A Qualitative Follow-Up to a Survey of Program Directors on Wellness Programming at a Large Healthcare Organization: Interviews of High- and Low-Exemplar Programs.

Background: The current research used a qualitative approach to understand which factors facilitate and hinder wellness programming in residency programs. Methods: Program directors identified from a previous quantitative study as having residency programs with notably more or less resident wellness programming than others (ie, high- and low-exemplars, respectively) were contacted. In total, semi-structured interviews were conducted over Zoom with 7 low-exemplars and 9 high-exemplars. Results: The results of this qualitative examination suggest common themes across the 2 exemplar groups, such as wanting more resources for resident wellness with fewer barriers to implementation, viewing wellness as purpose-driven, and seeing wellness as a shared responsibility. There were also critical distinctions between the exemplar groups. Those high in wellness programming expressed more of an emphasis on connections among residents in the program and between the faculty and residents. In contrast, those low in wellness programming described more barriers, such as staffing problems (ie, turnover and lack of faculty wellness) and a lack of integration between the varying levels involved in graduate medical education (GME) operations (ie, between GME programs and sponsoring hospitals, and between GME facilities and the larger health care organization). Conclusion: This study provides insight into program directors' experiences with wellness programming at a large health care organization. The results could point to potential next steps for investigating how the medical education community can improve resident wellness programming.

Lifestyle Medicine for the Health Care Worker, Workplace, and Community Well-Being: A Butterfly Effect.

Description Burnout is a prevalent and expensive problem in the US, and the National Plan For Health Workforce Well-Being included a goal to institutionalize well-being as a long-term value. Lifestyle Medicine (LM), an evidence-based practice using behavioral interventions to treat, prevent, and reverse certain chronic conditions, can achieve this goal. Implementing small changes in the workplace that support lifestyle medicine has a butterfly effect on both workplace and community well-being. Furthermore, the health of health care workers (HCWs) and patients improves, and health care costs decrease. This can be done with LM wellness programs or LM training for HCWs. LM wellness programs help the individual HCWs' and patients' well-being through the implementation of the 6 pillars of lifestyle medicine (nutrition, diet, stress reduction, social connection, avoiding/reducing toxins, restorative sleep) on an institutional level. LM initiatives, like LM training, help HCWs and their patients embark on this journey of optimal well-being, disease prevention, treatment, or reversal. Aligning policies to support evidence-based lifestyle changes that improve mood and stress reduction would support restorative rest, leaving HCWs less drained and allowing for more energy to be spent devoted to other lifestyle pillars. The Lifestyle Medicine Residency Curriculum is an example of an LM training program that leads to successful lifestyle change in residents' lives, improving their ability to coach patients. Finally, health care delivery that supports lifestyle medicine, such as shared medical appointments, is in alignment with the trend towards a value-based system for the improvement of public health.

Long-Term Efficacy of a Mobile Mental Wellness Program: Prospective Single-Arm Study.

BACKGROUND: Rising rates of psychological distress (symptoms of depression, anxiety, and stress) among adults in the United States necessitate effective mental wellness interventions. Despite the prevalence of smartphone app-based programs, research on their efficacy is limited, with only 14% showing clinically validated evidence. Our study evaluates Noom Mood, a commercially available smartphone-based app that uses cognitive behavioral therapy and mindfulness-based programming. In this study, we address gaps in the existing literature by examining postintervention outcomes and the broader impact on mental wellness. OBJECTIVE: Noom Mood is a smartphone-based mental wellness program designed to be used by the general population. This prospective study evaluates the efficacy and postintervention outcomes of Noom Mood. We aim to address the rising psychological distress among adults in the United States. METHODS: A 1-arm study design was used, with participants having access to the Noom Mood program for 16 weeks (N=273). Surveys were conducted at baseline, week 4, week 8, week 12, week 16, and week 32 (16 weeks' postprogram follow-up). This study assessed a range of mental health outcomes, including anxiety symptoms, depressive symptoms, perceived stress, well-being, quality of life, coping, emotion regulation, sleep, and workplace productivity (absenteeism or presenteeism). RESULTS: The mean age of participants was 40.5 (SD 11.7) years. Statistically significant improvements in anxiety symptoms, depressive symptoms, and perceived stress were observed by week 4 and maintained through the 16-week intervention and the 32-week follow-up. The largest changes were observed in the first 4 weeks (29% lower, 25% lower, and 15% lower for anxiety symptoms, depressive symptoms, and perceived stress, respectively), and only small improvements were observed afterward. Reductions in clinically relevant anxiety (7-item generalized anxiety disorder scale) and depression (8-item Patient Health Questionnaire depression scale) criteria were also maintained from program initiation through the 16-week intervention and the 32-week follow-up. Work productivity also showed statistically significant results, with participants gaining 2.57 productive work days from baseline at 16 weeks, and remaining relatively stable (2.23 productive work days gained) at follow-up (32 weeks). Additionally, effects across all coping, sleep disturbance (23% lower at 32 weeks), and emotion dysregulation variables exhibited positive and significant trends at all time points (15% higher, 23% lower, and 25% higher respectively at 32 weeks). CONCLUSIONS: This study contributes insights into the promising positive impact of Noom Mood on mental health and well-being outcomes, extending beyond the intervention phase. Though more rigorous studies are necessary to understand the mechanism of action at play, this exploratory study addresses critical gaps in the literature, highlighting the potential of smartphone-based mental wellness programs to lessen barriers to mental health support and improve diverse dimensions of well-being. Future research should explore the scalability, feasibility, and long-term adherence of such interventions across diverse populations.

Effects of occupational health promotion interventions on health-related outcomes among employees of small businesses and self-employed individuals: A systematic review.

BACKGROUND: Compared to workers of larger companies it is less clear what health promoting interventions might be beneficial for employees of small businesses and self-employed individuals. OBJECTIVE: Our aim was to critically appraise trials investigating health promotion programs among small business workers and self-employed individuals, by means of a systematic review. METHODS: We conducted a search of primary studies using MEDLINE, Web of Science, LIVIVO and the Cochrane library. Our assessment followed the recommendations of the Cochrane Handbook for Systematic Reviews of Interventions and PRISMA. RESULTS: We identified six trials including 5,854 participants from Asia, North America and Australia. Most were of moderate methodological quality, only one was of low quality. Some of the supervised psycho-educational lifestyle programs focusing on individual behavior changes showed benefits in terms of stress reduction and increased physical activity levels among small enterprise employees. CONCLUSIONS: There is a huge knowledge gap on evidence-based health promotion interventions for self-employed and for small business workers, especially in Europe.

Health care utilization and behavior changes after workplace genetic testing at a large US health care system.

PURPOSE: This study explored employee health behavior changes and health care utilization after workplace genetic testing (wGT). Wellness-program-associated wGT seeks to improve employee health, but the related health implications are unknown. METHODS: Employees of a large US health care system offering wGT (cancer, heart disease, and pharmacogenomics [PGx]) were sent electronic surveys. Self-reported data from those who received test results were analyzed. Descriptive statistics characterized responses, whereas logistic regression analyses explored correlates of responses to wGT. RESULTS: 53.9% (n = 418/776) of respondents (88.3% female, mean age = 44 years) reported receiving wGT results. 12.0% (n = 48/399) received results indicating increased risk (IR) of cancer, 9.5% (n = 38/398) had IR of heart disease, and 31.4% (n = 125/398) received informative PGx results. IR results for cancer and/or heart disease (n = 67) were associated with health behavior changes (adjusted odds ratio: 3.23; 95% CI 1.75, 6.13; P < .001) and health care utilization (adjusted odds ratio: 8.60; 95% CI 4.43, 17.5; P < .001). Informative PGx results (n = 125) were associated with medication changes (PGx-informative: 15.2%; PGx-uninformative: 4.8%; P = .002). CONCLUSION: This study explored employee responses to wGT, contributing to the understanding of the ethical and social implications of wGT. Receiving IR results from wGT may promote health behavior changes and health care utilization in employees.

Top down and bottom up: A review of strategies for wellness programs in academic radiology.

Formal physician-wellness programs have come into vogue in professional organizations in recent years. Wellness programs in academic centers vary from institution to institution but foundational to all is their aim to reduce burnout and increase professional fulfillment. As radiologists in charge of wellness program implementation in different academic institutions, we describe existing academic radiology wellness programs with two detailed examples. Physician well-being programs need to be both leadership-driven (i.e., "top down") and receptive to feedback ("bottom up").

Preliminary Investigation: Pilot Study of Program Directors' Perceptions of Wellness and Suicide Prevention for Student Registered Nurse Anesthetists.

The purpose of this pilot study was to investigate wellness and student suicidality in nurse anesthesia programs. Graduate students such as student registered nurse anesthetists (SRNAs) are at increased risk of suicide from environmental and educational stressors. Wellness interventions may help. An observational, anonymous online survey of all program directors (PDs) was conducted. Identical responses on a simultaneous pilot SRNA study were compared. Quantitative data were analyzed using Wilcoxon rank sum and Fisher's exact tests. Three PDs reported student suicides. Anxiety, depression, and emotional lability were warning signs. Student and PD responses to wellness program assessments were varied, with PD responses more positive and students more negative. PDs were as stressed as students and struggled to meet their own wellness needs. Most PDs reported no or insufficient training in suicide risk and prevention. Suggestions for improving wellness initiatives included to improve and standardize activities and make initiatives more accessible and seek innovative solutions to fit more content into an overcrowded curriculum. PDs and SRNAs need suicide prevention training and improved wellness efforts at local and national levels. Approaches are needed to counter stigma and reluctance to discuss mental health challenges. Suicide is multidimensional, but with proactive awareness, it may be preventable.

A Randomized Controlled Trial of the Effects of a Web-Based Intervention on Perceived Stress and Diet Quality Among First-Year University Students.

Background: e-Health interventions can potentially improve health care. My Viva Plan® (MVP) is a web-based program that focuses on mindfulness, nutrition, and physical fitness. The aim of this study was to evaluate the effects of this platform on stress indicators and diet quality among first-year university students. Methods: Ninety-seven university students were enrolled in a randomized, controlled clinical trial. Participants were randomized into control (n = 49) and MVP (n = 48) groups. Perceived stress was measured using the self-report Stress Indicator Questionnaire. Diet quality was assessed by the nutrient-rich foods index, and body composition was assessed by a hand-to-foot, multifrequency, bioelectrical impedance analysis. Results: There were no differences in physical, sleep, behavioral, emotional, and personal habit indicators between groups. Diet quality and body composition were similar between groups, except among women in the MVP group with decreased body fat (-1.2 ± 2.6 kg, p < 0.05). Participant engagement was low: 50% of the MVP group did not access the platform. Conclusions: The MVP web-based intervention was not associated with improvements in stress indicators, diet quality, and body composition, likely due to the characteristics of our cohort of healthy young individuals. Future studies should focus on enhancing motivational approaches to explore the potential of e-health interventions that improve health behavior.Clinical Trial Registration number: NCT03579264A.

Racial Differences in Perceptions of Genetic Wellness Programs.

PURPOSE: Genetic wellness programs (GWPs) are a highly innovative workforce wellness product. Recently marketed to U.S. employers by at least 16 vendors, GWPs take advantage of low-cost DNA sequencing to detect genetic risk factors for an increasing array of diseases. The purpose of this research is to understand perceptions, concerns, and barriers related to GWPs, among employees from Black, White, and Asian backgrounds and different income levels. APPROACH: Qualitative study with 3 focus groups (FGs). SETTING: Employees of large high-technology companies (deemed likely early GWP adopters). RESPONDENTS: 21 individuals recruited online through User Interviews. METHOD: FG guide developed via literature review and landscape analysis, and pre-tested. FGs led by a trained moderator and audio-recorded. Transcripts content analyzed for key themes. RESULTS: Nearly all respondents saw potential benefits to GWP participation for themselves or their families. However, there were profound differences in perceptions of risks to GWP participation between Black and White/Asian respondents. These differences surfaced in three broad areas: privacy and discrimination risks; family impact risks; and feelings about the employer. Willingness to participate in a GWP also varied between Black employee respondents and White and Asian employee respondents (including low-income White employees). Only 27% of Black employees would participate in GWP, compared to 90% of the other employees. CONCLUSION: Most employees appear likely to support employer adoption of GWPs. However, Black employees report significant concerns regarding participation. Addressing these concerns through program design would benefit all employees, and could increase trust and uptake of GWPs.

US state laws relevant to incentives for health behavior: A qualitative analysis.

Contingency management (CM) involves provision of incentives for positive health behaviors via a well-defined protocol and is among the most effective treatments for patients with substance use disorders (SUDs). An understanding of laws affecting incentives for health behaviors and outcomes, including contexts in which incentives are already permitted, could inform efforts to disseminate CM. We conducted a systematic NexisUni legal database review of state statutes and regulations effective during 2022 to identify (a) laws that explicitly permit or prohibit delivery of incentives to patients, employees, or insurance beneficiaries for SUD-specific behaviors or outcomes, and (b) laws that explicitly permit delivery of incentives for any health behaviors or outcomes. We identified 27 laws across 17 jurisdictions that explicitly permit delivery of incentives for SUD-related behaviors or outcomes, with most occurring in the context of wellness programs. No state laws were identified that explicitly prohibit SUD-specific incentives. More broadly, we identified 57 laws across 29 jurisdictions permitting incentives for any health outcomes (both SUD- and non-SUD-related). These laws occurred in the contexts of wellness programs, K-12/early childhood education, government public health promotion, and SUD treatment provider licensing. Considering the urgent need to expand evidence-based SUD treatment in rural and underserved areas throughout the US, these findings could inform efforts to develop laws explicitly permitting provision of incentives in SUD care and enhance efforts to disseminate CM more broadly.

Rationale for participation in university worksite wellness programs.

Objective: To understand the wellness needs of university employees to design more effective and inclusive worksite wellness programs (WWP) for health promotion. Methods: Cross-sectional assessment of university employees' wellness needs (online survey, n = 639). Results: Employees were most interested in physical activity (PA), nutrition, and lifestyle WWP. Principal barriers to participation were time, scheduling, location, motivation, and confidentiality concerns. Significant correlations exist between having a diagnosed health condition and the likelihood of participating in related programs. 67.1% of past participation was predicted by (1) health status today versus last year, (2) use of university recreational facilities, (3) gender, (4) general health status, (5) PA in the past month, (6) faculty/staff, and (7) age. Conclusions: Our findings contribute to building a road map of how-to better design university WWP based on understanding participation predictors, barriers/facilitators, and the influence of health status/conditions on topics of interest/participation. Tailoring WWP to meet employees' needs may increase reach, engagement and promote a health culture.

Workplace wellness programs for working mothers: A systematic review.

BACKGROUND: This systematic review aimed to uncover the evidence and benefits of employers' commitment to delivering workplace wellness programs for working mothers. METHODS: The articles published in PubMed, Embase, Scopus, and AgeLine-Medline databases between 2012 and 2021 were searched to evaluate the workplace wellness programs for working mothers with at least one resultant wellness or wellbeing (e.g., physical health, less stress, mental health, burnout, depression, smoking, bullying, alcohol consumption, overweight), work-life balance outcome, or job satisfaction. RESULTS: Eight studies that met the criteria were retrieved from databases. They showed some effective workplace wellness programs that can reduce depression, stress, and burnout, improve mental health, healthy behaviors, work-family balance and work-life balance. Working mothers participating in a workplace wellness program generally gain some benefits; one of which is reduced stress typically related to childcare, economic, and personal health issues. CONCLUSIONS: The implementation of workplace wellness programs for working mothers showed positive effects on their health problems and health costs. These eight studies revealed that workplace wellness programs specifically designed for working mothers can lead to time efficiency by holding the programs in or near the workplace and implementing them during the workdays. This greatly suits the conditions of many working mothers whose limited time and energy to balance the household, family and work tasks.

Impact of a Virtual Wellness Program on Quality of Life Measures for Patients Living With Multiple Sclerosis During the COVID-19 Pandemic.

BACKGROUND: Patients with multiple sclerosis (MS) were vulnerable to the effects of physical inactivity during the COVID-19 pandemic. As patients returned to in-person visits, providers reported seeing increased weakness, balance issues, falls, worsening pain, and spasticity. Social isolation also contributed to increased stress, depression, and anxiety. This study explored whether attending virtual wellness programs was associated with improvements in standard quality of life questionnaire scores for patients with MS. METHODS: The purposive convenience sample consisted of 43 patients in the treatment group and 28 in the control group. Patients in the treatment group attended 2 monthly programs for 6 months and completed a demographic questionnaire, the 36-Item Short Form Health Survey (SF-36), the Modified Fatigue Impact Scale, and the Medical Outcomes Study Pain Effects Scale (PES). Patients requested additional topics, resulting in 5 additional programs. The control group consisted of patients who chose not to attend the programs but agreed to complete the questionnaires. RESULTS: In comparing questionnaire responses (6 months minus baseline) among the participants in the treatment group, an association was found between higher meeting attendance and improvements in emotional well-being (P = .038), pain on the PES (P = .011), mindfulness on the SF-36 pain scale (P = .0472), and exercise on the PES (P = .0115). CONCLUSIONS: The results of this study suggest that a virtual wellness program may provide beneficial emotional support, physical exercise, and health promotion activities resulting in improved quality of life in people with MS. In addition, mindfulness and exercise programs may be beneficial in pain management.

Strategic Choice and Implementation of Workplace Wellness Programs in the United States.

Despite widespread discussion and public policy support for workplace wellness programs in the United States, their diffusion has been slow. Using data from the 2017 Workplace Health Administration Survey, this paper explored the importance of establishment characteristics, unionization, and strategic choice in the adoption of workplace health initiatives and employee participation in these programs. An ordinary least squares analysis revealed that unionization (ß = 1.59, 95% CI = 1.20−1.97, p < 0.001) and management support (ß = 1.67, 95% CI = 1.25−2.10, p < 0.001) were the strongest predictors of the number of programs adopted by an establishment. In logistic regression analyses of nine workplace wellness programs, it was also found that unionization and management were the strongest predictors of the adoption of these programs. Management support was also correlated with employee participation of in nutrition (OR = 2.66, 95% CI = 1.23−5.71, p < 0.05) and obesity programs (OR = 3.66, 95% CI = 1.03−12.97, p < 0.05).

Exploring Personal Development Workshops' Effect on Well-Being and Interconnectedness.

Introduction: Personal development workshops are increasingly popular. This study evaluated the relationships between the measures of well-being, interconnectedness, and extended perception in various workshops and explored which kinds of workshops and individual characteristics predicted changes in these outcomes. Materials and Methods: In a prospective, uncontrolled, within-participant design study, adult participants completed questionnaires and online tasks before and after personal development workshops. Three analyses were conducted: (1) examining the relationships between measures by using only pre-workshop measures using Spearman correlations; (2) exploring change scores pre- to post-workshop and workshop using Wilcoxon signed-rank test; (3) assessing workshop format and content, and individual characteristics as predictors of those change scores multivariate nonparametric regression. The following outcomes were collected: Well-being-Arizona Integrative Outcomes Scale, positive and negative affect, Dispositional Positive Emotions Scale-Compassion subscale, Sleep Quality Scale, Numeric Pain Rating Scale; Interconnectedness-Cloninger Self-Transcendence Scale, Inclusion of Nature in Self and Inclusion of the Other in Self; and Extended perception tasks-Intuition Jar, Quick Remote Viewing, Psychokinesis Bubble, and Time Estimation. The following potential predictor variables were collected: demographic, mental health, psychiatric and meditation history, Single General Self-Rated Health Question, Brief Five-Factor Inventory-10, and the Noetic Experience and Belief Scale. Workshop leaders also selected which format and content characteristics applied to their workshop. Results: Interconnectedness measures were significantly and positively correlated with well-being (ρ: 0.27 to 0.33), positive affect (ρ: 0.20 to 0.27), and compassion (ρ: 0.21 to 0.32), and they were negatively correlated with sleep disturbance (ρ: -0.13 to -0.16) and pain (ρ: -0.11 to -0.16). Extended perception task performance was not correlated with interconnectedness or well-being. General personal development workshops improved subjective interconnectedness, well-being, positive emotion, and compassion, and they reduced sleep disturbances, negative emotion, and pain (all p's < 0.00005). The lecture (p = 0.03), small groups (p = 0.001), pairs (p = 0.01), and discussion (p = 0.03) workshop formats were significant predictors of well-being outcomes. The workshop content categories of meditation (p = 0.0002) and technology tools (p = 0.01) were also predictive of well-being outcomes, with meditation being the most consistent predictor of positive well-being changes. Conscientiousness was the only significant individual characteristic predictor (p = 0.002), although it was associated with increases in some well-being measures and decreases in others. Conclusions: This study provides preliminary evidence for the positive relationship between the subjective sense of interconnectedness and multiple well-being measures and the beneficial effects of some personal development workshops.

Motivaciones de los estudiantes de fisioterapia para practicar actividad físico-deportiva / Motivations of physiotherapy students to practice sports and physical activity

Introducción. El sedentarismo es un problema de salud pública, siendo un riesgo latente para las enfermedades crónicas no trasmisibles. En un estudio previo en la Fundación Universitaria María Cano se encontró sedentarismo de 97% en estudiantes. El propósito del estudio es contribuir a la comprensión del comportamiento sedentario en estudiantes de fisioterapia, información clave para que la institución genere estrategias efectivas que incentiven la práctica físico-deportiva, considerando las motivaciones de los estudiantes. Metodología. Estudio de enfoque cuantitativo, diseño no experimental, de corte transversal. Participaron 178 estudiantes de Fisioterapia (I a VII semestre). Se aplicó un cuestionario sociodemográfico y el CAMIAF (Cuestionario de Actitudes, Motivaciones e Intereses hacia las Actividades Físico-deportivas). Resultados. Población joven, en su mayoría mujeres (77,5%), con edades entre 16 y 36 años, y media de 21,3 (DE: ±3,244). El 64% manifiesta no practicar deporte o actividad física (AF) de manera habitual. Se encuentra asociación significativa de la edad con los factores competencia (todas las variables), capacidad personal (por superarse), aventura (relacionarme y conocer gente), hedonismo (porque quiero ser celebre y popular) y forma física (para mejorar mi imagen y aspecto físico). El 92,2% de los participantes manifiestan que la Universidad motiva la práctica de AF con jornadas físicas permanentes (34,9%) y el incentivo académico (28,6%) Conclusiones. Entre las motivaciones para la práctica de AF predomina, en su orden, el factor competencia, social y recreativo, y el estético. El que genera menor motivación es el emocional. Limitaciones. El constructo motivacional es multidimensional; un abordaje cualitativo adicional podría mejorar la comprensión de los hallazgos.

Introduction. Sedentary lifestyle is a public health problem, being a latent risk for chronic non-communicable diseases. In a previous study at Fundación Universitaria María Cano, a sedentary lifestyle of 97% was found in students. The purpose of the study is to contribute to the understanding of sedentary behavior in physical therapy students, which is a key information for the institution to generate effective strategies to encourage sports and physical practice, considering the students' motivations. Methodology. A quantitative approach study, with a non-experimental and cross-sectional design. 178 physiotherapy students (1st to 7th semester) participated. A sociodemographic questionnaire and the CAMIAF (Questionnaire of Attitudes, Motivations, and Interests towards Physical-Sports Activities) were applied. Results. Young population, mostly women (77.5%), aged between 16 and 36, with an average of 21.3 (SD: ±3.244). Sixty-four percent stated that they did not practice sport or physical activity (PA) on a regular basis. A significant association was found between age and the following factors: competence (all variables), personal capacity (for self-im-provement), adventure (to socialize and meet people), hedonism (because I want to be famous and popular), and physical fitness (to improve my image and physical appear-ance). 92.2% of the participants state that the University motivates the practice of PA with permanent physical sessions (34.9%) and academic incentive (28.6%). Conclusions. Among the motivations for the practice of PA, the following factors predominate in this order: competition, social and recreational, and aesthetic. The least motivating factor was the emotional one.Limitations. The motivational construct is multidimensional; an additional quali-tative approach could improve the understanding of the findings.

The Impact of a Web-Based Mindfulness, Nutrition, and Physical Activity Platform on the Health Status of First-Year University Students: Protocol for a Randomized Controlled Trial.

BACKGROUND: First-year university students are at an increased risk for developing mental health issues and a poor nutritional status. Self-care plays an essential role in optimizing mental health and can prevent or manage stress, anxiety, and depression. Web-based self-monitoring of diet and physical activity can lead to similar or improved health outcomes compared with conventional methods. Such tools are also popular among university students. OBJECTIVE: The primary aim of this 12-week randomized controlled trial is to assess the impact of a web-based wellness platform on perceived stress among first-year university students. The secondary aim is to assess the effects of the platform on diet quality. The exploratory objectives are to explore the effects of the platform on body composition, health-related quality of life, mindfulness, mental well-being, and physical activity. METHODS: A total of 97 first-year undergraduate students were randomized to either the intervention (n=48) or control (n=49) group. The intervention consisted of access to a web-based platform called My Viva Plan (MVP), which aims to support healthy living by focusing on the topics of mindfulness, nutrition, and physical activity. The platform is fully automated and guided by the principles of cognitive behavioral theory. Participants in the intervention group were instructed to use the MVP as frequently as possible over 12 weeks. The control group did not receive access to MVP. Perceived stress was assessed using the Stress Indicators Questionnaire at baseline, week 6, and week 12. Three-day food records were used to analyze the dietary intake at baseline and week 12. Health-related quality of life, mindfulness, mental well-being, and physical activity questionnaires were completed at baseline, week 6, and week 12. Body composition was assessed at baseline and week 12. Study assessments were completed in person at baseline and week 12 and electronically at week 6. RESULTS: Study recruitment started in August 2018, with batch enrollment for students registered in the fall (September 2018 to December 2018) and winter (January 2019 to April 2019) academic terms at the University of Alberta, Edmonton, Alberta. CONCLUSIONS: This study is the first to explore the impact of a web-based platform designed to promote health and wellness on perceived stress and diet quality among first-year university students. TRIAL REGISTRATION: ClinicalTrials.gov NCT03579264; https://clinicaltrials.gov/ct2/show/NCT03579264. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/24534.

A Scoping Review of Economic Evaluations of Workplace Wellness Programs.

OBJECTIVE: Debates about the effectiveness of workplace wellness programs (WWPs) call for a review of the evidence for return on investment (ROI) of WWPs. We examined literature on the heterogeneity in methods used in the ROI of WWPs to show how this heterogeneity may affect conclusions and inferences about ROI. METHODS: We conducted a scoping review using systematic review methods and adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We reviewed PubMed, EconLit, Proquest Central, and Scopus databases for published articles. We included articles that (1) were published before December 20, 2019, when our last search was conducted, and (2) met our inclusion criteria that were based on target population, target intervention, evaluation method, and ROI as the main outcome. RESULTS: We identified 47 peer-reviewed articles from the selected databases that met our inclusion criteria. We explored the effect of study characteristics on ROI estimates. Thirty-one articles had ROI measures. Studies with costs of presenteeism had the lowest ROI estimates compared with other cost combinations associated with health care and absenteeism. Studies with components of disease management produced higher ROI than programs with components of wellness. We found a positive relationship between ROI and program length and a negative relationship between ROI and conflict of interest. Evaluations in small companies (≤500 employees) were associated with lower ROI estimates than evaluations in large companies (>500 employees). Studies with lower reporting quality scores, including studies that were missing information on statistical inference, had lower ROI estimates. Higher methodologic quality was associated with lower ROI estimates. CONCLUSION: This review provides recommendations that can improve the methodologic quality of studies to validate the ROI and public health effects of WWPs.

Ask the question, be the solution: Fostering well-being through contextualized assessment and strategy development.

In recent years, optimizing provider well-being and mitigating the effects of physician burnout have become increasingly important in the field of medicine. These efforts are in part of consequence because of significant costs associated with provider burnout, for both individuals and their workplace. Accordingly, robust work has focused on development of strategies to decrease the incidence of burnout or mitigate its effects, including both individual efforts and systematic organizational change. This article describes the development and implementation of a unique assessment strategy to identify the driving factors hindering well-being in our general anesthesiology division. We describe how collected data allowed us to identify important areas for improvement, build community, and target novel interventions to ultimately improve the well-being of our division for all members. This manuscript does not describe survey results in any detail, but rather aims to present a creative application of the Hawthorne Effect as it applies to understanding physician well-being.

Mobile Applications for Caregivers of Individuals with Chronic Conditions and/or Diseases: Quantitative Content Analysis.

BACKGROUND: Mobile health applications can help empowering caregivers and promote their wellbeing and their quality of life. OBJECTIVE: To analyze the technical and functional characteristics of mobile health applications designed for caregivers of individuals with chronic conditions and/or diseases. MATERIALS AND METHODS: Systematic search of mobile health applications for smartphones (apps) based on the PRISMA standard for systematic reviews on the App Store and Google Play store during May and June 2018. A second search was carried out on the Pubmed and Google Scholar database to determine whether the applications had been tested or evaluated with results published in scientific journals and then a third search was performed on the Spanish health apps catalogs to evaluate the quality and security of the selected apps. RESULTS: 746 available health apps were identified and 43 were included in this paper. 67% (n = 29) of the apps were aimed exclusively at informal caregivers, 51% (n = 22) were designed to support caregivers and only 21% (n = 9) of them provided any sort of social or emotional support. The screening in Pubmed and Google Scholar determined that the apps analyzed lacked published papers and most of the apps (84%; n = 36) lacked approval from official agencies supporting their usage. DISCUSSION: The apps available on the market that meet the actual needs of caregivers are limited. Most of the apps were aimed at improving the care of the individual with a chronic illness. CONCLUSION: Despite the remarkable benefits of mHealth regarding the care of chronic diseases, a relatively poor contribution has been made to support caregivers. Customized apps, interventions assessing their effectiveness and adequate evidence are needed to understand the impact of this digital tool on caregivers' health.