JMIR Publications

ABSTRACT

Background:

Poor mental health and emotional wellbeing can negatively impact the ability to engage in healthy lifestyle behavior change. Healthcare staff have higher sickness and absences rates than other public sector staff, which has implications at both individual and societal level. To support individual efforts to self-manage health and wellbeing and to add to the UK mental health prevention agenda, a co-designed, web-based, workplace health promotion programme was developed.

Objective:

To establish the feasibility and acceptability of the inclusion of a self-guided, automated, web-based Acceptance and Commitment Therapy intervention within an existing health promotion programme, to improve subjective wellbeing and encourage engagement with lifestyle behavior change.

Methods:

A 12-week, four-armed randomized controlled cluster feasibility study. Participants were recruited offline and randomized to one of three intervention arms or control (no wellbeing intervention) using an automated web-based allocation procedure. Eligibility criteria were; current healthcare staff in one Welsh health board, aged 18 plus, ability to read English and to provide consent. The primary researcher was blinded to cluster allocation. Feasibility outcomes included; randomization procedure, acceptance of intervention, and adherence and engagement to the wider programme. Health and wellbeing data were evaluated via self-assessment at two time points, registration and post-intervention, using the 14 item Warwick and Edinburgh Mental Wellbeing Scale (WEMWBS), the 4 item Patient Health Questionnaire (PHQ-4) and the 7 item Acceptance and Action Questionnaire version 2 (AAQ-II).

Results:

N=124 participants consented and were randomized. N=103 completed full registration and engaged with the programme. Most participants (76/103) enrolled on at least one health behavior change module and 43% of those randomized to an intervention arm enrolled onto the wellbeing module. Adherence and engagement was low (7%) however qualitative feedback was positive.

Conclusions:

The procedure and randomization process proved feasible and the addition of the wellbeing module proved acceptable to healthcare staff. However, participant engagement was limited and no one completed the full 12-week programme. User feedback should be used to develop the intervention to address poor engagement. Effectiveness should then be evaluated in a full-scale RCT, which would be feasible with additional recruitment. Clinical Trial: ISRCTN50074817 https://doi.org/10.1186/ISRCTN50074817