resiLIR HCP: A self-guided digital resilience intervention for healthcare professionals focusing on self-care and self-compassion – A randomized controlled trial

Background Healthcare professionals (HCPs) experience high occupational stress, contributing to mental health problems and workforce attrition. Scalable, low-threshold digital resilience interventions may alleviate this burden. Objective This randomized controlled trial evaluated the effectiveness of resiLIR HCP , a 6-week, self-guided, web-based intervention focusing on self-care and self-compassion with brief daily exercises, in promoting HCP resilience. Methods HCPs ( N = 234, IG: n = 118, CG: n = 116) were randomized to the intervention or a waitlist control group. Online assessments were conducted at baseline, mid-intervention, post-intervention, and at 3-, 6-, and 12-month follow-ups. The primary outcome was resilience operationalized as time-varying stressor reactivity. Secondary outcomes included resilience- and work-related outcomes. Intervention effects were primarily evaluated from baseline to post-intervention and 3-month follow-up. Analyses followed per-protocol (PP) and intention-to-treat (ITT) approaches. Preregistration: NCT05812716. Results PP analyses (IG: n = 45, CG: n = 84) revealed significant group × time intervention effects on stressor reactivity at post-intervention, which attenuated at follow-up. Significant effects at post-intervention were observed for self-care, self-compassion, self-efficacy, and psychological distress, whereas effects on depressive and anxiety symptoms were not robust after adjustment for multiple testing. No significant effects were found for work-related outcomes. ITT analyses did not reveal any significant effects, neither for the primary outcome nor secondary outcomes after adjusting for multiple testing. Only 43.2% met the predefined adherence criterion. Conclusions PP analyses revealed beneficial effects of resiLIR HCP , whereas ITT analyses provided weaker evidence. Limited adherence and non-significant effects on work-related outcomes highlight the need to enhance engagement and integrate digital interventions into multi-level prevention strategies.