Building Resilience @ Work Training Among Healthcare Workers

Study Overview
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Brief Summary
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Background Given that the challenges in adjusting to shifting work, physical workload and high-strung nature, healthcare workers often encounter high stress, emotional exhaustion, low empathy, fatigue and burnout, which, in turn, result in sickness, absence, and high turnover. Hence, building resilience for future adversity among healthcare workers in the workplace is necessary. Objectives To evaluate the effectiveness of the Building Resilience at Work (BRAW) on resilience, job engagement, intention to leave, employability, and work performance To explore healthcare workers' experience of the BRAW intervention. Methods This study will evaluate the effectiveness of BRAW using a sequential mixed methods design in two phases. In phase I, a two-armed randomized controlled trial will be conducted to compare resilience, work engagement, coping skills, job satisfaction and life satisfaction with a waiting list control condition among 410 healthcare workers. In phase II, the investigators will conduct a virtual individual interview to explore experiences on usability and acceptability after receiving the BRAW intervention using a sample of 33 healthcare workers. Significance of research Considering the multifactorial and complexity of resilience at work in an increasingly dynamic healthcare environment, the content of resilience training can promote resilience, work engagement, coping skills, job satisfaction and life satisfaction among healthcare workers in order to reduce the turnover rate among healthcare workers in Singapore.

Official Title
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Evaluation of Building Resilience at Work (BRAW) Training Among Healthcare Workers: A Sequential Mixed Methods Design

Conditions
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Resilience, Psychological

Intervention / Treatment
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* Behavioral: BRAW


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Healthcare workers aged 21 years or older Can read English Own and regularly use smartphone, tablet, laptop or desktop Can access the internet Exclusion Criteria: Previous diagnosis of psychosis, severe depression, personality disorder and substance abuse at any point in their life

Ages Eligible for Study
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Minimum Age: 21 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Triple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: BRAW intervention group<br>BRAW is designed as an online intervention comprising of six sessions over six weeks. The six sessions are: (1) happiness and positivity, (2) cognitive restructuring, (3) behavioural activation, (4) emotion regulation, (5) positive work climate and (6) problem solving. | Behavioral: BRAW<br>* Sessions Happiness and positivity Understanding strengths and resilience and positive attitude Cognitive restructuring Identification dysfunctional automatic thoughts in problematic and emotional arousing situations Usage of cognitive -behavioural techniques to evaluate and modify dysfunctional thoughts and beliefs Behavioural activation Initiation and utilization of behavioural activation techniques for positive change by increasing pleasant events Healthy interpersonal relationships Importance of peer support Emotion regulation Preventing and managing conflict Emotion regulation abilities Positive work climate Building supportive work environment Development of supportive collegial relationships Promotion of coworker support Problem solving Problem-solving work-life problems Work-life balance Bringing it together<br>|
| No Intervention: Waitlist control group<br>Participants will receive the intervention after the follow-up assessment. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Resilience | A 6-item Brief Resilience Scale (BRS) is used to assess the ability to recover from stress. Items are rated on a 5-point Likert scale from 1 (strongly disagree) to 5 (strongly agree). The total score ranges from 6 to 30, with higher scores signifying greater bounce-back resilience. BRS has demonstrated good reliability and validity. | Baseline | 
| Resilience | A 6-item Brief Resilience Scale (BRS) is used to assess the ability to recover from stress. Items are rated on a 5-point Likert scale from 1 (strongly disagree) to 5 (strongly agree). The total score ranges from 6 to 30, with higher scores signifying greater bounce-back resilience. BRS has demonstrated good reliability and validity. | at 6 weeks | 
| Resilience | A 6-item Brief Resilience Scale (BRS) is used to assess the ability to recover from stress. Items are rated on a 5-point Likert scale from 1 (strongly disagree) to 5 (strongly agree). The total score ranges from 6 to 30, with higher scores signifying greater bounce-back resilience. BRS has demonstrated good reliability and validity. | 12 weeks after training completes | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Work engagement | A 9-item Utrecht Working Engagement Scale short version (UWES-9) is used to measure the participant's feelings in the context of work. Participant rate how often they experience these feelings on a 4-point Likert scale from 1 (never) to 4 (always). The total score ranges from 9 to 36 and higher scoring on UWES-9 indicates more work engagement. UWES-9 has confirmed satisfactory validity and reliability. | Baseline | 
| Work engagement | A 9-item Utrecht Working Engagement Scale short version (UWES-9) is used to measure the participant's feelings in the context of work. Participant rate how often they experience these feelings on a 4-point Likert scale from 1 (never) to 4 (always). The total score ranges from 9 to 36 and higher scoring on UWES-9 indicates more work engagement. UWES-9 has confirmed satisfactory validity and reliability. | at 6 weeks | 
| Work engagement | A 9-item Utrecht Working Engagement Scale short version (UWES-9) is used to measure the participant's feelings in the context of work. Participant rate how often they experience these feelings on a 4-point Likert scale from 1 (never) to 4 (always). The total score ranges from 9 to 36 and higher scoring on UWES-9 indicates more work engagement. UWES-9 has confirmed satisfactory validity and reliability. | 12 weeks after training completes | 
| Intention to leave | 12-item Anticipated Turnover Scale (ATS)49 is used to measure intention to leave. Questions are related to one's anticipated length of time before leaving and certainty of leaving the job. Items are rated on a 5-point Likert scale from 1 (strongly disagree) to 5 (strongly agree). The total score ranges from 12 to 60, with higher scores reflecting higher degree of turnover. CVI was 0.80-0.95 for items. Cronbach's alphas were 0.85-0.94 in several researches. Test-retest reliability coefficient was 0.84 in 2 weeks' interval. | Baseline | 
| Intention to leave | 12-item Anticipated Turnover Scale (ATS)49 is used to measure intention to leave. Questions are related to one's anticipated length of time before leaving and certainty of leaving the job. Items are rated on a 5-point Likert scale from 1 (strongly disagree) to 5 (strongly agree). The total score ranges from 12 to 60, with higher scores reflecting higher degree of turnover. CVI was 0.80-0.95 for items. Cronbach's alphas were 0.85-0.94 in several researches. Test-retest reliability coefficient was 0.84 in 2 weeks' interval. | at 6 weeks | 
| Intention to leave | 12-item Anticipated Turnover Scale (ATS)49 is used to measure intention to leave. Questions are related to one's anticipated length of time before leaving and certainty of leaving the job. Items are rated on a 5-point Likert scale from 1 (strongly disagree) to 5 (strongly agree). The total score ranges from 12 to 60, with higher scores reflecting higher degree of turnover. CVI was 0.80-0.95 for items. Cronbach's alphas were 0.85-0.94 in several researches. Test-retest reliability coefficient was 0.84 in 2 weeks' interval. | 12 weeks after training completes | 
| Employability | A 11-item Self-perceived Employability Scale (SPE) is used to assess employability. Participants are required to state their agreement with the items by selecting a number on a 5-point scale, from 1 (strong disagreement) to 5 (strong agreement). The total score ranges from 11 to 55, with higher score indicating perceived better employability. SPE has reported good internal consistency | Baseline | 
| Employability | A 11-item Self-perceived Employability Scale (SPE) is used to assess employability. Participants are required to state their agreement with the items by selecting a number on a 5-point scale, from 1 (strong disagreement) to 5 (strong agreement). The total score ranges from 11 to 55, with higher score indicating perceived better employability. SPE has reported good internal consistency | at 6 weeks | 
| Employability | A 11-item Self-perceived Employability Scale (SPE) is used to assess employability. Participants are required to state their agreement with the items by selecting a number on a 5-point scale, from 1 (strong disagreement) to 5 (strong agreement). The total score ranges from 11 to 55, with higher score indicating perceived better employability. SPE has reported good internal consistency | 12 weeks after training completes | 
| Work performance | A 18-item Individual Work Performance Questionnaire (IWPQ) is used to measure individual work performance. The IWPQ has a recall period of 3 months and a rating scale from 0 (seldom/never) to 4 (always/often) for task, contextual performance and counterproductive work behaviour. A mean score is calculated by adding the item scores, and dividing their sum by the number of items that range between 0 and 4, with higher scores reflecting higher individual work performance. The psychometric properties of the IWPQ indicated excellent internal consistency and good validity. | Baseline | 
| Work performance | A 18-item Individual Work Performance Questionnaire (IWPQ) is used to measure individual work performance. The IWPQ has a recall period of 3 months and a rating scale from 0 (seldom/never) to 4 (always/often) for task, contextual performance and counterproductive work behaviour. A mean score is calculated by adding the item scores, and dividing their sum by the number of items that range between 0 and 4, with higher scores reflecting higher individual work performance. The psychometric properties of the IWPQ indicated excellent internal consistency and good validity. | at 6 weeks | 
| Work performance | A 18-item Individual Work Performance Questionnaire (IWPQ) is used to measure individual work performance. The IWPQ has a recall period of 3 months and a rating scale from 0 (seldom/never) to 4 (always/often) for task, contextual performance and counterproductive work behaviour. A mean score is calculated by adding the item scores, and dividing their sum by the number of items that range between 0 and 4, with higher scores reflecting higher individual work performance. The psychometric properties of the IWPQ indicated excellent internal consistency and good validity. | 12 weeks after training completes | 
| Usage and satisfaction of training | Usage is defined as an encompassing engagement, i.e., the time (in minutes) spent browsing the website and practicing the assigned homework in the previous weeks. Computer-generated indicators include the following: (1) session completion, (2) number of website visits, and (3) time spent on the website. At the end of the six-week program, attitude toward and satisfaction with the online training will be assessed using the self-developed eight-item usage and satisfaction of training. Each item is rated on a 4-point Likert scale from 1 to 4, and response options differed for the various items. The total score ranges from 8 to 32, and a high score represents better satisfaction of training. In addition, we have four open questions to obtain suggestions for improvement. | at 6 weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Resilience training, Healthcare Workers