Journal Article

Evaluation of a structured breathing-based intervention to reduce burnout and enhance mental well-being among healthcare professionals in community-based practice settings: study protocol for a single-arm pilot feasibility trial

Schuldt, Kristina, Sharma, Pravesh, Flock, Carolyn, Osman, Rowa, Nycklemoe, Marin, Jacobson, David N, Nation, Jody L, Murphy, Crystal M, Wilson, Melissa A, Boos, Danielle M, Min, Paul H, Lim, Seokbeen

2026

Overview

IntroductionBurnout among healthcare professionals remains a critical public health issue linked to impaired cognition, emotional exhaustion and diminished clinical performance. Structured breathing practices have demonstrated promise in improving autonomic regulation and cerebral oxygenation, yet their feasibility, acceptability and implementation in real-world healthcare settings remain underexplored.ObjectivesThis single-arm pilot feasibility trial aims to evaluate the feasibility, acceptability and implementation appropriateness of a structured breathing-based intervention for healthcare professionals across community-based Mayo Clinic Health System (MCHS) sites. Secondary objectives include assessing usability and engagement with the mobile breathing platform, while exploratory analyses will describe magnitude of variability and feasibility of collecting psychological and cerebral haemodynamic measures. This study will commence in November 2025 and is expected to be completed by June 2026.Methods and analysisA total of 40 clinicians (MD/DO/MBBS/PA) and nurses reporting moderate or greater burnout will be enrolled across four MCHS sites. Participants will complete a 4-month structured breathing programme delivered primarily online, supported by a mobile application for practice tracking. Assessments will occur at baseline, 2 months and 4 months, with functional near-infrared spectroscopy (fNIRS) measures of cerebral oxygenation collected at baseline and 4 months in a population subset. Primary outcomes include (1) recruitment yield, retention and adherence rates; (2) acceptability and participant satisfaction (survey and qualitative feedback); and (3) implementation appropriateness measured by the Acceptability of Intervention Measure (AIM), Intervention Appropriateness Measure (IAM) and Feasibility of Intervention Measure (FIM). Secondary outcomes include digital engagement and usability through mobile analytics and the System Usability Scale. Exploratory outcomes are psychological indicators (burnout, depression, anxiety, perceived stress, sleep, fatigue, professional fulfilment and resilience) and physiological endpoints (fNIRS). Analyses will be descriptive, summarising feasibility metrics with 95% CIs. Progression criteria (recruitment≥75%, retention≥80%, adherence≥70%, AIM/IAM/FIM≥4.0) will determine readiness for a definitive hybrid effectiveness–implementation trial.Ethics and disseminationThe study is approved by the Mayo Clinic Institutional Review Board (IRB # 25-009320). All participants will provide informed consent. Study procedures ensure confidentiality, cultural sensitivity and participant safety. Data will be securely stored in REDCap and disseminated through peer-reviewed publications and scientific conferenceTrial registration numberNCT07218458.

• Publisher: British Medical Journal Publishing Group,BMJ Publishing Group LTD,BMJ Publishing Group
• Subject: Amygdala / Blood / Brain / Breathing Exercises - methods / Burnout / Burnout, Professional / Burnout, Professional - prevention & control / Burnout, Professional - psychology / Burnout, Professional - therapy / Cerebrospinal fluid / Cognition & reasoning / Feasibility / Feasibility Studies / Health Personnel - psychology / Humans / Medical imaging / Medical personnel / Mental Health / Metabolism / Mobile communications networks / Nervous system / Neuroimaging / Occupational stress / Patient satisfaction / Physiology / Pilot Projects / Professionals / Protocol / Psychological Stress / Psychosocial Intervention / RADIOLOGY & IMAGING / Respiration / Sleep deprivation / Spectrum analysis / Usability