Single-session intervention with and without video support to prevent the worsening of emotional distress among healthcare workers during the SARS-CoV-2 pandemic : a randomised clinical trial

Abstract

Background: The SARS-CoV-2 pandemic was a major stressful event that significantly affected healthcare providers. Objective: To evaluate the efficacy of a single-session intervention (SSI), with and without weekly personalised prerecorded videos, in preventing emotional distress worsening. Methods: Nationwide randomised clinical trial conducted in Brazil from 19 May 2020 to 31 December 2021. We included healthcare professionals with anxiety, depression or irritability scores below a T-score of 70, measured by the Patient-Reported Outcomes Measurement Information System. Participants were randomised to SSI or SSI plus weekly personalised prerecorded videos for 4 weeks (SSI-ET). The primary outcome was the proportion of participants with a significant escalation of symptoms (ie, T-score above 70). Findings: From 3328 assessed for eligibility, 1112 participants were randomised (SSI=549; SSI-ET=563). The cumulative proportion of incident cases at 6 months was 17.5% (95% CI: 13.1% to 21.6%) for SSI and 15% (95% CI: 10.9% to 18.8%) for SSI-ET, with no difference between groups (HR=0.81, 95% CI: 0.83 to 1.79). Both groups showed significant symptom reductions at 1 month follow-up, maintained at 3 and 6 months (Cohen’s d=0.68–1.08). Conclusions: Adding asynchronous videos to SSI provided no additional benefit. While symptom improvements occurred over time, the lack of a control group limits conclusions about intervention efficacy. Clinical implications: Given its simplicity and scalability, the synchronous component, which includes core mental health support elements, such as active listening, validation, and empathic care, may represent a feasible way to assist healthcare professionals in crisis settings, even though further research is needed to determine its specific impact.