Efficacy of a web-based stress management intervention for employees experiencing adverse working conditions and occupational self-efficacy as mediator: A randomized controlled trial (Preprint)

• DOI: 10.2196/preprints.40488
• Publication Date: 2022-06-27T21:46:21Z
• Authors: Patricia Nixon; David Daniel Ebert; Leif Boss; Peter Angerer; Nico Dragano; Dirk Lehr
• Keywords: 03 medical and health sciences; 0302 clinical medicine; 3. Good health

BACKGROUND Work stress is highly prevalent and puts employees at risk for adverse health consequences. Web-based stress management interventions promoting occupational self-efficacy might be a feasible approach to aid employees to alleviate this burden.

OBJECTIVE The first aim of this randomized controlled trial (RCT) was to investigate the efficacy of a web-based stress management intervention (SMI) for employees perceiving elevated stress levels and effort-reward imbalance (ERI) compared to a wait list control group (WLC). Secondly, it was investigated if the efficacy of a SMI could be explained by an increase in occupational self-efficacy (OSE) and if the personal resource of OSE enables employees to change adverse working conditions.

METHODS A total of 262 employees reporting ERI (>0.715) and elevated stress levels (PSS-10≥22) was randomly assigned to either the SMI or WLC. The primary outcome was perceived stress (PSS-10). Secondary outcomes included mental and work-related health measures. Four different mediation analyses were conducted with occupational self-efficacy, efforts, and rewards as mediators. After eligibility screening, data was collected at baseline (T1), seven weeks (T2) and six months (T3).

RESULTS Analyses of covariance (ANCOVA) revealed that stress reduction was significantly higher for the SMI compared to the WLC at T2 (d=0.87, 95% CI 0.61-1.12) and T3 (d=0.65, 95% CI 0.41-0.90). Mediation analyses indicated that OSE mediated the beneficial effect of the SMI on stress directly. Furthermore, the analyses revealed a significant indirect effect of OSE via rewards but not via efforts, while efforts still had a negative impact on stress.

CONCLUSIONS The SMI was effective in reducing stress and improving OSE in employees despite experiencing ERI at work. Results from mediation analyses suggest that fostering personal resources such as OSE contributes to the efficacy of the SMI and enables employees to achieve positive changes regarding the rewarding aspects of the workplace. However, the SMI seemed to neither directly nor indirectly impact efforts, suggesting that person-focused interventions might not be sufficient and need to be complemented by organizational-focused interventions to comprehensively improve mental health in employees facing adverse working conditions.

CLINICALTRIAL German Clinical Trials Register (DRKS): DRKS00005990.