Effects of 12 Weeks of At-Home, App-Based Exercise on Healthcare Workers’ Depressive Symptoms, Burnout, and Absenteeism: A Randomised Controlled Trial

Background: During the COVID-19 pandemic, healthcare workers reported a significant decline in their mental health (e.g., increased depressive and anxiety symptoms). One potential health behaviour intervention that has been shown to be effective for improving mental health is exercise, which may be facilitated by taking advantage of mobile application technologies.Methods: A two-arm randomized trial was conducted to test the extent to which a 12-week exercise intervention reduced depressive symptoms (primary outcome; 10-item Centre for Epidemiological Studies – Depression Scale), burnout (16-item Maslach Burnout Inventory), and absenteeism (secondary outcomes) in healthcare workers. Participants were recruited from an urban health care organization in British Columbia, Canada. Participants completed measures before randomization and every 2 weeks thereafter. Exercise condition participants were asked to complete 4 x 20-minute sessions per week using a suite of Down DogTM body weight interval training (BWIT), yoga, barre, and running apps. Intention-to-treat analyses were completed with multilevel structural equation modeling.Findings: A total of 288 participants (Mage = 41 years, SD = 10.8) were randomized to either exercise (n = 142) or waitlist control (n = 146) conditions. Results revealed that week-to-week effect sizes for depressive symptoms were in the small-to-medium range by trial’s end (Week 12 Feingold’s ES = -0.41, 95%CI -0.69, -0.13). Significant and consistent treatment effects were revealed for two facets of burnout, namely cynicism (Week 12 Feingold’s E.S. = -0.33 95%CI, -0.53, -0.13) and exhaustion (Week 12 Feingold’s E.S. = -0.39, 95%CI -0.64, -0.14), as well as absenteeism (r = 0.15, 95%CI = [0.03, 0.26]).Interpretation: Although exercise was able to reduce depressive symptoms among healthcare workers, adherence was low towards the end of the trial. Optimizing adherence to exercise programming represents an important challenge to help maintain improvements in mental health among healthcare workers.Trial Registration: The study protocol was registered at ClinicalTrials.gov (NCT05271006) Funding: E Puterman is supported by the Canadian Institutes of Health Research – Canada Research Chair Program. VG Boucher is supported by the Michael Smith Health Research BC, Canadian Institutes of Health Research and the Fonds de Recherche du Québec en Santé. BL Haight is supported by the Canadian Institutes of Health Research – Canada Graduate Scholarship. The authors would like to thank the team at Providence Health Care: Pushokiran Ubi and Donald Wong. Finally, the authors would like to thank the research assistant team: Jeevan Bining, Brendan Chia, Julia Dancey, Katrin Denson, Simrit Dhillon, Daniel Elesin, Nicholas Feng, Gabriella Goodger, Boaz Injege, Chloe Kim, Owen Kwok, Jayden Lee, Rio Leung, Megan Mackay, Samantha Mikado, Katie Smith, Sayna Soleymanian, Nathan Wang, Christina Whang, Audrey Wong, Rebecca Wong. Funds for the trial were provided by the University of British Columbia’s School of Kinesiology Kinesiology Equipment and Research Accelerator Fund.Declaration of Interest: All authors declare no competing interestsEthical Approval: Ethics approval was provided by the University of British Columbia’s Behavioural Research Ethics Board and by Providence Health Care’s Institutional Ethics Board.