A mindfulness-based program implemented at the Clinical Center at the National Institutes of Health (NIH) in Bethesda, Maryland, was found to effectively reduce stress among health care professionals. Program results, published in JAMA Network Open, support the widespread implementation of mindfulness-based self-care (MBSC) at other healthcare institutions in the United States.
This intent-to-treat randomized clinical trial was conducted between September 2017 and May 2018 at the NIH Clinical Center, a biomedical research hospital. NIH employees were recruited through group emails and flyers. Participants were randomized to 1 of 2 conditions: the MBSC group or the life-as-usual control group. The MBSC group comprised 5 weekly, 1.5-hour mindfulness practice sessions conducted at the NIH main campus during work hours. At-home mindfulness practice was also strongly encouraged, and educational materials were provided to guide at-home sessions.
Outcomes included stress and anxiety levels, assessed using the Perceived Stress Scale 10-item version (PSS-10) and Visual Analog Scale – Anxiety (VAS-A), respectively. Assessments were conducted at baseline, postintervention (week 5), and follow-up (week 13) by self-report. Feasibility was measured as a function of participant adherence and satisfaction with the MBSC condition.
Of 82 randomized participants, 78 completed 5 weeks of the study and were included in the intent-to-treat analysis. The median age of study completers was 32 years (interquartile range [IQR], 23-48 years), and the majority (83%) were women. Overall, 43 were randomized to the MBSC group, and 35 were randomized to the life-as-usual group. At the postintervention assessment (week 5), the MBSC group had significantly lower levels of stress (mean [SD] PSS-10 score: 17.29 [5.84] vs 18.54 [6.30]; P =.02) and anxiety (mean [SD] VAS-A score: 2.58 [1.52] vs 4.23 [1.73]; P <.001) compared to the control group. The MBSC group experienced substantial reductions at week 5 compared to the baseline in stress (change in PSS-10 score, -2.50; 95% CI, -4.28 to -0.72; P =.009) and anxiety (change in VAS-A score, -2.13; 95% CI, -2.79 to -1.48; P <.001). At the week 13 follow-up assessment, reductions in stress (-6.14; 95% CI, -7.84 to -4.44; P <.001) and anxiety (-1.46; 95% CI, -1.97 to -0.94; P <.001) were maintained in the MBSC group.
Retention was high in the MBSC condition. Of 43 participants, 35 completed the program, resulting in an adherence rate of 81.4%. The overall quality of the program was rated “very good” to “excellent” by 34 participants (97.1%). Additionally, 32 participants (91.4%) reported that the course was helpful and improved their overall quality of life.
These data support the efficacy and feasibility of a mindfulness-based education program for healthcare professionals at a biomedical research facility in the United States. The small cohort and single study site limit data generalizability. Replication at other institutions is necessary to confirm these findings. “Engaging both individual and organizational involvement toward reducing stress and enhancing mindfulness may have far-reaching effects on employee health, patient outcomes, and organizational success,” the investigators wrote.
Ameli R, Sinaii N, West CP, et al. Effect of a brief mindfulness-based program on stress in health care professionals at a US biomedical research hospital: a randomized clinical trial [published online August 25, 2020]. JAMA Netw Open. doi:10.1001/jamanetworkopen.2020.13424