<?xml version="1.0" encoding="UTF-8"?><!DOCTYPE article PUBLIC "-//NLM//DTD Journal Publishing DTD v2.0 20040830//EN" "journalpublishing.dtd"><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" dtd-version="2.0" xml:lang="en" article-type="research-article"><front><journal-meta><journal-id journal-id-type="nlm-ta">JMIR Res Protoc</journal-id><journal-id journal-id-type="publisher-id">ResProt</journal-id><journal-id journal-id-type="index">5</journal-id><journal-title>JMIR Research Protocols</journal-title><abbrev-journal-title>JMIR Res Protoc</abbrev-journal-title><issn pub-type="epub">1929-0748</issn><publisher><publisher-name>JMIR Publications</publisher-name><publisher-loc>Toronto, Canada</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="publisher-id">v15i1e84729</article-id><article-id pub-id-type="doi">10.2196/84729</article-id><article-categories><subj-group subj-group-type="heading"><subject>Protocol</subject></subj-group></article-categories><title-group><article-title>Development of a Web-Based Intervention Course to Promote Academic Staff Well-Being: Protocol for a Mixed Methods Study Design</article-title></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name name-style="western"><surname>Asikainen</surname><given-names>Henna</given-names></name><degrees>PhD</degrees><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><name name-style="western"><surname>Lampinen</surname><given-names>Veera</given-names></name><degrees>MPS</degrees><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><name name-style="western"><surname>Katajavuori</surname><given-names>Nina</given-names></name><degrees>PhD</degrees><xref ref-type="aff" rid="aff1"/></contrib></contrib-group><aff id="aff1"><institution>Faculty of Education, University of Helsinki</institution><addr-line>Siltavuorenpenger 3</addr-line><addr-line>Helsinki</addr-line><country>Finland</country></aff><contrib-group><contrib contrib-type="editor"><name name-style="western"><surname>Schwartz</surname><given-names>Amy</given-names></name></contrib></contrib-group><contrib-group><contrib contrib-type="reviewer"><name name-style="western"><surname>Pankhurst</surname><given-names>Christian</given-names></name></contrib></contrib-group><author-notes><corresp>Correspondence to Henna Asikainen, PhD, Faculty of Education, University of Helsinki, Siltavuorenpenger 3, Helsinki, 00014, Finland, 358 503111941; <email>henna.asikainen@helsinki.fi</email></corresp></author-notes><pub-date pub-type="collection"><year>2026</year></pub-date><pub-date pub-type="epub"><day>3</day><month>6</month><year>2026</year></pub-date><volume>15</volume><elocation-id>e84729</elocation-id><history><date date-type="received"><day>24</day><month>09</month><year>2025</year></date><date date-type="rev-recd"><day>21</day><month>04</month><year>2026</year></date><date date-type="accepted"><day>06</day><month>05</month><year>2026</year></date></history><copyright-statement>&#x00A9; Henna Asikainen, Veera Lampinen, Nina Katajavuori. Originally published in JMIR Research Protocols (<ext-link ext-link-type="uri" xlink:href="https://www.researchprotocols.org">https://www.researchprotocols.org</ext-link>), 3.6.2026. </copyright-statement><copyright-year>2026</copyright-year><license license-type="open-access" xlink:href="https://creativecommons.org/licenses/by/4.0/"><p>This is an open-access article distributed under the terms of the Creative Commons Attribution License (<ext-link ext-link-type="uri" xlink:href="https://creativecommons.org/licenses/by/4.0/">https://creativecommons.org/licenses/by/4.0/</ext-link>), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Research Protocols, is properly cited. The complete bibliographic information, a link to the original publication on <ext-link ext-link-type="uri" xlink:href="https://www.researchprotocols.org">https://www.researchprotocols.org</ext-link>, as well as this copyright and license information must be included.</p></license><self-uri xlink:type="simple" xlink:href="https://www.researchprotocols.org/2026/1/e84729"/><abstract><sec><title>Background</title><p>Burnout and poor well-being are serious problems in the workforce all over the world. Especially in academia, high pressure is evident. Therefore, addressing burnout is essential for enhancing academic staff well-being. Acceptance and commitment therapy (ACT), which aims to enhance psychological flexibility skills comprising present moment awareness, value-based actions, and differentiation of thoughts from self, has been found to be a promising approach to enhance workers well-being and work satisfaction.</p></sec><sec><title>Objective</title><p>The purpose of this study was to first develop and describe our acceptance and commitment therapy&#x2013;based WELLS course, aimed at supporting academic staff well-being and working life skills, offered to academic staff. The second aim was to report the mixed methods study design protocol to explore the participants&#x2019; experiences of the effects of the course.</p></sec><sec sec-type="methods"><title>Methods</title><p>We will conduct a single-arm, nonrandomized, and mixed methods study with baseline, postintervention, and 6-month follow-up assessments. We will use an explanatory sequential design in which qualitative data are used to explain and deepen the quantitative findings. The quantitative part of the study aims to recruit 300 participants from the University of Helsinki. Questionnaire data will be collected from the participants 3 times: at the beginning, at the end, and 6 months after the course for well-being&#x2013;related measures such as burnout and working life skills such as time management and psychological flexibility. The participants will be clustered based on their initial burnout risk score using latent profile analysis. Differences in participants&#x2019; dropout, participation forms, and changes in well-being and working life skills during the course will be analyzed with mixed ANOVA. Qualitative data will be collected from reflective journals written at the end of the course, participants&#x2019; written goal statements, and interviews among willing participants. Reflective journals will be analyzed with qualitative content analysis, and interviews will be analyzed using thematic analysis.</p></sec><sec sec-type="results"><title>Results</title><p>As of March 2026, a total of 265 participants had enrolled in the course and given their consent to participate in the research. The current data are being analyzed, and the results are expected to be published in late 2026 or early 2027.</p></sec><sec sec-type="conclusions"><title>Conclusions</title><p>If the intervention proves successful, it may serve as an important tool for improving academics&#x2019; well-being, working life skills, and engagement by understanding how this intervention can help academic staff members with different initial burnout levels. In addition, it can help to understand and solve individual challenges related to well-being in the academic workplace.</p></sec><sec sec-type="registered-report"><title>International Registered Report Identifier (IRRID)</title><p>DERR1-10.2196/84729</p></sec></abstract><kwd-group><kwd>work-related well-being</kwd><kwd>psychological flexibility</kwd><kwd>acceptance and commitment therapy</kwd><kwd>online intervention</kwd><kwd>academic staff</kwd></kwd-group></article-meta></front><body><sec id="s1" sec-type="intro"><title>Introduction</title><sec id="s1-1"><title>Background</title><p>The work-related well-being of academics has been shown to be generally poor and has deteriorated over time [<xref ref-type="bibr" rid="ref1">1</xref>]. Studies have reported, for example, that people working in education are at higher risk of work-related stress than those in other occupations [<xref ref-type="bibr" rid="ref1">1</xref>,<xref ref-type="bibr" rid="ref2">2</xref>]. There are several aspects influencing the well-being of academic staff, and they have experienced increased demands on their work because of, for example, an increasing number of students, technology-based learning, and diversity in the student population [<xref ref-type="bibr" rid="ref3">3</xref>]. In addition, a decline in perceived job control has also been observed [<xref ref-type="bibr" rid="ref1">1</xref>]. A recent review study by Shen and Slater [<xref ref-type="bibr" rid="ref4">4</xref>] showed that the causes of academic staff stress are related, for example, to feelings of heavy workload, administrative problems, unfair rewarding, and program supervision. In addition, high expectations and a competitive atmosphere, including publication targets, were perceived as causing stress [<xref ref-type="bibr" rid="ref4">4</xref>]. It is clear that academic staff are in need of services to support their well-being.</p><p>Well-being is a multilayered concept that is usually very difficult to define [<xref ref-type="bibr" rid="ref5">5</xref>]. While a much-used concept, positive mental health is often used similarly with the term &#x201C;mental well-being,&#x201D; although they need to be considered separately [<xref ref-type="bibr" rid="ref6">6</xref>]. The dual continual model of well-being considers not only the positive aspects of well-being but also the absence of negative symptoms in well-being [<xref ref-type="bibr" rid="ref7">7</xref>]. The dual continual model of well-being divides well-being into hedonic and eudaimonic well-being, emphasizing both the absence of mental health problems and the presence of well-being [<xref ref-type="bibr" rid="ref7">7</xref>]. The hedonic perspective on well-being emphasizes the subjective experience of positive emotions, such as pleasure and happiness, and the absence of negative emotions, as the eudaimonic perspective on well-being emphasizes the psychological functioning and living a meaningful life [<xref ref-type="bibr" rid="ref8">8</xref>]. Mental well-being incorporates hedonic aspects, such as experiencing positive emotions (ie, feeling good), and eudaimonic aspects related to optimal functioning (ie, functioning well) in one&#x2019;s life [<xref ref-type="bibr" rid="ref8">8</xref>-<xref ref-type="bibr" rid="ref10">10</xref>].</p><p>Job-related or occupational burnout can be conceptualized as an aspect of eudaimonic well-being and is a critical problem all around the world in occupational contexts [<xref ref-type="bibr" rid="ref11">11</xref>]. Job-related burnout comprises 3 dimensions: exhaustion, cynicism related to one&#x2019;s job, and reduced professional efficacy [<xref ref-type="bibr" rid="ref12">12</xref>]. One way to conceptualize job-related burnout is the job demands&#x2013;resources model, which indicates that burnout is a product of an imbalance between job demands and resources [<xref ref-type="bibr" rid="ref13">13</xref>]. As mentioned earlier, academic staff can experience high demands in their work, such as an increasing number of students, a decline in perceived job control, administrative problems, unfair rewards, and supervision of programs [<xref ref-type="bibr" rid="ref1">1</xref>,<xref ref-type="bibr" rid="ref3">3</xref>,<xref ref-type="bibr" rid="ref4">4</xref>]. Thus, the model highlights the importance of personal resources in maintaining the balance between resources and demands [<xref ref-type="bibr" rid="ref13">13</xref>].</p><p>On the other hand, psychological flexibility, understood as opening up to difficult thoughts and emotions and moving toward important values, can act as a central personal resource [<xref ref-type="bibr" rid="ref14">14</xref>]. Psychological flexibility describes the ability to recognize and accept difficult thoughts and emotions (instead of avoidance) mindfully and engage in value-based actions [<xref ref-type="bibr" rid="ref14">14</xref>,<xref ref-type="bibr" rid="ref15">15</xref>]. Psychological flexibility is the key concept in acceptance and commitment therapy (ACT), which is a form of third-wave therapy and aims to develop psychological flexibility [<xref ref-type="bibr" rid="ref15">15</xref>]. ACT is grounded in functional contextualism, which seeks to understand psychological events (such as thoughts, emotions, and behaviors) by examining their function within a specific context rather than isolating them as individual entities [<xref ref-type="bibr" rid="ref16">16</xref>]. This approach emphasizes the relationship between an event and its context to determine its purpose or role, assuming that behavior is not inherently good or bad; its value depends on the context in which it occurs [<xref ref-type="bibr" rid="ref17">17</xref>]. Additionally, relational frame theory underpins this approach by focusing on how we understand and use language and thoughts through learned relationships between concepts [<xref ref-type="bibr" rid="ref18">18</xref>]. Relational frame theory views cognition and language as processes of relational learning, where the meaning of an event or thought is shaped by its relationship to other events or thoughts [<xref ref-type="bibr" rid="ref18">18</xref>].</p><p>Psychological flexibility is based on six basic processes: acceptance, cognitive defusion, being present, self-as-context, values, and committed actions [<xref ref-type="bibr" rid="ref19">19</xref>]. <italic>Acceptance</italic> means willingly embracing thoughts and emotions as they occur without trying to change or avoid them, and <italic>cognitive defusion</italic> can be defined as seeing thoughts and emotions as mental events instead of truths [<xref ref-type="bibr" rid="ref15">15</xref>]. <italic>Being present</italic> means engaging with the present moment instead of worrying about the past or the future, and <italic>self-as-context</italic> can be defined through viewing oneself as an observer of thoughts instead of letting them define oneself [<xref ref-type="bibr" rid="ref19">19</xref>]. <italic>Values</italic> are meaningful aspects of our lives which can be identified and clarified, and <italic>committed actions</italic> mean taking purposeful actions in line with the values instead of going through life without thinking about what is important [<xref ref-type="bibr" rid="ref14">14</xref>,<xref ref-type="bibr" rid="ref15">15</xref>,<xref ref-type="bibr" rid="ref19">19</xref>]. By helping individuals clarify their values and take purposeful actions, ACT fosters a sense of purpose and direction, which is associated with greater life satisfaction and well-being [<xref ref-type="bibr" rid="ref15">15</xref>].</p><p>Over 40 years of research have demonstrated that psychological flexibility is associated with a range of positive outcomes, including improved mental health, enhanced emotional well-being, and greater life satisfaction [<xref ref-type="bibr" rid="ref19">19</xref>]. It has been linked to reduced symptoms of depression, burnout, and anxiety, increased quality of life, and better coping strategies in the face of workplace stress [<xref ref-type="bibr" rid="ref20">20</xref>-<xref ref-type="bibr" rid="ref22">22</xref>]. The application of ACT in workplace settings has gained considerable attention, as organizations increasingly recognize the importance of employee well-being for both productivity and job satisfaction [<xref ref-type="bibr" rid="ref23">23</xref>]. Studies have shown that ACT interventions can effectively reduce workplace stress, improve mental health outcomes, and enhance overall well-being [<xref ref-type="bibr" rid="ref20">20</xref>,<xref ref-type="bibr" rid="ref24">24</xref>]. For instance, Flaxman and Bond [<xref ref-type="bibr" rid="ref25">25</xref>] conducted a randomized controlled trial examining the impact of an ACT-based stress management program on public sector employees. The results revealed significant reductions in stress and anxiety, as well as improvements in job performance and psychological flexibility [<xref ref-type="bibr" rid="ref25">25</xref>]. Participants reported greater acceptance of challenging work-related thoughts and feelings, which facilitated more adaptive coping strategies [<xref ref-type="bibr" rid="ref25">25</xref>]. Similarly, a meta-analysis by A-Tjak et al [<xref ref-type="bibr" rid="ref26">26</xref>] highlighted the efficacy of ACT in occupational settings, demonstrating moderate-to-large effect sizes for improvements in psychological flexibility and reductions in work-related stress and burnout. The analysis underscored the potential of ACT to foster a supportive work environment that prioritizes employee well-being [<xref ref-type="bibr" rid="ref26">26</xref>]. Although derived from nonacademic work contexts, these findings suggest that ACT may also be a valuable intervention for academic workers.</p><p>Despite the positive effects of ACT-based interventions on workers&#x2019; well-being, there has been a lack of such interventions targeted at academic staff, especially in online intervention formats [<xref ref-type="bibr" rid="ref21">21</xref>,<xref ref-type="bibr" rid="ref27">27</xref>]. Online interventions allow individuals to engage in more flexible support through materials that are constantly available, which may help to address barriers to seeking help, a key challenge for many who could benefit from such interventions [<xref ref-type="bibr" rid="ref28">28</xref>]. Moreover, online interventions may be particularly valuable in workplaces with a large or geographically dispersed workforces, also including those with remote or hybrid work models (such as universities), as online programs also require fewer physical resources [<xref ref-type="bibr" rid="ref29">29</xref>]. Thus, online interventions may provide substantial potential to be more scalable, accessible, and cost-effective than in-person interventions [<xref ref-type="bibr" rid="ref28">28</xref>-<xref ref-type="bibr" rid="ref30">30</xref>].</p><p>Although used more rarely, online ACT-based interventions have already shown promise in effectively improving mental well-being in a variety of contexts [<xref ref-type="bibr" rid="ref28">28</xref>], including occupational contexts [<xref ref-type="bibr" rid="ref29">29</xref>]. Despite this, far fewer online ACT-based interventions have been offered to workers [<xref ref-type="bibr" rid="ref21">21</xref>], and to our knowledge, no current publications explore online ACT-based interventions for university staff specifically, regardless of their potential.</p><p>Although increasingly accessible, a common issue among online intervention research is participant engagement [<xref ref-type="bibr" rid="ref21">21</xref>]. Engagement in this context refers to how users interact with an online intervention, namely through participants&#x2019; adherence to the intervention, particularly within the context of a study [<xref ref-type="bibr" rid="ref31">31</xref>]. Specifically, this indicates initial uptake via enrollment and early interaction with intervention features, and the extent to which participants continue to use the intervention as intended over time. Low engagement and dropping out of the intervention before the intended end of the intervention often disrupt the ability of online programs to deliver effective treatment and complicate research conclusions [<xref ref-type="bibr" rid="ref27">27</xref>,<xref ref-type="bibr" rid="ref28">28</xref>].</p><p>Despite this, factors such as baseline symptoms of, for instance, burnout and whether the online intervention is completely self-guided (indicating no live interaction with others) or partially guided (indicating a form of live interaction during the intervention through a facilitator or peer interaction) have been found to potentially support engagement in online interventions [<xref ref-type="bibr" rid="ref21">21</xref>,<xref ref-type="bibr" rid="ref27">27</xref>]. Thus, exploring individual differences in participants&#x2019; experiences, such as baseline burnout, and the format of delivery may help clarify what types of online interventions work, and for whom, in terms of adherence and dropout within a study context.</p><p>In addition to psychological flexibility, effective time management is crucial for academics to balance their multifaceted responsibilities and maintain well-being, and thus should be considered when designing interventions for academic staff. Time management involves setting goals, prioritizing tasks, and allocating time efficiently [<xref ref-type="bibr" rid="ref32">32</xref>]. A recent meta-analysis [<xref ref-type="bibr" rid="ref33">33</xref>] showed that time management was moderately related to job performance, academic achievement, and well-being, and that time management also showed a negative relationship with distress. According to this study, time management enhanced well-being to a greater extent than performance. Another meta-analytic review showed that time management was associated with a variety of beneficial employee outcomes, such as increased job satisfaction, job performance, and lower levels of stress and burnout [<xref ref-type="bibr" rid="ref34">34</xref>]. Thus, managing time can directly improve one&#x2019;s work-life balance. Time management training can enhance academics&#x2019; ability to prioritize tasks and manage workloads effectively [<xref ref-type="bibr" rid="ref35">35</xref>].</p><p>When developing online interventions, pedagogical aspects are also important to consider. Reflective learning and experiential learning are 2 pedagogical approaches, which both emphasize the importance of personal experience and reflection in the learning process and in promoting deeper understanding [<xref ref-type="bibr" rid="ref36">36</xref>,<xref ref-type="bibr" rid="ref37">37</xref>]. Sch&#x00F6;n [<xref ref-type="bibr" rid="ref36">36</xref>] introduced the concept of the &#x201C;reflective practitioner,&#x201D; highlighting the importance of reflection-in-action and reflection-on-action as mechanisms for professional growth and development, whereas Kolb&#x2019;s [<xref ref-type="bibr" rid="ref37">37</xref>] model underscores the interplay between experience and reflection, suggesting that effective learning requires individuals to engage in reflective observation to derive meaning from their experiences.</p></sec><sec id="s1-2"><title>Aims and Objectives</title><p>There is a need to enhance academics&#x2019; well-being, yet effective, research-based, and feasible tools are limited. Accordingly, this study pursues 4 goals. First, we aim to develop an online ACT-based intervention for academic staff that integrates working-life skills, specifically time management and reflective skills, and is feasible to complete within demanding work environments. Second, we aim to evaluate the intervention quantitatively by identifying latent burnout profiles among university staff and examining whether changes in burnout, psychological flexibility, perceived stress, overall well-being, and procrastination differ across profiles and participation formats. Third, we aim to examine participant engagement and retention by investigating whether dropout differs across latent burnout profiles and according to participation formats (individual vs group-based). Fourth, we aim to explore participants&#x2019; lived experiences of the intervention qualitatively, with a particular focus on psychological flexibility processes and on which of these processes&#x2019; participants perceive as most meaningful for their well-being and functioning at work.</p><p>Our research questions (RQs) are as follows:</p><list list-type="bullet"><list-item><p>RQ 1. What latent burnout profiles can be identified among staff at the University of Helsinki, and to what extent do the effects of the online ACT-based intervention differ between them?</p></list-item><list-item><p>RQ 2. How do observed pre-post changes in burnout, psychological flexibility, perceived stress, and overall well-being vary across burnout profiles and participation formats?</p></list-item><list-item><p>RQ 3. How do latent burnout profiles differ in training dropout rates, and does participation in group-based versus self-guided online ACT-based training relate to dropout?</p></list-item><list-item><p>RQ 4. How do participants describe their experiences of psychological flexibility processes following participation in a digital ACT-based intervention, and which of these processes do they perceive as most meaningful in supporting their well-being and functioning in their work?</p></list-item></list></sec></sec><sec id="s2" sec-type="methods"><title>Methods</title><sec id="s2-1"><title>Study Design</title><sec id="s2-1-1"><title>Mixed Methods Design</title><p>We will conduct a single-arm, nonrandomized, and mixed methods study with baseline, post-intervention, and 6-month follow-up assessments. Our study methodology description is based on the GRAMMS (Good Reporting of a Mixed Methods Study) reporting guidelines [<xref ref-type="bibr" rid="ref38">38</xref>] and checklist (<xref ref-type="supplementary-material" rid="app1">Checklist 1</xref>). A mixed methods approach is chosen, as the study aims to evaluate changes in participants&#x2019; well-being and related outcomes at the group level and to understand how participants experienced the intervention and its psychological flexibility processes at the individual level. An explanatory sequential design will be used, with priority given to the quantitative strand. Quantitative data will address latent burnout profiles (RQ 1), changes in outcomes, and dropout (RQs 2 and 3), whereas qualitative data will be used to explain, contextualize, and deepen these findings by examining participants&#x2019; final reflections, goal statements, and interview accounts (RQ 4). Although some qualitative material is generated during the course, qualitative interviews will be conducted after the main quantitative data collection phase.</p><p>Integration will occur at the interpretation stage once all data have been collected. Integration will be conducted by the researchers, involving the comparison and combination of quantitative findings (RQs 1&#x2010;3, changes in outcomes, burnout profiles, and dropout) with qualitative data (RQ 4, participant reflections and interviews). Through this, we will explore how quantitative patterns are potentially explained and contextualized by participants&#x2019; individual experiences, as well as identify possible convergence, complementarity, or divergence between the 2 data strands.</p></sec><sec id="s2-1-2"><title>Setting and Participants</title><p>This study is conducted at the University of Helsinki where the course is open to all university personnel, including teaching faculty, researchers, and administrative and support staff. The course has been available since fall 2023. For RQs 1 to 3, participants are recruited to attend the course via regular communications and advertisements to university personnel via university HR, intranet, email, and website. All willing participants can attend the course, and there are no exclusion criteria in the study. Participation in the research is optional, and participants can study in the course without consenting to research. At the beginning of the course, participants are asked to give or decline their permission to use their questionnaire data and written responses for research purposes.</p><p>For RQ 4, a purposive subsample (N&#x2248;30&#x2010;40) will be recruited from participants who have completed the course for semistructured interviews. Sampling will be stratified according to the latent burnout profiles identified in RQ 1 in order to include participants from each profile and permit systematic comparison of experiential patterns across profiles. Separate written consent is given for the interviews before the start of the interview.</p><p>For RQs 1 to 3, data collection started in 2023 when the course was opened to all staff members. For RQ 4, data collection is scheduled to take place in fall 2026.</p></sec></sec><sec id="s2-2"><title>The Course</title><p>The course &#x201C;Occupational Well-being for University Staff&#x201D; is based on ACT, with a central aim of enhancing participants&#x2019; skills in psychological flexibility. Training in key working life skills, such as time and effort management and reflection, is integrated into the course. The course was developed on the web-based Moodle platform and can be completed entirely online. Although it is recommended to complete the course over a 12-week period, participants are free to proceed at their own pace. The flexible schedule is an attempt to accommodate the varying time demands of academic work and allow participants to engage with the course at times that best suit their individual schedules. Participants can take the course either with a group or on their own. A group can be, for example, a research group, a team, or a unit. The small group discussions in the course work best if there are 3 to 5 people in the group, but participants can choose how to conduct this. The course is designed to function without a facilitator.</p></sec><sec id="s2-3"><title>Course Modules</title><p>The course consists of 6 modules. Each module includes all necessary materials, such as instructions, short video lectures, practical exercises, reflective assignments, and guidance for peer discussions. The course is structured so that participants complete 1 module at a time.</p><sec id="s2-3-1"><title>Introductory Part</title><p>In the beginning of the course, the participants are introduced to the working in the course and informed about the research concerning the course. The research permit is also asked in the beginning. In addition, the participants are asked to answer questionnaires concerning their well-being and working skills, from which they receive feedback.</p></sec><sec id="s2-3-2"><title>Module 1: Time Management</title><p>This module includes an introduction to the concept of psychological flexibility and a time management exercise in which participants are instructed to track their time use for a week. This exercise and the insights gained from it serve as a foundation for several reflective assignments throughout the course.</p></sec><sec id="s2-3-3"><title>Module 2: Values</title><p>This module consists of materials and exercises that are related to one&#x2019;s values and includes exercises that help participants to explore their values and think about the issues that are important for them. Participants can choose from a variety of exercises the ones that best suit them, and all exercises have been designed to help participants to recognize the issues and things that are important for them and to reflect on different areas of their lives and their current level of satisfaction with each. Based on this reflection, they are asked to formulate a personal goal for the course.</p></sec><sec id="s2-3-4"><title>Module 3: Recognizing Thoughts</title><p>This module is focused on identifying one&#x2019;s thoughts and understanding their effects on behavior. Procrastination, its influence on behavior, and strategies to overcome it are also discussed. Participants can choose from a variety of exercises tailored to their needs.</p></sec><sec id="s2-3-5"><title>Module 4: Focusing on the Present Moment</title><p>This module emphasizes the importance of being able to concentrate on the present and develop awareness of one&#x2019;s current feelings and emotions. Participants are encouraged to confront all varieties of their emotions, including negative ones, with acceptance and curiosity. Additionally, stress, its effects, and strategies to overcome it are discussed in this module.</p></sec><sec id="s2-3-6"><title>Module 5: Self-Compassion</title><p>This module focuses on self-compassion, comprising themes related to self-kindness, acceptance, and the self as context. Participants are also encouraged to cultivate a thankful attitude in their daily lives and practice compassion toward their peers.</p></sec><sec id="s2-3-7"><title>Module 6: Committed Action</title><p>The last module is related to committed actions and addresses how one&#x2019;s values can be concretely translated into action. As a weekly assignment, the participants are asked to reflect on value-based actions in their lives according to the square field below (<xref ref-type="fig" rid="figure1">Figure 1</xref>)&#x2014;thinking about their actions, emotions, and thoughts toward meaningful actions. Participants are instructed to consider how they will move forward after the course and what new goals they might set for themselves. In addition, the participants assess their well-being and working skills again and are encouraged to reflect on their change in the scores and overall development during the course.</p><fig position="float" id="figure1"><label>Figure 1.</label><caption><p>Square field for value-based actions.</p></caption><graphic alt-version="no" mimetype="image" position="float" xlink:type="simple" xlink:href="resprot_v15i1e84729_fig01.png"/></fig></sec></sec><sec id="s2-4"><title>Measures and Data Collection</title><sec id="s2-4-1"><title>Quantitative Data</title><p>First, for RQs 1 to 3, validated self-assessment questionnaire data will be collected before (T1), after (T2), and 6 months after the course (T3). The questionnaires measure emotional, psychological, and social well-being (Mental Health Continuum-Short Form) [<xref ref-type="bibr" rid="ref39">39</xref>]; psychological flexibility (Work-related Acceptance and Action Questionnaire) [<xref ref-type="bibr" rid="ref40">40</xref>]; perceived stress (Perceived Stress Scale) [<xref ref-type="bibr" rid="ref41">41</xref>]; and risk of burnout (15-item Bergen Burnout Indicator) [<xref ref-type="bibr" rid="ref42">42</xref>]. Psychometric properties will be further evaluated in the present sample via internal consistency (Cronbach &#x03B1;) and factor structure (confirmatory factor analysis). A 6-month follow-up is used to examine how potential changes during the course persist or change over time. Psychological flexibility especially is understood as a process that develops gradually through ongoing practice and integration into daily life, and changes may therefore continue to evolve beyond the course period [<xref ref-type="bibr" rid="ref21">21</xref>]. Furthermore, this timeframe is also consistent with prior research in the field, which commonly uses follow-up periods of 6 months [<xref ref-type="bibr" rid="ref43">43</xref>-<xref ref-type="bibr" rid="ref45">45</xref>].</p></sec><sec id="s2-4-2"><title>Qualitative Data</title><p>Subsequently, for RQ 4, the study will use qualitative data to deepen insights derived from quantitative data. Data will be collected from (1) participants&#x2019; written final reflections submitted on the course platform, (2) participants&#x2019; written goal statements completed at the beginning and end of the course, and (3) semistructured interviews conducted after the end of the course.</p><p>In the beginning, the participants are asked to analyze and identify what factors cause them stress in the workplace or in life and how they could affect it. They are also asked to set a value-based goal which they focus on during the course. At the end of the course, participants write a final individual reflection on how they experienced the course, how the course affected their well-being and working life, how they achieved their goal, and how they are planning to go forward.</p><p>Semistructured interviews will examine participants&#x2019; experiences of psychological flexibility processes following participation in the intervention, with particular attention to which processes are perceived as most meaningful in supporting well-being and functioning in academic work. The interview guide will be informed by the ACT model and will address core psychological flexibility processes, including acceptance, cognitive defusion, present-moment awareness, self-as-context, values clarification, and committed action, while allowing participants to elaborate on how these processes were experienced and applied in their work context.</p></sec></sec><sec id="s2-5"><title>Analyses</title><sec id="s2-5-1"><title>Statistical Analyses</title><p>For RQ 2, the effects of the course are analyzed with repeated-measures ANOVA and hierarchical modeling to see the changes at the group level. In addition, for RQ 1, the participants will be clustered based on their initial burnout risk score to compare the effects of the course in different risk groups using latent profile analysis and repeated-measures ANOVA. For RQ 3, attrition analyses are conducted using chi-square tests of independence and odds ratios to examine whether dropout rates differ across latent burnout profiles and between group-based and self-guided participation formats.</p></sec><sec id="s2-5-2"><title>Qualitative Analysis</title><p>For RQ 4, the final reflections will be analyzed and categorized with inductive content analysis to explore the different reported effects that the course had. In addition, the participants&#x2019; goals will be analyzed at the beginning and the end of the course, examining how the goals were achieved and what factors influenced changes in behavior. These will also be used to analyze the benefits of each module on different participants. These data will be combined to get a deeper understanding of the effects of the course and the changes in the participants&#x2019; behavior.</p><p>Interview data will be analyzed using reflexive thematic analysis following Braun and Clarke [<xref ref-type="bibr" rid="ref46">46</xref>]. The qualitative data will also be analyzed using reflexive thematic analysis following Braun and Clarke [<xref ref-type="bibr" rid="ref38">38</xref>,<xref ref-type="bibr" rid="ref46">46</xref>]. The analysis will adopt a primarily data-driven (inductive) approach, whereby patterns and shared meanings are identified from participants&#x2019; accounts rather than imposed a priori.</p><p>The analytic process will proceed in several phases. First, the researcher will engage in repeated reading of the interview transcripts to achieve familiarity with the data, while documenting preliminary observations and analytic reflections. Second, systematic coding will be conducted across the entire dataset. Segments of text relevant to the research questions will be identified and color-coded, with codes representing meaningful units of data that capture aspects pertinent to participants&#x2019; experiences of burnout and psychological flexibility processes. Following initial coding, codes from all interviews will be collated and examined comparatively. Through iterative review and refinement, potential themes will be developed to represent shared patterns of meaning across participants. Theme development will focus on conceptual coherence with the theoretical framework of psychological flexibility and relevance to the research questions rather than frequency alone, consistent with Braun and Clarke&#x2019;s [<xref ref-type="bibr" rid="ref38">38</xref>] guidelines. Themes will be reviewed, defined, and refined to ensure internal consistency and clear distinction between themes, resulting in a structured thematic representation of participants&#x2019; lived experiences.</p></sec></sec><sec id="s2-6"><title>Ethical Considerations</title><p>A statement of ethical acceptability has been given to the research plan of the course by the University of Helsinki&#x2019;s Research Ethics Committee in the Humanities and Social and Behavioral Sciences (statement 75/2024), and the research will be conducted according to the Finnish National Board on Research Integrity (TENK) guidelines<ext-link ext-link-type="uri" xlink:href="https://tenk.fi/sites/default/files/2021-01/Ethical_review_in_human_sciences_2020.pdf"> </ext-link>[<xref ref-type="bibr" rid="ref47">47</xref>]. Informed consent from all the participants is obtained at the beginning of the course, which is signed online. The participants are informed about the study with a study information sheet in the course area. In addition, a data privacy notice is given to the participants in the course area detailing the research protocol, data collection and management, and participants&#x2019; rights following the General Data Protection Regulation of the European Union. Participants are informed about the possibility to withdraw from the research at any time, and the course can be completed without participation in the research.</p><p>For RQs 1 to 3, all data are collected in the secured course area and downloaded and backed up on secure servers with restricted and password-protected access. The data comprising the questionnaire data used in the study are pseudonymized before analysis. Participants are distinguished in the data by an identification number. The identifiers are not shared outside the research group. The contact information of the participants is stored separately from the research data. The qualitative interview data are recorded and transcribed. The transcriptions and the written assignments used in research will be anonymized as much as possible by removing locations and other identifying information from the transcripts; names are replaced with identification numbers. The data with identifiers will be destroyed 10 years after the end of the research project.</p><p>For RQ 4, all interview data will be collected via the University of Helsinki&#x2019;s Zoom, where interview sessions are recorded. The data will be pseudonymized during transcription, and any potentially identifying details (such as names, colleagues, units, or departments) will be removed. The data is backed up on secure servers with restricted and password-protected access. Only the research team will have access to the recordings and transcripts. Audio recordings will be deleted after transcription. Neither the employer nor any other third party will have access to interview material, and no individual participant will be identifiable in any reports, publications, or presentations. We will emphasize to participants that their employer will not be informed of their participation or responses, and participation or nonparticipation will have no impact on their employment.</p></sec></sec><sec id="s3" sec-type="results"><title>Results</title><p>As of the first data freeze in November 2025, a total of 265 participants had enrolled in the course and given their consent to participate in the research, and 113 participants have completed the course (<xref ref-type="table" rid="table1">Table 1</xref>). Among participants who completed the course, the mean number of days between questionnaires at T1 and T2 was 123, and the median was 109 days. The first data cut is expected to be published in late 2026 or early 2027. Preliminary results suggest that participants&#x2019; burnout scores at T1 reflect 3 distinct profiles and that the profiles experiencing the highest burnout scores are also more likely to drop out. Similarly, participants completing the course alone were more likely to drop out than those in a peer group.</p><table-wrap id="t1" position="float"><label>Table 1.</label><caption><p>Characteristics of the study sample recruited in the first data cut (N=265).</p></caption><table id="table1" frame="hsides" rules="groups"><thead><tr><td align="left" valign="bottom">Background characteristics</td><td align="left" valign="bottom">Participants, n (%)</td></tr></thead><tbody><tr><td align="left" valign="top" colspan="2">Job description</td></tr><tr><td align="left" valign="top"><named-content content-type="indent">&#x00A0;&#x00A0;&#x00A0;&#x00A0;</named-content>Teaching and research staff</td><td align="left" valign="top">35 (13.2)</td></tr><tr><td align="left" valign="top"><named-content content-type="indent">&#x00A0;&#x00A0;&#x00A0;&#x00A0;</named-content>Other expert and support staff</td><td align="left" valign="top">226 (85.2)</td></tr><tr><td align="left" valign="top"><named-content content-type="indent">&#x00A0;&#x00A0;&#x00A0;&#x00A0;</named-content>Missing or N/A<sup><xref ref-type="table-fn" rid="table1fn1">a</xref></sup></td><td align="left" valign="top">4 (1.5)</td></tr><tr><td align="left" valign="top" colspan="2">Course completion method</td></tr><tr><td align="left" valign="top"><named-content content-type="indent">&#x00A0;&#x00A0;&#x00A0;&#x00A0;</named-content>Self-guided or alone</td><td align="left" valign="top">99 (37.4)</td></tr><tr><td align="left" valign="top"><named-content content-type="indent">&#x00A0;&#x00A0;&#x00A0;&#x00A0;</named-content>With a peer group</td><td align="left" valign="top">145 (54.7)</td></tr><tr><td align="left" valign="top"><named-content content-type="indent">&#x00A0;&#x00A0;&#x00A0;&#x00A0;</named-content>Missing or N/A</td><td align="left" valign="top">21 (7.9)</td></tr></tbody></table><table-wrap-foot><fn id="table1fn1"><p><sup>a</sup>N/A: not available.</p></fn></table-wrap-foot></table-wrap></sec><sec id="s4" sec-type="discussion"><title>Discussion</title><sec id="s4-1"><title>Overview</title><p>The aim of this paper was to develop an ACT-based well-being and working life skills course for academic staff, as well as to present our study design. The course was developed based on research on how to support academics&#x2019; well-being and working life skills to answer the current well-being problems they are facing [<xref ref-type="bibr" rid="ref3">3</xref>]. Thus, the course was based on the principles of ACT [<xref ref-type="bibr" rid="ref15">15</xref>], further fostering the development of psychological flexibility and working life skills.</p><p>During this course, each subprocess of psychological flexibility is addressed across the modules. In addition, several working life skills&#x2013;related themes are interwoven throughout the entire course. We have built the course with pedagogical tools to support participants&#x2019; learning and engagement, in particular guided reflection and collaborative peer group work.</p></sec><sec id="s4-2"><title>Principal Findings</title><p>We anticipate that participants&#x2019; baseline burnout levels will be heterogeneous and will reflect at least 2 distinct burnout profiles. We also hypothesize that academic staff will report improvements in their well-being at the end of the course and that dropout rates are significantly different between different burnout profiles and participation formats.</p></sec><sec id="s4-3"><title>Comparison to Prior Work</title><p>ACT has been studied widely among university students [<xref ref-type="bibr" rid="ref48">48</xref>-<xref ref-type="bibr" rid="ref51">51</xref>] and increasingly in wider occupational contexts [<xref ref-type="bibr" rid="ref21">21</xref>,<xref ref-type="bibr" rid="ref22">22</xref>]. However, to our knowledge, there is very limited research examining ACT-based online courses for university staff specifically.</p></sec><sec id="s4-4"><title>Strengths and Limitations</title><p>This study&#x2019;s key strength lies in its versatile mixed methods approach. First, by using latent profile analysis to profile participants&#x2019; baseline burnout scores (RQ 1), we explore burnout as a complex and heterogeneous construct and move beyond aggregated group-level averages to a more person-oriented perspective, which has gained more popularity in the last decades [<xref ref-type="bibr" rid="ref52">52</xref>]. We aim to additionally explore participants&#x2019; self-reported changes during the course quantitatively (RQ 2) but also deepen and contextualize these findings with qualitative insights (RQ 4). This integration allows us to identify not only whether change occurs but also to explore how and why participants perceive change happens or does not happen, and whether qualitative experiences converge with or diverge from quantitative trends. Thus, the study may provide a more nuanced understanding of what participants experience during the course and which aspects may be most useful for them. Finally, we also aim to examine whether burnout profiles and the format of participation may influence engagement in the course (RQ 3), which may provide practical information regarding how and to whom the course may be most beneficial.</p><p>Furthermore, the study design also benefits from its flexibility, as well as its ease of execution and implementation in university work environments. As the study takes place in an online environment with no facilitation, a flexible schedule, and is continuously open, the study does not require excessive resources and is relatively easy to carry out. Additionally, the flexible design may mitigate some of the burden on participants, as they are able to complete the course at their own pace, thus also following ethical research principles.</p><p>However, the study design also possesses limitations. The flexible schedule design also indicates that a control group cannot be used, and thus we are not able to randomize participants, which precludes, for instance, a randomized controlled trial. A nonrandomized design may also introduce selection bias, which may limit the generalizability of the results. Therefore, the conclusions regarding the effectiveness of the course are limited.</p><p>A potential limitation of the mixed methods design is that qualitative data are collected from a subsample, which may not fully represent the broader quantitative sample, potentially limiting the integration of the findings and the generalizability of the results.</p><p>We additionally recognize that participation in the course may introduce extra time demands for already busy academic staff, particularly given the inclusion of assignments, reflections, questionnaires, and (optional) group discussions. Lack of time is a common issue affecting engagement in online interventions [<xref ref-type="bibr" rid="ref21">21</xref>,<xref ref-type="bibr" rid="ref27">27</xref>] and is also a relevant concern in this study. Thus, although the course is designed with flexibility in mind, with participants being able to progress at their own pace, the time commitment needed to complete the course may still lead to excessive dropout. However, the study design attempts to address this by considering dropout, specifically by exploring whether additional factors, such as baseline burnout scores and the format of participation (self-guided vs. with a peer group), may contribute to this.</p></sec><sec id="s4-5"><title>Future Directions</title><p>Future research could address some of these limitations by investigating an iteration of the course that provides more structure via, for instance, facilitated sessions organized by the researchers, a predetermined time window for participation, and a control group for more robust investigations of effectiveness. Moreover, future research should more explicitly assess the perceived time burden of the course and how intervention components and workload can be best aligned with the realities of academic work.</p><p>Furthermore, recent process-based approaches to ACT underscore that changes in well-being unfold over time within individuals rather than between time points and group averages and should thus be examined beyond pre-post measures [<xref ref-type="bibr" rid="ref53">53</xref>]. As psychological flexibility is assessed only at the beginning and end of the course, this study does not idiomatically examine how change occurs during the intervention, especially for the individual. Future studies could therefore incorporate daily, within-person process-based assessments (such as the Process-based Assessment Tool [<xref ref-type="bibr" rid="ref54">54</xref>]) to more comprehensively capture how these processes may vary individually over time.</p></sec><sec id="s4-6"><title>Dissemination</title><p>The results from this research will be published in scientific peer-reviewed journals as well as scientific conferences.</p></sec></sec></body><back><ack><p>The authors wish to thank the participants of this course.</p><p>The authors declare the use of generative artificial intelligence (GAI) in the research and writing process. According to the GAIDeT taxonomy (2025), the following tasks were delegated to GAI tools under full human supervision: proofreading and editing. The GAI tool used was Chat-GPT 5.0.</p><p>Responsibility for the final manuscript lies entirely with the authors.</p><p>GAI tools are not listed as authors and do not bear responsibility for the final outcomes.</p><p>Declaration submitted by: the authors</p></ack><notes><sec><title>Funding</title><p>This work was supported by the Finnish Cultural Foundation (00250570).</p></sec><sec><title>Data Availability</title><p>The datasets generated or analyzed during this study are available from the corresponding author on reasonable request.</p></sec></notes><fn-group><fn fn-type="con"><p>Conceptualization: HA, VL, NK</p><p>Course development: HA, NK</p><p>Data curation: HA, NK</p><p>Investigation: HA, NK, VL</p><p>Methodology: HA, VL, NK</p><p>Writing &#x2013; original draft: HA, VL, NK</p><p>Writing &#x2013; review &#x0026; editing: HA, NK, VL</p></fn></fn-group><glossary><title>Abbreviations</title><def-list><def-item><term id="abb1">ACT</term><def><p>acceptance and commitment therapy</p></def></def-item><def-item><term id="abb2">GRAMMS</term><def><p>Good Reporting of a Mixed Methods Study</p></def></def-item><def-item><term id="abb3">RQ </term><def><p>research question</p></def></def-item></def-list></glossary><ref-list><title>References</title><ref id="ref1"><label>1</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>Wray</surname><given-names>S</given-names> </name><name name-style="western"><surname>Kinman</surname><given-names>G</given-names> </name></person-group><article-title>The psychosocial hazards of academic work: an analysis of trends</article-title><source>Stud High Educ</source><year>2022</year><month>04</month><day>3</day><volume>47</volume><issue>4</issue><fpage>771</fpage><lpage>782</lpage><pub-id pub-id-type="doi">10.1080/03075079.2020.1793934</pub-id></nlm-citation></ref><ref id="ref2"><label>2</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>Johnson</surname><given-names>S</given-names> </name><name name-style="western"><surname>Cooper</surname><given-names>C</given-names> </name><name name-style="western"><surname>Cartwright</surname><given-names>S</given-names> </name><name name-style="western"><surname>Donald</surname><given-names>I</given-names> </name><name name-style="western"><surname>Taylor</surname><given-names>P</given-names> </name><name name-style="western"><surname>Millet</surname><given-names>C</given-names> </name></person-group><article-title>The experience of work&#x2010;related stress across occupations</article-title><source>J Manag Psychol</source><year>2005</year><month>03</month><day>1</day><volume>20</volume><issue>2</issue><fpage>178</fpage><lpage>187</lpage><pub-id pub-id-type="doi">10.1108/02683940510579803</pub-id></nlm-citation></ref><ref id="ref3"><label>3</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>Fontinha</surname><given-names>R</given-names> </name><name name-style="western"><surname>Easton</surname><given-names>S</given-names> </name><name name-style="western"><surname>Van Laar</surname><given-names>D</given-names> </name></person-group><article-title>Overtime and quality of working life in academics and nonacademics: the role of perceived work-life balance</article-title><source>Int J Stress Manag</source><year>2019</year><volume>26</volume><issue>2</issue><fpage>173</fpage><lpage>183</lpage><pub-id pub-id-type="doi">10.1037/str0000067</pub-id></nlm-citation></ref><ref id="ref4"><label>4</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>Shen</surname><given-names>P</given-names> </name><name name-style="western"><surname>Slater</surname><given-names>P</given-names> </name></person-group><article-title>Occupational stress, coping strategies, health, and well-being among university academic staff&#x2014;an integrative review</article-title><source>Int Educ Stud</source><year>2021</year><volume>14</volume><issue>12</issue><fpage>99</fpage><pub-id pub-id-type="doi">10.5539/ies.v14n12p99</pub-id></nlm-citation></ref><ref id="ref5"><label>5</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>Jarden</surname><given-names>A</given-names> </name><name name-style="western"><surname>Roache</surname><given-names>A</given-names> </name></person-group><article-title>What is wellbeing?</article-title><source>Int J Environ Res Public Health</source><year>2023</year><month>03</month><day>12</day><volume>20</volume><issue>6</issue><fpage>5006</fpage><pub-id pub-id-type="doi">10.3390/ijerph20065006</pub-id><pub-id pub-id-type="medline">36981914</pub-id></nlm-citation></ref><ref id="ref6"><label>6</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>Keller</surname><given-names>S</given-names> </name></person-group><article-title>What does mental health have to do with well-being?</article-title><source>Bioethics</source><year>2020</year><month>03</month><volume>34</volume><issue>3</issue><fpage>228</fpage><lpage>234</lpage><pub-id pub-id-type="doi">10.1111/bioe.12702</pub-id><pub-id pub-id-type="medline">31782815</pub-id></nlm-citation></ref><ref id="ref7"><label>7</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>Keyes</surname><given-names>CLM</given-names> </name></person-group><article-title>The mental health continuum: from languishing to flourishing in life</article-title><source>J Health Soc Behav</source><year>2002</year><month>06</month><volume>43</volume><issue>2</issue><fpage>207</fpage><lpage>222</lpage><pub-id pub-id-type="doi">10.2307/3090197</pub-id><pub-id pub-id-type="medline">12096700</pub-id></nlm-citation></ref><ref id="ref8"><label>8</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>Ryan</surname><given-names>RM</given-names> </name><name name-style="western"><surname>Deci</surname><given-names>EL</given-names> </name></person-group><article-title>On happiness and human potentials: a review of research on hedonic and eudaimonic well-being</article-title><source>Annu Rev Psychol</source><year>2001</year><volume>52</volume><fpage>141</fpage><lpage>166</lpage><pub-id pub-id-type="doi">10.1146/annurev.psych.52.1.141</pub-id><pub-id pub-id-type="medline">11148302</pub-id></nlm-citation></ref><ref id="ref9"><label>9</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>Clarke</surname><given-names>A</given-names> </name><name name-style="western"><surname>Friede</surname><given-names>T</given-names> </name><name name-style="western"><surname>Putz</surname><given-names>R</given-names> </name><etal/></person-group><article-title>Warwick-Edinburgh Mental Well-being Scale (WEMWBS): validated for teenage school students in England and Scotland. A mixed methods assessment</article-title><source>BMC Public Health</source><year>2011</year><month>06</month><day>21</day><volume>11</volume><fpage>487</fpage><pub-id pub-id-type="doi">10.1186/1471-2458-11-487</pub-id><pub-id pub-id-type="medline">21693055</pub-id></nlm-citation></ref><ref id="ref10"><label>10</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>McKay</surname><given-names>MT</given-names> </name><name name-style="western"><surname>Andretta</surname><given-names>JR</given-names> </name></person-group><article-title>Evidence for the psychometric validity, internal consistency and measurement invariance of Warwick Edinburgh Mental Well-being scale scores in Scottish and Irish adolescents</article-title><source>Psychiatry Res</source><year>2017</year><month>09</month><volume>255</volume><fpage>382</fpage><lpage>386</lpage><pub-id pub-id-type="doi">10.1016/j.psychres.2017.06.071</pub-id><pub-id pub-id-type="medline">28666244</pub-id></nlm-citation></ref><ref id="ref11"><label>11</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>Nagarajan</surname><given-names>R</given-names> </name><name name-style="western"><surname>Ramachandran</surname><given-names>P</given-names> </name><name name-style="western"><surname>Dilipkumar</surname><given-names>R</given-names> </name><name name-style="western"><surname>Kaur</surname><given-names>P</given-names> </name></person-group><article-title>Global estimate of burnout among the public health workforce: a systematic review and meta-analysis</article-title><source>Hum Resour Health</source><year>2024</year><month>05</month><day>21</day><volume>22</volume><issue>1</issue><fpage>30</fpage><pub-id pub-id-type="doi">10.1186/s12960-024-00917-w</pub-id><pub-id pub-id-type="medline">38773482</pub-id></nlm-citation></ref><ref id="ref12"><label>12</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>Maslach</surname><given-names>C</given-names> </name><name name-style="western"><surname>Schaufeli</surname><given-names>WB</given-names> </name><name name-style="western"><surname>Leiter</surname><given-names>MP</given-names> </name></person-group><article-title>Job burnout</article-title><source>Annu Rev Psychol</source><year>2001</year><volume>52</volume><fpage>397</fpage><lpage>422</lpage><pub-id pub-id-type="doi">10.1146/annurev.psych.52.1.397</pub-id><pub-id pub-id-type="medline">11148311</pub-id></nlm-citation></ref><ref id="ref13"><label>13</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>Bakker</surname><given-names>AB</given-names> </name><name name-style="western"><surname>Demerouti</surname><given-names>E</given-names> </name></person-group><article-title>Job demands-resources theory: taking stock and looking forward</article-title><source>J Occup Health Psychol</source><year>2017</year><month>07</month><volume>22</volume><issue>3</issue><fpage>273</fpage><lpage>285</lpage><pub-id pub-id-type="doi">10.1037/ocp0000056</pub-id><pub-id pub-id-type="medline">27732008</pub-id></nlm-citation></ref><ref id="ref14"><label>14</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>Kashdan</surname><given-names>TB</given-names> </name><name name-style="western"><surname>Rottenberg</surname><given-names>J</given-names> </name></person-group><article-title>Psychological flexibility as a fundamental aspect of health</article-title><source>Clin Psychol Rev</source><year>2010</year><month>11</month><volume>30</volume><issue>7</issue><fpage>865</fpage><lpage>878</lpage><pub-id pub-id-type="doi">10.1016/j.cpr.2010.03.001</pub-id><pub-id pub-id-type="medline">21151705</pub-id></nlm-citation></ref><ref id="ref15"><label>15</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>Hayes</surname><given-names>SC</given-names> </name><name name-style="western"><surname>Luoma</surname><given-names>JB</given-names> </name><name name-style="western"><surname>Bond</surname><given-names>FW</given-names> </name><name name-style="western"><surname>Masuda</surname><given-names>A</given-names> </name><name name-style="western"><surname>Lillis</surname><given-names>J</given-names> </name></person-group><article-title>Acceptance and commitment therapy: model, processes and outcomes</article-title><source>Behav Res Ther</source><year>2006</year><month>01</month><volume>44</volume><issue>1</issue><fpage>1</fpage><lpage>25</lpage><pub-id pub-id-type="doi">10.1016/j.brat.2005.06.006</pub-id><pub-id pub-id-type="medline">16300724</pub-id></nlm-citation></ref><ref id="ref16"><label>16</label><nlm-citation citation-type="book"><person-group person-group-type="author"><name name-style="western"><surname>Biglan</surname><given-names>A</given-names> </name><name name-style="western"><surname>Hayes</surname><given-names>SC</given-names> </name></person-group><person-group person-group-type="editor"><name name-style="western"><surname>Zettle</surname><given-names>RD</given-names> </name><name name-style="western"><surname>Hayes</surname><given-names>SC</given-names> </name><name name-style="western"><surname>Barnes-Holmes</surname><given-names>D</given-names> </name><name name-style="western"><surname>Biglan</surname><given-names>A</given-names> </name></person-group><article-title>Functional contextualism and contextual behavioral science</article-title><source>The Wiley Handbook of Contextual Behavioral Science</source><year>2015</year><publisher-name>John Wiley &#x0026; Sons, Ltd</publisher-name><fpage>37</fpage><lpage>61</lpage><pub-id pub-id-type="doi">10.1002/9781118489857</pub-id></nlm-citation></ref><ref id="ref17"><label>17</label><nlm-citation citation-type="book"><person-group person-group-type="author"><name name-style="western"><surname>Gifford</surname><given-names>EV</given-names> </name><name name-style="western"><surname>Hayes</surname><given-names>SC</given-names> </name></person-group><person-group person-group-type="editor"><name name-style="western"><surname>O&#x2019;Donohue</surname><given-names>W</given-names> </name><name name-style="western"><surname>Kitchener</surname><given-names>R</given-names> </name></person-group><article-title>Functional contextualism: a pragmatic philosophy for behavioral science</article-title><source>Handbook of Behaviorism</source><year>1999</year><publisher-name>Academic Press</publisher-name><fpage>285</fpage><lpage>327</lpage><pub-id pub-id-type="doi">10.1016/B978-012524190-8/50012-7</pub-id></nlm-citation></ref><ref id="ref18"><label>18</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>Hayes</surname><given-names>SC</given-names> </name></person-group><article-title>Acceptance and commitment therapy, relational frame theory, and the third wave of behavioral and cognitive therapies</article-title><source>Behav Ther</source><year>2004</year><volume>35</volume><issue>4</issue><fpage>639</fpage><lpage>665</lpage><pub-id pub-id-type="doi">10.1016/S0005-7894(04)80013-3</pub-id></nlm-citation></ref><ref id="ref19"><label>19</label><nlm-citation citation-type="book"><person-group person-group-type="author"><name name-style="western"><surname>Hayes</surname><given-names>SC</given-names> </name></person-group><source>A Liberated Mind: How to Pivot toward What Matters</source><year>2019</year><publisher-name>Penguin</publisher-name><pub-id pub-id-type="other">9780735214002</pub-id></nlm-citation></ref><ref id="ref20"><label>20</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>Rad</surname><given-names>Y</given-names> </name><name name-style="western"><surname>Prudenzi</surname><given-names>A</given-names> </name><name name-style="western"><surname>Zernerova</surname><given-names>L</given-names> </name><name name-style="western"><surname>Gerson</surname><given-names>J</given-names> </name><name name-style="western"><surname>Flaxman</surname><given-names>PE</given-names> </name></person-group><article-title>Effects of workplace acceptance and commitment therapy (ACT) programs on psychological flexibility&#x2019;s subprocesses: a systematic review</article-title><source>J Contextual Behav Sci</source><year>2025</year><month>07</month><volume>37</volume><fpage>100915</fpage><pub-id pub-id-type="doi">10.1016/j.jcbs.2025.100915</pub-id></nlm-citation></ref><ref id="ref21"><label>21</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>Lampinen</surname><given-names>VS</given-names> </name><name name-style="western"><surname>K&#x00E4;mper</surname><given-names>E</given-names> </name><name name-style="western"><surname>Balla</surname><given-names>VR</given-names> </name><name name-style="western"><surname>Katajavuori</surname><given-names>N</given-names> </name><name name-style="western"><surname>Asikainen</surname><given-names>H</given-names> </name></person-group><article-title>The effectiveness of online acceptance and commitment therapy-based interventions on depression, burnout, anxiety and stress in occupational contexts: a systematic narrative review</article-title><source>Internet Interv</source><year>2026</year><month>03</month><volume>43</volume><fpage>100909</fpage><pub-id pub-id-type="doi">10.1016/j.invent.2026.100909</pub-id><pub-id pub-id-type="medline">41657724</pub-id></nlm-citation></ref><ref id="ref22"><label>22</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>Towey-Swift</surname><given-names>KD</given-names> </name><name name-style="western"><surname>Lauvrud</surname><given-names>C</given-names> </name><name name-style="western"><surname>Whittington</surname><given-names>R</given-names> </name></person-group><article-title>Acceptance and commitment therapy (ACT) for professional staff burnout: a systematic review and narrative synthesis of controlled trials</article-title><source>J Ment Health</source><year>2023</year><month>04</month><volume>32</volume><issue>2</issue><fpage>452</fpage><lpage>464</lpage><pub-id pub-id-type="doi">10.1080/09638237.2021.2022628</pub-id><pub-id pub-id-type="medline">35105253</pub-id></nlm-citation></ref><ref id="ref23"><label>23</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>Cross</surname><given-names>SP</given-names> </name><name name-style="western"><surname>Alvarez-Jimenez</surname><given-names>M</given-names> </name></person-group><article-title>The digital cumulative complexity model: a framework for improving engagement in digital mental health interventions</article-title><source>Front Psychiatry</source><year>2024</year><volume>15</volume><fpage>1382726</fpage><pub-id pub-id-type="doi">10.3389/fpsyt.2024.1382726</pub-id><pub-id pub-id-type="medline">39290300</pub-id></nlm-citation></ref><ref id="ref24"><label>24</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>Vega-Campos</surname><given-names>M</given-names> </name><name name-style="western"><surname>P&#x00E9;rez-P&#x00E9;rez</surname><given-names>M</given-names> </name><name name-style="western"><surname>Sarabia-Cobo</surname><given-names>C</given-names> </name></person-group><article-title>Acceptance and commitment therapy for well-being at worksites: charting the field for enhancing its applicability</article-title><source>SAGE Open</source><year>2025</year><month>01</month><volume>15</volume><issue>1</issue><fpage>21582440251320192</fpage><pub-id pub-id-type="doi">10.1177/21582440251320192</pub-id></nlm-citation></ref><ref id="ref25"><label>25</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>Flaxman</surname><given-names>PE</given-names> </name><name name-style="western"><surname>Bond</surname><given-names>FW</given-names> </name></person-group><article-title>A randomised worksite comparison of acceptance and commitment therapy and stress inoculation training</article-title><source>Behav Res Ther</source><year>2010</year><month>08</month><volume>48</volume><issue>8</issue><fpage>816</fpage><lpage>820</lpage><pub-id pub-id-type="doi">10.1016/j.brat.2010.05.004</pub-id><pub-id pub-id-type="medline">20627269</pub-id></nlm-citation></ref><ref id="ref26"><label>26</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>A-Tjak</surname><given-names>JGL</given-names> </name><name name-style="western"><surname>Davis</surname><given-names>ML</given-names> </name><name name-style="western"><surname>Morina</surname><given-names>N</given-names> </name><name name-style="western"><surname>Powers</surname><given-names>MB</given-names> </name><name name-style="western"><surname>Smits</surname><given-names>JAJ</given-names> </name><name name-style="western"><surname>Emmelkamp</surname><given-names>PMG</given-names> </name></person-group><article-title>A meta-analysis of the efficacy of acceptance and commitment therapy for clinically relevant mental and physical health problems</article-title><source>Psychother Psychosom</source><year>2015</year><volume>84</volume><issue>1</issue><fpage>30</fpage><lpage>36</lpage><pub-id pub-id-type="doi">10.1159/000365764</pub-id><pub-id pub-id-type="medline">25547522</pub-id></nlm-citation></ref><ref id="ref27"><label>27</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>Borghouts</surname><given-names>J</given-names> </name><name name-style="western"><surname>Eikey</surname><given-names>E</given-names> </name><name name-style="western"><surname>Mark</surname><given-names>G</given-names> </name><etal/></person-group><article-title>Barriers to and facilitators of user engagement with digital mental health interventions: systematic review</article-title><source>J Med Internet Res</source><year>2021</year><month>03</month><day>24</day><volume>23</volume><issue>3</issue><fpage>e24387</fpage><pub-id pub-id-type="doi">10.2196/24387</pub-id><pub-id pub-id-type="medline">33759801</pub-id></nlm-citation></ref><ref id="ref28"><label>28</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>Philippe</surname><given-names>TJ</given-names> </name><name name-style="western"><surname>Sikder</surname><given-names>N</given-names> </name><name name-style="western"><surname>Jackson</surname><given-names>A</given-names> </name><etal/></person-group><article-title>Digital health interventions for delivery of mental health care: systematic and comprehensive meta-review</article-title><source>JMIR Ment Health</source><year>2022</year><month>05</month><day>12</day><volume>9</volume><issue>5</issue><fpage>e35159</fpage><pub-id pub-id-type="doi">10.2196/35159</pub-id><pub-id pub-id-type="medline">35551058</pub-id></nlm-citation></ref><ref id="ref29"><label>29</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>Moe-Byrne</surname><given-names>T</given-names> </name><name name-style="western"><surname>Shepherd</surname><given-names>J</given-names> </name><name name-style="western"><surname>Merecz-Kot</surname><given-names>D</given-names> </name><etal/></person-group><article-title>Effectiveness of tailored digital health interventions for mental health at the workplace: a systematic review of randomised controlled trials</article-title><source>PLOS Digit Health</source><year>2022</year><month>10</month><volume>1</volume><issue>10</issue><fpage>e0000123</fpage><pub-id pub-id-type="doi">10.1371/journal.pdig.0000123</pub-id><pub-id pub-id-type="medline">36812547</pub-id></nlm-citation></ref><ref id="ref30"><label>30</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>Sch&#x00E4;fer</surname><given-names>SK</given-names> </name><name name-style="western"><surname>von Boros</surname><given-names>L</given-names> </name><name name-style="western"><surname>Schaubruch</surname><given-names>LM</given-names> </name><etal/></person-group><article-title>Digital interventions to promote psychological resilience: a systematic review and meta-analysis</article-title><source>NPJ Digit Med</source><year>2024</year><month>02</month><day>8</day><volume>7</volume><issue>1</issue><fpage>30</fpage><pub-id pub-id-type="doi">10.1038/s41746-024-01017-8</pub-id><pub-id pub-id-type="medline">38332030</pub-id></nlm-citation></ref><ref id="ref31"><label>31</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>Gulliver</surname><given-names>A</given-names> </name><name name-style="western"><surname>Calear</surname><given-names>AL</given-names> </name><name name-style="western"><surname>Sunderland</surname><given-names>M</given-names> </name><name name-style="western"><surname>Kay-Lambkin</surname><given-names>F</given-names> </name><name name-style="western"><surname>Farrer</surname><given-names>LM</given-names> </name><name name-style="western"><surname>Batterham</surname><given-names>PJ</given-names> </name></person-group><article-title>Predictors of acceptability and engagement in a self-guided online program for depression and anxiety</article-title><source>Internet Interv</source><year>2021</year><month>09</month><volume>25</volume><fpage>100400</fpage><pub-id pub-id-type="doi">10.1016/j.invent.2021.100400</pub-id><pub-id pub-id-type="medline">34026569</pub-id></nlm-citation></ref><ref id="ref32"><label>32</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>Claessens</surname><given-names>BJC</given-names> </name><name name-style="western"><surname>van Eerde</surname><given-names>W</given-names> </name><name name-style="western"><surname>Rutte</surname><given-names>CG</given-names> </name><name name-style="western"><surname>Roe</surname><given-names>RA</given-names> </name></person-group><article-title>A review of the time management literature</article-title><source>Pers Rev</source><year>2007</year><month>02</month><day>13</day><volume>36</volume><issue>2</issue><fpage>255</fpage><lpage>276</lpage><pub-id pub-id-type="doi">10.1108/00483480710726136</pub-id></nlm-citation></ref><ref id="ref33"><label>33</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>Aeon</surname><given-names>B</given-names> </name><name name-style="western"><surname>Faber</surname><given-names>A</given-names> </name><name name-style="western"><surname>Panaccio</surname><given-names>A</given-names> </name></person-group><article-title>Does time management work? A meta-analysis</article-title><source>PLoS ONE</source><year>2021</year><volume>16</volume><issue>1</issue><fpage>e0245066</fpage><pub-id pub-id-type="doi">10.1371/journal.pone.0245066</pub-id><pub-id pub-id-type="medline">33428644</pub-id></nlm-citation></ref><ref id="ref34"><label>34</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>Bedi</surname><given-names>A</given-names> </name><name name-style="western"><surname>Sass</surname><given-names>MD</given-names> </name></person-group><article-title>But I have no time to read this article! A meta-analytic review of the consequences of employee time management behaviors</article-title><source>J Soc Psychol</source><year>2023</year><month>09</month><day>3</day><volume>163</volume><issue>5</issue><fpage>676</fpage><lpage>697</lpage><pub-id pub-id-type="doi">10.1080/00224545.2022.2159302</pub-id><pub-id pub-id-type="medline">36579835</pub-id></nlm-citation></ref><ref id="ref35"><label>35</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>Elsabahy</surname><given-names>HE</given-names> </name><name name-style="western"><surname>Sleem</surname><given-names>WF</given-names> </name><name name-style="western"><surname>El Atroush</surname><given-names>HG</given-names> </name></person-group><article-title>Effect of time management program on job satisfaction for head nurses</article-title><source>J Educ Pract</source><year>2015</year><access-date>2026-05-13</access-date><volume>6</volume><issue>32</issue><fpage>36</fpage><lpage>44</lpage><comment><ext-link ext-link-type="uri" xlink:href="https://eric.ed.gov/?id=EJ1083546">https://eric.ed.gov/?id=EJ1083546</ext-link></comment></nlm-citation></ref><ref id="ref36"><label>36</label><nlm-citation citation-type="book"><person-group person-group-type="author"><name name-style="western"><surname>Sch&#x00F6;n</surname><given-names>DA</given-names> </name></person-group><source>The Reflective Practitioner: How Professionals Think in Action</source><year>1983</year><access-date>2026-05-13</access-date><publisher-name>Basic Books</publisher-name><comment><ext-link ext-link-type="uri" xlink:href="https://raggeduniversity.co.uk/wp-content/uploads/2025/03/1_x_Donald-A.-Schon-The-Reflective-Practitioner_-How-Professionals-Think-In-Action-Basic-Books-1984_redactedaa_compressed3.pdf">https://raggeduniversity.co.uk/wp-content/uploads/2025/03/1_x_Donald-A.-Schon-The-Reflective-Practitioner_-How-Professionals-Think-In-Action-Basic-Books-1984_redactedaa_compressed3.pdf</ext-link></comment></nlm-citation></ref><ref id="ref37"><label>37</label><nlm-citation citation-type="book"><person-group person-group-type="author"><name name-style="western"><surname>Kolb</surname><given-names>DA</given-names> </name></person-group><source>Experiential Learning: Experience as the Source of Learning and Development</source><year>1984</year><publisher-name>Prentice-Hall</publisher-name><pub-id pub-id-type="other">9780132952613</pub-id></nlm-citation></ref><ref id="ref38"><label>38</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>Braun</surname><given-names>V</given-names> </name><name name-style="western"><surname>Clarke</surname><given-names>V</given-names> </name></person-group><article-title>Using thematic analysis in psychology</article-title><source>Qual Res Psychol</source><year>2006</year><month>01</month><volume>3</volume><issue>2</issue><fpage>77</fpage><lpage>101</lpage><pub-id pub-id-type="doi">10.1191/1478088706qp063oa</pub-id></nlm-citation></ref><ref id="ref39"><label>39</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>Lamers</surname><given-names>SMA</given-names> </name><name name-style="western"><surname>Westerhof</surname><given-names>GJ</given-names> </name><name name-style="western"><surname>Bohlmeijer</surname><given-names>ET</given-names> </name><name name-style="western"><surname>ten Klooster</surname><given-names>PM</given-names> </name><name name-style="western"><surname>Keyes</surname><given-names>CLM</given-names> </name></person-group><article-title>Evaluating the psychometric properties of the Mental Health Continuum-Short Form (MHC-SF)</article-title><source>J Clin Psychol</source><year>2011</year><month>01</month><volume>67</volume><issue>1</issue><fpage>99</fpage><lpage>110</lpage><pub-id pub-id-type="doi">10.1002/jclp.20741</pub-id><pub-id pub-id-type="medline">20973032</pub-id></nlm-citation></ref><ref id="ref40"><label>40</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>Bond</surname><given-names>FW</given-names> </name><name name-style="western"><surname>Lloyd</surname><given-names>J</given-names> </name><name name-style="western"><surname>Guenole</surname><given-names>N</given-names> </name></person-group><article-title>The Work&#x2010;related Acceptance and Action Questionnaire: initial psychometric findings and their implications for measuring psychological flexibility in specific contexts</article-title><source>J Occupat Organ Psyc</source><year>2013</year><month>09</month><volume>86</volume><issue>3</issue><fpage>331</fpage><lpage>347</lpage><pub-id pub-id-type="doi">10.1111/joop.12001</pub-id></nlm-citation></ref><ref id="ref41"><label>41</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>Harris</surname><given-names>KM</given-names> </name><name name-style="western"><surname>Gaffey</surname><given-names>AE</given-names> </name><name name-style="western"><surname>Schwartz</surname><given-names>JE</given-names> </name><name name-style="western"><surname>Krantz</surname><given-names>DS</given-names> </name><name name-style="western"><surname>Burg</surname><given-names>MM</given-names> </name></person-group><article-title>The Perceived Stress Scale as a measure of stress: decomposing score variance in longitudinal behavioral medicine studies</article-title><source>Ann Behav Med</source><year>2023</year><month>09</month><day>13</day><volume>57</volume><issue>10</issue><fpage>846</fpage><lpage>854</lpage><pub-id pub-id-type="doi">10.1093/abm/kaad015</pub-id><pub-id pub-id-type="medline">37084792</pub-id></nlm-citation></ref><ref id="ref42"><label>42</label><nlm-citation citation-type="book"><person-group person-group-type="author"><name name-style="western"><surname>N&#x00E4;&#x00E4;t&#x00E4;nen</surname><given-names>P</given-names> </name><name name-style="western"><surname>Aro</surname><given-names>A</given-names> </name><name name-style="western"><surname>Matthiesen</surname><given-names>S</given-names> </name><name name-style="western"><surname>Salmela-Aro</surname><given-names>K</given-names> </name></person-group><source>Bergen Burnout Indicator-15</source><year>2003</year><access-date>2026-05-13</access-date><publisher-name>Edita Publishing</publisher-name><comment><ext-link ext-link-type="uri" xlink:href="https://researchportal.helsinki.fi/en/publications/bergen-burnout-indicator-15/">https://researchportal.helsinki.fi/en/publications/bergen-burnout-indicator-15/</ext-link></comment></nlm-citation></ref><ref id="ref43"><label>43</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>Puolakanaho</surname><given-names>A</given-names> </name><name name-style="western"><surname>Tolvanen</surname><given-names>A</given-names> </name><name name-style="western"><surname>Kinnunen</surname><given-names>SM</given-names> </name><name name-style="western"><surname>Lappalainen</surname><given-names>R</given-names> </name></person-group><article-title>A psychological flexibility-based intervention for burnout: a randomized controlled trial</article-title><source>J Contextual Behav Sci</source><year>2020</year><month>01</month><volume>15</volume><fpage>52</fpage><lpage>67</lpage><pub-id pub-id-type="doi">10.1016/j.jcbs.2019.11.007</pub-id></nlm-citation></ref><ref id="ref44"><label>44</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>Sasaki</surname><given-names>N</given-names> </name><name name-style="western"><surname>Imamura</surname><given-names>K</given-names> </name><name name-style="western"><surname>Nishi</surname><given-names>D</given-names> </name><etal/></person-group><article-title>The effect of internet-based acceptance and commitment therapy (iACT) on psychological well-being among working women with a pre-school child: a randomized controlled trial</article-title><source>J Contextual Behav Sci</source><year>2023</year><month>04</month><volume>28</volume><fpage>33</fpage><lpage>47</lpage><pub-id pub-id-type="doi">10.1016/j.jcbs.2023.03.002</pub-id></nlm-citation></ref><ref id="ref45"><label>45</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>Lappalainen</surname><given-names>P</given-names> </name><name name-style="western"><surname>Kaipainen</surname><given-names>K</given-names> </name><name name-style="western"><surname>Lappalainen</surname><given-names>R</given-names> </name><etal/></person-group><article-title>Feasibility of a personal health technology-based psychological intervention for men with stress and mood problems: randomized controlled pilot trial</article-title><source>JMIR Res Protoc</source><year>2013</year><month>01</month><day>9</day><volume>2</volume><issue>1</issue><fpage>e1</fpage><pub-id pub-id-type="doi">10.2196/resprot.2389</pub-id><pub-id pub-id-type="medline">23611946</pub-id></nlm-citation></ref><ref id="ref46"><label>46</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>Braun</surname><given-names>V</given-names> </name><name name-style="western"><surname>Clarke</surname><given-names>V</given-names> </name></person-group><article-title>Reflecting on reflexive thematic analysis</article-title><source>Qual Res Sport Exerc Health</source><year>2019</year><month>08</month><day>8</day><volume>11</volume><issue>4</issue><fpage>589</fpage><lpage>597</lpage><pub-id pub-id-type="doi">10.1080/2159676X.2019.1628806</pub-id></nlm-citation></ref><ref id="ref47"><label>47</label><nlm-citation citation-type="report"><article-title>The ethical principles of research with human participants and ethical review in the human sciences in Finland</article-title><year>2019</year><access-date>2026-05-13</access-date><publisher-name>Finnish National Board on Research Integrity (TENK)</publisher-name><comment><ext-link ext-link-type="uri" xlink:href="https://tenk.fi/sites/default/files/2021-01/Ethical_review_in_human_sciences_2020.pdf">https://tenk.fi/sites/default/files/2021-01/Ethical_review_in_human_sciences_2020.pdf</ext-link></comment></nlm-citation></ref><ref id="ref48"><label>48</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>R&#x00E4;ih&#x00E4;</surname><given-names>K</given-names> </name><name name-style="western"><surname>Asikainen</surname><given-names>H</given-names> </name><name name-style="western"><surname>Katajavuori</surname><given-names>N</given-names> </name></person-group><article-title>Changes in university students&#x2019; behaviour and study burnout risk during ACT-based online course intervention: a mixed methods study</article-title><source>J Contextual Behav Sci</source><year>2024</year><month>10</month><volume>34</volume><fpage>100845</fpage><pub-id pub-id-type="doi">10.1016/j.jcbs.2024.100845</pub-id></nlm-citation></ref><ref id="ref49"><label>49</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>Katajavuori</surname><given-names>N</given-names> </name><name name-style="western"><surname>Vehkalahti</surname><given-names>K</given-names> </name><name name-style="western"><surname>Asikainen</surname><given-names>H</given-names> </name></person-group><article-title>Promoting university students&#x2019; well-being and studying with an acceptance and commitment therapy (ACT)-based intervention</article-title><source>Curr Psychol</source><year>2023</year><month>02</month><volume>42</volume><issue>6</issue><fpage>4900</fpage><lpage>4912</lpage><pub-id pub-id-type="doi">10.1007/s12144-021-01837-x</pub-id></nlm-citation></ref><ref id="ref50"><label>50</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>Howell</surname><given-names>AJ</given-names> </name><name name-style="western"><surname>Passmore</surname><given-names>HA</given-names> </name></person-group><article-title>Acceptance and commitment training (ACT) as a positive psychological intervention: a systematic review and initial meta-analysis regarding ACT&#x2019;s role in well-being promotion among university students</article-title><source>J Happiness Stud</source><year>2019</year><month>08</month><volume>20</volume><issue>6</issue><fpage>1995</fpage><lpage>2010</lpage><pub-id pub-id-type="doi">10.1007/s10902-018-0027-7</pub-id></nlm-citation></ref><ref id="ref51"><label>51</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>Viskovich</surname><given-names>S</given-names> </name><name name-style="western"><surname>Pakenham</surname><given-names>KI</given-names> </name></person-group><article-title>Randomized controlled trial of a web-based Acceptance and Commitment Therapy (ACT) program to promote mental health in university students</article-title><source>J Clin Psychol</source><year>2020</year><month>06</month><volume>76</volume><issue>6</issue><fpage>929</fpage><lpage>951</lpage><pub-id pub-id-type="doi">10.1002/jclp.22848</pub-id><pub-id pub-id-type="medline">31468528</pub-id></nlm-citation></ref><ref id="ref52"><label>52</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>M&#x00E4;kikangas</surname><given-names>A</given-names> </name><name name-style="western"><surname>Kinnunen</surname><given-names>U</given-names> </name></person-group><article-title>The person-oriented approach to burnout: a systematic review</article-title><source>Burn Res</source><year>2016</year><month>03</month><volume>3</volume><issue>1</issue><fpage>11</fpage><lpage>23</lpage><pub-id pub-id-type="doi">10.1016/j.burn.2015.12.002</pub-id></nlm-citation></ref><ref id="ref53"><label>53</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>Hayes</surname><given-names>SC</given-names> </name><name name-style="western"><surname>Hofmann</surname><given-names>SG</given-names> </name><name name-style="western"><surname>Stanton</surname><given-names>CE</given-names> </name><etal/></person-group><article-title>The role of the individual in the coming era of process-based therapy</article-title><source>Behav Res Ther</source><year>2019</year><month>06</month><volume>117</volume><fpage>40</fpage><lpage>53</lpage><pub-id pub-id-type="doi">10.1016/j.brat.2018.10.005</pub-id><pub-id pub-id-type="medline">30348451</pub-id></nlm-citation></ref><ref id="ref54"><label>54</label><nlm-citation citation-type="journal"><person-group person-group-type="author"><name name-style="western"><surname>Ciarrochi</surname><given-names>J</given-names> </name><name name-style="western"><surname>Sahdra</surname><given-names>B</given-names> </name><name name-style="western"><surname>Hofmann</surname><given-names>SG</given-names> </name><name name-style="western"><surname>Hayes</surname><given-names>SC</given-names> </name></person-group><article-title>Developing an item pool to assess processes of change in psychological interventions: the Process-Based Assessment Tool (PBAT)</article-title><source>J Contextual Behav Sci</source><year>2022</year><month>01</month><volume>23</volume><fpage>200</fpage><lpage>213</lpage><pub-id pub-id-type="doi">10.1016/j.jcbs.2022.02.001</pub-id></nlm-citation></ref></ref-list><app-group><supplementary-material id="app1"><label>Checklist 1</label><p>GRAMMS checklist.</p><media xlink:href="resprot_v15i1e84729_app1.docx" xlink:title="DOCX File, 15 KB"/></supplementary-material></app-group></back></article>