Web-Based Mindfulness Intervention for Reducing Perceived Stress in Health Care Professionals: Secondary Analysis of Moderators in a Stepped-Wedge Cluster Randomized Trial
Gloria Guerrero-Pertiñez, Vera Carbonell, Jonathan Joseph Dawood-Histrova, Gloria Pérez-Guerrero, Adrián Pérez-aranda, Selene Fernández-martínez, Alicia Monreal-Bartolomé, Alberto Barceló-soler, Javier García-campayo, Yolanda López-del-hoyo, Jesús Herrera-Imbroda, Jessica Marian Goodman‐Casanova, José Guzmán‐Parra
JMIR Nursing June 22, 2026 DOI: 10.2196/98624 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Secondary analysis of a stepped-wedge cluster randomized trial Peer reviewed |
|---|---|
| Sample size | 347 |
| Population | Health care professionals from 6 clusters |
| Duration | 8-week intervention, assessments every 8 weeks across 5 waves |
| Measures | Perceived Stress Scale (implied), 9-item Patient Health Questionnaire (PHQ-9), 15-item Five Facet Mindfulness Questionnaire (FFMQ-15) |
| Topics | Meditation |
| Key findings | Higher baseline depressive symptoms (PHQ-9) and higher observing facet of mindfulness (FFMQ-15) were associated with greater reductions in perceived stress. Nursing staff showed greater reductions compared with physicians and other health care professionals. |
Abstract
Background: Health care professionals are exposed to high levels of occupational stress, emotional exhaustion, and anxiety-depressive symptoms. Digital interventions using mindfulness- and acceptance-based approaches have shown promising results in improving psychological well-being in this population. The MINDxYOU program is a self-guided digital intervention designed to reduce perceived stress and enhance emotional regulation, resilience, and psychological flexibility. Although its effectiveness has been demonstrated, treatment response may vary substantially between individuals.
Objective: The aims of this study are to explore the sociodemographic, occupational, and psychological moderators of the effectiveness of the digital MINDxYOU program on perceived stress among health care professionals and to identify differential response profiles.
Methods: This study is a secondary analysis of a stepped-wedge cluster randomized trial including 347 health care professionals from 6 clusters allocated to 3 intervention start sequences. The intervention (MINDxYOU) is a self-guided, web-based program designed to be completed over 8 weeks, grounded in third-wave psychological approaches and incorporating mindfulness-, compassion-, and acceptance-based components. Weekly support was provided via WhatsApp Messenger (Meta Platforms Inc), phone calls, or email to promote adherence. Assessments were conducted every 8 weeks across 5 measurement waves. Linear mixed-effects models were used to evaluate moderation effects by testing condition × moderator interactions, accounting for repeated measures within participants and clustering effects.
Results: Moderation analyses showed greater reductions in perceived stress among participants with higher baseline depressive symptom scores (9-item Patient Health Questionnaire [PHQ-9]; B=-0.22, SE 0.08; P=.004) and those with higher scores in the observing facet of mindfulness (15-item Five Facet Mindfulness Questionnaire [FFMQ-15]; B=-0.86, SE 0.41; P=.04). In addition, nursing staff exhibited greater reductions in perceived stress compared with physicians (B=1.92, SE 0.81; P=.02) and other health care professionals (B=1.80, SE 0.90; P=.04).
Conclusions: The results suggest that baseline psychological and occupational characteristics may contribute to differences in the effectiveness of the MINDxYOU program in reducing perceived stress. These findings provide preliminary evidence regarding potential response profiles in digital mental health interventions and support the development of more personalized and targeted approaches to stress management in health care settings.