Posted 07.16.2019 | by AMRA

Emergency medical dispatchers (EMDs) face stressful job demands. In addition to dispatching emergency medical personnel, EMDs provide emergency advice over the phone and may be the last person to speak to an injured party alive. They are also subject to rotating shifts and mandatory overtime.

While EMDs might benefit from stress reduction interventions, the nature of their workplaces makes it difficult to implement time-intensive group-based trainings. Lily et al. [Occupational and Environmental Medicine] conducted a randomized controlled study to discover whether an on-line mindfulness-based intervention could successfully reduce stress among EMDs.

The researchers randomly assigned 323 North American EMDs (82% female; 90% Caucasian; modal age = 25-55 years) to either a mindfulness-based intervention or a wait list control. The mindfulness program (Destress 9-1-1) was delivered once per week for seven weeks in 20-30 minute online modules.

Each module included a brief video introduction to the theme of the week, an audio-guided mindfulness exercise, and suggestions for mindfulness activities to engage in during the week. The program was modeled after mindfulness-based stress reduction (MBSR), but required less time in terms of coursework, meditation length, and suggested weekly practice.

Participants were assessed on measures of stress and mindfulness (using the Mindful Attention Awareness Scale, or MAAS) at baseline, post-intervention, and 3-month follow-up.

Attrition was fairly high with 32% of mindfulness assignees and 18% of controls failing to complete the post-intervention assessment, and 47% of mindfulness assignees and 38% of controls failing to complete the 3-month follow-up.

Of those assigned to the mindfulness intervention, 25% completed 0 modules, 20% completed 1-5 modules, and 55% completed 6-7 modules over the seven weeks. Mindfulness assignees engaged in practice an average of twice per week. The relatively high attrition rate may reflect the fact that many EMDs weren’t permitted to participate in the intervention during work hours.

Results showed the mindfulness group displayed a significantly greater reduction in stress than the control group. While stress scores in the mindfulness group decreased by an average of 8 points from baseline to post-intervention (Cohen’s d = 0.34), control group scores increased by an average of 2 points.

At the 3-month follow-up, the mindfulness group retained its improvement and the control group showed no change from baseline. There were no significant post-intervention group differences in mindfulness.

While there were no significant differences between the groups in post-intervention mindfulness, baseline levels of mindfulness for the total sample were associated with lower stress (r=-.71). Individuals who showed the largest increases in mindfulness from baseline to post-intervention (regardless of group) showed the greatest decreases in stress (r=-.53).

The study shows decreased levels of stress in EMDs who were assigned to an on-line mindfulness intervention. This decrease in stress occurred in the absence of measurable changes in mindfulness. Nevertheless, there were associations between higher baseline levels of mindfulness and increases in mindfulness over time and lower levels of stress. The study is limited by its relatively high attrition rate.

Lilly, M., Calhoun, R., Painter, I., Beaton, R., Stangenes, S., Revere, D., . . . Meischke, H. (2019). Destress 9-1-1—an online mindfulness-based intervention in reducing stress among emergency medical dispatchers: A randomised controlled trial. Occupational and Environmental Medicine.

[Link to study]