BACKGROUND The COVID-19 pandemic yielded extraordinary stressors and well-being challenges for physicians. OBJECTIVE We sent light-touch SMS messages to improve well-being in Ontario physicians and sought to determine which types of messages were most effective. METHODS We conducted a randomized longitudinal study with three trial arms for comparison of changes. All residents and practicing physician members of the Ontario Medical Association with available mobile numbers were randomly assigned to a trial arm: messages with well-being resources, stories from fellow Ontario physicians, or combined resources and stories. Baseline and endline data were collected through online surveys primarily using the short Warwick-Edinburgh Mental Wellbeing Scale, with single-item ‘pulse surveys’ delivered via SMS weekly through the intervention. RESULTS 3,356 and 1,230 participants completed the baseline and endline surveys, respectively. Of these, 614 participants also completed the endline survey and were included in our analyses. There were no significant differences in well-being, happiness, anxiety, life satisfaction, or worthwhileness across treatment groups, nor in how helpful participants found the messages. Participants in the resources-only trial arm were more likely (p=0.036) to report reading the messages compared to members in other groups. CONCLUSIONS Texts with stories from peer physicians and referral to well-being resources alone or in combination were not superior to each other in improving physicians’ well-being. Our findings support the notion that interventions focused on individual physicians alone are unlikely to address poor well-being and burnout among physicians. Further research is needed on the use of digital-based interventions in relation to well-being and burnout, particularly as health human resource well-being and sustainability are key to post-pandemic recovery efforts. CLINICALTRIAL ClinicalTrials.gov NCT04803812
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