Comparing effectiveness of heart rate variability biofeedback, mindfulness, and mindfulness-based heart rate variability biofeedback for work place stress reduction: a three-armed randomised controlled trial

Abstract

Background: Psychophysiological disorders due to work-related stress continue to be highly costly for health systems and new approaches for stress reduction are much needed. Both heart rate variability-biofeedback (HRV-Bfb) and mindfulness-based interventions (MBI) have been empirically shown to reduce stress. A combination of both methods could produce an even greater improvement of psychophysiological parameters by increasing autonomic regulation through mindfulness. This study compares these three interventions in the work context. Method: In this three-armed randomized controlled trial (RCT), 60 healthy adults employed in the same organization were randomized to participate in HRV-Bfb, MBI or the wait-list-control-group (WLCG). The WLCG later received a combined training (MBI-HRV-Bfb). Participants trained for 6 weeks. Primary outcomes were psychophysiological parameters of stress: Stress perception, coping, psychological wellbeing, HRV parameters and cortisol. Secondary outcomes were mindfulness, self-compassion and depressive symptoms. Outcomes were assessed at four assessment points. Expected results: MBI-HRV-Bfb is expected to produce a greater reduction in stress indicators than the singular interventions, which in turn are expected to produce greater stress reduction compared to the WLCG. Preliminary results of the comparison will be discussed as well as the implementation of the interventions in corporate health management. Current stage of work: The 60 participants were trained and assessed. Data are now being analyzed. Discussion: This study evaluates a novel approach to stress reduction on an organizational level as well as provides a comparison of two established methods. In addition, it highlights issues and challenges of the implementation of such interventions in corporate health management.