{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T23:31:40Z","timestamp":1789428700197,"version":"build-2803163510"},"reference-count":28,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2025,5,21]],"date-time":"2025-05-21T00:00:00Z","timestamp":1747785600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Anderson\u2019s CIHR Mental Wellness in Public Safety Team Grant","award":["172806"],"award-info":[{"award-number":["172806"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Public safety personnel and frontline healthcare professionals are at increased risk of exposure to potentially psychologically traumatic events (PPTEs) and developing post-traumatic stress injuries (PTSIs, e.g., depression, anxiety) by the nature of their work. PTSI is also connected to increased absenteeism, suicidality, and performance decrements, which compromise occupational and public health and safety in trauma-exposed workers. There is limited evidence on the cost effectiveness of proactive \u201cprevention\u201d programs aimed at reducing the risk of PTSIs. The purpose of this meta-analysis is to measure the economic effectiveness of proactive PTSI mitigation programs among occupational groups exposed to frequent occupational PPTEs, focusing on the outcomes related to PTSI symptoms, absenteeism, and psychological wellness. Findings from 15 included studies demonstrate that proactive interventions can yield substantial economic and health benefits, with Return On Investment (ROI) values ranging widely from \u221220% to 3560%. Shorter interventions (\u22646 months) often produced higher returns, while longer interventions (&gt;12 months) showed more moderate or negative returns. Notably, the level at which an intervention is targeted significantly affects outcomes\u2014programs aimed at managers, such as the 4 h RESPECT training course, demonstrated a high ROI and broad organizational impact by enhancing leadership support for employee mental health. Sensitivity analyses highlighted significant variability based on the organizational context, program design, and participant characteristics. The majority of proactive interventions successfully reduced psychological distress and enhanced workplace outcomes, although thoughtful consideration of program design and implementation context is essential.<\/jats:p>","DOI":"10.3390\/ijerph22050809","type":"journal-article","created":{"date-parts":[[2025,5,21]],"date-time":"2025-05-21T09:58:22Z","timestamp":1747821502000},"page":"809","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Economic Evaluation of Proactive PTSI Mitigation Programs for Public Safety Personnel and Frontline Healthcare Professionals: A Systematic Review and Meta-Analysis"],"prefix":"10.3390","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5785-9495","authenticated-orcid":false,"given":"Hadiseh","family":"Azadehyaei","sequence":"first","affiliation":[{"name":"Faculty of Science, Thompson Rivers University, Kamloops, BC V2C 0C8, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yue","family":"Zhang","sequence":"additional","affiliation":[{"name":"Faculty of Science, Thompson Rivers University, Kamloops, BC V2C 0C8, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8431-7037","authenticated-orcid":false,"given":"Yan","family":"Song","sequence":"additional","affiliation":[{"name":"Faculty of Science, Thompson Rivers University, Kamloops, BC V2C 0C8, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tania","family":"Gottschalk","sequence":"additional","affiliation":[{"name":"Faculty of Science, Thompson Rivers University, Kamloops, BC V2C 0C8, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory S.","family":"Anderson","sequence":"additional","affiliation":[{"name":"Faculty of Science, Thompson Rivers University, Kamloops, BC V2C 0C8, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,5,21]]},"reference":[{"key":"ref_1","unstructured":"Canadian Institute for Public Safety Research and Treatment (CIPSRT) (2020, October 23). 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