Klatt 2015.

Study characteristics
Methods	Study design: RCT Study grouping: parallel group Unit of randomisation: individuals Power (power sample size calculation, level of power achieved): not specified Imputation of missing data: not specified
Participants	Country: USA Setting: ICUs Age: see Population description; age not specified Sample size (randomised): 34 (information received from authors; Klatt 2019 [pers comm]) Sex: not specified Comorbidity (mean (SD) of respective measures in indicated, if available) at baseline: not specified Population description: employees at ICUs Inclusion criteria: not specified Exclusion criteria: not specified Attrition (withdrawals and exclusions): not specified Reasons for missing data: not specified
Interventions	Intervention: Mindfulness in Motion (MIM) (n = 17; information received from authors; Klatt 2019 [pers comm]) delivery: face‐to‐face (Modified mindfulness‐based intervention (MBI) specific for onsite delivery, Yoga movement is done standing or seated, music in background); power‐point presentation, mind‐body relaxation; delivery at work providers: M. Klatt (developer of MIM protocol in this study; trained yoga instructor (Yoga Alliance Certified) and attendee at a MBSR 9‐day training for Health Professionals (M. Klatt has additionally designed a train‐the‐trainer programme for others with previous yoga/mindfulness training in order to scale its delivery) duration of treatment period and timing: 8 x weekly 1‐hour sessions + 1 x 2‐hour “retreat”); 20 minutes daily homework description: MIM teaches mindful awareness principles, rehearses mindfulness as a group, emphasises the use of gentle yoga stretches, uses unique relaxing music in the background of group sessions/individual practice, and requires daily individual mindfulness practice The weekly session’s content and structure follow that of the traditional MBSR, with an increased emphasis on bodily relaxation with the soft background music preceding the discussion of mindful awareness of cognitive habits Participants receive 3 daily practice CDs (with 20‐minute practice tracks) and 1 yoga DVD with the background music and similar meditations to the ones practised as a group, to be used for individual practice same format for weekly 1‐hour sessions: 1. Begin each session by asking participants to count their respiration by placing their right hand on their chest and counting only inhales for 30 seconds as timed by the instructor. Ask each participant to record their breath count in a log provided 2. Play relaxing music in the background to set the climate for MIM 3. State that the intent of the didactic/experiential sessions is to encourage the explicitly‐defined objective of the programme: resiliency building and stress reduction through mindful awareness of habitual patterns of stress reactivity 4. Each week, deliver a prompt for contemplation during the next hour and assure the participants that the response to the prompt is personal and silent. Invite the participants to choose to share responses, without any pressure to verbalise personal reflections. The prompts directly relate to each weekly theme 5. Deliver a 15‐minute PowerPoint presentation on topics including stress and work‐related stress, theoretical material related to mindfulness, the somatic mind/body connection, relaxation, yoga, meditation, self‐awareness, and bodily cues relating to emotional reactivity and the relation of these topics to the specific workplace stressors 6. Following the prompt, lead the participants through a mind‐body relaxation relating to the weekly prompt 7. End each session by asking each participant to count their respirations for 30 seconds and record their individual end‐of‐weekly‐session breath count in the log provided; homework assignments compliance: intervention well received with 97% retention rate integrity of delivery: not specified economic information (intervention cost, changes in other costs as result of intervention): Other shift nurses were paid to come in an hour before their normal start time so that the MBI participant’s patients were cared for by experienced nurses theoretical basis: MBSR: stress reduction intervention that can be used to retrain the mind to change its usual responses to stressful situations; teaches non‐reactive awareness of one’s affective response to external events and is presented as the key to changing one’s internal experience of stress Mindfulness is characterised by non‐judgemental, sustained moment‐to‐moment awareness of physical sensations, perceptions, affective states, thoughts and imagery MIM is offered as a modified, less time‐intensive method to be delivered in the workplace, and intends to enable busy working adults to experience the benefits of mindfulness Development of MIM protocol based on previous studies that suggest the efficacy of mindfulness interventions do not correlate with the length of time spent on the group didactic practice (Jha 2010; Klatt 2009; Carmody 2009) and yield similar results to the longer traditional MBSR The self‐reflection and awareness, and the shared experience of the emerging self‐awareness, may contribute to a climate/culture change in a highly stressed work environment. Bishop 2004 generated a functional definition of mindfulness for researchers concerning the role and essential elements of an MBI. Two critical components were determined to be (1) self‐regulation of attention and (2) the adoption of an orientation toward one’s experiences in the present moment (Bishop 2004). MIM, the onsite MBI protocol described in this report, was constructed to retain the essential elements of mindfulness, as it was conceived and has developed in traditional MBSR (Kabat‐Zinn 1982; Kabat‐Zinn 1990), while adapting it in a pragmatic way for working adults. It uses the operational definition of mindfulness, yet differs in the worksite location of the intervention, and the weekly time commitment of the group meeting and individual “homework” suggestion. Control: wait‐list control (n = 17; information received from authors; Klatt 2019 [pers comm])
Outcomes	Outcomes collected and reported: resiliency ‐ CD‐RISC work engagement, vigor ‐ UWES work engagement, dedication ‐ UWES work engagement, absorption ‐ UWES breath counts (only in IG) Time points measured and reported: 1) pre‐intervention (1 week before the intervention); 2) post‐intervention (1 week after last session) Adverse events: not specified
Notes	Contact with authors: We contacted authors to ask for the number of participants allocated to and analysed in each group, as well as the means and SDs for resiliency for the 2 groups at each time point. We also inquired whether the authors performed an intention‐to‐treat analysis. We received the information about the number of participants in each group from the authors (Klatt 2019 [pers comm]). Study start/end date: not specified Funding source: financial contributions to the project by the following entities at the Ohio State University: Stress, Trauma, and Resilience (STAR) Program, Health System Administration, Critical Care Nursing, and the Faculty Associates Program through the Women’s Place Declaration of interest: Subsequent to the completion of this research conducted at the Ohio State University, Dr Klatt has served as a consultant to Mindful Management, Limited Liability Company to whom The Ohio State University has licensed the rights of the individual practice CD/DVD; all other authors have nothing to disclose. Ethical approval needed/obtained for study: IRB approval from The Ohio State University Comments by authors: not specified Miscellaneous outcomes by the review authors: information recevied from authors: 17 participants in each group (Klatt 2019 [pers comm]) Correspondence: Maryanna Klatt, Department of Family Medicine, The Ohio State University College of Medicine; Maryanna.Klatt@osumc.edu
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Quote: "To determine the intervention feasibility/efficacy, we conducted a randomized wait‐list control group in Intensive Care Units (ICUs)." Judgement comment: insufficient information about random‐sequence generation to permit judgement of ‘Low risk’ or ‘High risk’; no information about comparability of groups at baseline or respective analysis
Allocation concealment (selection bias)	Unclear risk	Judgement comment: insufficient information about allocation concealment to permit judgement of ‘Low risk’ or ‘High risk’
Blinding of participants and personnel (performance bias) Subjective outcomes	High risk	Judgement comment: blinding of participants and personnel probably not done (face‐to‐face intervention) and the outcome is likely to be influenced by lack of blinding
Blinding of outcome assessment (detection bias) Subjective outcomes	High risk	Judgement comment: insufficient information on blinding of outcome assessment; however, due to potential performance bias (no blinding of participants), the review authors judge that the participants' responses to questionnaires and the self‐measurement of breath counts may be affected by the lack of blinding (i.e. knowledge and beliefs about intervention they received)
Incomplete outcome data (attrition bias) All outcomes	Unclear risk	Quote: "The intervention is well received with 97% retention rate." Judgement comment: insufficient reporting of attrition/exclusions to permit judgement of ‘Low risk’ or ‘High risk’; information received from authors: n = 17 participants allocated to each group; for some results, n = 34 participants analysed; however the amount of potential missing data not stated
Selective reporting (reporting bias)	Low risk	Judgement comment: no study protocol available but it is clear that the published reports include all expected outcomes, including those that were prespecified (pre‐specified paired t‐tests were reported)