Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Dec 30, 2022
Open Peer Review Period: Dec 30, 2022 - Feb 24, 2023
Date Accepted: May 3, 2024
(closed for review but you can still tweet)
Complex Interactive Multimodal Intervention Improve Personalized Stress Management Among Healthcare Workers in China: a controlled non-randomized study
ABSTRACT
Background:
Healthcare is considered one of the most stressful occupations because multiple stressors exist in the workplace. Mobile stress management intervention is currently widely used in mental health intervention as an affordable and accessible approach. However, one of the major challenges in applying mobile intervention is the low interaction and engagement of participants, which hinders the optimal effects of mobile intervention, especially in self-guided mobile interventions where employees receive no human support during the intervention.
Objective:
The present study aims to compare the effects of CIMI, a complex interactive multimodal intervention, on physiological and psychological stress measures in comparison to the self-guided mobile intervention.
Methods:
We conducted a non-randomized, controlled study in two Chinese general hospitals. This study enrolled 245 healthcare workers who met the inclusion criteria for at least one of the three dimensions of the Depression, Anxiety, and Stress scale. All eligible participants were required to complete a questionnaire and wear a 24-hour Holter device to assess the physiological indicators of stress as indexed by heart rate variability at both baseline and post-intervention. During the program, participants in the CIMI group received a 12-week online intervention with the following four components: mobile stress management education, a web-based WeChat social network, tailored feedback, and a nurse coach, while the control group only received a self-guided intervention.
Results:
After a 12-week intervention, the perceived stress, depression, anxiety, fatigue, sleepiness symptoms, and subjective happiness in the CIMI group improved more significantly than those in the self-guided group. Additionally, we found a reduction in HRV parameters in the control group rather than the CIMI group.
Conclusions:
CIMI was an effective intervention for improving both psychological and physiological indicators of stress among distressed HCWs. The findings provide objective evidence for developing an effective and economically viable mobile stress management intervention with a minimum of human support, but further research is needed. Clinical Trial: ClinicalTrial.gov., NCT05239065; https://clinicaltrials.gov/ct2/show/NCT05239065.
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