German Clinical Trials Register

Acronym/abbreviation of the study

RUPERT

URL of the study

http://www.rupert-community.de/studie

Brief summary in lay language

Depression is a serious mental disorder that causes substantial suffering. In Germany, approximately one in five adults will suffer from depression at some point in their lifetime. In addition to genetic factors, risk factors for the occurrence of depression include a high level of stress and the frequent experience of extremely stressful events. Emergency medical personnel (EMP) are particularly exposed to these risk factors due to their job. It can therefore be assumed that they have an increased risk of developing depression. More than half of the employees in medical rescue sector are male. Studies indicate that men in particular show unfavourable help-seeking behaviour for mental health-related problems. One explanation for this is the social role perception of men as “strong” and “resilient”. Consequently, mental suffering in men is considered as socially unacceptable and is accordingly associated with stigma. This stigmatisation can have an even higher impact if it meets a traditionally male-dominated organisational culture with rigid masculinity norms, as it can still prevail in the emergency services. As a result, the help-seeking behaviour of both genders can be inhibited to such an extent that available health care offers are not taken up at all or not at an early stage. However, early treatment of depression is important to increase the chance of an uncomplicated, mild course of the disease and to minimize the risk of relapse. This requires suitable and low-threshold care services that are tailored to the needs of the target group. This is the point of departure for the RUPERT project. The aim of the current study is conducting a national roll-out of the RUPERT intervention in Germany. We will analyze whether an implementation strategy that includes regional alliances against depression is superior to the implementation via national communication channels only. We will also investigate the social networks within the digital community of RUPERT, make contact with stakeholders in the rescue services to understand the added value of RUPERT, and explore ideas about generalizing RUPERT to other first responders by interviewing police officers and firefighters.

Brief summary in scientific language

Emergency medical personnel (EMP) are at risk for depressive disorders, as they experience several risk factors such as high job-related strain and frequent exposure to traumatic situations during their work. In addition, some EMP may be little receptive for secondary preventive measures and professional treatment. In particular, males have been shown to struggle with help-seeking for mental health related problems due to their social role perception, norms of masculinity, and fear of stigmatization. Through assuring anonymity, digital interventions can facilitate informal and professional help-seeking for depression. In this context, online self-help forums are a promising approach, as they offer easily accessible information and community-based first help. The RUPERT project aims to create, implement, and evaluate an online intervention for depression, offering psychoeducational information and community-based support through a discussion forum to EMP. The objective of the current study is to conduct a national roll-out of the RUPERT intervention in Germany. Utilizing an effectiveness-implementation hybrid type 2 design, we will i) explore the social networks within the discussion forum and the content shared among the participants using mixed-method content analysis and social network analysis, and we will ii) compare different implementation strategies (regionally targeted vs. nationwide) regarding adoption and penetration of the intervention. Secondary aims are to explore whether the RUPERT intervention can be generalized to other groups of first responders and to collect feedback from multipliers and stakeholders regarding their engagement with RUPERT and the added value for the employers in the rescue service.