{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T01:43:55Z","timestamp":1792374235238,"version":"4.4.0"},"reference-count":85,"publisher":"JMIR Publications Inc.","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Mhealth Uhealth"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Health care workers experience high stress. Accessible, affordable, and effective approaches to reducing stress are lacking. In-person mindfulness-based interventions can reduce health care worker stress but are not widely available or accessible to busy health care workers. Unguided, digital, mindfulness-based self-help (MBSH) interventions show promise and can be flexibly engaged with. However, their effectiveness in reducing health care worker stress has not yet been explored in a definitive trial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to investigate the effectiveness of an unguided digital MBSH app (Headspace) in reducing health care worker stress.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was a definitive superiority randomized controlled trial with 2182 National Health Service staff in England recruited on the web and allocated in a 1:1 ratio to fully automated Headspace (n=1095, 50.18%) or active control (Moodzone; n=1087, 49.82%) for 4.5 months. Outcomes were subscales of the Depression, Anxiety, and Stress (primary outcome) Scale short form; Short Warwick Edinburgh Mental Well-being Scale; Maslach Burnout Inventory; 15-item Five-Facet Mindfulness Questionnaire minus Observe items; Self-Compassion Scale\u2013Short Form; Compassionate Love Scale; Penn State Worry Questionnaire; Brooding subscale of the Ruminative Response Scale; and sickness absence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Intention-to-treat analyses found that Headspace led to greater reductions in stress over time than Moodzone (b=\u20130.31, 95% CI \u20130.47 to \u20130.14; P&lt;.001), with small effects. Small effects of Headspace versus Moodzone were found for depression (b=\u20130.24, 95% CI \u20130.40 to \u20130.08; P=.003), anxiety (b=\u20130.19, 95% CI \u20130.32 to \u20130.06; P=.004), well-being (b=0.14, 95% CI 0.05-0.23; P=.002), mindfulness (b=0.22, 95% CI 0.09-0.34; P=.001), self-compassion (b=0.48, 95% CI 0.33-0.64; P&lt;.001), compassion for others (b=0.02, 95% CI 0.00-0.04; P=.04), and worry (b=\u20130.30, 95% CI \u20130.51 to \u20130.09; P=.005) but not for burnout (b=\u20130.19, \u20130.04, and 0.13, all 95% CIs &gt;0; P=.65, .67, and .35), ruminative brooding (b=\u20130.06, 95% CI \u20130.12 to 0.00; P=.06), or sickness absence (\u03b3=0.09, 95% CI \u20130.18 to 0.34). Per-protocol effects of Headspace (454\/1095, 41.46%) versus Moodzone (283\/1087, 26.03%) over time were found for stress, self-compassion, and compassion for others but not for the other outcomes. Engagement (practice days per week) and improvements in self-compassion during the initial 1.5-month intervention period mediated pre- to postintervention improvements in stress. Improvements in mindfulness, rumination, and worry did not mediate pre- to postintervention improvements in stress. No serious adverse events were reported.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>An unguided digital MBSH intervention (Headspace) can reduce health care workers\u2019 stress. Effect sizes were small but could have population-level benefits. Unguided digital MBSH interventions can be part of the solution to reducing health care worker stress alongside potentially costlier but potentially more effective in-person mindfulness-based interventions, nonmindfulness courses, and organizational-level interventions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>International Standard Randomised Controlled Trial Number ISRCTN15424185; https:\/\/tinyurl.com\/rv9en5kc<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2196\/31744","type":"journal-article","created":{"date-parts":[[2022,8,25]],"date-time":"2022-08-25T10:00:41Z","timestamp":1661421641000},"page":"e31744","source":"Crossref","is-referenced-by-count":93,"title":["Health Care Workers\u2019 Need for Headspace: Findings From a Multisite Definitive Randomized Controlled Trial of an Unguided Digital Mindfulness-Based Self-help App to Reduce Healthcare 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