Promoting the Mental Health of Hospital Professionals Through a Workplace-Based Mindfulness Intervention: Protocol for a Randomized Controlled Pilot Trial With a Realist Evaluation (PROMIND)

Abstract

Abstract Background Hospital professionals face mental health challenges caused by the high demands of their work. Mindfulness meditation (MM) is a nonpharmacological practice with promising effects in promoting mental health and well-being across various hospital professionals. However, the benefits obtained from its implementation in the context of real work in hospital departments are understudied. Objective The aims of this pilot study are to implement and evaluate, at both the individual and collective levels, the exploratory outcomes of a workplace-based mindfulness intervention developed participatively for hospital teams in a French university hospital. The feasibility of the implementation of the intervention, the influence of the work environment, and the mechanisms through which it produces its effects will also be assessed. Methods For this prospective interventional study, a preliminary co-construction with the stakeholders (a task force with professionals and management) made it possible to develop and adapt the intervention to the needs and capacities of the professionals, using the intervention mapping model for health program planning. Inclusion and an MM information meeting were proposed to 8 hospital departments, which were then randomized into 2 parallel cluster groups (intervention or control group). In the intervention group, an MM test session was proposed before committing to the MM program (10 one-hour sessions) for a maximum of 15 professionals per department. A convergent mixed methods design with concomitant quantitative and qualitative data collection was used, before integration of findings. Quantitative evaluation was based on a comparison of “before-after” measurements, with a comparison between intervention and control groups. The primary exploratory outcome was the evolution of psychological flourishing at work, which was measured using the adapted and validated French-language scale Psychological Flourishing at Work (EEPMT-8), to which the Professional Life Satisfaction Scale (ÉSVP-5) was added, to form a new 13-item Psychological Flourishing at Work Scale (EEPMT-13). Realist evaluation by qualitative methods explored the influence of contexts on the implementation (barrier and facilitators), and the links between context, mechanisms, and effects of MM. The study was approved by the Sud-Est VI ethics committee (Clermont Ferrand, France). Results Funding was obtained in October 2021 and June 2024. This study was conducted from May 2024 to June 2025. As of May 2024, 108 participants were enrolled. Analyses are in progress. Results are expected to be published by the end of 2026. Conclusions Participative approaches are essential for a challenged, tailored implementation of a workplace-based mindfulness intervention in hospital teams. The evaluation of the intervention with mixed methods and the characterization of both individual and organizational levels are aligned with the recommendations to evaluate a complex intervention in a workplace; challenges include the use of an innovative primary endpoint and methodological pluralism to plan for scalability at a subsequent stage.