A Web-Delivered Acceptance and Commitment Therapy Intervention With Email Reminders to Enhance Subjective Well-Being and Encourage Engagement With Lifestyle Behavior Change in Health Care Staff: Randomized Cluster Feasibility Stud
A Web-Delivered Acceptance and Commitment Therapy Intervention With Email Reminders to Enhance Subjective Well-Being and Encourage Engagement With Lifestyle Behavior Change in Health Care Staff: Randomized Cluster Feasibility Stud
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DOI：
10.2196/18586
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发表时间：
2020-08-01
影响因子：
2.2
通讯作者：
John, Ann
中科院分区：
文献类型：
--
作者：
Brown, Menna;Hooper, Nic;John, Ann
背景：心理健康和情绪健康状况不佳会对参与健康生活方式行为改变的能力产生负面影响。卫生保健工作人员的患病率和缺勤率高于其他公共部门工作人员，这对个人和社会都有影响。个人努力自我管理的健康和福祉，增加了英国的心理健康预防agenda.Objective：本研究的目的是建立一个自我指导，自动化，基于网络的接受和承诺治疗干预纳入现有的健康促进计划的可行性和可接受性，以提高主观幸福感，并鼓励参与生活方式的行为改变。在这项为期12周、4组、随机对照的群集可行性研究中，我们离线招募了参与者，并使用基于网络的自动分配程序将他们随机分配到3个干预组或对照组（无健康干预）中的1个。资格标准为1个威尔士卫生委员会的现任卫生保健工作人员，年龄≥ 18岁，能够阅读英语，并能够提供同意。主要研究者对群集分配不知情。可行性结果是随机化程序，接受干预，坚持和参与更广泛的计划。我们评估了健康和幸福的数据，通过自我评估在2个时间点，注册和干预后，使用14项沃里克-爱丁堡心理健康量表，4项患者健康问卷，和7项接受和行动量表修订版。结果：124名参与者提供同意，并随机分配，103完成了完整的注册，并从事该计划。大多数参与者（76/103）参加了至少一个健康行为改变模块，43%（41/96）的随机分配到干预组的参与者参加了幸福模块。依从性和参与度低（7/103，6.8%），但定性反馈是positive.Conclusions：程序和随机化过程证明是可行的，并证明可以接受的医疗保健人员的福祉模块的增加。然而，参与者的参与是有限的，没有人完成了完整的12周计划。应利用用户反馈制定干预措施，以解决参与度差的问题。然后，应该在一个全面的随机对照试验中评估有效性，这在额外招募的情况下是可行的。
Background: Poor mental health and emotional well-being can negatively impact ability to engage in healthy lifestyle behavior change. Health care staff have higher rates of sickness and absence than other public sector staff, which has implications at both individual and societal levels. Individual efforts to self-manage health and well-being which add to the UK mental health prevention agenda need to be supported.Objective: The objective of this study was to establish the feasibility and acceptability of the inclusion of a self-guided, automated, web-based acceptance and commitment therapy intervention in an existing health promotion program, to improve subjective well-being and encourage engagement with lifestyle behavior change.Methods: For this 12-week, 4-armed, randomized controlled cluster feasibility study, we recruited participants offline and randomly allocated them to 1 of 3 intervention arms or control (no well-being intervention) using an automated web-based allocation procedure. Eligibility criteria were current health care staff in 1 Welsh health board, age >= 18 years, ability to read English, and ability to provide consent. The primary researcher was blinded to cluster allocation. Feasibility outcomes were randomization procedure, acceptance of intervention, and adherence to and engagement with the wider program. We evaluated health and well-being data via self-assessment at 2 time points, registration and postintervention, using the 14-item Warwick-Edinburgh Mental Well-Being Scale, the 4-item Patient Health Questionnaire, and the 7-item Acceptance and Action Questionnaire-Revised.Results: Of 124 participants who provided consent and were randomly allocated, 103 completed full registration and engaged with the program. Most participants (76/103) enrolled in at least one health behavior change module, and 43% (41/96) of those randomly allocated to an intervention arm enrolled in the well-being module. Adherence and engagement was low (7/103, 6.8%), but qualitative feedback was positive.Conclusions: The procedure and randomization process proved feasible, and the addition of the well-being module proved acceptable to health care staff. However, participant engagement was limited, and no one completed the full 12-week program. User feedback should be used to develop the intervention to address poor engagement. Effectiveness should then be evaluated in a full-scale randomized controlled trial, which would be feasible with additional recruitment.