Effects of a mindfulness app on employee stress: results of a randomised controlled trial in an Australian public sector workforce (Preprint)

BACKGROUND Workplace-based mindfulness programs (WMPs) have good evidence for improving employee stress and mental health outcomes, although less is known about effects on employee productivity and citizenship behaviours. Most of the supporting evidence for WMPs is derived from randomised controlled trials (RCTs) of programs that use in-person or online class-based approaches. Mindfulness apps have potential to increase access to training for distributed workforces, but little is known about whether self-directed app use is sufficient to realise benefits equivalent to WMPs that include classes. OBJECTIVE This study primarily aimed to assess the effectiveness of a mindfulness app, both with and without supporting classes, for reducing employees’ perceived stress. Changes in participants’ mindfulness, mental health, quality of life, perceptions of job demand, control and support, productivity indicators, and observer-reported changes in citizenship and mindful behaviours at work were also investigated. METHODS A three-arm randomised controlled trial was conducted in an Australian public sector workforce. The app used in the Smiling Mind Workplace Program (SMWP) formed the basis of the intervention. The app has 43 elements, including lessons, activities and guided meditations, and is supported by four instructional emails delivered over eight weeks. Usage guides recommend 10-20 minutes engagement with the app, five days a week. Reported data were collected using online surveys at baseline (T0), three-months from baseline (T1), then at six-months follow-up (T2). At T0 respondents could nominate a work-based observer to answer some questions about the participant’s behaviours. Eligible participants (n=211) were randomly assigned to self-guided app use plus four one-hour classes (App+), self-guided app use (App-only), or wait-list control (WLC). Linear mixed effects models were used to assess changes in the two active groups compared with the WLC at T1, and for head-to-head comparison of the App+ and App-only groups at follow-up. RESULTS App engagement by the App+ group (35%) and App-only group (13%) was considerably lower than the recommended dose. Compared with the WLC at T1, no significant change in perceived stress was observed in either active group. However, the App+ group, but not the App-only group, reported lower psychological distress (= -1.77, SE=0.75, P=.02, d=0. -21) and higher mindfulness (=0.31, SE=0.12, P=.01, d=0.19). These beneficial effects were retained in the App+ group at six-months. No significant changes were observed in the other study outcomes. Compared with the WLC at T1, observers reported no significant changes in either active group, however, at T2 the App+ participants were more noticeably mindful and altruistic at work than App-only participants. CONCLUSIONS Including classes in the training protocol appears to have motivated engagement and led to benefits, while self-guided app-use did not realise any significant results. Effect sizes were smaller and less consistent than meta-analytic estimates for class-based mindfulness training. CLINICALTRIAL ANZCTR Ref: 12617001386325

Download Full-text

Hearing dogs for people with severe and profound hearing loss: a wait-list design randomised controlled trial investigating their effectiveness and cost-effectiveness

Trials ◽

10.1186/s13063-021-05607-9 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Lucy Stuttard ◽

Philip Boyle ◽

Caroline Fairhurst ◽

Catherine Hewitt ◽

Francesco Longo ◽

...

Keyword(s):

Hearing Loss ◽

Public Sector ◽

Randomised Controlled Trial ◽

Controlled Trial ◽

Cost Effective ◽

Well Being ◽

The Public ◽

Hearing Dogs ◽

Randomised Controlled ◽

Mental Well Being

Abstract Background Hearing loss increases the risk of poor outcomes across a range of life domains. Where hearing loss is severe or profound, audiological interventions and rehabilitation have limited impact. Hearing dogs offer an alternative, or additional, intervention. They live permanently with recipients, providing sound support and companionship. Methods A single-centre, randomised controlled trial (RCT) evaluated the impacts of a hearing dog on mental well-being, anxiety, depression, problems associated with hearing loss (responding to sounds, fearfulness/social isolation), and perceived dependency on others. Participants were applicants to the UK charity ‘Hearing Dogs for Deaf People’. Eligibility criteria were as follows: first-time applicant; applying for a hearing dog (as opposed to other support provided by the charity). Participants were randomised 1:1 to the following: receive a hearing dog sooner than usual [HD], or within the usual application timeframe (wait-list [WL] comparator). The primary outcome was mental well-being (Short Warwick-Edinburgh Mental Well-Being Scale) 6 months (T1) after HD received a hearing dog. The cost-effectiveness analysis took a health and social care perspective. Results In total, 165 participants were randomised (HD n = 83, WL n = 82). A total of 112 (67.9%) were included in the primary analysis (HD n = 55, WL n = 57). At T1, mental well-being was significantly higher in the HD arm (adjusted mean difference 2.53, 95% CI 1.27 to 3.79, p < 0.001). Significant improvements in anxiety, depression, functioning, fearfulness/social isolation, and perceived dependency, favouring the HD arm, were also observed. On average, HD participants had used fewer statutory health and social care resources. In a scenario whereby costs of provision were borne by the public sector, hearing dogs do not appear to be value for money. If the public sector made a partial contribution, it is possible that hearing dogs would be cost-effective from a public sector perspective. Conclusions Hearing dogs appear to benefit recipients across a number of life domains, at least in the short term. Within the current funding model (costs entirely borne by the charity), hearing dogs are cost-effective from the public sector perspective. Whilst it would not be cost-effective to fully fund the provision of hearing dogs by the public sector, a partial contribution could be explored. Trial registration The trial was retrospectively registered with the International Standard Randomised Controlled Trial Number (ISRCTN) registry on 28.1.2019: ISRCTN36452009.

Download Full-text