Acceptability, Feasibility, and Efficacy of a Workplace Mindfulness Program for Public Sector Employees: a Pilot Randomized Controlled Trial with Informant Reports
- 843 Downloads
Mindfulness training appears to reduce stress and distress, but little is known about whether it results in changes that can be observed by colleagues, family, or friends or its appropriateness as a workplace stress management intervention for a large and distributed public sector workforce. This study evaluated a pilot 5-week Mindfulness at Work Program (MaWP) for acceptability, feasibility, and efficacy in relation to stress and related mental health and productivity problems for public sector employees. A parallel group randomized controlled trial compared the MaWP intervention (n = 20) with an information-only control (n = 100). Exploratory qualitative and quantitative methods were used to assess changes observed by informants (n = 63). Results suggest a high degree of acceptability, although location and inflexible work schedules presented feasibility obstacles. Compared with the control, the primary outcome of mindfulness improved for MaWP participants (d = 0.57, p < 0.001), as did perceived stress (d = 0.97, p < 0.001), psychological distress (d = 0.61, p < 0.001), health-related quality of life (d = 0.51, p = 0.002), and social functioning (d = 0.08, p = 0.019). All secondary outcomes were at least partly mediated by changes in mindfulness. The intervention thus appears to have potential merit as a workplace intervention for public sector employees across a range of outcomes. Obtaining informant observations was feasible and while qualitative analyses indicated positive changes that supported self-reported outcomes, quantitative analyses returned ambiguous results. A seven-item scale adapted from a popular self-report mindfulness scale for use by informants showed promise, but further work is needed to establish validity, reliability, and scalability of this method of assessing observable changes following mindfulness training.
KeywordsMindfulness Workplace Stress Mental health Informants
This project was conducted at the Menzies Institute for Medical Research.
The primary author received support through the Groom Kennedy Lawyers Scholarship in Medical Research.
The study team gratefully acknowledges Pamela Lovell (Mindful Intent Pty Ltd) and Carl Cazaly (Tasmanian State Service Management Office) for facilitating this research as well as all participants and informants who completed surveys.
Compliance with Ethical Standards
Conflicts of Interest
Pamela Lovell (Director of Mindful Intent Pty Ltd) designed and delivered the MaWP. This author was not involved in study design, data collection, analysis, or interpretation. The remaining authors declare no potential conflicts of interest.
All procedures were in accordance with the ethical standards of the University of Tasmania’s Social Sciences Human Research Ethics Committee, which approved the study on April 2, 2015, with ID number H0014746. This article does not contain any studies with animals performed by any of the authors. Informed consent was obtained from all individual participants included in the study.
- Alidina, S., & Adams, J. (2014). Mindfulness at work for dummies. West Sussex, Great Britain: John Wiley & Sons.Google Scholar
- Allen, T. D., & Paddock, E. L. (2015). How being mindful impacts individuals’ work-family balance, conflict, and enrichment: a review of existing evidence, mechanisms and future directions. In: Mindfulness in Organizations: Foundations, Research, and Applications (pp. 213).Google Scholar
- Allexandre, D., Bernstein, A., Walker, E., Hunter, J., Roizen, M., & Morledge, T. J. (2016). A web-based mindfulness stress management program in a corporate call center: a randomized clinical trial to evaluate the added benefit of onsite group support. Journal of Occupational and Environmental Medicine, 58(3), 254–264.PubMedPubMedCentralCrossRefGoogle Scholar
- Australian Bureau of Statistics (2013). Australian and New Zealand Standard Classification of Occupations, 2013, Version 1.2 http://www.abs.gov.au/ANZSCO.Google Scholar
- Backé, E.-M., Seidler, A., Latza, U., Rossnagel, K., & Schumann, B. (2012). The role of psychosocial stress at work for the development of cardiovascular diseases: a systematic review. International Archives of Occupational and Environmental Health, 85(1), 67–79. doi: 10.1007/s00420-011-0643-6.PubMedCrossRefGoogle Scholar
- Baer, R. A. (2003). Mindfulness training as a clinical intervention: a conceptual and empirical review. Clinical Psychology: Science & Practice, 10(2), 125–143.Google Scholar
- Beehr, T. A. (2014). Psychological stress in the workplace (psychology revivals). London and New York: Routledge.Google Scholar
- Bhui, K. S., Dinos, S., Stansfeld, S. A., & White, P. D. (2012). A synthesis of the evidence for managing stress at work: a review of the reviews reporting on anxiety, depression, and absenteeism. Journal of Environmental and Public Health, 2012, 515874. doi: 10.1155/2012/515874.PubMedPubMedCentralCrossRefGoogle Scholar
- Boutron, I., Moher, D., Altman, D. G., Schulz, K. F., & Ravaud, P. (2008). Extending the CONSORT statement to randomized trials of nonpharmacologic treatment: explanation and elaboration. Annals of Internal Medicine, 148(4), 295–309. doi: 10.7326/0003-4819-148-4-200802190-00008.PubMedCrossRefGoogle Scholar
- Butterworth, P., Leach, L. S., Rodgers, B., Broom, D. H., Olesen, S. C., & Strazdins, L. (2011). Psychosocial job adversity and health in Australia: analysis of data from the HILDA Survey. Australian and New Zealand Journal of Public Health, 35(6), 564–571.Google Scholar
- Cartwright, S., & Cooper, C. L. (2014). Towards organizational health: stress, positive organizational behavior, and employee well-being. In Bridging Occupational, Organizational and Public Health (pp. 29–42). Netherlands: Springer.Google Scholar
- Floyd, R. G. (2005). Measurement properties of indirect assessment methods for functional behavioral assessment: a review of research. School Psychology Review, 34(1), 58–73.Google Scholar
- Frost, N. (2011). Qualitative research methods in psychology: combining core approaches. Maidenhead: Open University Press: McGraw-Hill Education.Google Scholar
- Grant, S. P., Mayo-Wilson, E., Melendez-Torres, G. J., & Montgomery, P. (2013). Reporting quality of social and psychological intervention trials: a systematic review of reporting guidelines and trial publications. PloS One, 8(5), e65442. doi: 10.1371/journal.pone.0065442.PubMedPubMedCentralCrossRefGoogle Scholar
- Gu, J., Strauss, C., Bond, R., & Cavanagh, K. (2015). How do mindfulness-based cognitive therapy and mindfulness-based stress reduction improve mental health and wellbeing? A systematic review and meta-analysis of mediation studies. Clinical Psychology Review, 37C, 1–12. doi: 10.1016/j.cpr.2015.01.006.CrossRefGoogle Scholar
- Höfler, M., Pfister, H., Lieb, R., & Wittchen, H.-U. (2005). The use of weights to account for non-response and drop-out. Social Psychiatry and Psychiatric Epidemiology, 40(4), 291.Google Scholar
- Hölzel, B. K., Lazar, S. W., Gard, T., Schuman-Olivier, Z., Vago, D. R., & Ott, U. (2011). How does mindfulness meditation work? Proposing mechanisms of action from a conceptual and neural perspective. Perspectives on Psychological Science, 6(6), 537–559. doi: 10.1177/1745691611419671.PubMedCrossRefGoogle Scholar
- Jarman, L., Martin, A., Venn, A., Otahal, P., Taylor, R., Teale, B., et al. (2014a). Prevalence and correlates of psychological distress in a large and diverse public sector workforce: baseline results from Partnering Healthy@Work. BMC Public Health, 14(1), 125.PubMedPubMedCentralCrossRefGoogle Scholar
- Jarman, L., Venn, A., Martin, A., Otahal, P., Ogle, F., & Sanderson, K. (2014b). Trends, costs and correlates of stress-related workers’ compensation claims in a public sector workforce. Journal of Health, Safety and Environment, 30(2), 243–258.Google Scholar
- Johnston, D. W., & Lee, W.-S. (2013). Extra status and extra stress: are promotions good for us? Industrial and Labor Relations Review, 66(1), 32–54.Google Scholar
- Kabat-Zinn, J. (2013). Full catastrophe living: how to cope with stress, pain and illness using mindfulness meditation. London: Piatkus.Google Scholar
- Kilpatrick, M., Sanderson, K., Blizzard, L., Nelson, M., Venn, A., Frendin, S., et al. (2014). Workplace health promotion: what public-sector employees want, need, and are ready to change. Journal of Occupational and Environmental Medicine, 56(6), 645–651. doi: 10.1097/JOM.0000000000000161.PubMedCrossRefGoogle Scholar
- Kilpatrick, M., Blizzard, L., Sanderson, K., Teale, B., & Venn, A. (2015). Factors associated with availability of, and employee participation in, comprehensive workplace health promotion (WHP) in a large and diverse Australian public-sector setting: a cross-sectional survey. Journal of Occupational and Environmental Medicine, 57(11), 1197–1206. doi: 10.1097/JOM.0000000000000538.PubMedCrossRefGoogle Scholar
- Lallukka, T., Ferrie, J., Kivimäki, M., Shipley, M., Sekine, M., Tatsuse, T., et al. (2014). Conflicts between work and family life and subsequent sleep problems among employees from Finland, Britain, and Japan. International Journal of Behavioral Medicine, 21(2), 310–318.PubMedCrossRefGoogle Scholar
- Levy, D. M., Wobbrock, J. O., Kaszniak, A. W., & Ostergren, M. (2012). The effects of mindfulness meditation training on multitasking in a high-stress information environment. Paper presented at the Proceedings of Graphics Interface 2012, Toronto, Ontario, Canada.Google Scholar
- Manotas, M., Segura, C., Eraso, M., Oggins, J., & McGovern, K. (2014). Association of brief mindfulness training with reductions in perceived stress and distress in Colombian health care professionals. International Journal of Stress Management, 21(2), 207–225. doi: 10.1037/a0035150.CrossRefGoogle Scholar
- McDonald, R. P. (1999). Test theory: a unified treatment. Mahwah, New Jersey: Lawrence Erlbaum Associates Publishers.Google Scholar
- Moher, D., Hopewell, S., Schulz, K. F., Montori, V., Gøtzsche, P. C., Devereaux, P. J., Elbourne, D., Egger, M., & Altman, D. G. (2010). CONSORT 2010 explanation and elaboration: updated guidelines for reporting parallel group randomised trials. Journal of Clinical Epidemiology, 63(8), e1–e37.Google Scholar
- Newby, J. M., McKinnon, A., Kuyken, W., Gilbody, S., & Dalgleish, T. (2015). Systematic review and meta-analysis of transdiagnostic psychological treatments for anxiety and depressive disorders in adulthood. Clinical Psychology Review, 40, 91–110. doi: 10.1016/j.cpr.2015.06.002.PubMedCrossRefGoogle Scholar
- Safe Work Australia. (2013). The incidence of accepted workers compensation claims for mental stress in Australia. Canberra, ACT: Safe Work Australia.Google Scholar
- Tabachnick, B. G., & Fidell, L. S. (2013). Using Multivariate Statistics (4th ed.). Boston: Harper Collins College Publishers.Google Scholar
- Tan, C.-M. (2012). Search inside yourself: increase productivity, creativity and happiness. HarperCollins.Google Scholar
- van Berkel, J., Boot, C. R. L., Proper, K. I., Bongers, P. M., & van der Beek, A. J. (2014). Effectiveness of a worksite mindfulness-related multi-component health promotion intervention on work engagement and mental health: results of a randomized controlled trial. PloS One, 9(1), e84118. doi: 10.1371/journal.pone.0084118.PubMedPubMedCentralCrossRefGoogle Scholar
- White, I. R., Horton, N. J., Carpenter, J., & Pocock, S. J. (2011). Strategy for intention to treat analysis in randomised trials with missing outcome data. British Medical Journal, 342(feb07 1), d40–d40.Google Scholar
- White, I. R., Carpenter, J., & Horton, N. J. (2012). Including all individuals is not enough: Lessons for intention-to-treat analysis. Clinical Trials, 9(4), 396–407.Google Scholar
- Wolever, R. Q., Bobinet, K. J., McCabe, K., Mackenzie, E. R., Fekete, E., Kusnick, C. A., et al. (2012). Effective and viable mind-body stress reduction in the workplace: a randomized controlled trial. Journal of Occupational Health Psychology, 17(2), 246–258. doi: 10.1037/a0027278.PubMedCrossRefGoogle Scholar
- Wooden, M., Freidin, S., & Watson, N. (2002). The household, income and labour dynamics in Australia (HILDA) survey: Wave 1. The Australian Economic Review, 35(3), 339–348.Google Scholar