Effectiveness of an online self-guided intervention (MINDxYOU) for reducing stress and promoting mental health among health professionals: results from a stepped wedge cluster-randomized trial (Preprint)

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