A Self-directed Mobile Mindfulness Intervention to Address Distress and Burnout in Frontline Healthcare Workers
Phase: NA
Conditions: Emotional Distress, Burnout, Professional, Stress, Job, Anxiety, Depressive Symptoms
Sponsor: Duke University

Pro00107657: A self-directed mobile mindfulness intervention to address distress and burnout 
in frontline healthcare workers. 
Version Date:  v1.0 - 3/31/2021 
NCT04816708 
 
Clinical Protocol Synopsis 
 
1. Title 
 
A self-directed mobile mindfulness intervention to address distress and burnout in frontline 
healthcare workers. 
 
2. Background 
 
Emotional distress and burnout are common amongst U.S. health care workers1,2. In nurses 
specifically, observational studies have estimated the rate of burnout to be as high as 50% (3). 
Nurses are also more likely than the general population to report insomnia, depressive 
symptoms, and anxiety 4-8. The onset of the COVID-19 pandemic has led to increased physical 
and psychological demands on frontline healthcare workers, as they have been asked to work 
more hours with an increased risk to their own personal health and safety 9,10.  
 
Mindfulness is a type of mind-body therapy that promotes a practice of non-judgmental 
awareness that can alleviate distress by uncoupling emotional reactions and habitual behavior 
from unpleasant symptoms, thoughts, and emotions. LIFT is a mobile app which can assess 
levels of emotional distress via survey, and subsequently offer mindfulness content that has 
previously been used in ICU patients, where it was shown to reduce symptoms of depression, 
anxiety, and PTSD11.  
 
3. Focus of the Study and Specific Aims.  
 
LIFT-HC is a pilot randomized waitlist control trial (RCT) that tests the efficacy of the 
LIFT mobile app in relieving symptoms of emotional distress amongst nurses directly 
caring for COVID-19 patients in the Duke University Health System.  
 
AIM 1: To determine the feasibility of using the LIFT app among nurses directly caring for 
COVID-19 patients. Hypothesis: Nurses taking care of COVID-19 patients will have high levels 
of Lift app use and low levels of dropout over the course of 1 month follow up. Data collected by 
the app will inform the study team as to the frequency of use and compliance among 
participants randomized to receive mobile mindfulness content. Participants will be allowed to 
comment on usability of app and features that they thought worked well and did not work well. A 
subset of participants randomized to intervention with high app usage and a subset with low app 
usage will be approached to complete a telephone interview to comment on usability and areas 
for improvement in the app.  
 
AIM 2: To assess the clinical impact of LIFT compared to control among nurses directly 
caring for COVID-19 patients at 1 month. Hypothesis: Nurses using the LIFT app’s 
mindfulness content will have reduced levels of emotional distress compared to usual 
care. After completion of baseline studies, 100 nurses will be randomized in a 2:1 fashion to 
LIFT (intervention) or waitlist (control). Levels of emotional distress for all participants in both 
arms will be reassessed after 30 days via questionnaire completion. Surveys will assess anxiety 
(GAD-7), depression (PHQ-9), burnout (MBI), stress (PSS-4) as well as self-reported job 
performance quality and medical errors.  
 

Pro00107657: A self-directed mobile mindfulness intervention to address distress and burnout 
in frontline healthcare workers. 
Version Date:  v1.0 - 3/31/2021 
NCT04816708 
 
 
 
4. Study Population 
This study will enroll nurses working primarily in units where they take direct care of 
patients with COVID-19.  
 
Inclusion Criteria: 
1. Adult ≥ 18 years of age 
2. Currently working as a nurse primarily in an adult COVID unit at Duke University 
Hospital  
3. English Fluency 
 
Exclusion Criteria 
1. Lack of access to either reliable smartphone with cellular data plan or home internet 
access. 
2. Anticipation of leaving current position in ≤30 days.  
 
5. Screening and Recruitment 
No active screening to identify potential participants will take place. The study team will use e-
mail and flyers as the main way to recruit participants. There will also be an in-person 
introduction to the study at nursing huddles, but this will direct potential participants to e-mail or 
flyers to enroll in the study if they wish to proceed. The IRB approved e-mail will contain a 
hyperlink to a website (https://lift.duke.edu/nurse/) that describes the study’s purpose, duration, 
and risks and benefits. The e-mail/flyer will also contain a link to a video explaining the LIFT app 
and mindfulness therapy.  
 
If a participant wishes to enroll, then they will be directed via hyperlinks in the e-mail or QR code 
in the flyer to download the generic Pattern Health mobile app platform from either the Google 
App store (for Android phones) or the Apple App store (for Apple phones).  Both the e-mail and 
the flyer will contain contact information for the study PI, Dr. Pratt, so that all questions can be 
answered prior to consent.  
 
6. Process of obtaining informed consent 
Prior to conduct of study procedures, informed consent will be obtained from all participants. 
Consent will be obtained through Pattern Health app. After downloading the generic Pattern Health 
app as outlined in section 5., participants will enter the registration code “NURSE” contained in e-
mail/flyer.  This will then initiate the in-app self-guided consent process where participants sign an 
IRB-approved informed consent document electronically. A copy of the consent for each participant 

Pro00107657: A self-directed mobile mindfulness intervention to address distress and burnout 
in frontline healthcare workers. 
Version Date:  v1.0 - 3/31/2021 
NCT04816708 
 
will be saved within the Pattern Health server, and will be available for each participant via the app. 
On a monthly basis, a copy of the consents will be exported into secure, Duke University-approved, 
password protected, cloud systems (i.e., Box) for long term storage.  
 
 
 
 
7. Data collection 
 
All data will be collected via the LIFT app. Each participant, regardless of randomization arm, 
will be asked to complete the following surveys at the listed time points below: 
• 
Baseline (upon app registration and randomization); T1 
o 
Baseline sociodemographic data 
o 
GAD-7, PHQ-9, MBI, and PSS-4 
o 
Single item questions regarding impact of COVID-19 on mental health 
o 
Single item questions regarding perceived job performance and medical errors 
• 
T2 (30 days post-enrollment) 
o 
GAD-7, PHQ-9, MBI and PSS4 
o 
Single item questions regarding perceived job performance and medical errors 
Participants randomized to the intervention arm will also be asked to complete the following: 
• 
T2 (30 days post-enrollment) 
o 
An open-ended narrative question commenting on usability of the app 
 
8. Randomization 
 
Randomization will happen via the LIFT app. After completion of the in-app consent process, as 
well as a baseline demographic survey, participants will be randomized in a 2:1 fashion to 
intervention vs. waitlist (control). Randomization will be stratified based on baseline PHQ-9 
scores and years of experience as a nurse.  
 
9. LIFT-Healthcare Worker procedures.  
This is a single site, pilot randomized waitlist control trial exploring feasibility of use and clinical 
impact of the LIFT app amongst nurses directly caring for COVID-19 patients. We aim to enroll 
100 participants. Nurses agreeing to participate will be asked to download and register the LIFT 
app on their mobile device. Consent will be provided electronically through the LIFT app. After 
signing consent, participants will be randomized via the LIFT app in a 2:1 fashion into two 
arms:   

Pro00107657: A self-directed mobile mindfulness intervention to address distress and burnout 
in frontline healthcare workers. 
Version Date:  v1.0 - 3/31/2021 
NCT04816708 
 
• 
Arm 1: Intervention group (access to LIFT mindfulness content) 
• 
Arm 2: Waitlist (delayed access to LIFT content)         
                                  
LIFT is a self-directed mobile app platform based on a solid conceptual model that guides 
participants through a 1-month program.  LIFT content includes 4 weekly app-based sessions as 
previously tested in a pilot RCT (NCT02701361). Each session is composed of three parts:  1. 
Video presentation describing rationale (3-5 min.), 2. Audio guided meditation (8-10 min.), and 3. 
Other relevant in-app exercises (e.g., tips to help apply mindfulness to daily life). The app-based 
approach to non-responders, defined as those whose PHQ-9 score has increased in comparison to 
the previous week or whose PHQ-9 score is ≥20, uses the app's logic to display hovering messages 
and notifications within the app that may be applicable to the user.  Depending on whether 
emotional or somatic depression symptoms are dominating the PHQ-9 score for the individual, a 
unique video is shown within the app that features the study interventionists leading a brief exercise 
in which the participant is coached by the interventionist in the application of mindfulness for the 
symptoms the participant has endorsed.  The app-based approach to non-responders has 8 unique 
videos, 2 for each week (i.e., one tailored to emotional symptoms, one tailored to somatic 
symptoms).   
 
AIM 1, which is to determine the feasibility of using the LIFT app among nurses directly caring 
for COVID-19 patients, will be assessed via the app which tracks user fidelity and adherence, 
and the use of an interactive dashboard for administrative users (i.e., study team) to track 
individual participant use. The open-ended narrative question at T2 will also help provide 
guidance for improving usability in future studies, as will directed telephone interviews with 
participants with high and low app usage as outlined above.    
     
AIM 2, which is to assess the clinical impact of LIFT compared to control among nurses directly 
caring for COVID-19 patients at 1 month, will be assessed by comparing changes from in the 
GAD-7, PHQ-9, MBI-7, and PSS-4 over the study duration between intervention and waitlist 
groups.  
10. Statistical design, analyses, sample size, and power 
Statistical Design and Analyses Plan 
                        
The primary goal of this pilot RCT is to explore the feasibility and impact of the LIFT app in 
healthcare workers to inform a definitive future clinical trial. To do so, we will test differences 
between observed and a priori defined benchmarks among LIFT recipients using t-tests for 
continuous variables and chi-square tests for categorical variables. 
                        
The secondary goal is to estimate a reasonable range of clinical effect of LIFT in comparison to 
a usual care control condition. General linear models will be used to estimate mean changes 
and corresponding 95% confidence intervals (CIs) in psychological distress (i.e., GAD-7, PHQ-
9) for each treatment group over the 1-month study period using SAS PROC MIXED (SAS 
Institute, Cary NC). We will fit the models with an unstructured covariance matrix to better 
understand and represent the correlation between repeated measures.  
 

Pro00107657: A self-directed mobile mindfulness intervention to address distress and burnout 
in frontline healthcare workers. 
Version Date:  v1.0 - 3/31/2021 
NCT04816708 
 
Participants with low baseline levels of emotional distress, as indicated by a PHQ-9<5, will not 
be excluded from participating in the study, but we do not plan to use them in the primary 
analysis.  
                        
Sample Size and Power 
                        
This exploratory trial is not intended to test LIFT efficacy. While the 100-person sample size 
reflects the pragmatics of recruitment during a short enrollment period, it is large enough both to 
inform us about feasibility of use as well as to provide meaningful confidence intervals for our 
estimates as was true for the similarly sized LIFT pilot RCT. 
                                              
11. Subject Participation and Duration      
 
It will require 1 month (30 days) for participants to complete the entire study, from the time of 
randomization to completion of T2 surveys.    
 
 
12.  Study Duration  
 
We estimate that from the time the RCT opens to enrollment it will require 1 year to complete all 
study activities. 
 
13. Costs to the Subject 
There are no costs to participants. 
 
14.  Compensation 
 
Participants will receive a $10 gift-card for completion of the study. 
 
15.  IRB 
Duke University Health System (DUHS) IRB will be utilized as the IRB of record for this project 
pilot randomized, RCT and the future RCT.  
 
16.  Risk-benefit assessment 
 
The overall study is believed to be a minimal risk trial. However, there is a potential risk for mild 
anxiety when answering survey questions although this has not been observed in previous 
similar studies to date. Participants will be informed that should they need to pause survey 
completion at any time, they can do so and return at a later time to complete the survey. They 
may also choose to not answer any questions that make them uncomfortable. The LIFT app 
also provides numbers for distress resources nationally and at Duke.  
 
 
Additionally, as with any research, but especially one that involves technology (i.e., mobile app), 
there is always a potential loss of confidentiality. Appropriate safeguards are in place to ensure 
confidentiality, as described in the RDSP. Participants can choose not to participate and 
continue receiving normal standard of care. 
                                                       

Pro00107657: A self-directed mobile mindfulness intervention to address distress and burnout 
in frontline healthcare workers. 
Version Date:  v1.0 - 3/31/2021 
NCT04816708 
 
Adequacy of protection against risks  
Recruitment and informed consent procedures 
First, the Duke Institutional Review Board (IRB) will review and approve the safety and ethics of the 
study protocol before study initiation. Informed consent will be required from all participants. Participant 
enrollment is completely voluntary, as the potential participants will not be individually approached by 
study personnel for enrollment.  
 
Protections against risk   
General oversight   
There are several ongoing mechanisms for monitoring the occurrence of adverse events.  The 
investigators will perform day-to-day monitoring of the study. This research team has demonstrated in 
research involving nearly 1,500 participants to date that they can keep careful records of participants 
study engagement and wellbeing.  Careful monitoring of all persons entering the study will minimize 
attrition and will ensure the clinical safety.  This monitoring is facilitated by a telephone number (PI's 
cell phone) and email address (PI’s e-mail address) provided to participants upon entry into the study to 
report concerns related to study participation, weekly meetings between the clinical research 
coordinators and co-investigators to discuss study progress and any adverse events, and direct 
supervision of the study by the PIs.   
 
Plans to prevent coercion and to ensure voluntary participation 
We will strive to create an environment free of any coercive practices for participants. We will stress 
that study involvement is absolutely voluntary and that choosing to participate or not participate will not 
their employment in any way. Dr. Cox will not be involved in any recruitment activities in the medical 
ICU, as he holds a clinical leadership position in that unit, so as to avoid the appearance of coercion. 
No nursing managers will be involved in recruitment either, also  to avoid the appearance of coercion.  
 
Vulnerable populations.  We will not enroll participants from vulnerable populations (e.g., imprisoned 
persons, minors). 
 
17.  Data & safety monitoring 
 
Data Accuracy and Protocol Compliance. 
                                
The PI will supervise the study, including data management, data accuracy, and protocol 
compliance. The PI will be the chief data manager and will adhere to established federal and 
institutional safety and protection guidelines. To assure data accuracy, the PI will review data 
system reports on a routine basis. These reports will show enrollment, missing data, and other 
values that are neither study ID- nor outcome-based.  
 
Quality Assurance  
                                    
First, the electronic data entry system “forces” responses to key questionnaire items (e.g., 
baseline demographics and surveys) before allowing progression to treatment arm 
randomization and access to app content, thereby minimizing missing data at timepoint 1. 
Similarly forced responses are required at timepoint 2 before a participant can be noted to have 
completed the study. Each time the study team logs into the secure data entry system, prompts 
appear on the welcome screen that show what data elements remain incomplete (as well as the 
time frame within which they must be entered) for all site participants. 

Pro00107657: A self-directed mobile mindfulness intervention to address distress and burnout 
in frontline healthcare workers. 
Version Date:  v1.0 - 3/31/2021 
NCT04816708 
 
 
The study PI will ensure the validity of the data system by examining electronic summary case 
report forms within the EDC system to ensure adequacy and accuracy of data collection as well 
as transcription to the database itself after enrollment of the first 5 participants. Agreement will 
be reviewed, and discrepancies will be discussed. 
 
 
Adverse events (AEs), serious adverse events, (SAEs) and unanticipated problems (UPs). 
                        
It is recognized that there is a slight risk that some participants may experience mild anxiety 
when answering survey questions. This has not been experienced to date from similar studies 
previously performed. However, should a participant report symptoms related to increased 
anxiety/emotional distress, an alert will automatically be triggered via the mobile app and sent to 
the study team (i.e. the study manager, PI, and co-PI). When necessary, participants who 
experience psychological distress related to completing questionnaires will be referred for 
appropriate psychiatric or psychological care. In addition, phone numbers for institutional, local, 
and national resources for acute distress will be available in the app. 
 
Certain questions in baseline and completion questionnaires will trigger “alert” values (e.g. 
suicidal ideation).  For specific symptoms (such as the suicidal ideation), a delegated study 
team member (Dr. Cox or Dr. Pratt) will call the participant and assess the severity of the 
situation, triaging them as appropriate to psychiatric support. For other matters, the study team 
will maintain frequent telephone contact with participants and can refer those with concerning 
symptoms as appropriate. 
 
Since this is a psychosocial intervention, we do not expect study related physical issues to 
occur.  Furthermore, there is no lab work involved.    
 
It is anticipated, in this study, for AEs to be extremely rare as it is a behavioral study. However, 
it is possible that participants could become distressed due to the ongoing stress of work and 
the COVID-19 pandemic. Therefore, for this study, only increased levels of distress related to 
completing the questionnaires or completing the mobile mindfulness therapy will be considered 
AEs.  
                                
Like AEs, it is not anticipated that SAEs will occur. However, for this study, an SAE would be 
defined as a suicide attempt, a hospitalization, or death. All serious adverse events will be 
reported within the standard timelines required to the IRB as appropriate and when applicable. 
 
It is expected that some LIFT practices will be missed by most participants. As such, these will 
not be considered protocol deviations. Should other protocol deviations or unanticipated 
problems occur, they will be discussed with the PI, documented, and reported to the IRB as 
appropriate and when applicable. 
 
Period and Frequency for Event Assessment and Follow-Up 
                                
Protocol deviations and other unanticipated problems, as well as AEs and SAEs, will be 
recorded in the data collection system throughout the study and reported, as appropriate, to the 
IRB when applicable. 

Pro00107657: A self-directed mobile mindfulness intervention to address distress and burnout 
in frontline healthcare workers. 
Version Date:  v1.0 - 3/31/2021 
NCT04816708 
 
                                
The study team will record all reportable events with start dates occurring any time after 
informed consent is obtained until 7 (for non-serious AEs) or 30 days (for SAEs) after the last 
day of study participation.  
 
Characteristics of an Adverse or Serious Adverse Event   
To assess relationship of an event to study intervention, the following guidelines are used: 
                                
1. Related (Possible, Probable, Definite) 
1. The event is known to occur with the study intervention.  
2.  There is a temporal relationship between the intervention and event onset. 
3. The event abates when the intervention is discontinued. 
4. The event reappears upon a re-challenge with the intervention. 
2. Not Related (Unlikely, Not Related) 
1. There is no temporal relationship between the intervention and event onset.  
2. An alternate etiology has been established.                                
Expectedness 
 
The Study PI will be responsible for determining whether an event is expected or unexpected. 
An event will be considered unexpected if the nature, severity, or frequency of the event is not 
consistent with the risk information previously described for the intervention. 
 
Severity 
 
The following scale will be used to grade adverse events: 
 
1. Mild: no intervention required; no impact on activities of daily living (ADL) 
2. Moderate: minimal, local, or non-invasive intervention indicated; moderate impact on 
ADL 
3. Severe: significant symptoms requiring invasive intervention; subject seeks medical 
attention, needs major assistance with ADL                                                   
                                
Reporting Procedures 
                                                                   
Serious (fatal or life-threatening) SAEs that are unanticipated and that are related to the 
intervention will be reported to the IRB in the following manner: 
 
(a) Immediately (within 24 hours) upon learning of an unanticipated study-related death, study 
personnel will notify the IRB via e-mail or fax by providing a brief summary of the event. Then, 
within 1 week (five business days), study personnel will send to the IRB a Safety Event 
submission in the eIRB. 
 
(b) For a reportable serious adverse event, study personnel will notify the IRB within five business days of the 
investigator becoming aware of the event. Study personnel will send a Safety Event 

Pro00107657: A self-directed mobile mindfulness intervention to address distress and burnout 
in frontline healthcare workers. 
Version Date:  v1.0 - 3/31/2021 
NCT04816708 
 
submission in the eIRB. 
                                                
Protocol Deviations and Other Unanticipated Problem Reporting 
                                
Incidents or events that meet the reporting criteria, as outlined by the Duke IRB, will be reported 
to the Duke IRB as needed. 
The following will be included, at a minimum: 
• 
A detailed description of the event, incident, experience, or outcome. 
• 
A description of any changes to the protocol or other corrective actions that have been 
taken or are proposed in response to the unanticipated problem.                                
Compliance regarding Adverse Event Reporting. 
                                
The study team will be required to document and report adverse events (including serious 
adverse events) to the Institutional Review Board (IRB), as appropriate and in line with 
institutional reporting criteria. 
                                
17.  Data management.  
 
All data is captured via the electronic data capture system (EDC) has been developed and is 
supported by programming service providers, Pattern Health. This data will be exported data will be 
exported from Pattern Health Servers in .CSV format, and stored in secure, Duke University-
approved, password protected, cloud systems (i.e., Box). Study staff will complete electronic case 
report forms (eCRFs) securely integrated within the LIFT platform that includes an electronic 
database. Study personnel will utilize these data systems to create scheduled reports on the trials’ 
conduct (e.g., study milestones) to enhance the study's quality.  We will monitor the quality and 
consistency of data in a number of ways.  Monthly data cleaning will be done by the study team 
using customized group-blinded reports that will identify missing, outlier, or nonsensical data at time 
points when remedying them is feasible. 
 
18. Privacy, Data Storage & Confidentiality 
 
Privacy 
                                
The study team will closely safeguard participant privacy regarding protected health and 
personal information. A study ID number will be generated at the time of consent and will be 
maintained in a secure file (e.g., linker file) which will contain the participant. Further, names, 
birth dates, telephone numbers, and addresses will be stored securely as described in the 
RDSP and only accessible by delegated study team members. Study participants cannot view 
data via the ePRO system or the electronic data capture (EDC) system, supported by Pattern 
Health. Participants will only have access to the ePRO system and will access the one-way view 
ePRO system via secure, PHI-free email or text links sent from the app. 
                                
Digital security 
The study digital infrastructure consists of a mobile (i.e., native) app with a built-in electronic 
participant reported outcomes (ePRO) function, an electronic data capture (EDC) system, and a 
separate Duke University-approved, password protected, cloud systems (i.e., Box). 

Pro00107657: A self-directed mobile mindfulness intervention to address distress and burnout 
in frontline healthcare workers. 
Version Date:  v1.0 - 3/31/2021 
NCT04816708 
 
• 
LIFT app: LIFT is a native app. The programming service providers, Pattern Health, 
endeavor to build technological solutions that preserve the privacy, confidentiality, and 
security of protected health information that may be part of health records or research 
datasets. Protected Health Information (PHI) is handled according to appropriate Health 
Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy and Security 
Regulations. All staff who work with sensitive data are required to complete appropriate 
HIPAA training with periodic updates, complete human subjects and data privacy 
training, comply with site IT Security Policies, and agree to the provisions of the 
University Rules of Behavior and Sanction Policy. All sites strive to implement 
reasonable security controls in its product builds guided by FISMA, HIPAA, and OMB 
Circular A-130, Appendix III. Pattern Health has implemented and maintains several 
security protocols and controls for apps as well. Pattern Health has developed a formal 
information security program, with a named individual responsible for its overall 
execution. Pattern Health also periodically conducts an information technology (IT) 
security risk assessment on its projects, maintains formal documented protocols for 
reporting security breaches, assesses and manages security risks associated with 
vendors and subcontractors, maintains employee on-boarding and off-boarding policies 
that protect study data and integrity, and ensures continuing employee awareness of 
and education on security policies, standards, and procedures. In terms of development 
approaches to security, Pattern Health evaluates and installs security patches in a timely 
fashion, protects systems against self- propagating malware, maintains secure coding 
policies and practices, and utilizes standardized secure build processes to protect 
Pattern Health hardware that accesses customer networks, protecting confidential data 
against attack. All storage of confidential participant data on Pattern Health hardware is 
strictly prohibited, and the use of off-shore service providers and/or data center facilities 
is prohibited unless approved by client. For our study, the native app application and 
supporting backend system that Pattern Health develops will be hosted securely per 
DHTS regulations.  
• 
EDC: The electronic data capture system (EDC) has been developed and is supported 
by programming service providers, Pattern Health. As noted above, Pattern Health 
maintains all appropriate PHI and HIPAA regulations related to human subject research 
and data privacy and integrity pertaining to data management and IT security. The EDC 
will be a central location in which all study related data will be stored. Data will be 
exported and analyzed for research purposes as described elsewhere.  
                                
All data entry will be self-completed by participants using the validated ePRO system accessed 
via the LIFT app. The LIFT app dashboard, developed by Pattern Health for administrative use 
only, will be accessed and used by delegated study team members to create scheduled reports 
on the trials’ conduct (e.g., study milestones) to enhance the study's quality. Through this 
dashboard, quality and consistency of data will be monitored. The principal investigator will do 
routine data cleaning. 
 
Confidentiality 
                                    
Subjects will not be identified on any study reports. University firewalls, multiple passwords, and 
encryption programs protect the security of the electronic data system, which will be housed on 
a highly secure Duke University server. All personal computers are located in lockable offices 

Pro00107657: A self-directed mobile mindfulness intervention to address distress and burnout 
in frontline healthcare workers. 
Version Date:  v1.0 - 3/31/2021 
NCT04816708 
 
and are accessible only by frequently changed passwords. The server room is accessible only 
to designated University Systems Administrators. 
 
      
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Pro00107657: A self-directed mobile mindfulness intervention to address distress and burnout 
in frontline healthcare workers. 
Version Date:  v1.0 - 3/31/2021 
NCT04816708