NCT06648928

Brief Summary

This study examines mental health challenges among World Trade Center (WTC) General Responders, who continue to experience significant psychological trauma from the WTC collapse. PTSD and depression remain common, and nearly six percent of the WTC Health Program (WTCHP) cohort now resides in Florida. Many identify as Hispanic, underscoring the need for linguistically appropriate services. Research shows that remotely delivered, clinician-supported mobile applications can reduce mental health symptoms. PTSD Coach, developed by the Veterans Administration, is a free self-managed mobile app designed to help users manage PTSD symptoms through tools such as relaxation exercises, calming self-talk, and sleep hygiene practices. Reviews of the app have found it feasible, acceptable, and effective in reducing PTSD symptoms. Clinician-Supported PTSD Coach was designed for individuals unlikely to use the app independently. This model pairs the PTSD Coach app with four remote 20-30-minute clinician sessions over eight weeks. Studies with Veterans demonstrate reductions in PTSD and depression, higher satisfaction, and increased treatment engagement compared with usual care. However, these interventions have not yet been tested with WTC General Responders or Hispanic populations. This study will evaluate the feasibility, acceptability, and effectiveness of Clinician-Supported PTSD Coach in reducing PTSD, depression, anxiety, and sleep disturbances among English- and Spanish-speaking WTC General Responders in Florida. Participants will be randomly assigned to one of three conditions: (1) Clinician-Supported PTSD Coach, (2) Self-Managed PTSD Coach, or (3) Waitlist Control. Assessments at 8 and 12 weeks will measure symptom reductions and examine engagement, satisfaction, and barriers within the app-based conditions. It is expected that both interventions will reduce symptoms, with greater improvements in the clinician-supported condition. This project addresses a critical gap in evidence-based mental health treatments for dispersed WTC Responders and responds to the WTCHP Scientific/Technical Advisory Committee's call for more research on mental health interventions. By focusing on Hispanic and Spanish-speaking Responders-an understudied group-this study may support the development of scalable, app-based interventions that can be deployed nationally to meet the mental health needs of WTC responders and survivors.

Trial Health

75
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
120

participants targeted

Target at P50-P75 for not_applicable

Timeline
2mo left

Started Feb 2025

Geographic Reach
1 country

1 active site

Status
enrolling by invitation

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Progress89%
Feb 2025Jul 2026

First Submitted

Initial submission to the registry

October 17, 2024

Completed
1 day until next milestone

First Posted

Study publicly available on registry

October 18, 2024

Completed
4 months until next milestone

Study Start

First participant enrolled

February 21, 2025

Completed
1.3 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

June 1, 2026

Expected
1 month until next milestone

Study Completion

Last participant's last visit for all outcomes

July 1, 2026

Last Updated

February 18, 2026

Status Verified

February 1, 2026

Enrollment Period

1.3 years

First QC Date

October 17, 2024

Last Update Submit

February 16, 2026

Conditions

Keywords

First respondersWorld Trade CenterRandomized Clinical TrialMental HealthTelehealthLatinx

Outcome Measures

Primary Outcomes (1)

  • PTSD Checklist for DSM-5 (PCL-5)

    A self-report measure used to assess the presence and severity of PTSD symptoms. It consists of 20 items that correspond to the DSM-5 criteria for PTSD.

    Evaluate changes in PTSD symptoms from pretest to posttest (8 weeks) and follow-up four weeks later (12 weeks).

Secondary Outcomes (3)

  • Patient Health Questionnaire-9 (PHQ-9).

    Evaluate changes in depression symptoms from pretest to posttest (8 weeks) and follow-up four weeks later (12 weeks).

  • Generalized Anxiety Disorder-7 (GAD-7)

    Evaluate changes in anxiety symptoms from pretest to posttest (8 weeks) and follow-up four weeks later (12 weeks).

  • Insomnia Severity Index (ISI)

    Evaluate changes in sleep disturbance symptoms from pretest to posttest (8 weeks) and follow-up four weeks later (12 weeks).

Study Arms (3)

Clinician Supported PTSD Coach

EXPERIMENTAL

PTSD Coach application combined with remotely delivered clinician support, focusing on app use, symptom monitoring, and management strategies.

Behavioral: Clinician Supported PTSD Coach

Self Managed PTSD Coach application

ACTIVE COMPARATOR

Participant remotely receives basic instructions on using the PTSD Coach application but receives no further clinician support

Behavioral: Self Managed PTSD Coach

Wait list control

NO INTERVENTION

No intervention until after the follow-up assessment when they have a choice of receiving either CS PTSD Coach or SM PTSD Coach.

Interventions

Combines self-managed PTSD Coach application with four 20-30 minute sessions delivered by a clinician. The app includes modules on learning about PTSD, self-assessment, symptom management, and finding support.

Clinician Supported PTSD Coach

A widely available mobile application designed to help individuals manage PTSD symptoms available in English and Spanish.

Self Managed PTSD Coach application

Eligibility Criteria

Sexall
Healthy VolunteersNo
Age GroupsChild (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

  • World Trade Center General Responders (GRs) currently living in Florida.
  • Any age.
  • Must have a smartphone device capable of using the PTSD Coach app.
  • Must be fluent in either English or Spanish.

You may not qualify if:

  • Active or recent (past month) suicidal ideation or attempt.
  • Low levels of distress as measured by the PCL-5 (score below 27).
  • Severe alcohol use measured by an AUDIT score of 20 or above.
  • Use of illicit or unprescribed drugs (except for cannabis) in the last 2 weeks, as indicated on the Modified ASSIST Measure.
  • Presence of neurologic or neurodegenerative conditions associated with significant cognitive impairment (e.g., Parkinson's, Alzheimer's diseases) or current severe cognitive impairment measured using the Montreal Cognitive Assessment (MoCA).
  • Current mental health treatment for PTSD.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Florida International University

Miami, Florida, 33199, United States

Location

Related Links

MeSH Terms

Conditions

Anxiety DisordersDepressionParasomniasPsychological Well-Being

Condition Hierarchy (Ancestors)

Mental DisordersBehavioral SymptomsBehaviorSleep Wake DisordersNervous System DiseasesPersonal Satisfaction

Study Officials

  • Mark Macgowan, PhD

    Florida International University

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
SINGLE
Who Masked
OUTCOMES ASSESSOR
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

October 17, 2024

First Posted

October 18, 2024

Study Start

February 21, 2025

Primary Completion (Estimated)

June 1, 2026

Study Completion (Estimated)

July 1, 2026

Last Updated

February 18, 2026

Record last verified: 2026-02

Data Sharing

IPD Sharing
Will not share

Protecting the privacy of these World Trade Center General Responders is paramount. Sharing IPD could risk exposing sensitive personal information, even if anonymized, which might lead to re-identification.

Locations