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Post Traumatic Stress DisorderNCT07457801

CARE Study for Paramedics in Singapore

A study testing Oxford-Online and Mind-Online in people with Post Traumatic Stress Disorder and Depression, run by Singapore General Hospital at 1 site in Singapore.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The purpose of this study is to compare the effectiveness of two different online education courses (Oxford-Online and Mind-Online) for preventing stress related conditions among paramedics who have been working during a period of COVID-19 occurrence in Singapore. Read more about this study

Who is it for?
Ages 21 years and olderHealthy volunteers can take part
What is being tested?
Oxford-Online and Mind-Online
Could I receive a placebo?
No, everyone receives an active treatment
How many people
63 participants
Where
1 siteSingapore
Study dates
12 Sep 2020to 30 Jun 2025
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 21 years and older
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

  • Age 21 and above
  • English speaking
  • Employed or subcontracted as paramedics by SCDF who have been working during the COVID-19 pandemic
  • Able to provide informed consent and read study materials
  • Willing to enter randomised trial

Who cannot join

  • Non-English speaking
  • Not working during COVID-19 outbreak (e.g. on medical or maternity leave)
  • Working as trainees, conscripts, medics or ambulance drivers
  • Unwilling or unable to complete study procedures
  • Unwilling to enter randomised trial

Trial locations and contacts

1 site in 1 country.

Singapore1 site

  • Duke-NUS Medical School

    Singapore, 169857

Other trials in Singapore

About this study

Official title: Cognitive Training And Resilience Education (CARE) for Paramedics on the Frontlines of the COVID-19 Epidemic: A Randomised Controlled Trial in Singapore

The purpose of this study is to compare the effectiveness of two different online education courses (Oxford-Online and Mind-Online) for preventing stress related conditions among paramedics who have been working during a period of COVID-19 occurrence in Singapore.

The study aims to:

Read more
  • Compare the efficacy of a locally-adapted version of internet-delivered cognitive training for resilience (Oxford Online) to an existing educational online training (Mind Online) on depressive symptom severity
  • Compare the efficacy of Oxford Online to Mind Online for improving posttraumatic stress symptoms, resilience, general psychological distress, anxiety symptoms, social support, work engagement, and health-related quality of life

Participants will:

  • Complete an online battery of baseline questionnaires
  • Be randomised to receive 6 modules of either Oxford Online or Mind Online, delivered once per week over a 6-week period
  • Complete the same online questionnaire battery immediately following the intervention, and again at the 6-month and 12-month follow up
Read the detailed description

Aim 1 (Primary): To compare the efficacy of a locally-adapted version of internet-delivered cognitive training for resilience (Oxford Online) to an existing educational online training (Mind Online) on depressive symptom severity in a sample of paramedics recruited during the COVID-19 pandemic in Singapore.

Aim 2 (Secondary): To compare the efficacy of Oxford-Online to Mind-Online for improving posttraumatic stress symptoms, resilience, general psychological distress, anxiety symptoms, social support, work engagement, and health-related quality of life in a sample of paramedics recruited during the COVID-19 pandemic in Singapore.

Aim 3 (Economic): To evaluate the incremental cost and cost-effectiveness of Oxford Online in a sample of paramedics recruited during the COVID-19 pandemic in Singapore.

Being tested
Oxford-Online, Mind-Online
Medical subject headings
Stress Disorders, Post-Traumatic, Depression, Anxiety Disorders, Burnout, Psychological

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Oxford-OnlineBehavioural

    The Oxford Online programme targets cognitive predictors of depression and posttraumatic stress disorder. The core information is delivered in six 20-minute modules over a 6-week period. The modules include whiteboard videos to explain concepts, audio files for practicing concrete thinking, video testimonies and footage of paramedics on-call for use in experiential exercises. A trained online wellbeing coordinator will provide individual email feedback on participants' responses and send brief automated message reminders.

  • Mind-OnlineBehavioural

    Mind Online is a series of six modules available online where participants read information and advice about stress, depression, posttraumatic stress, sleep problems, anger, and mindfulness. A trained online wellbeing coordinator will provide individual email feedback on participants' responses and send brief automated message reminders.

Study groups in NCT07457801
Study groupRoleWhat they receive
Oxford-OnlineExperimentalThe Oxford-Online programme is a series of six modules that targets cognitive predictors of depression and posttraumatic stress disorder.
Receives: Behavioral: Oxford-Online
Mind-OnlineActive comparatorMind-Online is a series of six modules available online where participants read information and advice about stress, depression, posttraumatic stress, sleep problems, anger, and mindfulness.
Receives: Behavioral: Mind-Online

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change in Depression Symptoms

    Patient Health Questionnaire 9 (PHQ-9)

    Measured: Change from baseline at post-intervention (6-8 weeks after baseline), 6 months and 12 months post-intervention

Secondary outcomes (10)

  1. Change in Posttraumatic Stress Symptoms

    Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5)

    Measured: Change from baseline at post-intervention (6-8 weeks after baseline), 6 months and 12 months post-intervention

  2. Change in Resilience

    Connor-Davidson Resilience Scale (CD-RISC)

    Measured: Change from baseline at post-intervention (6-8 weeks after baseline), 6 months and 12 months post-intervention

  3. Change in Rumination

    Response to Intrusions Questionnaire (RIQ-s)

    Measured: Change from baseline at post-intervention (6-8 weeks after baseline), 6 months and 12 months post-intervention

  4. Change in Anxiety Symptoms

    Generalized Anxiety Disorder seven item scale (GAD-7)

    Measured: Change from baseline at post-intervention (6-8 weeks after baseline), 6 months and 12 months post-intervention

  5. Change in Psychological Distress

    General Health Questionnaire (GHQ)

    Measured: Change from baseline at post-intervention (6-8 weeks after baseline), 6 months and 12 months post-intervention

  6. Change in Burnout

    Physician Work-Life Study's Single Item (PWLS)

    Measured: Change from baseline at post-intervention (6-8 weeks after baseline), 6 months and 12 months post-intervention

  7. Change in Social Support

    Multidimensional Scale of Perceived Social Support (MSPSS)

    Measured: Change from baseline at post-intervention (6-8 weeks after baseline), 6 months and 12 months post-intervention

  8. Change in Work Engagement

    Utrecht Work Engagement Scale (UWES)

    Measured: Change from baseline at post-intervention (6-8 weeks after baseline), 6 months and 12 months post-intervention

  9. Change in Health-related Quality of Life

    EuroQol 5 Dimensions Questionnaire (EQ-5D5L)

    Measured: Change from baseline at post-intervention (6-8 weeks after baseline), 6 months and 12 months post-intervention

  10. Change in Posttraumatic Growth

    Posttraumatic Growth Inventory (PTGI-SF)

    Measured: Change from baseline at 6 months and 12 months post-intervention (intervention completed 6-8 weeks after baseline).

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted9 Mar 2026
  2. Study start12 Sep 2020
  3. Primary completion30 Jun 2025
  4. Study completion30 Jun 2025

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Prevention
Allocation
Randomised
Intervention model
Parallel groups
Model description
Parallel group block RCT design
Masking
None (open label)
Enrolment
63 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07457801
Sponsor's protocol ID
2020/2516
Status last verified
May 2025
First submitted
30 May 2023
Last updated
9 Mar 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No

Publications

  • Sung SC, Rush AJ. A timely investment: coordinated care for depression and anxiety disorders. Ann Acad Med Singap. 2011 Oct;40(10):436-8. No abstract available.

    PubMed 22206051

  • Sung SC, Dryman MT, Marks E, Shear MK, Ghesquiere A, Fava M, Simon NM. Complicated grief among individuals with major depression: prevalence, comorbidity, and associated features. J Affect Disord. 2011 Nov;134(1-3):453-8. doi: 10.1016/j.jad.2011.05.017. Epub 2011 May 31.

    PubMed 21621849

  • Sung SC, Haley CL, Wisniewski SR, Fava M, Nierenberg AA, Warden D, Morris DW, Kurian BT, Trivedi MH, Rush AJ; CO-MED Study Team. The impact of chronic depression on acute and long-term outcomes in a randomized trial comparing selective serotonin reuptake inhibitor monotherapy versus each of 2 different antidepressant medication combinations. J Clin Psychiatry. 2012 Jul;73(7):967-76. doi: 10.4088/JCP.11m07043. Epub 2012 May 29.

    PubMed 22687487

  • Teo I, Sung SC, Cheung YB, Wong WHM, Abu Bakar Aloweni F, Ang HG, Ayre TC, Chai-Lim C, Chen R, Heng AL, Nadarajan GD, Ong MEH, Soh CR, Tan BH, Tan KBK, Tan BS, Tan MH, Tan PH, Tay KXK, Wijaya L, Tan HK. Burnout, anxiety and depression in healthcare workers during the early COVID-19 period in Singapore. Singapore Med J. 2024 Mar 1;65(Suppl 1):S26-S29. doi: 10.11622/smedj.2021156. Epub 2021 Oct 7. No abstract available.

    PubMed 34617698

  • Yoon S, Goh H, Nadarajan GD, Sung S, Teo I, Lee J, Ong MEH, Graves N, Teo TL. Perceptions of Mobile Health Apps and Features to Support Psychosocial Well-being Among Frontline Health Care Workers Involved in the COVID-19 Pandemic Response: Qualitative Study. J Med Internet Res. 2021 May 31;23(5):e26282. doi: 10.2196/26282.

    PubMed 33979296

  • Sung SC, L.Y., Chen AM, Chay J, Tewani K, Yeo LF, Tan HK. , Psychological Resilience among Healthcare Workers during the COVID-19 Pandemic in Singapore, in SingHealth Duke-NUS Scientific Congress. 2021: Singapore

  • Tan BYQ, Chew NWS, Lee GKH, Jing M, Goh Y, Yeo LLL, Zhang K, Chin HK, Ahmad A, Khan FA, Shanmugam GN, Chan BPL, Sunny S, Chandra B, Ong JJY, Paliwal PR, Wong LYH, Sagayanathan R, Chen JT, Ng AYY, Teoh HL, Ho CS, Ho RC, Sharma VK. Psychological Impact of the COVID-19 Pandemic on Health Care Workers in Singapore. Ann Intern Med. 2020 Aug 18;173(4):317-320. doi: 10.7326/M20-1083. Epub 2020 Apr 6. No abstract available.

    PubMed 32251513

  • Tan BYQ, Kanneganti A, Lim LJH, Tan M, Chua YX, Tan L, Sia CH, Denning M, Goh ET, Purkayastha S, Kinross J, Sim K, Chan YH, Ooi SBS. Burnout and Associated Factors Among Health Care Workers in Singapore During the COVID-19 Pandemic. J Am Med Dir Assoc. 2020 Dec;21(12):1751-1758.e5. doi: 10.1016/j.jamda.2020.09.035. Epub 2020 Oct 5.

    PubMed 33256955

  • Wild J, Smith KV, Thompson E, Bear F, Lommen MJ, Ehlers A. A prospective study of pre-trauma risk factors for post-traumatic stress disorder and depression. Psychol Med. 2016 Sep;46(12):2571-82. doi: 10.1017/S0033291716000532. Epub 2016 Jun 28.

    PubMed 27348599

  • Wild, J., S. El-Salahi, and M. Degli-Eposti, The effectiveness of interventions aimed at improving wellbeing and resilience to stress in first responders: A systematic review. European Psychologist, in press

  • Wild J, El-Salahi S, Tyson G, Lorenz H, Pariante CM, Danese A, Tsiachristas A, Watkins E, Middleton B, Blaber A, Ehlers A. Preventing PTSD, depression and associated health problems in student paramedics: protocol for PREVENT-PTSD, a randomised controlled trial of supported online cognitive training for resilience versus alternative online training and standard practice. BMJ Open. 2018 Dec 31;8(12):e022292. doi: 10.1136/bmjopen-2018-022292.

    PubMed 30598484

  • Ehring T, Ehlers A, Glucksman E. Do cognitive models help in predicting the severity of posttraumatic stress disorder, phobia, and depression after motor vehicle accidents? A prospective longitudinal study. J Consult Clin Psychol. 2008 Apr;76(2):219-30. doi: 10.1037/0022-006X.76.2.219.

    PubMed 18377119

  • Ehlers A, Clark DM, Hackmann A, McManus F, Fennell M, Herbert C, Mayou R. A randomized controlled trial of cognitive therapy, a self-help booklet, and repeated assessments as early interventions for posttraumatic stress disorder. Arch Gen Psychiatry. 2003 Oct;60(10):1024-32. doi: 10.1001/archpsyc.60.10.1024.

    PubMed 14557148

  • Ehring T, Ehlers A, Glucksman E. Contribution of cognitive factors to the prediction of post-traumatic stress disorder, phobia and depression after motor vehicle accidents. Behav Res Ther. 2006 Dec;44(12):1699-716. doi: 10.1016/j.brat.2005.11.013. Epub 2006 Feb 7.

    PubMed 16460669

  • Shepherd L, Wild J. Emotion regulation, physiological arousal and PTSD symptoms in trauma-exposed individuals. J Behav Ther Exp Psychiatry. 2014 Sep;45(3):360-7. doi: 10.1016/j.jbtep.2014.03.002. Epub 2014 Mar 26.

    PubMed 24727342

Questions about this trial

What is this clinical trial studying?

A study testing Oxford-Online and Mind-Online in people with Post Traumatic Stress Disorder and Depression, run by Singapore General Hospital at 1 site in Singapore.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 9 Mar 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Singapore. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change in Depression Symptoms (time frame: Change from baseline at post-intervention (6-8 weeks after baseline), 6 months and 12 months post-intervention). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT07457801, which also lists 19 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 9 Mar 2026.

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