                    <jats:title>Trial registration<\/jats:title>\n                    <jats:p>Australian New Zealand Clinical Trials Registry ACTRN12622001324707<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0342419","type":"journal-article","created":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T18:39:03Z","timestamp":1770316743000},"page":"e0342419","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy of a smartphone app to improve mental health among emergency service workers: A randomised controlled trial"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5230-2401","authenticated-orcid":true,"given":"Mark","family":"Deady","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mikayla","family":"Gregory","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Quincy J. J.","family":"Wong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4895-8969","authenticated-orcid":true,"given":"Denise","family":"Meuldijk","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2195-9037","authenticated-orcid":true,"given":"Daniel A. J.","family":"Collins","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lasse B.","family":"Sander","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9607-819X","authenticated-orcid":true,"given":"Richard","family":"Bryant","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samuel B.","family":"Harvey","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2026,2,5]]},"reference":[{"issue":"6","key":"pone.0342419.ref001","doi-asserted-by":"crossref","first-page":"404","DOI":"10.1093\/occmed\/kqm070","article-title":"Post-traumatic stress disorder in occupational settings: anticipating and managing the risk","volume":"57","author":"AC McFarlane","year":"2007","journal-title":"Occup Med (Lond)"},{"issue":"4","key":"pone.0342419.ref002","doi-asserted-by":"crossref","first-page":"821","DOI":"10.1023\/A:1024461920456","article-title":"Exposure to duty-related incident stressors in urban firefighters and paramedics","volume":"11","author":"R Beaton","year":"1998","journal-title":"J Trauma Stress"},{"issue":"3","key":"pone.0342419.ref003","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1093\/occmed\/kqt003","article-title":"Work-related post-traumatic stress disorder","volume":"63","author":"M Skogstad","year":"2013","journal-title":"Occup Med (Lond)"},{"issue":"9","key":"pone.0342419.ref004","doi-asserted-by":"crossref","first-page":"897","DOI":"10.1007\/s00127-018-1539-5","article-title":"Prevalence of PTSD and common mental disorders amongst ambulance personnel: a systematic review and meta-analysis","volume":"53","author":"K Petrie","year":"2018","journal-title":"Soc Psychiatry Psychiatr Epidemiol"},{"issue":"3","key":"pone.0342419.ref005","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1037\/trm0000275","article-title":"Systematic review of mental health symptoms in firefighters exposed to routine duty-related critical incidents.","volume":"27","author":"SL Wagner","year":"2021","journal-title":"Traumatology"},{"issue":"4","key":"pone.0342419.ref006","doi-asserted-by":"crossref","DOI":"10.1002\/smi.3372","article-title":"Are rescue workers still at risk? 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National Center for PTSD and National Child Traumatic Stress Network, Skills for Psychological Recovery: Field Operations Guide. 2010."},{"issue":"2","key":"pone.0342419.ref027","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1080\/00049530.2021.1882271","article-title":"Mental health help-seeking experiences and service use among Australian first responders","volume":"73","author":"W Rikkers","year":"2021","journal-title":"Aust J Psychol"},{"issue":"3","key":"pone.0342419.ref028","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1016\/j.beth.2024.01.001","article-title":"Naturalistic evaluation of headgear: a smartphone app to reduce depressive symptoms in workers","volume":"56","author":"M Deady","year":"2025","journal-title":"Behav Ther"},{"issue":"3","key":"pone.0342419.ref029","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1017\/S0033291720002081","article-title":"Preventing depression using a smartphone app: a randomized controlled trial","volume":"52","author":"M Deady","year":"2022","journal-title":"Psychol Med"},{"issue":"1","key":"pone.0342419.ref030","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1027\/1016-9040\/a000349","article-title":"Best practices and recommendations for digital interventions to improve engagement and adherence in chronic illness sufferers","volume":"24","author":"M Karekla","year":"2019","journal-title":"Eur Psychol"},{"issue":"6","key":"pone.0342419.ref031","first-page":"768","article-title":"What works best to engage participants in mobile app interventions and e-health: a scoping review","volume":"28","author":"I Oakley-Girvan","year":"2022","journal-title":"Telemed J E Health"},{"key":"pone.0342419.ref032","doi-asserted-by":"crossref","DOI":"10.2196\/50995","article-title":"Feasibility of a mental health app intervention for emergency service workers and volunteers: single-arm pilot study","volume":"9","author":"D Meuldijk","year":"2025","journal-title":"JMIR Form Res"},{"issue":"2","key":"pone.0342419.ref033","doi-asserted-by":"crossref","first-page":"100","DOI":"10.4103\/0976-500X.72352","article-title":"CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials","volume":"1","author":"KF Schulz","year":"2010","journal-title":"J Pharmacol Pharmacother"},{"issue":"4","key":"pone.0342419.ref034","article-title":"CONSORT-EHEALTH: improving and standardizing evaluation reports of Web-based and mobile health interventions","volume":"13","author":"CONSORT-EHEALTH Group","year":"2011","journal-title":"J Med Internet Res"},{"key":"pone.0342419.ref035","volume-title":"The PHQ-9: a new depression diagnostic and severity measure","author":"K Kroenke","year":"2002"},{"issue":"7","key":"pone.0342419.ref036","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2017-020510","article-title":"Smartphone application for preventing depression: study protocol for a workplace randomised controlled trial","volume":"8","author":"M Deady","year":"2018","journal-title":"BMJ Open"},{"key":"pone.0342419.ref037","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1037\/0000255-007","article-title":"Review of treatments for PTSD.","volume-title":"Treating PTSD in first responders. 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Kroenke","year":"2001","journal-title":"J Gen Intern Med"},{"issue":"1","key":"pone.0342419.ref041","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1016\/j.genhosppsych.2005.07.003","article-title":"Validity of the Brief Patient Health Questionnaire Mood Scale (PHQ-9) in the general population","volume":"28","author":"A Martin","year":"2006","journal-title":"Gen Hosp Psychiatry"},{"issue":"10","key":"pone.0342419.ref042","doi-asserted-by":"crossref","first-page":"1092","DOI":"10.1001\/archinte.166.10.1092","article-title":"A brief measure for assessing generalized anxiety disorder: the GAD-7","volume":"166","author":"RL Spitzer","year":"2006","journal-title":"Arch Intern Med"},{"key":"pone.0342419.ref043","first-page":"15","article-title":"Measuring the dimension of psychological general well-being by the WHO-5","author":"P Bech","year":"2004","journal-title":"Qual Life Newsl"},{"key":"pone.0342419.ref044","volume-title":"Wellbeing measures in primary health care\/the DepCare Project: report on a WHO meeting: Stockholm, Sweden, 12\u201313 February 1998","author":"Organization WH","year":"1998"},{"key":"pone.0342419.ref045","first-page":"100020","article-title":"The WHO-5 well-being index \u2013 validation based on item response theory and the analysis of measurement invariance across 35 countries","volume":"1","author":"PE Sischka","year":"2020","journal-title":"J Affect Disord Rep"},{"issue":"3","key":"pone.0342419.ref046","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1159\/000376585","article-title":"The WHO-5 Well-Being Index: a systematic review of the literature","volume":"84","author":"CW Topp","year":"2015","journal-title":"Psychother Psychosom"},{"key":"pone.0342419.ref047","doi-asserted-by":"crossref","first-page":"101","DOI":"10.2174\/1745017901006010101","article-title":"PTSD-8: a short PTSD inventory","volume":"6","author":"M Hansen","year":"2010","journal-title":"Clin Pract Epidemiol Ment 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Ambulatory Care Quality Improvement Project (ACQUIP). Alcohol Use Disorders Identification Test","volume":"158","author":"K Bush","year":"1998","journal-title":"Arch Intern Med"},{"issue":"8","key":"pone.0342419.ref056","doi-asserted-by":"crossref","first-page":"1417","DOI":"10.1111\/j.1530-0277.2010.01225.x","article-title":"Is the full version of the AUDIT really necessary? 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The development and protocol for testing a co-created digital intervention (Sentinel) to improve mental wellbeing and help manage and prevent trauma in first responders. 2024.","DOI":"10.31234\/osf.io\/8j32t"},{"key":"pone.0342419.ref069","doi-asserted-by":"crossref","DOI":"10.2196\/55528","article-title":"Efficacy of BrighterSide, a self-guided app for suicidal ideation: randomized controlled trial","volume":"11","author":"N Josifovski","year":"2024","journal-title":"JMIR Ment Health"},{"issue":"1","key":"pone.0342419.ref070","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1186\/s12888-020-02782-y","article-title":"Distant mood monitoring for depressive and bipolar disorders: a systematic review","volume":"20","author":"ASJ van der Watt","year":"2020","journal-title":"BMC Psychiatry"},{"issue":"2","key":"pone.0342419.ref071","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1017\/S0033291717001659","article-title":"A systematic review of the psychometric properties, usability and clinical impacts of mobile mood-monitoring applications in young people","volume":"48","author":"M Dubad","year":"2018","journal-title":"Psychol Med"},{"issue":"3","key":"pone.0342419.ref072","doi-asserted-by":"crossref","first-page":"278","DOI":"10.1017\/S2045796018000665","article-title":"The waiting list is an inadequate benchmark for estimating the effectiveness of psychotherapy for depression","volume":"28","author":"IA Cristea","year":"2019","journal-title":"Epidemiol Psychiatr Sci"},{"issue":"2","key":"pone.0342419.ref073","doi-asserted-by":"crossref","DOI":"10.2196\/12894","article-title":"Resilience@Work mindfulness program: results from a cluster randomized controlled trial with first responders","volume":"21","author":"S Joyce","year":"2019","journal-title":"J Med Internet Res"},{"issue":"6","key":"pone.0342419.ref074","doi-asserted-by":"crossref","first-page":"500","DOI":"10.1016\/S2215-0366(21)00077-8","article-title":"Dismantling, optimising, and personalising internet cognitive behavioural therapy for depression: a systematic review and component network meta-analysis using individual participant data","volume":"8","author":"TA Furukawa","year":"2021","journal-title":"Lancet Psychiatry"},{"issue":"1","key":"pone.0342419.ref075","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1080\/10503307.2017.1395922","article-title":"Component studies of psychological treatments of adult depression: a systematic review and meta-analysis","volume":"29","author":"P Cuijpers","year":"2019","journal-title":"Psychother Res"},{"issue":"5","key":"pone.0342419.ref076","doi-asserted-by":"crossref","first-page":"1108","DOI":"10.1037\/tra0001667","article-title":"Yoga resilience training to prevent the development of posttraumatic stress disorder in active-duty first responders: a cluster randomized controlled trial","volume":"17","author":"L Tan","year":"2025","journal-title":"Psychol Trauma"},{"issue":"7","key":"pone.0342419.ref077","article-title":"Mind-body exercise interventions for prevention of post-traumatic stress disorder in trauma-exposed populations: a systematic review and meta-analysis","volume":"13","author":"L Tan","year":"2023","journal-title":"BMJ Open"},{"key":"pone.0342419.ref078","doi-asserted-by":"crossref","first-page":"20552076221149294","DOI":"10.1177\/20552076221149294","article-title":"An online mental health informed physical activity intervention for emergency service workers and their families: a stepped-wedge trial","volume":"9","author":"G McKeon","year":"2023","journal-title":"Digit Health"},{"issue":"2","key":"pone.0342419.ref079","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1017\/S0033291721004621","article-title":"Impact of guidance on intervention adherence in computerised interventions for mental health problems: a meta-analysis","volume":"52","author":"P Musiat","year":"2022","journal-title":"Psychol Med"},{"issue":"6","key":"pone.0342419.ref080","doi-asserted-by":"crossref","first-page":"4787","DOI":"10.3390\/ijerph20064787","article-title":"Exploring first responders\u2019 use and perceptions on continuous health and environmental monitoring","volume":"20","author":"J Grothe","year":"2023","journal-title":"Int J Environ Res Public Health"},{"key":"pone.0342419.ref081","doi-asserted-by":"crossref","first-page":"20552076231155680","DOI":"10.1177\/20552076231155680","article-title":"The development of a smartphone app to enhance post-traumatic stress disorder treatment in high-risk workers","volume":"9","author":"M Deady","year":"2023","journal-title":"Digit Health"},{"issue":"7","key":"pone.0342419.ref082","doi-asserted-by":"crossref","DOI":"10.2196\/jmir.7583","article-title":"Improving employee well-being and effectiveness: systematic review and meta-analysis of web-based psychological interventions delivered in the workplace","volume":"19","author":"S Carolan","year":"2017","journal-title":"J Med Internet Res"},{"issue":"1","key":"pone.0342419.ref083","doi-asserted-by":"crossref","DOI":"10.2196\/jmir.1367","article-title":"Online interventions for social marketing health behavior change campaigns: a meta-analysis of psychological architectures and adherence factors","volume":"13","author":"B Cugelman","year":"2011","journal-title":"J Med Internet Res"},{"issue":"2","key":"pone.0342419.ref084","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1089\/tmj.2011.0062","article-title":"What design features are used in effective e-health interventions? 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