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

Comparison of Two Nutrition-Based Interventions on Physician Well-being - A Randomized Controlled Trial

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.

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. Surveys will be completed at baseline and in weeks 3 and 6 after the start of the intervention.

If this proof-of-concept intervention is effective, it will not only provide evidence regarding the value of the specific intervention tested for increasing self-valuation in physicians but also provide a novel framework for future interventions evaluating the ability of mindset interventions to foster self-valuation and clinician well-being.

Primary outcome measures: percentage change in mean scores from baseline at week 6 in scores of the measures below.

1) Self-valuation: We will use two standardized measures to assess self-valuation:

1a. 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. (1) This assessment will be collected at baseline, week 3, and week 6.

1b. The 3-item self-kindness subscale of the Modified State Self-Compassion Measure, a validated construct developed by Kristin Neff, PhD in 2021 (2). This assessment will be collected at baseline, week 3, and week 6.

2) We will also evaluate participants' self-reported readiness to practice self-valuation, and the importance and confidence in practicing it on a sliding scale.

3) 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. These assessments will be collected at baseline, week 3, and week 6.(3)

Secondary outcome measure: percentage change in mean score from baseline at week 6 in scores of diet quality assessed by the validated 9-item Mini-EAT dietary questionnaire designed to assess diet quality in clinician practice. (4) This assessment will be collected at baseline, week 3, and week 6.

In the final survey ( week 6) we will collect participant feedback about satisfaction with the program and recommendations for improvement.

References:

1. Trockel MT, Hamidi MS, Menon NK, et al. Self-valuation: Attending to the Most Important Instrument in the Practice of Medicine. Mayo Clin Proc. 2019;94(10):2022-2031.
2. Neff, K. D., Tóth-Király, I., Knox, M. C., Kuchar, A., & Davidson, O. (2021). The Development and Validation of the State Self-Compassion Scale (Long-and Short Form). Mindfulness, 12(1), 121-140.
3. Trockel M, Bohman B, Lesure E, et al. 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;42(1):11-24.
4. Lara-Breitinger KM, Medina Inojosa JR, Li Z, et al. Validation of a Brief Dietary Questionnaire for Use in Clinical Practice: Mini-EAT (Eating Assessment Tool). J Am Heart Assoc. 2023;12(1):e025064.

Inclusion Criteria:

• 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)

Exclusion Criteria:

• 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.