Resilience as a Mediator in a Web-Based Intervention (MINDxYOU) to Reduce Stress Among #Health Care Professionals: Stepped-Wedge Cluster Randomized Trial
Background: The mechanisms through which mindfulness and third wave based #Digital programs exert their effects on stress reduction remain poorly understood. Identifying these mediators is essential to optimize their implementation, particularly in healthcare settings. This #Approach is particularly relevant for healthcare professionals, who are constantly exposed to high levels of emotional demands, work overload, and risk of burnout, especially in the aftermath of the COVID-19 pandemic. Despite the growing need for scalable and accessible #MentalHealth support in this population, such #Digital programs remain scarce and underutilized. Objective: The primary aim of this study was to analyze the psychological mechanisms through which the MINDxYOU online program may contribute to stress reduction among healthcare professionals, focusing on a mediation model. Specifically, we explored if variables such as resilience, facets of mindfulness, compassion, and acceptance mediated the effects of the intervention on perceived stress. Methods: In a stepped-wedge cluster randomized design, 357 #Health professionals from #Health centers in Aragon and Málaga, Spain, were recruited. They were divided into 6 clusters—3 per region—and randomly assigned to 1 of the 3 sequences, each starting with a control phase and then transitioning to the intervention phase (the MINDxYOU program) after 8, 16, or 24 weeks. This self-guided, web-based program, designed to be completed over 8 weeks, included weekly contact (via Whats#App, call, or email) from the research team to promote adherence. Participants were assessed on the web every 8 weeks for 5 assessments. Perceived stress was the study’s primary outcome, with additional measures of clinical factors (#anxiety, #depression, and somatization) and process variables (resilience, mindfulness, compassion, and acceptance). Mediation models using mixed-effects regressions and bootstrap resampling (1,000 iterations) were #Applied to analyze the direct and indirect effects of the treatment on psychological outcomes. Results: Resilience emerged as the most consistent and significant mediator, exerting a relevant indirect effect on reducing stress (B = -1.41, p =0 .028), #anxiety (B = -0.88, p = 0.034), and #depression (B = -0.97, p = 0.018), even in multivariate models. Mindfulness facets such as Observing, Describing, and non-reacting also showed significant, albeit less consistent, mediating effects. In contrast, compassion and acceptance were weakly associated and did not play a significant mediating role. Conclusions: These results demonstrate resilience as the key psychological mediator. Strengthening resilience through online interventions #Appears to be a crucial pathway for reducing stress and emotional symptoms in this population. Specific mindfulness skills may also contribute to the intervention’s therapeutic effect, although with less robust evidence. Clinical Trial: NCT05436717
