Comparison of Two Nutrition-Based Interventions on Physician Well-being

NCT06598540 | Completed

• 1 other identifier: 75576
• Study Type: interventional
• Target: 177
• Locations: 1 country
• Sites: 1

Brief Summary

Several studies have shown that self-valuation (also known as self-compassion) strongly predicts burnout in physicians. Although effective, existing self-compassion cultivation programs designed for physicians have significant time commitments and, historically, have had low physician participation rates. With occupational burnout among US physicians at an all-time high, there is a compelling and urgent need to identify pragmatic approaches to address low levels of self-valuation in physicians. This study aims to test the impact of a brief mindset intervention that frames daily food choices as an opportunity to demonstrate self-kindness on self-valuation and burnout in physicians over 6 weeks. Instilling a mindset shift that enables physicians to practice self-valuation as part of their existing, daily routine amidst extreme time pressures is a pragmatic and potentially powerful vehicle to promote self-valuation for physicians.

Conditions

Self-care; Self-care Agency; Self-kindness; Self-valuation; Self-Compassion

Keywords

self-compassion; physician well-being; diet; diet quality; self-care; physician burnout; self-valuation

Outcome Measures

Primary Outcomes (4)

• Percentage change in mean score of self-kindness from baseline at week 6

  The 3-item self-kindness subscale of the Modified State Self-Compassion Measures: A validated construct developed by Kristin Neff, PhD in 2021. This assessment will be collected at baseline, week 3, and week 6. Instructions ask respondents to answer questions about their relevant experience "during the past 2 weeks." An example of an item is "I'm being kind to myself."; Scale items are scored on a 5-point Likert scale (Not at all true for me=1;Very true for me=5). The scale range is standardized to 0 to 10. Higher scores are more favorable.

  6 weeks

• Percentage change in mean score of self-valuation from baseline at week 6

  The 4-item Clinician Self-valuation Scale assesses deferment of self-care to meet work demands and harsh responses to personal imperfections and errors during the past two weeks. This assessment will be collected at baseline, week 3, and week 6. Instructions ask respondents to answer questions about their relevant experience "during the past 2 weeks." Example items are "When I made a mistake, I felt more self-condemnation than self-encouragement to learn from the experience" and "I put off taking care of my own health due to time pressure." Scale items are scored on a 5-point Likert scale (always = 0; never = 4) and reverse scored such that higher scores are more favorable. The scale range is 0 to 10.

  6 weeks

• Changes in Stage of Change from baseline at week 6

  Perceptions of importance and confidence in practicing self-valuation will be measured on a sliding scale that ranges from 0 to 10 with higher scores being more favorable. Together, indicate how ready the client is to change target behaviors. Lower scores of both ( less than 30) indicate pre-contemplation stage and higher scores ( more than 90) indicate the maintenance stage in terms of four stages of the change: Precontemplation, Contemplation, Action, and Maintenance. We will also evaluate participants' self-reported readiness (5 option Likert scale from not ready to practice: 0, to have been practicing it consistently for 6 months: 4).These assessments will be collected at baseline, week 3 and week 6.

  6 weeks

• Physician Burnout

  We will use the burnout sub-scales of the validated Stanford Professional Fulfillment Index which includes 4 items evaluating the Work Exhaustion domain of burnout and 6 items assessing the Interpersonal Disengagement domain of burnout over the past 2 weeks. This includes 4 items that assess work exhaustion and 6 items that assess interpersonal disengagement. Items are scored on a 5-point Likert scale from "not at all" to "extremely." The average item score from the 10 work exhaustion items and interpersonal disengagement items is used to derive an overall burnout score ranging from 0 to 10 with lower scores being favorable. This assessment will be collected at baseline, week 3 and week 6.

  6 weeks

Secondary Outcomes (1)

• Percentage change in mean scores from baseline at week 6 in diet quality

  6 weeks

Study Arms (2)

Kindness-focused intervention arm

EXPERIMENTAL

Mindset intervention framing food choices as an opportunity to practice self-kindness. Individuals randomized to this arm will participate in a 15-20-minute live virtual educational session delivered via the Stanford Zoom platform. The recording of the session will be available for 7 days on a private and secure educational platform for those who cannot attend the live session and for future review. After participating in the initial educational session, participants can engage in brief (less than 10 minutes) web-based activities on their own time during weeks 2 and 5.

Behavioral: Kindness-focused

Health-focused intervention arm

ACTIVE COMPARATOR

Brief education intervention framing food choices as a component of a healthy lifestyle. Individuals randomized to this arm will participate in a 15-20-minute live virtual educational session. The recording of the session will be available for 7 days on a private and secure educational platform for those who cannot attend the live session and for future review. After participating in the initial educational session, participants will have the option to engage in brief (less than 10-minute) web-based activities on their own time during weeks 2 and 5.

Behavioral: Health-focused

Interventions

Kindness-focused BEHAVIORAL

This mindset intervention frames food choices as an opportunity to practice self-kindness. Individuals randomized to this arm will participate in a 15-20-minute live virtual educational session delivered via the Stanford Zoom platform. The recording of the session will be available for 7 days on a private and secure educational web-based platform. After participating in the initial educational session, participants will have the option to engage in brief (less than 10-minute) web-based activities on their own time during weeks 2 and 5. Examples of such activities include sharing their experiences about considering food choices as an act of self-kindness with other study participants or writing an encouraging letter to a study participant and physician colleague through the private and secure message board of a web-based educational platform.

Kindness-focused intervention arm

Health-focused BEHAVIORAL

Brief education intervention framing food choices as a component of a healthy lifestyle. Individuals randomized to this arm will participate in a 15-20-minute live virtual educational session. The recording of the session will be available for 7 days on a private and secure educational web-based platform. After participating in the initial educational session, participants will have the option to engage in brief (less than 10-minute) web-based activities on their own time during weeks 2 and 5. Examples of such activities include writing a brief statement about their perspective on the usefulness of healthy eating and sharing it with physician colleagues in their group through the private and secure message board of a web-based educational platform.

Health-focused intervention arm

Eligibility Criteria

• Age: 21 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Physicians of all genders and racial/ethnic backgrounds licensed to practice medicine in the US, and
• Physicians who spend at least 8 hours per week doing clinical work (based on self-report)

You may not qualify if:

• Anyone who is not a licensed physician in the US
• Physicians who are not licensed to practice medicine in the US, and
• Physicians who spend less than 8 hours per week doing clinical work.

Sponsors & Collaborators

• Stanford University: lead

Study Sites (1)

Stanford University

Stanford, California, 94305, United States

Location

Related Publications (4)

• Lara-Breitinger KM, Medina Inojosa JR, Li Z, Kunzova S, Lerman A, Kopecky SL, Lopez-Jimenez F. Validation of a Brief Dietary Questionnaire for Use in Clinical Practice: Mini-EAT (Eating Assessment Tool). J Am Heart Assoc. 2023 Jan 3;12(1):e025064. doi: 10.1161/JAHA.121.025064. Epub 2022 Dec 30.

  PMID: 36583423 RESULT

• Trockel M, Bohman B, Lesure E, Hamidi MS, Welle D, Roberts L, Shanafelt T. A Brief Instrument to Assess Both Burnout and Professional Fulfillment in Physicians: Reliability and Validity, Including Correlation with Self-Reported Medical Errors, in a Sample of Resident and Practicing Physicians. Acad Psychiatry. 2018 Feb;42(1):11-24. doi: 10.1007/s40596-017-0849-3. Epub 2017 Dec 1.

  PMID: 29196982 RESULT

• Neff, K.D., Tóth-Király, I., Knox, M.C. et al. The Development and Validation of the State Self-Compassion Scale (Long- and Short Form). Mindfulness 12, 121-140 (2021). https://doi.org/10.1007/s12671-020-01505-4

  RESULT

• Trockel MT, Hamidi MS, Menon NK, Rowe SG, Dudley JC, Stewart MT, Geisler CZ, Bohman BD, Shanafelt TD. Self-valuation: Attending to the Most Important Instrument in the Practice of Medicine. Mayo Clin Proc. 2019 Oct;94(10):2022-2031. doi: 10.1016/j.mayocp.2019.04.040. Epub 2019 Sep 19.

  PMID: 31543254 RESULT

Study Officials

• Maryam Makowski, PhD

  Stanford University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, OUTCOMES ASSESSOR
• Masking Details: Participants would not know the difference between the two arms of the study other than there are two different behavioral nutrition interventions. The biostatistician analyzing the data would not know which arm of the study participants were assigned to.
• Purpose: OTHER
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Clinical Associate Professor

Model Details: We will conduct a randomized controlled trial to compare the impact on physician well-being outcomes of a brief mindset intervention that frames daily food choices as an opportunity for demonstrating self-kindness to a brief nutrition education intervention among physicians on burnout, self-compassion, self-kindness, diet quality, and readiness to change in physician during 6-weeks. Surveys will be completed at baseline and in weeks 3 and 6.

Study Record Dates

• First Submitted: September 14, 2024
• First Posted: September 19, 2024
• Study Start: March 15, 2025
• Primary Completion: July 20, 2025
• Study Completion: July 20, 2025
• Last Updated: April 24, 2026

Record last verified: 2026-04

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)