Background: Nurses have a higher suicide rate than the general population and experience high rates of burnout and depression, which have escalated further since the COVID-19 pandemic. Studies support that nurses' mental health adversely impacts healthcare quality and safety. Suicide prevention strategies, designed specifically for nurses, are urgent public health imperatives.
Research Aims: 1) Assess acceptability and usability of a digitalized on-line interactive version of the MINDBODYSTRONG© cognitive-behavioral skills building program with 10 nurses, and 2) conduct a rigorous randomized controlled trial (RCT) to determine the effects of the Healer Education Assessment and Referral (HEAR) program's adaptation of the American Foundation for Suicide Prevention's (AFSP) Interactive Screening program (ISP) combined with the on-line version of the MINDBODYSTRONG© program versus the HEAR program alone on depression, suicidal ideation, burnout, anxiety, post-traumatic stress, healthy lifestyle beliefs, healthy lifestyle behaviors, and job satisfaction in 364 U.S. nurses
Design: First, acceptability and usability of a new digitalized version of MINDBODYSTRONG© will be created and feedback obtained with 10 nurses. Second, a two arm RCT will be conducted in which nurses who screen positive for moderate to high suicide risk will receive either the HEAR program plus the on-line MINDBODYSTRONG© program or the HEAR program alone with follow-up immediately post-intervention and at three, six and 12 months.
Sample: Ten nurses from Ohio State's Wexner Medical Center will test the acceptability and usability of the digitalized version of MINDBODYSTRONG©. The RCT sample will include 364 nurses (182 per arm) recruited through the American Nurses Association.
Measures: Valid and reliable measures will assess depression, suicidal intent, anxiety, burnout, post-traumatic stress, healthy lifestyle beliefs, healthy lifestyle behaviors and job satisfaction. A short evaluation questionnaire also will gain feedback on the helpfulness of the intervention and obtain data regarding type of treatment (e.g., therapy, medication) the nurses have received.
Procedures: Ten nurses will answer questions on acceptability and usability of the digitalized version of MINDBODYSTRONG©. Feedback will be used to refine the program for the full-scale RCT. Nurses from the ANA who consent will be screened with the HEAR Screening Program. Participants will be randomly assigned to the intervention or control group. Those who score moderate- to high-risk for suicide will be contacted by a mental health counselor who will engage them through an encrypted interface online. The counselor will offer support online or by phone. Those who screen moderate- to high-risk and who are randomized to the intervention group will be offered the on-line version of MINDBODYSTRONG©. Reminders will be sent weekly to complete the next MINDBODYSTRONG© session and a MINDBODYSTRONG© coach will check in with participants at weeks 3 and 5. Data will be collected at baseline and post-intervention as well as at three, six- and 12-months post-intervention through an on-line confidential survey.
Impact: If effective, this suicide prevention package could be readily scaled to reduce depression and suicide risk throughout the nursing profession.
Next Steps: Plans include refining the intervention and replicating this study with other health professionals experiencing high rates of burnout, depression, and suicide.
