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      Mindfulness-Based and Mindfulness-Informed Interventions at the Workplace: A Systematic Review and Meta-Regression Analysis of RCTs

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          Abstract

          Objectives

          Positive effects of mindfulness-based interventions (MBIs) on occupational health have been demonstrated by several systematic review studies during the last two decades. So far, existing reviews excluded mindfulness-informed interventions (MIIs) that build on informal approaches or mixed techniques aiming at improving mindfulness indirectly. To address this research gap, the present comprehensive meta-analysis synthesizes the results of RCTs of MBIs and MIIs conducted in various workplace settings.

          Method

          A systematic literature search was conducted in five electronic databases complemented by manual search. Random-effects models were used to synthesize standardized mean differences ( SMDs) for 25 outcomes and seven overarching categories of outcomes, and to detect various temporal effects. Meta-regressions were run to elucidate average SMDs between mindfulness intervention types and intervention and population characteristics, with the goal of detecting sources of heterogeneity and help guide the selection of the most appropriate mindfulness intervention type.

          Results

          Based on 91 eligible studies (from 92 publications), including 4927 participants and 4448 controls, the synthesis shows that MBIs and MIIs significantly improve mindfulness ( SMD = 0.43; 95%- CI [0.33;0.52]), well-being ( SMD = 0.63; 95%- CI [0.34;0.93]), mental health ( SMD = 0.67; 95%- CI [0.48;0.86]), stress ( SMD = 0.72; 95%- CI [0.54;0.90]), resilience ( SMD = 1.06; 95%- CI [−0.22;2.34]), physical health ( SMD = 0.45; 95%- CI [0.32;0.59]), and work-related factors ( SMD = 0.62; 95%- CI [0.14;1.10]). Sensitivity analyses demonstrate a tendency towards smaller effect sizes due to extreme outliers. Effect sizes are stable in short-term follow-up assessments (1-12 weeks) for most outcomes, but not for long-term follow-up assessments (13-52 weeks). Meta-regressions suggest that observable intervention characteristics (e.g., online delivery) and population characteristics (e.g., age of participants), as well as study quality, do not explain the prevalence of heterogeneity in effect sizes.

          Conclusions

          Generally effective, mindfulness interventions are a useful tool to enhance aspects of employee health. However, because of heterogeneity and risk of bias, studies aiming at high-quality data collection and thorough reporting are necessary to draw firm conclusions.

          Preregistration

          A protocol of this systematic review was registered with PROSPERO (Registration-No. CRD42020159927).

          Supplementary Information

          The online version contains supplementary material available at 10.1007/s12671-023-02130-7.

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          Most cited references128

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          Bias in meta-analysis detected by a simple, graphical test

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            Attention regulation and monitoring in meditation.

            Meditation can be conceptualized as a family of complex emotional and attentional regulatory training regimes developed for various ends, including the cultivation of well-being and emotional balance. Among these various practices, there are two styles that are commonly studied. One style, focused attention meditation, entails the voluntary focusing of attention on a chosen object. The other style, open monitoring meditation, involves nonreactive monitoring of the content of experience from moment to moment. The potential regulatory functions of these practices on attention and emotion processes could have a long-term impact on the brain and behavior.
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              Outlier and influence diagnostics for meta-analysis.

              The presence of outliers and influential cases may affect the validity and robustness of the conclusions from a meta-analysis. While researchers generally agree that it is necessary to examine outlier and influential case diagnostics when conducting a meta-analysis, limited studies have addressed how to obtain such diagnostic measures in the context of a meta-analysis. The present paper extends standard diagnostic procedures developed for linear regression analyses to the meta-analytic fixed- and random/mixed-effects models. Three examples are used to illustrate the usefulness of these procedures in various research settings. Issues related to these diagnostic procedures in meta-analysis are also discussed. Copyright © 2010 John Wiley & Sons, Ltd.
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                Author and article information

                Contributors
                maren.michaelsen@uni-wh.de
                Journal
                Mindfulness (N Y)
                Mindfulness (N Y)
                Mindfulness
                Springer US (New York )
                1868-8527
                1868-8535
                11 May 2023
                11 May 2023
                : 1-34
                Affiliations
                [1 ]GRID grid.412581.b, ISNI 0000 0000 9024 6397, Institute for Integrative Health Care and Health Promotion, Faculty of Health, , Witten/Herdecke University, ; Witten, Germany
                [2 ]GRID grid.412581.b, ISNI 0000 0000 9024 6397, Department of Psychology and Psychotherapy, Faculty of Health, , Witten/Herdecke University, ; Witten, Germany
                [3 ]GRID grid.473452.3, Faculty of Health Sciences Brandenburg, Brandenburg Medical School (Theodor Fontane), , Institute for Health Services and Health System Research, ; Rüdersdorf, Germany
                [4 ]GRID grid.473452.3, Center for Health Services Research, , Brandenburg Medical School (Theodor Fontane), ; Rüdersdorf, Germany
                Author information
                http://orcid.org/0000-0001-8872-5839
                Article
                2130
                10.1007/s12671-023-02130-7
                10172073
                37362186
                11e45beb-9a6a-47ff-837b-7c87dc8bf5b7
                © The Author(s) 2023

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

                History
                : 10 April 2023
                Funding
                Funded by: Private Universität Witten/Herdecke gGmbH (3128)
                Categories
                Review

                Clinical Psychology & Psychiatry
                mindfulness-based interventions,mindfulness-informed interventions,occupational health,systematic review,meta-analysis

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