Marcelo Trombka1,2,3,4,5,6, Marcelo Demarzo7, Daniel Campos8,9, Sonia B Antonio7, Karen Cicuto7, Ana L Walcher1,2,3,4, Javier García-Campayo9, Zev Schuman-Olivier5,6, Neusa S Rocha1,2,3,4. 1. Postgraduate Program in Psychiatry and Behavioral Sciences, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil. 2. Department of Psychiatry, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil. 3. Innovations and Interventions for Quality of Life Research Group, Porto Alegre, Brazil. 4. Clinical Research Center, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil. 5. Department of Psychiatry, Harvard Medical School, Boston, MA, United States. 6. Cambridge Health Alliance, Center for Mindfulness and Compassion, Cambridge, MA, United States. 7. Mente Aberta, Brazilian Center for Mindfulness and Health Promotion, Department of Preventive Medicine, Federal University of São Paulo (UNIFESP), São Paulo, Brazil. 8. Department of Psychology and Sociology, University of Zaragoza, Huesca, Spain. 9. Grupo de Investigación en Salud Mental en Atención Primaria, Miguel Servet University Hospital, Zaragoza, Spain.
Abstract
Background: Police officers' high-stress levels and its deleterious consequences are raising awareness to an epidemic of mental health problems and quality of life (QoL) impairment. There is a growing evidence that mindfulness-based interventions are efficacious to promote mental health and well-being among high-stress occupations. Methods: The POLICE study is a multicenter randomized controlled trial (RCT) with three assessment points (baseline, post-intervention, and 6-month follow-up) where police officers were randomized to mindfulness-based health promotion (MBHP) (n = 88) or a waiting list (n = 82). This article focuses on QoL, depression and anxiety symptoms, and religiosity outcomes. Mechanisms of change and MBHP feasibility were evaluated. Results: Significant group × time interaction was found for QoL, depression and anxiety symptoms, and non-organizational religiosity. Between-group analysis showed that MBHP group exhibited greater improvements in QoL, and depression and anxiety symptoms at both post-intervention (QoL d = 0.69 to 1.01; depression d = 0.97; anxiety d = 0.73) and 6-month follow-up (QoL d = 0.41 to 0.74; depression d = 0.60; anxiety d = 0.51), in addition to increasing non-organizational religiosity at post-intervention (d = 0.31). Changes on self-compassion mediated the relationship between group and pre-to-post changes for all QoL domains and facets. Group effect on QoL overall health facet at post-intervention was moderated by mindfulness trait and spirituality changes. Conclusion:MBHP is feasible and efficacious to improve QoL, and depression and anxiety symptoms among Brazilian officers. Results were maintained after 6 months. MBHP increased non-organizational religiosity, although the effect was not sustained 6 months later. To our knowledge, this is the first mindfulness-based intervention RCT to empirically demonstrate these effects among police officers. Self-compassion, mindfulness trait, and spirituality mechanisms of change are examined. Clinical Trial Registration: www.ClinicalTrials.gov. identifier: NCT03114605.
RCT Entities:
Background: Police officers' high-stress levels and its deleterious consequences are raising awareness to an epidemic of mental health problems and quality of life (QoL) impairment. There is a growing evidence that mindfulness-based interventions are efficacious to promote mental health and well-being among high-stress occupations. Methods: The POLICE study is a multicenter randomized controlled trial (RCT) with three assessment points (baseline, post-intervention, and 6-month follow-up) where police officers were randomized to mindfulness-based health promotion (MBHP) (n = 88) or a waiting list (n = 82). This article focuses on QoL, depression and anxiety symptoms, and religiosity outcomes. Mechanisms of change and MBHP feasibility were evaluated. Results: Significant group × time interaction was found for QoL, depression and anxiety symptoms, and non-organizational religiosity. Between-group analysis showed that MBHP group exhibited greater improvements in QoL, and depression and anxiety symptoms at both post-intervention (QoL d = 0.69 to 1.01; depression d = 0.97; anxiety d = 0.73) and 6-month follow-up (QoL d = 0.41 to 0.74; depression d = 0.60; anxiety d = 0.51), in addition to increasing non-organizational religiosity at post-intervention (d = 0.31). Changes on self-compassion mediated the relationship between group and pre-to-post changes for all QoL domains and facets. Group effect on QoL overall health facet at post-intervention was moderated by mindfulness trait and spirituality changes. Conclusion: MBHP is feasible and efficacious to improve QoL, and depression and anxiety symptoms among Brazilian officers. Results were maintained after 6 months. MBHP increased non-organizational religiosity, although the effect was not sustained 6 months later. To our knowledge, this is the first mindfulness-based intervention RCT to empirically demonstrate these effects among police officers. Self-compassion, mindfulness trait, and spirituality mechanisms of change are examined. Clinical Trial Registration: www.ClinicalTrials.gov. identifier: NCT03114605.
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