Data-analytic strategies for examining the effectiveness of daily interventions

Mindful Self-Compassion Smartphone Intervention for Worker Mental Health in Japan: Protocol for a Randomized Controlled Trial

BACKGROUND

Mental health problems among workers cause enormous losses to companies in Japan. However, workers have been considered to have limited access to psychological support because of time constraints, which makes it difficult for them to engage in face-to-face psychological support interventions.

OBJECTIVE

This study aimed to present an intervention protocol that describes a randomized controlled trial to examine whether brief guided mindfulness meditation (MM) or self-compassion meditation (SCM) provided by a smartphone app is effective for mental health and work-related outcomes among workers.

METHODS

This is an open-label, 3-arm randomized controlled trial. The participants will be recruited through an open call on relevant websites with the following inclusion criteria: (1) employees who are working more than 20 hours per week, (2) between the ages of 18 and 54 years, (3) not on a leave of absence, (4) not business owners or students, and (5) not currently diagnosed with a mental disorder and have a Kessler Psychological Distress Scale-6 score below 13 points. We will include 200 participants and randomly assign them to an SCM course (n=67), an MM course (n=67), and a waitlist group (n=66). The intervention groups (SCM and MM) will be instructed to engage in daily guided self-help, self-compassion, and MMs lasting 6-12 minutes per day over 4 weeks. Primary outcomes will include psychological distress and job performance, and secondary outcomes will include somatic symptoms, cognitive flexibility, self-esteem, self-compassion, perceived stress, well-being, emotion regulation, work engagement, anger, psychological safety, and creativity. All procedures were approved by the ethics committee of the University of Tokyo (22-326). All participants will be informed of the study via the websites, and written informed consent will be collected via web-based forms.

RESULTS

The recruitment of participants began in December 2022, and the intervention began in January 2023. As of September 2023, a total of 375 participants have been enrolled. The intervention and data collection were completed in late October 2023.

CONCLUSIONS

This study will contribute to the development of effective self-care intervention content that will improve mental health, work performance, and related outcomes and promote mindful and self-compassionate attitudes when faced with distress.

TRIAL REGISTRATION

University Hospital Medical Information Network Clinical Trials Registry UMIN000049466; https://tinyurl.com/23x8m8nf.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/53541.

A lighthearted approach to mindfulness: development and evaluation of a humor-enriched mindfulness-based program in a randomized trial

Objectives

Recently, research on mindfulness and humor has begun to spark interest, both being essential contributors to well-being. This article proposes that forms of humor that share intention and attitudinal foundations with mindfulness, constitute the foundation of a mindful-humorous perspective and mindful humor. Once intention and attitude are in alignment, shared mechanisms underlying a mindful-humorous perspective may lead to synergetic effects (e.g., reinforcing a shift in perspective and attitudinal foundations) as summarized in the proposed mindful humor filter model (MHFM). Based on this theoretical framework, the humor-enriched mindfulness-based program (HEMBP) was developed and evaluated for validity and efficacy in a randomized controlled trial as a first step to test the newly introduced model.

Methods

A total of 60 participants were randomly allocated to either the HEMBP or a wait-list control group. Participants' mindfulness, comic styles (e.g., benevolent humor, sarcasm, and cynicism), psychological well-being, life satisfaction, stress, and gelotophobia (fear of being laughed at) were assessed 1 week before and after training, and at a 1-month follow-up. Linear mixed-effects models were fitted to model changes in outcome variables over time.

Results

The HEMBP was effective in increasing mindfulness, benevolent humor, and psychological well-being, and in reducing sarcasm, cynicism, stress, and gelotophobia, compared to the control group.

Conclusion

Results support the validity and efficacy of the HEMBP as a promising approach for improving well-being and reducing stress. The HEMBP broadens the scope of existing mindfulness-based programs by cultivating a mindful-humorous outlook on life, facilitating mindfulness practice and insights, and fostering positive emotions and relationships with others through mindful humor. Results are also suggestive of the validity of the mindful humor filter model.

Comparing Web-Based and Blended Training for Coping With Challenges of Flexible Work Designs: Randomized Controlled Trial

BACKGROUND

Workers with flexible work designs (FWDs) face specific challenges, such as difficulties in detaching from work, setting boundaries between work and private life, and recovering from work.

OBJECTIVE

This study evaluated the effectiveness of an intervention in improving the recovery, work-life balance, and well-being of workers with FWDs compared with a waitlist control group. It also compares the effectiveness of a web-based training format and blended training format.

METHODS

In the web-based training format, participants individually completed 6 web-based modules and daily tasks over 6 weeks, learning self-regulation strategies to meet the particular challenges of FWDs. In the blended training format, participants attended 3 group sessions in addition to completing the 6 web-based modules. In a randomized controlled trial, participants were assigned to a web-based intervention group (196/575, 34.1%), blended intervention group (198/575, 34.4%), or waitlist control group (181/575, 31.5%). Study participants self-assessed their levels of primary outcomes (psychological detachment, satisfaction with work-life balance, and well-being) before the intervention, after the intervention, at a 4-week follow-up, and at a 6-month follow-up. The final sample included 373 participants (web-based intervention group: n=107, 28.7%; blended intervention group: n=129, 34.6%; and control group: n=137, 36.7%). Compliance was assessed as a secondary outcome.

RESULTS

The results of multilevel analyses were in line with our hypothesis that both training formats would improve psychological detachment, satisfaction with work-life balance, and well-being. We expected blended training to reinforce these effects, but blended training participants did not profit more from the intervention than web-based training participants. However, they reported to have had more social exchange, and blended training participants were more likely to adhere to the training.

CONCLUSIONS

Both web-based and blended training are effective tools for improving the recovery, work-life balance, and well-being of workers with FWDs. Group sessions can increase the likelihood of participants actively participating in web-based modules and exercises.

TRIAL REGISTRATION

German Clinical Trials Register DRKS00032721; https://drks.de/search/en/trial/DRKS00032721.

Daily automated feedback enhances self-regulated learning: a longitudinal randomized field experiment

The goal of the present study was to investigate the effects of automatically generated, adaptive feedback on daily self-regulated learning (SRL) in an experimental field study. University students reported their application of SRL strategies in the morning and in the evening over the course of 36 days using electronic learning diaries. Students were randomly assigned to the experimental group with feedback (LDF, n = 98) or the control group without feedback (LD, n = 96). Based on their self-reports, students in group LDF received daily written feedback regarding their satisfaction with the study day, adherence to time schedule, procrastination, and effort. This feedback either reinforced students in their study approach (confirmative feedback), encompassed information on learning outcomes or processes (informative feedback), or included feed forward on how to improve learning processes (transformative feedback). Multilevel analysis of daily process data revealed better average goal setting, planning and adherence to time schedule, as well as higher self-efficacy, and satisfaction with the study day in group LDF compared to group LD. Motivation, procrastination and effort were not affected by feedback. In contrast to the process measures, pre-post comparisons of students' self-reported general use of SRL strategies (trait measures) did not reveal any effects of feedback on SRL. Further explorative analyses investigated the effects of confirmative, informative, and transformative feedback on next day's learning behavior, showing that confirmative and transformative feedback had stronger effects on students' satisfaction and procrastination than informative feedback. Transformative feedback, which included specific strategies for moving forward, was effective in improving time management. Results provide theoretical insight into the interplay of feedback and SRL and offer practical implications regarding the design of feedback in a learning context.

Preliminary effectiveness of an evidence-based mobile application to promote resilience among working adults in Singapore and Hong Kong: Intensive longitudinal study

Evidence-based mobile health (mHealth) applications on smartphones are a cost-effective way for employees to take proactive steps to improve well-being and performance. However, little is known about what sustains engagement on these applications and whether they could dynamically improve occupational outcomes such as resilience and mood. Using real-world data, this intensive longitudinal study examines (a) which employees would continually engage with a cognitive behavioural therapy-informed mHealth application ('Intellect'); and (b) if daily engagement of 'Intellect' would relate to better occupational outcomes on the following day. A total of 515 working adults in Singapore and Hong Kong (Mage = 32.4, SDage = 8.17) completed daily in-app items on mood and resilience components (i.e. sleep hours, sleep quality, physical activity, and stress levels). Our results revealed that employees with lower baseline resilience (β = -0.048, odds ratio (OR) = 0.953, p < 0.01), specifically poorer sleep quality (β = -0.212, OR = 0.809, p = 0.001) and/or higher stress levels (β = -0.255, OR = 0.775, p = 0.05), were more likely to resume engagement on the application. Among the 150 active users (i.e. ≥3 consecutive days of engagement) (Mage = 32.2, SDage = 8.17), daily engagement predicted higher resilience (β = 0.122; 95% confidence interval (CI) 0.039-0.206), specifically lower stress levels (β = 0.018; 95% CI 0.004-0.032), higher physical activity (β = 0.079; 95% CI 0.032-0.126), and mood levels (β = 0.020; 95% CI 0.012-0.029) on the following day even after controlling for same-day outcomes. Our preliminary findings suggest that engaging with a mHealth application was associated with higher dynamic resilience and emotional well-being in employees.

From asymmetric to symmetric consumption opportunities: Extractions from common resources by privileged and underprivileged group members

In social dilemmas, asymmetric opportunities among actors can aggravate the conflict between individual and collective interests. We examine if and under what conditions redistributing extraction opportunities symmetrically fosters sustainable resource consumption. Participants in two studies (total n=640) completed a common resource game, first under asymmetric distribution of extraction opportunities (i.e., two advantaged group members could extract more than two disadvantaged group members) and then under symmetric distribution (i.e., all group members could extract the same amount). Advantaged (vs. disadvantaged) individuals took more from the resource in the asymmetric game and voted more often for the maintenance of the asymmetric system. Consumption was overall not more sustainable under symmetric (vs. asymmetric) distribution. We did not find evidence that these effects depend on the legitimacy of status positions. Of note, the symmetric game elicited higher satisfaction and fairness ratings in both status groups. The findings demonstrate how unequal access to resources fosters unequal consumption despite broad support for symmetry as the fairer system.

Why Do We Punish?

Abstract. We investigated whether individuals’ punishment behavior aims at compensating for inflicted harm (i.e., retribution) or at deterring the offender from committing the offense again (i.e., deterrence) and whether punishment motives depend on the punishment system. Participants ( N = 149) assigned punishment for selfish decisions in a group resource allocation task under three conditions: Open punishment (the allocator is informed about the punishment, allowing for retribution and deterrence); hidden punishment (the allocator is not informed about the punishment, precluding deterrence); and unintentional offense (decision is made by the computer not the allocator, precluding retribution and deterrence). In line with retribution motives, participants assigned more punishment under hidden punishment compared to unintentional offense and open punishment. We found these differences in punishment between punishment conditions only under centralized punishment (i.e., punishment can only be executed by one group member), but not under decentralized punishment (i.e., each group member can punish).

A school rampage threatens beliefs in justice: A longitudinal study of the belief in a just world among Chinese adolescents

INTRODUCTION

The current study examined whether and how severe injustice such as a school attack threatens the belief in a just world (BJW).

METHOD

We collected longitudinal data on the BJW from adolescents in China who witnessed random school attacks on the news (N = 227).

RESULTS

Change analyses provided evidence that the BJW increased after witnessing severe injustice. Furthermore, we tested for moderating effects of buffer variables, such as life satisfaction and perceived social support, on change in the BJW. Findings showed that these variables buffered the threat to the BJW after observing unfairness.

DISCUSSION

We discuss these results in the context of justice motive theory and suggest implications for future research and practical implications.

Promoting recovery in daily life: study protocol for a randomized controlled trial

BACKGROUND

Work-related stress shows steadily increasing prevalence rates and has tangible consequences for individual workers, their organizations, and society as a whole. One mechanism that may help offset the negative outcomes of work-related stress on employees' well-being is recovery. Recovery refers to the experience of unwinding from one's job when not at work. However, employees who experience high levels of work-related stress and are thus particularly in need of recovery tend to struggle to switch-off. Due to the detrimental effects of this prolonged and sustained mental representation of job stressors, interventions promoting recovery may contribute to improvements in employees' mental health.

METHODS

In this randomized, waitlist controlled trial, we will investigate the effectiveness of two 6-week online training programs (cognitive behavioral and mindfulness-based). The sample will include employees working at least part-time during regular work hours. Besides the pre-post-follow-up assessments, the trial will include measurement bursts with the goal of examining the underlying mechanisms. We expect that both interventions will reduce work-related perseverative thinking (PT) compared with the waitlist control groups (primary outcome). Also, we expect that both interventions will result in similar improvements, but the underlying mechanisms will differ (process outcomes). In the cognitive-behavioral intervention group, we expect that the main mechanism responsible for lower PT levels will be an increase in recovery experiences across time. In the mindfulness-based group, we expect that the main mechanism responsible for lower PT levels will be an increase in facets of mindfulness across time.

DISCUSSION

In the present study, we will investigate mechanisms underlying assumed changes in work-related PT in great detail. Besides evaluating the overall effectiveness of the two interventions in terms of pre-post-follow-up changes, we will look at the underlying processes at different levels-that is, within days, within weeks, across weeks, and between individuals. Accordingly, our study will offer a fine-grained approach to investigating potential determinants, mediators, and moderators of the processes that may, in the end, be responsible for work-related strain. From a public health perspective, if effective, the online training programs may offer valuable, low-threshold, and low-intensity interventions for a broad range of occupations. Trial registration German Clinical Trials Registration: DRKS00024933. Registered prospectively 7 April 2021. https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00024933.

Daily interventions and assessments: The effect of online self-compassion meditation on psychological health

Traditional self-compassion-based interventions have been shown to be beneficial for improving psychological health. With the development of technology, online interventions accessible via smart phones start to emerge. The current study aimed to use daily assessments to investigate the effect of online daily self-compassion interventions and its improvement pattern. Sixty-five employees were recruited and completed a 4-week study. The first week was the control period; the second week and the third week were the intervention period and the fourth week was the follow-up period. Online self-compassion meditation significantly improved daily self-compassion and reduced perceived stress and emotional exhaustion, with varied changing patterns. Daily self-compassion and perceived stress did not change in the control period, then started to increase/decline with time during the intervention period, and remained stable in the follow-up period. Daily emotional exhaustion declined with time in the control period and remained stable in the intervention and follow-up period. The intervention effects did not differ for individuals with different levels of trait self-compassion. This study shows that daily online self-compassion meditation is effective and reveals how it works. Future studies can apply this method to examine the effectiveness of other daily online interventions.

Experiments in the Wild: Introducing the Within-Person Encouragement Design

The within-person encouragement design introduced here combines methodological approaches from three research traditions: (a) the analysis of within-person couplings using multilevel models, (b) the experimental manipulation of a treatment variable at the within-person level, and (c) the use of random encouragements as instrumental variables to induce exogenous experimental variation when strict treatment adherence is unrealistic. The proposed combination of these approaches opens up new possibilities to study treatment effects of a broad range of behavioral variables in realistic everyday contexts. We introduce this new research design together with a corresponding data analysis framework: instrumental variable estimation with two-level structural equation models. Using simulations, we show that the approach is applicable with feasible design dimensions regarding numbers of measurement occasions and participants and realistic assumptions about adherence to the encouragement conditions. Possible applications and extensions, as well as potential problems and limitations are discussed.

Boosting healthy food choices by meal colour variety: results from two experiments and a just-in-time Ecological Momentary Intervention

BACKGROUND

Dietary guidelines typically specify rather complex goals and indicators for healthy food choices, such as nutrient and energy content patterns. However, translating these complex goals into practice in real life is often a major obstacle for many people. The present studies propose an intervention strategy for boosting healthy food choices by prompting consumers at a meaningful moment with a simple behavioural trigger, that is to eat a colourful lunch. Effectivity and feasibility of this intervention strategy were tested in two laboratory experiments and one real-life, smartphone-based Ecological Momentary Intervention.

METHODS

In Studies 1 and 2, 83 / 42 participants self-served four meals (colourful, typical, healthy, and low-calorie) / three meals (colourful, typical, and varied) from a Fake Food Buffet. In Study 3, 80 participants recorded images of 1,210 lunch meals over a period of 3 weeks using mobile visual food recording. In the second week, participants additionally received a daily smartphone prompt to eat a colourful lunch. In all studies, participants were asked to rate the prompts' feasibility.

RESULTS

Prompting participants to eat a colourful meal increased the proportion of healthy foods consumed compared to typical meals in all three studies. In Studies 1 and 2, colourful meals contained more fruit and vegetables, while in Study 3 the prompt increased vegetable consumption. Furthermore, participants evaluated colourful meals to be the tastiest (Study 1) and most pleasant, and reported that the prompt was easy to follow and act upon.

CONCLUSIONS

Results suggest that prompting individuals to eat colourful meals is a promising strategy to facilitate healthy food choices in daily life.

TRIAL REGISTRATION

German Clinical Trials Register, DRKS00017552 (Study 3; retrospectively registered on 24th June 2019).

Acceptance and treatment effects of an internet-delivered cognitive-behavioral intervention for family caregivers of people with dementia: A randomized-controlled trial

OBJECTIVES

The study evaluated the efficacy of an internet-delivered cognitive-behavioral intervention for caregivers of people with dementia and examined acceptance of program characteristics.

METHOD

Thirty-nine caregivers (M _age  = 62.11 ± 9.67, 78.4% female) were enrolled in a 2 × 3 randomized-controlled trial (RCT) that compared an intervention and wait-list control group. A cognitive-behavioral intervention program was adapted for delivery via an internet platform. Participants exchanged eight weekly messages with a therapist.

RESULTS

Treatment satisfaction and acceptance of the program were high. Well-being increased over the intervention duration and intervention group participants were better able to cope with the anticipated death of the care recipient and utilized more psychosocial resources after the intervention ended. Effects were not maintained until follow-up and there were no treatment effects for depression and burden of care.

CONCLUSIONS

Internet-delivered cognitive-behavioral interventions are suitable for caregivers. A larger RCT needs to investigate possible combinations of classic and internet-delivered programs and confirm efficacy.

Persuasive technology to support active and healthy ageing: An exploration of past, present, and future

The age of the population worldwide is rapidly increasing, bringing social and economic challenges. Persuasive technology can alleviate the burden on traditional healthcare services when used to support healthy behaviors, for instance in the prevention and treatment of chronic diseases. Additionally, healthy behaviors are key factors for active and healthy ageing by delaying or even reversing functional decline. In this manuscript, we present a multi-perspective analysis of technologies that can be used in the support of active and healthy ageing in the daily life. First, we take the perspective of physical and mental health, by focusing on the promotion of physical activity and emotional wellbeing. From a temporal perspective, we look at how technology evolved from past, present and future. The overview of the literature is structured in four main sections: (1) measurement of current behavior (monitoring), (2) analysis of the data gathered to derive meaningful information (analyzing & reasoning), (3) support the individual in the adoption or maintenance of a behavior (coaching), and (4) tools or interfaces that provide the information to the individual to stimulate the desired behavior (applications). Finally, we provide recommendations for the design, development and implementation of future technological innovations to support Active and Healthy Ageing in daily life.

Does the distribution frequency matter? A subgroup specific analysis of the effectiveness of the EU School Fruit and Vegetable Scheme in Germany comparing twice and thrice weekly deliveries

OBJECTIVE

The present study aimed to examine the effectiveness of two different implementation forms of the EU School Fruit and Vegetable Scheme (SFVS).

DESIGN

A quasi-experimental design was applied including a thrice as well as a twice weekly intervention group. Repeated 24 h dietary recalls were used to measure children's fruit and vegetable (F&V) intake. Effects were analysed on days with and without F&V deliveries using hierarchical linear regression models.

SETTING

Twelve primary schools in North Rhine-Westphalia, Germany.

SUBJECTS

Third and fourth graders (n 664).

RESULTS

Average daily F&V intake at pre-intervention was 0·84 frequencies in the thrice weekly intervention group, 0·90 frequencies in the twice weekly intervention group and 1·25 frequencies in the control group. Providing children thrice weekly with F&V increased children's F&V intake on average by 0·96 (P<0·001) frequencies/d. The effects were higher on days with (1·07; P<0·001) than on days without (0·75; P<0·001) F&V deliveries. Distributing F&V twice weekly resulted in an increase of 0·75 (P<0·001) frequencies/d on average, again with higher effects on days with (1·30; P<0·001) than without (0·48; P<0·003) F&V deliveries. Subgroup analysis revealed some indications for differential effectiveness only in the twice weekly intervention group.

CONCLUSIONS

The SFVS with thrice or twice weekly deliveries of F&V led to a significant increase in children's F&V intake on days with and without deliveries. The latter might provide an indication of positive long-term effects of the scheme. The scheme shows equal efficiency for almost all subgroups.

Supportive Mental Health Self-Monitoring among Smartphone Users with Psychological Distress: Protocol for a Fully Mobile Randomized Controlled Trial

Mobile health (mHealth) could be widely used in the population to improve access to psychological treatment. In this paper, we describe the development of a mHealth intervention on the basis of supportive self-monitoring and describe the protocol for a randomized controlled trial to evaluate its effectiveness among smartphone users with psychological distress. Based on power analysis, a representative quota sample of N = 186 smartphone users will be recruited, with an over-sampling of persons with moderate to high distress. Over a 4-week period, the intervention will be compared to a self-monitoring without intervention group and a passive control group. Telephone interviews will be conducted at baseline, post-intervention (4 weeks), and 12-week follow-up to assess study outcomes. The primary outcome will be improvement of mental health. Secondary outcomes will include well-being, intentions toward help-seeking and help-seeking behavior, user activation, attitudes toward mental-health services, perceived stigmatization, smartphone app quality, user satisfaction, engagement, and adherence with the intervention. Additionally, data from the user's daily life as collected during self-monitoring will be used to investigate risk and protective factors of mental health in real-world settings. Therefore, this study will allow us to demonstrate the effectiveness of a smartphone application as a widely accessible and low-cost intervention to improve mental health on a population level. It also allows to identify new assessment approaches in the field of psychiatric epidemiology.

Führungskräfte-Coaching bei Change Prozessen

Zusammenfassung. Ziel dieser Längsschnittstudie ist es, die Wirkung von Führungskräfte-Coaching bei organisationalen Change Prozessen auf die berufliche Selbstwirksamkeitserwartung, das Führungsverhalten und den Affekt von Führungskräften zu evaluieren. Dabei wird der Einfluss von Autonomie und Managementunterstützung als moderierende Kontextbedingungen berücksichtigt. Den theoretischen Rahmen bildet das Job Demands-Resources Model ( Demerouti, Bakker, Nachreiner & Schaufeli, 2001 ). Mit einem quasi-experimentellen Kontrollgruppendesign wurden 66 Führungskräfte im mittleren Management unterschiedlicher Organisationen während laufender Change Prozesse (NEG = 28; NKG = 38) zu drei Messzeitpunkten befragt. Die Multilevel-Analysen ergaben signifikante Dreifach-Interaktionseffekte, die zeigen, dass Führungskräfte mit Coaching (EG) bei hoher Autonomie bzw. hoher Managementunterstützung nach sechs Monaten (T3) höhere Werte hinsichtlich beruflicher Selbstwirksamkeitserwartung, Führungsverhalten und positivem Affekt sowie niedrigere Werte im negativen Affekt aufweisen als Führungskräfte ohne Coaching (KG). Basierend auf den Ergebnissen werden praxisorientierte Handlungsempfehlungen für Führungskräfte, Coaches und Personalentwickler abgeleitet, damit Coaching bei organisationalen Veränderungen wirksam werden kann.