App-based Mindfulness Training for Employee Stress Protection

INTERVENTION: The two intervention arms in this study are: Arm 1. App group will use the Smiling Mind Workplace App for self‐guided progression. Arm 2. App+ group will use the Smiling Mind Workplace App, and attend four 1‐hour seminars. The Smiling Mind Workplace App (the App) is a complete online learning tool for mindfulness training. The App’s modules (Everyday Mindfulness, Calm, Clarity, Connection and Mindful Mastery) each include instructional videos, meditations (e.g. 7 and 15‐minute sitting and body scan practices) and brief practices and activities to help bring moments of informal mindfulness into the everyday (e.g. 1 and 3‐minute practices for moving with awareness between meetings, breathing techniques, and listening). In total, there are 41 different App elements. While the App provides user guidance, the amount of time spent each day engaging with App elements is at the discretion of participants. The App is supported by fortnightly email communications for the first 10 weeks, which include suggestions for how to use App elements, e.g. “Find a time that works for you each day, maybe it’s first thing in the morning, or before you go to sleep. Create a routine”; and “Listen to 'Brain Break: the breath' when you need a brief moment during your day to stop and reset”. The App can be used as a stand alone training program or can be offered in conjunction with face to face seminars, which are run in the initial 10 week period. Licences to the full App content last for 12‐months. The four seminars (attended by the App+ group) will be held at multiple locations at three different times in weeks 1, 2, 4 and 6, and be delivered by an experienced organisational consultant and mindfulness teacher. Attendance will be in‐person or via video‐conference. Each seminar has a key message: choosing to respond mindfully to stressors; remaining calm in the face of demands; managing attention wisely; and cultivating good relationships with the self and others. Attendance at the seminars will be collected by self‐report, and venue count data. User data from the Smiling Mind Servers will enable objective assessment of adherence to the App program. Participant ratings of the usefulness of the seminars and different elements of the App will also be collected. CONDITION: Stress PRIMARY OUTCOME: Perceived Stress Scale ‐ 10 item INCLUSION CRITERIA: INCLUSION CRITERIA: current employees of Tasmanian Training Consortium (TTC) client organisations with approval to attend seminars, who are not participating in any concurrent health and wellbeing program(s) and who do not have an unmanaged mental health condition, Eligibility criteria: 1) line managers’ approval to attend all seminars; 2) no concurrent participation in meditation or stress‐management programs; 3) PHQ‐9 scores less than or equal to 15, and no indication of suicide ideation; 4) evidence of appropriate management for pre‐existing mental health condition (assessed by study psychologist) SECONDARY OUTCOME: Health‐related lost productive time. This outcome is assessed using participant self reports of absenteeism and presenteeism days over the preceding 4‐weeks. The number of inefficient days is calculated from the reported number of presenteeism days and self‐rated productivity on those days (e.g. six presenteeism days at 60% productivity: [(100–60%) × 6 days] = 2.4 inefficient days. Total lost productive time is the sum of absenteeism days and inefficient days. Health‐related quality of life will be assessed using the Assessment of Quality of Life 8 Dimension instrument (AQoL‐8D), a multi‐attribute utility instrument which provides data for Physical (independent living, senses, pain) and Psychosocial (mental health, relationships, coping, self‐worth, happiness) domains. Kessler‐10 Measure of Psychological Distress Mindful Attention and Awareness Scale Observed Mindfulness Measure ‐ informant reports of the presence and extent of mindfulness of study participants Organisational citizenship behaviours, using Smith's 16‐item Organizational Citizenship Behaviour questionnaire (Informant report) Perceived usefulness of the program will be assessed using self‐report ratings of the App elements, seminar attendance for the App+ group (whether, where and how they attended) and responses from all participants to an open question "Can you please take a few moments to share with us your general impressions of the Smiling Mind Workplace Program?". Program adherence will be assessed using participant data from the Smiling Mind Servers throughout the 12 month App licence period. This covers usage during the active intervention phase and allows monitoring of ongoing engagement with the App. Seminar attendance will be measured by self‐report and count data from seminar venues. Psychosocial job quality will draw on self‐reports of job demand, control and support. Items from the Household, Income and Labour Dynamics (HILDA) Survey for Job Demand and Control; and Support items drawn from the Swedish Job Demand Control Support (JDCS) Survey will be used. Workplace incidents (safety, damage, conflict, achievement or success). The World Health Organization Health and Performance Questionnaire (HPQ) item A8 is used for this outcome.