This research study is a cluster randomized controlled trial (RCT) evaluating the effectiveness of the Resilience@Work (RAW) Mindfulness Program among emergency services personnel. The trial involved 24 New South Wales (NSW) Primary Fire and Rescue and Hazmat Stations, with 12 stations assigned to receive the RAW Mindfulness Program and the other 12 assigned to an attention-matched control intervention.

Participants were full-time firefighters from the selected stations. They were informed about the study during a standard well-being talk conducted by the FRNSW Peer Support Team. Participation was voluntary, and firefighters who chose to participate received a participant information sheet, consent form, and study questionnaire.

The RAW Mindfulness Program is a mindfulness-based intervention with an emphasis on self-compassion and acceptance skills. It consists of 6 online training sessions, each taking about 20 to 25 minutes to complete. Tablets (iPads) were provided in the stations to access the program. The control group received access to the Healthy Living Program, which consisted of 6 modules on various health and well-being topics.

The primary outcome was resilience, measured using the Connor-Davidson Resilience Scale (CDRISC_10) and the Brief Resilience Scale (BRS). Secondary outcomes included acceptance and mindfulness skills, measured by the Freiburg Mindfulness Inventory, Cognitive Fusion Questionnaire, Acceptance and Action Questionnaire, and Self-Compassion Scale. Resilience resources were assessed using the Life Orientation Test-Revised (LOT-R), Brief-Coping Orientation to Problems Experienced (Brief-COPE), and Life Engagement Test (LET).

The statistical analysis followed an intent-to-treat framework using mixed-model repeated measures (MMRM). This approach utilized all available data without substituting missing values. The analysis examined the rates of change in resilience scores between the intervention and control groups over time, and planned contrasts were used to compare differences between groups at each follow-up time point against baseline. Similar analyses were conducted for secondary outcomes. The study aimed to recruit 24 fire stations (clusters) and 144 firefighters to achieve sufficient statistical power. All tests used a 2-sided alpha level of .05 and 95% confidence intervals, and analyses were performed in IBM SPSS version 24.

Despite some limitations, this cluster randomized controlled trial provided essential insights into the effectiveness of the Resilience@Work (RAW) Mindfulness Program in enhancing adaptive psychological resilience among active firefighters. The findings demonstrated that online mindfulness-based resilience training can lead to significant improvements in resilience and related resources among high-risk workers, such as firefighters. This is particularly significant, considering the potential role of resilience as a modifiable risk factor for mental health conditions in emergency workers. Programs like RAW can play a proactive role in safeguarding the psychological well-being of high-risk groups and may have broader applications in other professions, such as military personnel, journalists, nurses, doctors, and midwives.

The results indicate that the RAW Mindfulness Program is a practical and scalable approach to delivering online resilience training. Further large-scale trials across diverse workplaces and occupations would allow for a more comprehensive evaluation of outcomes. Additionally, longer follow-up periods beyond six months would be valuable to assess the long-term impacts and determine the optimal timing for retraining.

In conclusion, the RAW Mindfulness Program holds promise as an effective means of delivering online resilience training to high-risk groups, particularly first responders. With continued research and development, this approach has the potential to make a significant impact on mental health and well-being, offering protection and support to workers engaged in challenging roles within society.