000169410 001__ 169410
000169410 005__ 20260225153355.0
000169410 0247_ $$2doi$$a10.2196/82905
000169410 0248_ $$2sideral$$a148347
000169410 037__ $$aART-2026-148347
000169410 041__ $$aeng
000169410 100__ $$aGuerrero-Pertiñez, Gloria
000169410 245__ $$aResilience as a mediator in a web-based intervention (MINDxYOU) to reduce stress among health care professionals: stepped-wedge cluster randomized trial
000169410 260__ $$c2026
000169410 5060_ $$aAccess copy available to the general public$$fUnrestricted
000169410 5203_ $$aBackground: The mechanisms through which mindfulness and third wave–based digital programs exert their effects on stress reduction remain poorly understood. Identifying these mediators is essential to optimize their implementation, particularly in health care settings. This approach is particularly relevant for health care professionals, who are constantly exposed to high levels of emotional demands, work overload, and risk of burnout, especially in the aftermath of the COVID-19 pandemic. Despite the growing need for scalable and accessible mental health support in this population, such digital programs remain scarce and underused. Objective: The primary aim of this study was to analyze the psychological mechanisms through which the MINDxYOU online program may contribute to stress reduction among health care professionals, focusing on a mediation model. Specifically, we explored if variables such as resilience and facets of mindfulness, compassion, and acceptance mediated the effects of the intervention on perceived stress. Methods: In a stepped-wedge cluster randomized design, 357 health professionals from health centers in Aragon and Málaga, Spain, were recruited. They were divided into 6 clusters, 3 per region, and randomly assigned to one of the 3 sequences, each starting with a control phase and then transitioning to the intervention phase (the MINDxYOU program) after 8, 16, or 24 weeks. This self-guided, web-based program, designed to be completed over 8 weeks, included weekly contact (via WhatsApp, call, or email) from the research team to promote adherence. Participants were assessed on the web every 8 weeks for 5 assessments. Perceived stress was the study’s primary outcome, with additional measures of clinical factors (anxiety, depression, and somatization) and process variables (resilience, mindfulness, compassion, and acceptance). Mediation models using mixed-effects regressions and bootstrap resampling (1000 iterations) were applied to analyze the direct and indirect effects of the treatment on psychological outcomes. Results: Resilience emerged as the most consistent and significant mediator, exerting a relevant indirect effect on reducing stress (β=−1.41; P=.02), anxiety (β=−0.88; P=.03), and depression (β=−0.97; P=.01), even in multivariate models. Mindfulness facets such as observing, describing, and nonreacting also showed significant, albeit less consistent, mediating effects. In contrast, compassion and acceptance were weakly associated and did not play a significant mediating role. Conclusions: These results demonstrate resilience as the key psychological mediator. Strengthening resilience through online interventions appears to be a crucial pathway for reducing stress and emotional symptoms in this population. Specific mindfulness skills may also contribute to the intervention’s therapeutic effect, although with less robust evidence.
000169410 536__ $$9info:eu-repo/grantAgreement/ES/ISCIII/CD20-00181$$9info:eu-repo/grantAgreement/ES/ISCIII/PI21-01328$$9info:eu-repo/grantAgreement/ES/ISCIII/PI21-01338
000169410 540__ $$9info:eu-repo/semantics/openAccess$$aby$$uhttps://creativecommons.org/licenses/by/4.0/deed.es
000169410 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/publishedVersion
000169410 700__ $$aCarbonell-Aranda, Vera
000169410 700__ $$aPérez-Guerrero, Gloria
000169410 700__ $$aDawood-Hristova, Jonathan Joseph
000169410 700__ $$aPérez-Aranda, Adrián
000169410 700__ $$aFernández-Martínez, Selene
000169410 700__ $$0(orcid)0000-0003-2088-2007$$aMonreal-Bartolomé, Alicia$$uUniversidad de Zaragoza
000169410 700__ $$0(orcid)0000-0002-2116-9257$$aBarceló-Soler, Alberto$$uUniversidad de Zaragoza
000169410 700__ $$0(orcid)0000-0002-3797-4218$$aGarcía-Campayo, Javier$$uUniversidad de Zaragoza
000169410 700__ $$0(orcid)0000-0002-1690-4130$$aLópez del Hoyo, Yolanda$$uUniversidad de Zaragoza
000169410 700__ $$aHerrera-Imbroda, Jesús
000169410 700__ $$aGoodman-Casanova, Jessica Marian
000169410 700__ $$aGuzman-Parra, Jose
000169410 7102_ $$14009$$2730$$aUniversidad de Zaragoza$$bDpto. Psicología y Sociología$$cÁrea Psicología Básica
000169410 7102_ $$11007$$2745$$aUniversidad de Zaragoza$$bDpto. Medicina, Psiqu. y Derm.$$cArea Psiquiatría
000169410 7102_ $$14009$$2735$$aUniversidad de Zaragoza$$bDpto. Psicología y Sociología$$cÁrea Psicolog.Evolut.Educac
000169410 773__ $$g13 (2026), e82905-e82905 [16 pp.]$$tJMIR mental health$$x2368-7959
000169410 8564_ $$s916710$$uhttps://zaguan.unizar.es/record/169410/files/texto_completo.pdf$$yVersión publicada
000169410 8564_ $$s2560979$$uhttps://zaguan.unizar.es/record/169410/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada
000169410 909CO $$ooai:zaguan.unizar.es:169410$$particulos$$pdriver
000169410 951__ $$a2026-02-25-14:58:51
000169410 980__ $$aARTICLE