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Mental health informed physical activity for first responders and their support partner: a protocol for a stepped-wedge evaluation of an online, codesigned intervention
  1. Grace McKeon1,
  2. Zachary Steel1,2,3,
  3. Ruth Wells1,
  4. Jill M Newby4,
  5. Dusan Hadzi-Pavlovic1,
  6. Davy Vancampfort5,6,
  7. Simon Rosenbaum1,3
  1. 1School of Psychiatry, UNSW, Sydney, New South Wales, Australia
  2. 2St John of God Health Care North Richmond Hospital North, North Richmond, New South Wales, Australia
  3. 3Black Dog Institute, Prince of Wales Hospital, Sydney, New South Wales, Australia
  4. 4School of Psychology, University of New South Wales, Sydney, New South Wales, Australia
  5. 5University Psychiatric Centre KU Leuven, Leuven, Belgium
  6. 6Department of Rehabilitation Sciences, KU Leuven, Leuven, Vlaanderen, Belgium
  1. Correspondence to Grace McKeon; g.mckeon{at}


Background First responders (police, fire and ambulance officers) are at a significantly increased risk of experiencing poor mental health, including depression and post-traumatic stress disorder. These conditions are associated with high rates of cardiovascular disease, in part due to low levels of physical activity (PA) and high levels of sedentary behaviour. Using a person’s social support system may be an effective solution to help increase PA levels to improve mental and physical health outcomes. We will examine the efficacy of a group-based online intervention in increasing PA in first responders and their support partners, iteratively codesigned with advisors with lived experience of mental illness among first responders.

Methods This study will recruit a convenience sample of self-identified sedentary first responders and their self-selected support partners to a 10-week PA programme delivered through a private Facebook group. We will deliver education on predetermined topics related to PA and diet and provide participants with an activity tracker (Fitbit). A stepped-wedged design will be applied to compare multiple baselines to intervention and follow-up phases within subjects. Five cohorts of n=20 will be recruited, with each cohort randomised to a different baseline length. Our primary outcome will be psychological distress (Kessler-6). Secondary outcomes include feasibility, self-report and objective PA data (Simple Physical Activity Questionnaire and Fitbit accelerometry), depression and anxiety (Depression Anxiety and Stress Scale-21 items), post-traumatic stress disorder symptoms (PTSD Checklist for DSM-5), quality of life Assessment of Quality of Life-6 dimensions, sleep quality (The Pittsburgh Sleep Quality Index), suicidal ideation (Suicidal Ideation Attributes Scale) and social support for exercise. The mobile data collection platform MetricWire will be used.

Ethics and dissemination Ethical approval was obtained from the University of New South Wales, Deupty Vice-Chancellor Research, Human Research Ethics Committee on 3 June 2019, HC180561. Findings will be published in peer-reviewed journals and disseminated at national conferences.

Trial registration number ACTRN12619000877189.

  • physical activity
  • facebook
  • first responder
  • PTSD
  • mental health
  • emergency service workers

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  • Contributors GM and SR conceived the study. GM drafted the protocol with input from ZS, RW, JMN and DV. DH-P, ZS and RW provided statistical expertise. All authors contributed to the study design. GM and SR will run the online Facebook group with input from RW, JMN and DV. DHP will lead the statistical analysis. All authors critically reviewed the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.