Importance During the COVID-19 pandemic, health care workers (HCWs) reported a significant decline in their mental health. One potential health behavior intervention that has been shown to be effective for improving mental health is exercise, which may be facilitated by taking advantage of mobile application (app) technologies. Objective To determine the extent to which a 12-week app-based exercise intervention can reduce depressive symptoms, burnout, and absenteeism in HCWs, compared with a wait list control condition. Design, Setting, and Participants A 2-group randomized clinical trial was conducted, with participants screened from April 6 to July 4, 2022. Participants were recruited from an urban health care organization in British Columbia, Canada. Participants completed measures before randomization and every 2 weeks thereafter. Interventions Exercise condition participants were asked to complete four 20-minute sessions per week using a suite of body weight interval training, yoga, barre, and running apps. Wait-listed control participants received the apps at the end of the trial. Main Outcomes and Measures The primary outcome consisted of the between-group difference in depressive symptoms measured with the 10-item Center for Epidemiological Studies Depression Scale. The secondary outcomes corresponded to 3 subfacets of burnout (cynicism, emotional exhaustion, and professional efficacy) and absenteeism. Intention-to-treat analyses were completed with multilevel structural equation modeling, and Feingold effect sizes (ES) were estimated every 2 weeks. Results A total of 288 participants (mean [SD] age, 41.0 [10.8] years; 246 [85.4%] women) were randomized to either exercise (n = 142) or wait list control (n = 146) conditions. Results revealed that ESs for depressive symptoms were in the small to medium range by trial's end (week 12, -0.41 [95% CI, -0.69 to -0.13]). Significant and consistent treatment effects were revealed for 2 facets of burnout, namely cynicism (week 12 ES, -0.33 [95% CI, -0.53 to -0.13]) and emotional exhaustion (week 12 ES, -0.39 [95% CI, -0.64 to -0.14]), as well as absenteeism (r = 0.15 [95% CI, 0.03-0.26]). Adherence to the 80 minutes per week of exercise decreased from 78 (54.9%) to 33 (23.2%) participants between weeks 2 and 12. Conclusions and Relevance Although exercise was able to reduce depressive symptoms among HCWs, adherence was low toward the end of the trial. Optimizing adherence to exercise programming represents an important challenge to help maintain improvements in mental health among HCWs. Trial Registration ClinicalTrials.gov Identifier: NCT05271006.

中文翻译：

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12 周在家进行基于应用的运动对医护人员抑郁症状、倦怠和缺勤的影响：一项随机临床试验。

重要性 在 COVID-19 大流行期间，医护人员 (HCW) 报告称，他们的心理健康状况显着下降。锻炼是一种已被证明可有效改善心理健康的潜在健康行为干预措施，可以通过利用移动应用程序 (app) 技术来促进锻炼。目的 确定与等候名单控制条件相比，为期 12 周的基于应用程序的运动干预可以在多大程度上减少医护人员的抑郁症状、倦怠和缺勤。设计、设置和参与者进行了一项 2 组随机临床试验，参与者于 2022 年 4 月 6 日至 7 月 4 日进行筛选。参与者是从加拿大不列颠哥伦比亚省的一个城市医疗保健组织招募的。参与者在随机分组前以及此后每两周完成一次测量。干预措施 运动条件参与者被要求每周完成四次每次 20 分钟的课程，使用一套自重间歇训练、瑜伽、杠铃和跑步应用程序。等待名单上的对照参与者在试验结束时收到了应用程序。主要结果和测量 主要结果包括使用流行病学研究中心抑郁量表的 10 项抑郁症状测量的组间差异。次要结果对应于倦怠的 3 个子方面（愤世嫉俗、情绪疲惫和职业效能）和缺勤。通过多级结构方程模型完成意向治疗分析，每两周估计一次 Feingold 效应大小 (ES)。结果 共有 288 名参与者（平均 [SD] 年龄，41.0 [10.8] 岁；246 名 [85.4%] 女性）被随机分配到锻炼组 (n = 142) 或候补名单对照组 (n = 146)。结果显示，到试验结束时（第 12 周，-0.41 [95% CI，-0.69 至 -0.13]），抑郁症状的 ES 处于小到中等范围内。倦怠的两个方面显示出显着且一致的治疗效果，即愤世嫉俗（第 12 周 ES，-0.33 [95% CI，-0.53 至 -0.13]）和情绪衰竭（第 12 周 ES，-0.39 [95% CI，- 0.64 至 -0.14]），以及缺勤（r = 0.15 [95% CI，0.03-0.26]）。第 2 周至第 12 周期间，坚持每周 80 分钟锻炼的参与者从 78 名 (54.9%) 减少到 33 名 (23.2%)。 结论和相关性 尽管锻炼能够减轻医护人员的抑郁症状，但在接近 20 周末时，坚持程度较低。试用。优化对运动计划的遵守是帮助医护人员保持心理健康改善的一项重要挑战。试验注册 ClinicalTrials.gov 标识符：NCT05271006。