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Graphs showing the progression of the estimated means from linear mixed models of total burnout symptoms, exhaustion, mental distance, cognitive impairment, and emotional impairment over a 36-week period. The baseline, intervention, and follow-up phases are presented. Each intervention week is indicated by the corresponding number. Error bars represent CIs. *P<.05, **P<.01 significant change from baseline (wk 7).
Source publication
Background
Work-related stress and burnout remain common problems among employees, leading to impaired health and higher absenteeism. The use of mobile health apps to promote well-being has grown substantially; however, the impact of such apps on reducing stress and preventing burnout is limited.
Objective
This study aims to assess the effectivene...
Contexts in source publication
Context 1
... examining the progression over time, a significant decrease in emotional impairment was found after the first week of app use and was sustained for both 1 week post use and 3 weeks after use until follow-up (Figure 4). Consistent improvements following initial app use were found for exhaustion as well, with no significant change at follow-up (Figure 4). ...
Context 2
... examining the progression over time, a significant decrease in emotional impairment was found after the first week of app use and was sustained for both 1 week post use and 3 weeks after use until follow-up (Figure 4). Consistent improvements following initial app use were found for exhaustion as well, with no significant change at follow-up (Figure 4). No consistent and sustained improvements were found for the level of mental distance and cognitive impairment (Figure 4). ...
Context 3
... improvements following initial app use were found for exhaustion as well, with no significant change at follow-up (Figure 4). No consistent and sustained improvements were found for the level of mental distance and cognitive impairment (Figure 4). Graphs showing the progression of the estimated means from linear mixed models of total burnout symptoms, exhaustion, mental distance, cognitive impairment, and emotional impairment over a 36-week period. ...
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Introduction: Health care professionals can experience extreme occupational stress due to the rigorous requirements of their work. Professionals such as doctors, nurses, lab technicians, and physiotherapists frequently encounter high levels of stress in their daily routines. They are facing different kinds of stress during their working hours and a...
Citations
... Nevertheless, it should be noted that the effects of the program on every outcome were stronger when considering the per-protocol approach (the sample of intervention completers). Different studies have observed a significant association between an eHealth program's dose and its effects on stress, among other outcomes [24,66,79,80], which highlights the importance of fostering treatment adherence. ...
Background: The high levels of sustained stress that health professionals often experience pose a significant risk factor for developing mental health problems, such as anxiety, depression, and somatic symptoms that not only affect their well-being but also have major social and organizational consequences. Different interventions, including those based on third-wave psychotherapy principles (ie, mindfulness, compassion, and acceptance), have proven to be effective in reducing stress in this population. Among them, those delivered on the web constitute a promising alternative with notable advantages in accessibility and flexibility, but some adherence inconveniences may limit their efficacy.
Objective: This study aimed to evaluate the effectiveness of the MINDxYOU program, a web-based self-guided intervention based on third-wave psychotherapy principles, to reduce perceived stress and promote mental health in a sample of health professionals.
Methods: In a stepped-wedge cluster randomized design, 357 health professionals from health centers in Aragon and Málaga, Spain, were recruited. They were divided into 6 clusters—3 per region—and randomly assigned to 1 of the 3 sequences, each starting with a control phase, and then transitioning to the intervention phase (the MINDxYOU program) after 8, 16, or 24 weeks. This self-guided, web-based program, designed to be completed over 8 weeks, included weekly contact (via WhatsApp, call, or email) from the research team to promote adherence. Participants were assessed on the web every 8 weeks for 5 assessments. Perceived stress was the study’s primary outcome, with additional measures of clinical factors (anxiety, depression, and somatization) and process variables (resilience, mindfulness, compassion, and acceptance).
Results: The program was initiated by 229 participants, 112 (48.9%) of whom were completers (ie, completed at least 3 of the 4 modules). Perceived stress demonstrated a significant reduction both when considering the entire sample (β=–1.08, SE 0.51; P=.03) and the sample of completers (β=–1.84, SE 0.62; P=.003). The proportion of participants reflecting “low stress” increased after the treatment (n=90, 46.6% vs n=100, 28.8% at baseline). Intracluster analysis revealed that pre- versus postintervention moderate effects were present in 2 clusters (Cohen d=0.46 and 0.62), and these were maintained in subsequent assessments. The linear mixed-effects models also showed that depression, anxiety, and somatization, as well as resilience, self-compassion, and some mindfulness facets, experienced significant improvements (P<.05) when comparing the intervention and control phases.
Conclusions: The MINDxYOU program was effective in reducing perceived stress and promoting mental health, as well as increasing resilience, mindfulness facets, and self-compassion. These effects suggest that participants experienced a tangible improvement that could potentially enhance their well-being. Adherence to the intervention was moderate, while program use was notable compared to similar interventions. Finding ways to promote adherence to the intervention would contribute to increasing the effectiveness of this program.
Trial Registration: ClinicalTrials.gov NCT05436717; https://clinicaltrials.gov/study/NCT05436717
... Nevertheless, it should be noted that the effects of the program on every outcome were stronger when considering the per-protocol approach (the sample of intervention completers). Different studies have observed a significant association between an eHealth program's dose and its effects on stress, among other outcomes [24,66,79,80], which highlights the importance of fostering treatment adherence. ...
Background
The high levels of sustained stress that health professionals often experience are a significant risk factor for developing mental health problems, such as anxiety, depression, and somatic symptoms, that not only affect their well-being but also have major social and organizational consequences. Different interventions, including those based on third-wave psychotherapy principles (ie, mindfulness, compassion, and acceptance), have proven to be effective in reducing stress in this population. Among them, those delivered on the web constitute a promising alternative with notable advantages in accessibility and flexibility, but some adherence inconveniences may limit their efficacy.
Objective
This study aimed to evaluate the effectiveness of the MINDxYOU program, a web-based self-guided intervention based on third-wave psychotherapy principles, to reduce perceived stress and promote mental health in a sample of health professionals.
Methods
In a stepped-wedge cluster randomized design, 357 health professionals from health centers in Aragon and Málaga, Spain, were recruited. They were divided into 6 clusters—3 per region—and randomly assigned to 1 of the 3 sequences, each starting with a control phase and then transitioning to the intervention phase (the MINDxYOU program) after 8, 16, or 24 weeks. This self-guided, web-based program, designed to be completed over 8 weeks, included weekly contact (via WhatsApp, call, or email) from the research team to promote adherence. Participants were assessed on the web every 8 weeks for 5 assessments. Perceived stress was the study’s primary outcome, with additional measures of clinical factors (anxiety, depression, and somatization) and process variables (resilience, mindfulness, compassion, and acceptance).
Results
The program was initiated by 229 participants, 112 (48.9%) of whom were completers (ie, completed at least 3 of the 4 modules). Perceived stress demonstrated a significant reduction both when considering the entire sample (β=–1.08, SE 0.51; P=.03) and the sample of completers (β=–1.84, SE 0.62; P=.003). The proportion of participants reflecting “low stress” increased after the treatment (n=90, 46.6% vs n=100, 28.8% at baseline). Intracluster analysis revealed that pre- versus postintervention moderate effects were present in 2 clusters (Cohen d=0.46 and 0.62), and these were maintained in subsequent assessments. The linear mixed-effects models also showed that depression, anxiety, and somatization, as well as resilience, self-compassion, and some mindfulness facets, experienced significant improvements (P<.05) when comparing the intervention and control phases.
Conclusions
The MINDxYOU program was effective in reducing perceived stress and promoting mental health, as well as increasing resilience, mindfulness facets, and self-compassion. These effects suggest that participants experienced a tangible improvement that could potentially enhance their well-being. Adherence to the intervention was moderate, while program use was notable compared to similar interventions. Finding ways to promote adherence to the intervention would contribute to increasing the effectiveness of this program.
Trial Registration
ClinicalTrials.gov NCT05436717; https://clinicaltrials.gov/study/NCT05436717
International Registered Report Identifier (IRRID)
RR2-10.1186/s12912-022-01089-5
... Nevertheless, it should be considered that the effects of the program on every outcome were stronger when considering the per-protocol approach (the sample of intervention completers). Different studies have observed a significant association between an online program's dose and its effects on stress, among other outcomes [24,66,79,80], which highlights the importance of fostering treatment adherence. ...
BACKGROUND
The high levels of sustained stress that health professionals often experience pose a significant risk factor for developing mental health problems such as anxiety, depression, and somatic symptoms that not only affect their wellbeing but also have major social and organizational consequences. Different interventions, including those based on “third wave” psychotherapy principles (i.e., mindfulness, compassion, acceptance), have proved to be effective for reducing stress in this population. Among them, those delivered online constitute a promising alternative with notable advantages in terms of accessibility and flexibility, yet some adherence inconveniences that may limit their efficacy.
OBJECTIVE
The objective of this study was to evaluate the effectiveness of the MINDxYOU program, an online self-guided intervention based on “third wave” psychotherapy principles, to reduce perceived stress and promote mental health in a sample of health professionals.
METHODS
Following a stepped wedge cluster-randomized design, 357 health professionals working for different health centers in two Spanish regions (Aragón and Málaga) were recruited and distributed into 6 clusters, which were randomly allocated to three possible sequences. Sequentially, they were given access to the MINDxYOU program. This self-guided web-based program, which was designed to be completed in 8 consecutive weeks, included weekly contact (text message, phone call, or email) with the research team meant to foster adherence to the program. The study participants were assessed 5 times, once every 8 weeks. Every assessment was conducted online, and perceived stress was the primary outcome of the study; other clinical aspects (i.e., anxiety, depression, and somatization) and process variables (i.e., resilience, mindfulness, compassion, and acceptance) were also evaluated.
RESULTS
The online program was initiated by 229 participants, 112 (48.9%) of whom were completers (i.e., completed at least 3 of the 4 modules). Perceived stress demonstrated a significant reduction both when considering the entire sample (B= -1.08, SE= 0.51, P= .034) and the sample of completers (B= -1.84, SE= 0.62, P= .003). Intra-cluster analysis revealed that pre- vs. post-intervention moderate effects were present in two clusters, and that these were maintained in subsequent assessments. The linear mixed-effects models also showed that most secondary outcomes and process variables experienced significant effects when comparing the intervention and control phases.
CONCLUSIONS
The MINDxYOU program was effective in reducing perceived stress and promoting mental health, as well as increasing certain aspects, such as resilience, mindfulness facets, and self-compassion. Adherence to the intervention was moderate, while program utilization was notable compared to similar interventions.
CLINICALTRIAL
This study was registered on ClinicalTrials.gov on 29/06/2022; registration number: NCT05436717.
INTERNATIONAL REGISTERED REPORT
RR2-10.1186/s12912-022-01089-5
Mobile health (mHealth) apps have gained recognition as effective means of delivering interventions for managing stress, offering accessible and scalable alternatives to traditional therapies. However, from a persuasion standpoint , there is a notable gap in the literature regarding the design and effectiveness of mobile-based behaviour change apps for stress management over the years. Therefore, we conduct a comparative analysis to explore trends in persuasive mobile apps for stress management (PMAS) in the literature and in the wild from 2003 to 2024 (21 years). Specifically, we identify the most frequently used persuasive strategies in PMAS design, including their operationalization and effectiveness. Additionally, we compare the persuasive strategies employed in the academic literature and those in commercial apps, as well as examine the therapeutic frameworks for intervention design, target audience, evaluation methods, and effectiveness of PMAS in reducing stress. Based on our findings, we developed a two-stage framework for designing effective PMAS and offer recommendations for future research to address identified gaps.
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