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Journal of happiness studies
2025;26 (3): 27.

Evaluation of a Positive Psychological Intervention to Reduce Work Stress among Rural Community Health Workers in India: Results from a Randomized Pilot Study.

Ameya P Bondre, Spriha Singh, Abhishek Singh, Aashish Ranjan, Azaz Khan, Lochan Sharma, Dinesh Bari, G Sai Teja, Laxmi Verma, Mehak Jolly, Payal Pandit, Radhika Sharma, Ritu Dangi, Romi Ahuja, Sneha Rani Nayak, Surbhi Agrawal, Jyotsna Agrawal, Seema Mehrotra, Rahul Shidhaye, Anant Bhan, John A Naslund, Steve D Hollon, Deepak Tugnawat
Author Information
  1. Ameya P Bondre: Sangath Bhopal Hub, 106, Good Shepherd Colony, Kolar Road, Bhopal, Madhya Pradesh 462042 India. ORCID
  2. Spriha Singh: Sangath Bhopal Hub, 106, Good Shepherd Colony, Kolar Road, Bhopal, Madhya Pradesh 462042 India.
  3. Abhishek Singh: Sangath Bhopal Hub, 106, Good Shepherd Colony, Kolar Road, Bhopal, Madhya Pradesh 462042 India.
  4. Aashish Ranjan: Sangath Bhopal Hub, 106, Good Shepherd Colony, Kolar Road, Bhopal, Madhya Pradesh 462042 India.
  5. Azaz Khan: Sangath Bhopal Hub, 106, Good Shepherd Colony, Kolar Road, Bhopal, Madhya Pradesh 462042 India.
  6. Lochan Sharma: Sangath Bhopal Hub, 106, Good Shepherd Colony, Kolar Road, Bhopal, Madhya Pradesh 462042 India.
  7. Dinesh Bari: Sangath Bhopal Hub, 106, Good Shepherd Colony, Kolar Road, Bhopal, Madhya Pradesh 462042 India.
  8. G Sai Teja: Sangath Bhopal Hub, 106, Good Shepherd Colony, Kolar Road, Bhopal, Madhya Pradesh 462042 India.
  9. Laxmi Verma: Sangath Bhopal Hub, 106, Good Shepherd Colony, Kolar Road, Bhopal, Madhya Pradesh 462042 India.
  10. Mehak Jolly: Sangath Bhopal Hub, 106, Good Shepherd Colony, Kolar Road, Bhopal, Madhya Pradesh 462042 India.
  11. Payal Pandit: Sangath Bhopal Hub, 106, Good Shepherd Colony, Kolar Road, Bhopal, Madhya Pradesh 462042 India.
  12. Radhika Sharma: Sangath Bhopal Hub, 106, Good Shepherd Colony, Kolar Road, Bhopal, Madhya Pradesh 462042 India.
  13. Ritu Dangi: Sangath Bhopal Hub, 106, Good Shepherd Colony, Kolar Road, Bhopal, Madhya Pradesh 462042 India.
  14. Romi Ahuja: Sangath Bhopal Hub, 106, Good Shepherd Colony, Kolar Road, Bhopal, Madhya Pradesh 462042 India.
  15. Sneha Rani Nayak: Sangath Bhopal Hub, 106, Good Shepherd Colony, Kolar Road, Bhopal, Madhya Pradesh 462042 India.
  16. Surbhi Agrawal: Sangath Bhopal Hub, 106, Good Shepherd Colony, Kolar Road, Bhopal, Madhya Pradesh 462042 India.
  17. Jyotsna Agrawal: National Institute of Mental Health and Neurosciences, Hosur Road, Lakkasandra, Wilson Garden, Bengaluru, Karnataka 560029 India.
  18. Seema Mehrotra: National Institute of Mental Health and Neurosciences, Hosur Road, Lakkasandra, Wilson Garden, Bengaluru, Karnataka 560029 India.
  19. Rahul Shidhaye: Pravara Institute of Medical Sciences, Rahata, Ahmednagar, Maharashtra 413736 India.
  20. Anant Bhan: Sangath Bhopal Hub, 106, Good Shepherd Colony, Kolar Road, Bhopal, Madhya Pradesh 462042 India.
  21. John A Naslund: Department of Global Health and Social Medicine, Harvard Medical School, 25 Shattuck St, Boston, MA 02115 United States.
  22. Steve D Hollon: Department of Psychology, Vanderbilt University, Nashville, TN 37023 United States.
  23. Deepak Tugnawat: Sangath Bhopal Hub, 106, Good Shepherd Colony, Kolar Road, Bhopal, Madhya Pradesh 462042 India.
PMID: 39975944 DOI: 10.1007/s10902-024-00852-6

Abstract

Efforts to reduce work stress among frontline health workers in India, namely the rural Accredited Social Health Activists or 'ASHAs' (resident women, lay health workers) have predominantly emphasized on 'extrinsic' variables (e.g., financial incentives, or enhanced supervision), with little consideration of 'intrinsic' factors like the wellbeing of ASHAs themselves or building their abilities in managing work stress. 'Character-strengths' based positive psychological interventions have shown improvements in work wellbeing and engagement, but these findings have been largely observed in the Global North, with no experimental studies in India. This study is a pilot randomized controlled trial where rural ASHAs were allocated to receive regular supervision by their supervisors appointed by the health system (control arm), or a character-strengths based coaching intervention in addition to regular supervision (intervention arm). The intervention included a residential workshop and follow-on weekly individual telephonic coaching support. We aimed to examine the preliminary effectiveness of the intervention on happiness of ASHAs using the Authentic Happiness Inventory (primary outcome). At 3-month follow-up, ASHAs in the intervention arm showed higher total happiness scores (n = 30, Mean = 83.6; SD = 13.32) than ASHAs in the control arm (n = 31, Mean = 76.32; SD = 13.16), with a significant between-arm difference (Cohen's d: 0.55). Secondary outcomes (e.g., burnout, motivation) showed non-significant between-arm differences at follow-up. We conducted telephone-interviews of ASHAs to gather their experiences of the intervention and used thematic analysis to assess its feasibility and acceptability. This study critically contributes to inform the ways by which rural frontline workers can use character-strengths to improve work wellbeing in low-resource settings.
Supplementary Information: The online version contains supplementary material available at 10.1007/s10902-024-00852-6.

Keywords

Burnout Character strengths Community health workers Happiness India Work stress

References

  1. Perspect Public Health. 2014 Sep;134(5):276-82 [PMID: 25169614]
  2. BMC Health Serv Res. 2016 Aug 09;16(a):366 [PMID: 27507034]
  3. BMC Health Serv Res. 2008 Dec 04;8:247 [PMID: 19055827]
  4. Behav Res Ther. 2015 Jun;69:11-21 [PMID: 25847276]
  5. J Adv Nurs. 2013 Mar;69(3):697-707 [PMID: 22897490]
  6. J Ment Health. 2022 Aug;31(4):506-516 [PMID: 33522336]
  7. BMC Health Serv Res. 2017 Jun 19;17(1):412 [PMID: 28629360]
  8. Am Psychol. 2000 Jan;55(1):5-14 [PMID: 11392865]
  9. Int J Ment Health Syst. 2018 Aug 18;12:47 [PMID: 30140307]
  10. AIDS Care. 2010;22 Suppl 2:1606-12 [PMID: 21161765]
  11. Int J Environ Res Public Health. 2020 Sep 01;17(17): [PMID: 32883018]
  12. Am Psychol. 2005 Jul-Aug;60(5):410-21 [PMID: 16045394]
  13. Hum Resour Health. 2009 May 20;7:40 [PMID: 19457237]
  14. Arch Psychiatr Nurs. 2019 Dec;33(6):186-191 [PMID: 31753226]
  15. Health Res Policy Syst. 2019 Mar 25;17(1):29 [PMID: 30909926]
  16. Hum Resour Health. 2019 Jul 18;17(1):58 [PMID: 31319872]
  17. J Glob Health. 2023 Feb 17;13:04018 [PMID: 36799239]
  18. J Relig Health. 2016 Dec;55(6):2189-98 [PMID: 27460673]
  19. Qual Life Res. 2014 Mar;23(2):443-7 [PMID: 23921597]
  20. Health Policy Plan. 2016 Jun;31(5):551-62 [PMID: 26491059]
  21. Soc Sci Med. 2023 Nov;336:116234 [PMID: 37778144]
  22. Spine (Phila Pa 1976). 2000 Dec 15;25(24):3186-91 [PMID: 11124735]
  23. BMJ. 2016 Oct 24;355:i5239 [PMID: 27777223]
  24. Hum Resour Health. 2019 Jan 8;17(1):3 [PMID: 30616656]
  25. J Clin Psychol. 2012 Apr;68(4):382-9 [PMID: 24469930]
  26. Hum Resour Health. 2021 Jan 6;19(1):7 [PMID: 33407518]
  27. J Clin Epidemiol. 1999 Jan;52(1):19-26 [PMID: 9973070]
  28. Contemp Clin Trials. 2021 Mar;102:106267 [PMID: 33421650]
  29. BMC Med Res Methodol. 2013 Aug 20;13:104 [PMID: 23961782]
  30. J Thorac Dis. 2009 Dec;1(1):51-4 [PMID: 22263004]
  31. BMJ Open. 2012 Sep 27;2(5): [PMID: 23019208]
  32. Health Technol Assess. 2007 Oct;11(43):iii, ix-107 [PMID: 17935683]
  33. Hum Resour Health. 2015 Jul 14;13:58 [PMID: 26169179]
  34. Proc Natl Acad Sci U S A. 2017 Aug 1;114(31):8148-8156 [PMID: 28705870]
  35. Gates Open Res. 2018 Jun 11;2:4 [PMID: 29984356]
  36. Hum Resour Health. 2015 Dec 09;13:95 [PMID: 26646109]
  37. BMJ Open. 2014 Jun 05;4(6):e004897 [PMID: 24902730]
  38. J Family Med Prim Care. 2021 May;10(5):1845-1851 [PMID: 34195114]
  39. Aging Ment Health. 2014;18(8):997-1005 [PMID: 24712501]
  40. Glob Health Action. 2014 Oct 13;7:25352 [PMID: 25319596]
  41. Health Policy Plan. 2020 Feb 1;35(1):58-66 [PMID: 31670772]
  42. Asian J Psychiatr. 2019 Oct;45:99-106 [PMID: 31557716]
Journal Article

Word Cloud

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