Nature-Based + Virtual Mindfulness for Stress in Healthcare Workers

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: National Institutes of Health Clinical Center (CC)

Disqualifiers: Acute psychiatric condition, Hearing impairment

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 14

54 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to reduce stress in healthcare workers treating COVID-19 patients by combining outdoor activities with online mindfulness exercises. The goal is to see if this combination is more effective than either approach alone.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

Is Nature-Based + Virtual Mindfulness safe for healthcare workers?

Mindfulness-based interventions, similar to Nature-Based + Virtual Mindfulness, have been shown to be generally safe for healthcare workers, with only a small number of participants reporting minor adverse effects like increased anxiety or dizziness. ^{1 2 3 4 5}

How does the Nature+Mindfulness treatment for stress in healthcare workers differ from other treatments?

The Nature+Mindfulness treatment is unique because it combines nature exposure with mindfulness practices, potentially enhancing stress reduction through the calming effects of nature and the mental focus of mindfulness. This approach may offer a novel way to engage healthcare workers who might find traditional mindfulness practices challenging, by incorporating the soothing elements of nature. ^{4 5 6 7 8}

What data supports the effectiveness of the treatment Nature+Mindfulness for stress in healthcare workers?

Research shows that mindfulness-based interventions, like Mindfulness-Based Stress Reduction (MBSR) and mindfulness-based cognitive therapy, can significantly reduce stress and improve well-being among healthcare workers. Additionally, combining mindfulness with yoga has been effective in reducing stress and anxiety, suggesting that similar approaches could benefit healthcare workers. ^{1 4 5 7 9}

Who Is on the Research Team?

Ann Berger, MD

Principal Investigator

National Institutes of Health (NIH)

Are You a Good Fit for This Trial?

This trial is for healthcare workers over 18 who treat COVID-19 patients and can consent to participate. They must be fluent in English, have online access for study materials, and not have acute psychiatric conditions or unaided hearing impairments.

Inclusion Criteria

Is fluent in English

You are a healthcare worker who takes care of patients with COVID-19.

You are currently having a mental health crisis.

Exclusion Criteria

You have trouble hearing, even with the help of hearing aids or devices.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

1-2 weeks

Nature-based Intervention

Participants engage in a three-day nature-based intervention including activities such as hiking, mountain-biking, and kayaking

1 week

3 days (in-person)

Virtual Mindfulness Intervention

Participants complete a 10-day virtual mindfulness intervention with daily exercises such as mindful breathing, body scan, and loving-kindness meditation

2 weeks

10 sessions (virtual)

Follow-up

Participants are monitored for stress-related symptoms and psychological resilience

8 weeks

1 visit (in-person or virtual)

What Are the Treatments Tested in This Trial?

Interventions

• Nature+Mindfulness
• Nature Only

Trial Overview The trial tests if nature-based activities combined with virtual mindfulness reduce stress more effectively than just nature activities or no intervention. Ninety participants will be randomly assigned to one of three groups and assessed over approximately 11 weeks.

How Is the Trial Designed?

Group I: Nature+Mindfulness Experimental Treatment 1 Intervention

In the combined nature-based and virtual mindfulness intervention, participants will complete the nature intervention followed by the mindfulness intervention. The virtual mindfulness intervention is 10 days long and offered online. Each day the participant will receive a notification that a new mindfulness audio is ready for viewing, which is from 10 to 25 minutes long. Mindfulness exercises include mindful breathing, body scan, and loving-kindness meditation. Participants can view the daily audio as many times as they wish but cannot view the next day's content to maintain treatment fidelity. At the end of each day, participants will be asked to indicate if they viewed the mindfulness audio to track adherence.

Group II: Nature Only Active Control 1 Intervention

The nature-based intervention is three days long, is offered at various locations throughout the United States, and includes activities such as hiking, mountain-biking, and kayaking. The healthcare workers can participate in the programs that are offered locally pending availability. Each program will enroll between 15 and 30 healthcare workers. All First Descents nature-based interventions have been intentionally designed with input from more than 450 hospital partners nationwide to improve psychosocial health, nurture supportive peer relationships, and better position healthcare workers to carry out their critical mission. There is no cost to attend, and meals and lodging are included. Special precautions against SARS-CoV-2 transmission are implemented.

Group III: Control Active Control 1 Intervention

The control group will complete the first three assessments similar to the two treatment groups but will not participate in the nature-based or virtual mindfulness interventions. At the end of their study participation (\~week 3), they will be offered the opportunity to partake in the nature-based and virtual mindfulness interventions.

Who Is Running the Clinical Trial?

National Institutes of Health Clinical Center (CC)

Lead Sponsor

Trials

391

Recruited

30,880,000+

Published Research Related to This Trial

A mindfulness-based training program called Focusing significantly reduced perceived stress among 20 healthcare workers, with stress levels decreasing from an average of 21.4 to 17.5 after the intervention (P=0.0195).

Participants reported qualitative improvements such as increased calmness, better emotional self-regulation, and enhanced coping skills, indicating that the training effectively helped them manage work-related stress.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The educational intervention "Focusing" as a strategy to stress reduction among health care workers: a pilot study in an Italian teaching hospital. Rinaldi, A., Tecchio, R., Perugino, S., et al.[2020]

Citations

1. Switzerland pubmed.ncbi.nlm.nih.gov

Effect of Mindfulness-Based Stress Reduction on the Well-Being, Burnout and Stress of Italian Healthcare Professionals during the COVID-19 Pandemic. [2022]

2. Switzerland pubmed.ncbi.nlm.nih.gov

Yoga and Mindfulness as a Tool for Influencing Affectivity, Anxiety, Mental Health, and Stress among Healthcare Workers: Results of a Single-Arm Clinical Trial. [2020]

3. Italy pubmed.ncbi.nlm.nih.gov

The educational intervention "Focusing" as a strategy to stress reduction among health care workers: a pilot study in an Italian teaching hospital. [2020]

4. Spain pubmed.ncbi.nlm.nih.gov

Reducing stress and promoting well-being in healthcare workers using mindfulness-based cognitive therapy for life. [2021]

5. England pubmed.ncbi.nlm.nih.gov

How Effective are Mindfulness-Based Interventions for Reducing Stress Among Healthcare Professionals? A Systematic Review and Meta-Analysis. [2022]

6. United States pubmed.ncbi.nlm.nih.gov

Effect of Mindfulness-Based Stress Reduction Training on Health Care Worker Safety: A Randomized Waitlist Controlled Trial. [2019]

7. Switzerland pubmed.ncbi.nlm.nih.gov

Implementation of a Mindfulness-Based Crisis Intervention for Frontline Healthcare Workers During the COVID-19 Outbreak in a Public General Hospital in Madrid, Spain. [2020]

8. Switzerland pubmed.ncbi.nlm.nih.gov

Exploring the Use of Virtual Reality for the Delivery and Practice of Stress-Management Exercises. [2021]

9. England pubmed.ncbi.nlm.nih.gov

The influence of mindfulness-based stress reduction on the work life of healthcare professionals - A qualitative study. [2023]