# A Wearable-Based Program to Optimise Stress Regulation, Resilience, and Wellbeing in Emergency Care Settings: A Proof-of-Concept Study Protocol

## TL;DR

This study tests a wearable-based program to help manage stress and improve wellbeing in high-pressure emergency care settings.

## Contribution

A novel wearable-integrated, self-guided stress management program for emergency care settings is proposed and evaluated.

## Key findings

- The program's feasibility, acceptability, and preliminary effectiveness will be assessed using mixed methods.
- Physiological and self-reported outcomes like heart rate variability and perceived stress will be measured.
- Results will guide refining the program for a larger trial in high-stress healthcare environments.

## Abstract

Emergency Departments (EDs) are high-pressure environments that place significant psychological and physiological stress on both patients and healthcare staff. Despite increasing awareness of stress-related impacts, proactive stress management interventions have limited uptake in healthcare. This proof-of-concept study will evaluate WeCare: a 6-week, wearable-integrated, self-guided program grounded in a “Learn–Track–Act” framework to support stress regulation, resilience, and wellbeing. The study will examine four key aspects of implementing the program: (1) feasibility, (2) acceptability and usability, (3) preliminary clinical effectiveness (self-report and physiological outcomes), and (4) preliminary economic impacts. Using a mixed-methods, multiple-baseline N-of-1 design, the program will be trialled with up to 32 participants across four ED-exposed groups: patients with non-severe or severe injuries, patients with acute medical presentations, and ED staff. The intervention includes digital psychoeducation, continuous biofeedback via a smart ring, personalised guidance, and evidence-based self-regulation strategies. Assessments will include standardised questionnaires combined with continuous physiological monitoring via a smartwatch, and interviews. Quantitative outcomes include heart rate variability, sleep patterns, perceived stress, wellbeing, healthcare use, and time off work. Qualitative interviews will explore user experience, usability, and perceived barriers. The findings will inform the refinement of the intervention and co-design of a larger-scale trial, contributing valuable evidence to support low-cost, wearable-enabled proactive mental healthcare in high-stress healthcare environments.