Maintenance Notice

Due to necessary scheduled maintenance, the JMIR Publications website will be unavailable from Wednesday, July 01, 2020 at 8:00 PM to 10:00 PM EST. We apologize in advance for any inconvenience this may cause you.

Who will be affected?

Accepted for/Published in: JMIR Formative Research

Date Submitted: Jan 9, 2025
Date Accepted: Jul 5, 2025

The final, peer-reviewed published version of this preprint can be found here:

Optimizing Intervention Components of a Preventive Stress Management mHealth Intervention for Health Care Workers: Experimental Factorial Study

Kowalski L, Finnes A, Koch S, Bujacz A

Optimizing Intervention Components of a Preventive Stress Management mHealth Intervention for Health Care Workers: Experimental Factorial Study

JMIR Form Res 2025;9:e71032

DOI: 10.2196/71032

PMID: 41078177

PMCID: 12377794

Preventive Stress Management mHealth Intervention for Healthcare Workers: Factorial Experiment to Optimize Intervention Components

  • Leo Kowalski; 
  • Anna Finnes; 
  • Sabine Koch; 
  • Aleksandra Bujacz

ABSTRACT

Background:

Work stress is a prevalent risk factor for health problems such as burnout and cardiovascular disease. Mobile health interventions – digital interventions delivered via mobile devices - are a promising way to combat this issue, offering the possibility of scalable programs that are easily accessible. A wide range of evidence-based stress management techniques can be used in the digital context to mitigate the negative consequences of work stress. However, evidence is needed to support what specific intervention content is most effective at preventing symptoms of stress-related health problems.

Objective:

The primary aim of the research was to identify which digital intervention components are most effective at preventing symptoms of stress-related health problems. This may inform future intervention development and provide valuable insights for how to optimize intervention effects.

Methods:

This study tested five digital intervention components that may improve stress management among workers – Engagement, Demands, Control, Journaling, and Psychoeducation. In a factorial experimental study, Swedish healthcare workers (N = 283) tested different versions of the intervention containing all possible combinations of these components. Stress-related health outcomes such as burnout, anxiety, and depression were measured using questionnaires immediately before, immediately after, and one month after the end of the intervention.

Results:

The most promising intervention effects were observed when the Demands and Control components were present together in the intervention. Including these components led to an increase in social support (β = 0.68, p < 0.001) and job crafting (β = 0.41, p = 0.063) during the intervention, as well as a decrease in symptoms of emotional exhaustion (β = -0.50, p = 0.005), burnout (β = -0.54, p = 0.004), and anxiety (β = -0.44, p = 0.035) after the intervention.

Conclusions:

Results indicate that components aiding self-insight should be integrated with components providing actionable advice for optimal intervention effects. Results from this optimization study may inform the development of digital stress management interventions to be tested in future randomized controlled trials. Clinical Trial: NCT04719351


 Citation

Please cite as:

Kowalski L, Finnes A, Koch S, Bujacz A

Optimizing Intervention Components of a Preventive Stress Management mHealth Intervention for Health Care Workers: Experimental Factorial Study

JMIR Form Res 2025;9:e71032

DOI: 10.2196/71032

PMID: 41078177

PMCID: 12377794

Download PDF


Request queued. Please wait while the file is being generated. It may take some time.

© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.