Stress, Mindfulness, and Occupational Engagement: A Pilot Study of the Huntington Occupational Mindfulness and Engagement (HOME) Protocol

PURPOSE: Stress and disengagement from meaningful occupations are barriers graduate students face daily. Current literature identified a need to examine the use of mindfulness as a coping strategy to decrease high levels of perceived stress and to promote occupational engagement. The pilot study aimed to investigate the effectiveness of the nine-minute Huntington Occupational Mindfulness and Engagement (HOME) Protocol for occupational therapy doctoral (OTD) students for stress reduction and reengagement in occupations.

DESIGN: The mixed-methods study involved a quasi-experimental design and focus groups to examine participants’ reported levels of stress and occupational engagement following four weeks of using the HOME Protocol. Following university institutional board approval, researchers recruited participants from an accredited OTD program in the Midwestern United States. Inclusion criteria required participants to be enrolled in the OTD program, attend a two-hour training session, complete the designated protocol at least one time per week for the four-week duration of the study, and complete both pre-test and post-test assessments.

METHOD: Thirty-four participants were initially selected through voluntary convenience sampling and were randomly assigned to either the experimental HOME protocol group or a control journaling group. Students completed the Coping Orientation to Problems Experienced (COPE) Inventory and the Perceived Stress Scale (PSS) as pre and post assessments and received training in their assigned protocols. Participants utilized their designated protocols at least one time per week for four weeks when feeling disengaged from an activity. Each protocol began and ended with a self-assessment of the participant’s level of stress, engagement, difficulty of activity, and meaningfulness of activity as measured on four visual analogue scales (VAS). Quantitative data of the COPE, PSS, and the protocol VAS scores were analyzed through paired t-tests and independent samples t-tests using SPSS software. Optional focus groups were implemented to gain insight into participants’ perceived stress, engagement, and use of the protocols. Qualitative data obtained through the HOME protocol and focus groups was examined through a process of triangulation and thematic analysis.

RESULTS: Of the 34 participants, five participants were excluded from the study due to not completing the full duration of the protocol. Data from 29 participants (experimental n = 15; control n = 14) analyzed through paired t-tests and independent samples t-tests demonstrated significance in the reduction of stress levels (p = .000) and increased levels of engagement (p = .001) for the experimental group following the use of the HOME Protocol. No statistically significant difference was found between change scores of the experimental and control groups. Qualitative data revealed themes of Habit Forming, Beneficial, and Few Challenges. Triangulation of qualitative and quantitative data supported the use of the HOME Protocol as a beneficial tool for OTD students’ reengagement in meaningful activities.

CONCLUSIONS: The pilot study suggested positive benefits for increasing engagement and decreasing stress levels of OTD students using the HOME Protocol. Further research is indicated to determine its effectiveness when expanded to other academic programs that allow for a larger and more diverse sample size. The HOME Protocol offers a unique coping strategy for students experiencing high levels of perceived stress and disengagement from meaningful activities. The occupational focus of the protocol and its blend of mindfulness with occupational engagement demonstrate potential value for personal and professional health and well-being applications.

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