Engagement with an Online Mindfulness Intervention for 9-1-1 Telecommunicators: A Mixed Methods Study

Abstract

Introduction - We depend on 9-1-1 telecommunicators to coordinate emergency responses, but demanding working conditions and secondary exposure to trauma may contribute to a high burden of stress in this population, thereby decreasing their ability to work effectively and efficiently. Online mindfulness-based interventions (MBIs) have shown promising results in reducing stress in similar populations. However, low engagement may limit intervention effectiveness. Understanding who engages, as well as how and why they engage, could improve future interventions. Objective - In this study we sought to determine demographic, psychosocial, and workplace factors associated with completion of an online, workplace MBI for stress reduction among 9-1-1 telecommunicators. Participants’ lived experiences of engaging in the intervention and perceived barriers and facilitators to engagement were also explored. Methods - This study involved a mixed methods secondary analysis. In the exploratory quantitative analysis, descriptive statistics were used to describe participant characteristics and inferential statistics were used to analyze associations. A thematic analysis of qualitative data from the intervention’s six weekly check-in surveys and a final training evaluation was used to derive themes around engagement with the intervention, including barriers and facilitators to engagement. Results - No individual participant characteristics were associated with completion of the intervention. Only call center of employment was associated with completion (p=0.042). Qualitative analyses resulted in four overarching themes: “incorporation into daily life”, “perceived effects”, “individual-level barriers and facilitators of engagement”, and “workplace and intervention-level barriers and facilitators of engagement.” Participants exhibited commitment to incorporating mindfulness into their daily lives and expressed positive beliefs in the perceived effects of mindfulness, including increased self-efficacy in coping with stressors, decreased stress, and increased empathy with callers. Workplace barriers and stress were identified as key barriers to engagement, while shorter practices, the use of mixed media, and belief in the benefits of practicing mindfulness were identified as key facilitators. Conclusions - The results of this study suggest that engaging in an online MBI can reduce stress and improve wellbeing in an emergency responder population, and that the general population may benefit as a result. Future research should explore tailoring of online MBIs to reduce workplace barriers to engagement.