BMJ Mental Health (May 2024)

Work Engagement and Well-being Study (SWELL): a randomised controlled feasibility trial evaluating the effects of mindfulness versus light physical exercise at work

  • Caitlin Hitchcock,
  • Tim Dalgleish,
  • Peter Watson,
  • Julieta Galante,
  • Maris Vainre,
  • Quentin Dercon,
  • Christina Haag

DOI
https://doi.org/10.1136/bmjment-2023-300885
Journal volume & issue
Vol. 27, no. 1

Abstract

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Background Mindfulness-based programmes (MBPs) are increasingly offered at work, often in online self-guided format. However, the evidence on MBPs’ effect on work performance (WP) is inconsistent.Objective This pragmatic randomised controlled feasibility trial assessed procedural uncertainties, intervention acceptability and preliminary effect sizes of an MBP on WP, relative to an alternative intervention.Methods 241 employees from eight employers were randomised (1:1) to complete a 4-week, self-guided, online MBP or a light physical exercise programme (LE)(active control). Feasibility and acceptability measures were of primary interest. WP at postintervention (PostInt) was the primary outcome for preliminary assessment of effect sizes. Secondary outcomes assessed mental health (MH) and cognitive processes hypothesised to be targeted by the MBP. Outcomes were collected at baseline, PostInt and 12-week follow-up (12wFUP). Prospective trial protocol: NCT04631302.Findings 87% of randomised participants started the course. Courses had high acceptability. Retention rates were typical for online trials (64% PostInt; 30% 12wFUP). MBP, compared with the LE control, offered negligible benefits for WP (PostInt (d=0.06, 95% CI −0.19 to 0.32); 12wFUP (d=0.02, 95% CI −0.30 to 0.26)). Both interventions improved MH outcomes (ds=−0.40 to 0.58, 95% CI −0.32 to 0.18); between-group differences were small (ds=−0.09 to 0.04, 95% CI −0.15 to 0.17).Conclusion The trial is feasible; interventions are acceptable. Results provide little support for a later phase trial comparing an MBP to a light exercise control. To inform future trials, we summarise procedural challenges.Clinical implications Results suggest MBPs are unlikely to improve WP relative to light physical exercise. Although the MBP improved MH, other active interventions may be just as efficacious.Trial registration number NCT04631302.