Participant Engagement in and Perspectives on a Web-Based Mindfulness Intervention for 9-1-1 Telecommunicators: Multimethod Study
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Abstract
BACKGROUND: Demanding working conditions and secondary exposure to trauma may contribute to a high burden of stress among 9-1-1 telecommunicators, decreasing their ability to work effectively and efficiently. Web-based mindfulness-based interventions (MBIs) can be effective in reducing stress in similar populations. However, low engagement may limit the effectiveness of the intervention. OBJECTIVE: The aim of this study was to assess participant engagement in a Web-based MBI designed for 9-1-1 telecommunicators. Specifically, we sought to describe the following: (1) participant characteristics associated with intervention engagement, (2) participant perspectives on engaging with the intervention, and (3) perceived challenges and facilitators to engaging. METHODS: We used qualitative and quantitative data from participant surveys (n=149) that were collected to assess the efficacy of the intervention. We conducted descriptive and bivariate analyses to identify associations between demographic, psychosocial, and workplace characteristics and engagement. We conducted a thematic analysis of qualitative survey responses to describe participant experiences with the MBI. RESULTS: We found that no individual participant characteristics were associated with the level of engagement (low vs high number of lessons completed). Participant engagement did vary by the call center (P<.001). We identified the following overarching qualitative themes: (1) the participants perceived benefits of mindfulness practice, (2) the participants perceived challenges to engage with mindfulness and the intervention, and (3) intervention components that facilitated engagement. The participants expressed positive beliefs in the perceived benefits of practicing mindfulness, including increased self-efficacy in coping with stressors and increased empathy with callers. The most commonly cited barriers were work-related, particularly not having time to participate in the intervention at work. Facilitators included shorter meditation practices and the availability of multiple formats and types of intervention content. CONCLUSIONS: The findings of this study suggest that efforts to improve intervention engagement should focus on organizational-level factors rather than individual participant characteristics. Future research should explore the effect of mindfulness practice on the efficiency and effectiveness of 9-1-1 telecommunicators at work. TRIAL REGISTRATION: ClinicalTrials.gov NCT02961621; https://clinicaltrials.gov/ct2/show/NCT02961621.
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Evaluation studies have shown that more severe symptoms hamper actual engagement with digital interventions.
“However, evaluation studies have shown that more severe symptoms hamper actual engagement with digital interventions [51,56,83-101].”
From Barriers to and facilitators of user engagement with digital mental health interventions: Systematic review (2021) · cites this paper as [90]
The Introduction (Background; no page provided) says psychological symptoms may make mindfulness practice harder and may lead participants to disengage. But the Results (Participant Characteristics and Engagement) found no significant relationship between psychosocial characteristics and lesson completion, and the Discussion (Principal Findings) specifically found no significant association between baseline stress and engagement. This study therefore supports a possible barrier, not the claim that more severe symptoms were shown to hamper actual engagement. (LLM, conf=0.85)
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Paterson, C., Leduc, C., Maxwell, M., Aust, B., Strachan, H., O’Connor, A., Tsantila, F., Cresswell‐Smith, J., Purebl, G., Winter, L., et al. (2024) · Figshare · doi:10.6084/m9.figshare.25996998
Paterson, C., Leduc, C., Maxwell, M., Aust, B., Strachan, H., O’Connor, A., Tsantila, F., Cresswell‐Smith, J., Purebl, G., Winter, L., et al. (2024) · Figshare · doi:10.6084/m9.figshare.26731105
Paterson, C., Leduc, C., Maxwell, M., Aust, B., Strachan, H., O’Connor, A., Tsantila, F., Cresswell‐Smith, J., Purebl, G., Winter, L., et al. (2024) · Figshare · doi:10.6084/m9.figshare.26731108
Paterson, C., Leduc, C., Maxwell, M., Aust, B., Strachan, H., O’Connor, A., Tsantila, F., Cresswell‐Smith, J., Purebl, G., Winter, L., et al. (2024) · Figshare · doi:10.6084/m9.figshare.26731117
Paterson, C., Leduc, C., Maxwell, M., Aust, B., Strachan, H., O’Connor, A., Tsantila, F., Cresswell‐Smith, J., Purebl, G., Winter, L., et al. (2024) · Figshare · doi:10.6084/m9.figshare.26731102
Paterson, C., Leduc, C., Maxwell, M., Aust, B., Strachan, H., O’Connor, A., Tsantila, F., Cresswell‐Smith, J., Purebl, G., de Winter, L., et al. (2024) · Figshare · doi:10.6084/m9.figshare.26731096
Mikkelsen, P., Mikkelsen, E. G., Svendsen, L. K. B., Bonde, E. H., & Juul, L. (2026) · Mindfulness · doi:10.1007/s12671-026-02972-x
- Authors
- Kerr, D. C., Ornelas, I. J., Lilly, M. M., Calhoun, R., & Meischke, H.
- Affiliations
- University of Washington (US)
- Northern Illinois University (US)
- Corresponding author
- Kerr, Darragh C
- Venue
- Journal of Medical Internet Research
- Publisher
- JMIR Publications Inc.
- Published
- 2019-06-19
- Volume
- 21
- Issue
- 6
- Pages
- e13449
- ISSN
- 1438-8871 (ISSN-L)
- PMC
- PMC6607772
- OpenAlex
- W2944515028
- Cited by
- 25
- References
- 41
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 7 · 2023: 4 · 2022: 6 · 2021: 1 · 2020: 3
- FWCI
- 2.92
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- Journal of Medical Internet Research (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Funders
- National Institute for Occupational Safety and Health (R01OH010536)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Social Sciences › Psychology › Social Psychology › Stress and Burnout Research
- Keywords
- mindfulness-based interventions, participant engagement, online intervention, occupational stress, call centers, organizational factors, self-efficacy, empathy
- MeSH terms
- Emergency Medical Dispatcher, Adolescent, Adult, Female, Humans, Male, Middle Aged, Surveys and Questionnaires, Telecommunications, Workplace, Internet, Young Adult, Mindfulness
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