To address this issue, we are proud to introduce WellMe, a wellbeing and resilience application specifically designed to promote resilience-building behaviors and prevent burnout among Frontline Workers. While there is strong evidence that resilience is a learned skill that can prevent burnout, the feasibility and acceptability of using a mobile application to improve Frontline Worker resilience needs to be tested. In this post, we outline our theory of change for WellMe and discuss our plan to pilot the platform with 1200 Frontline Workers in the coming year. As part of our commitment to openly learning and sharing, this is the first in a series of posts in which we will report our findings and feedback from Frontline Workers throughout this year-long process.
What is Resilience, and Why Does it Matter?
Resilience can be likened to the roots of a tree, which are designed to burrow deep into the ground until a storm subsides, enabling the tree to remain standing tall even after being bent by strong winds. According to The Resilience Collaborative, resilience is “the acquired ability to recover, adapt, and grow in response to stress”. In other words, resilience is the learned ability to successfully manage stress.
Because it helps with stress management, building an individual’s resilience is an effective preventative skill against burnout. By preventing burnout, we hope to enhance the quality of Frontline Workers’ jobs, and consequently boost workforce retention, and improve community outcomes. This aligns with Dimagi’s strategic priority of improving Frontline Worker jobs to improve outcomes. While we are focused on building individual resilience, we understand that this is only part of the story: there are many systems-level factors that contribute to Frontline Worker burnout that are also important to address.
Watch a Demo of WellMe
(Click below for a video demo of WellMe)
WellMe is a mobile application built on Dimagi’s platform CommCare, the most widely-deployed digital platform for enabling Frontline Workers. The content in WellMe includes a combination of the Resilience Collaborative’s Resilience Message Program and original content that was developed in consultation with a resilience expert. Content is organized according to The Resilience Collaborative’s framework for building resilience– detailed in their toolkit for building health worker resilience to protect against burnout on the front lines– which centers around building five core and two supporting behaviors that are shown to increase resilience. The examples below illustrate how these behaviors are taught using the application through a combination of learning and practice activities such as:
Engage in stress management: Take a short validated survey to understand your perceived stress level.
Practice mindfulness and relaxation: Take a few minutes to relax by closing your eyes and listening to an audio recording of forest sounds.
Engage in essential self-care: After completing lessons about self-care, take a quiz to reinforce what you’ve learned about building a self-care practice.
Connect to purpose: Write a journal entry about your future self, imagining that it’s one year from now. What are you doing in your life? What are the things you value? a) Seek growth: Watch a video to learn how to set goals for yourself.
Connect with others: Set a micro-goal to reconnect with a friend or loved one you haven’t spoken to in a while. a) Seek further support when needed: Complete a lesson to learn about the importance of building your support system so they can help you in tough times.
How was WellMe Designed?
Although WellMe is being launched now, it is the culmination of nearly three years of formative work on resilience with Frontline Workers and partners. Dimagi’s work on resilience began in 2020 after receiving funding from the Johnson & Johnson Foundation Center for Health Worker Innovation to participate in The Resilience Collaborative Community of Practice. As part of this consortium of organizations, Dimagi helped to develop and test the Resilience Message Program: an evidence-based, free, and adaptable set of messages designed to increase health worker resilience.
Our theory of change is that WellMe is a cost-effective intervention to improve the resilience and wellbeing of Frontline Workers, which will in turn improve Frontline Worker retention, and lead to better outcomes for the communities they serve. To validate this theory of change, we believe it is important to test the following hypotheses:
Substantial use of WellMe will increase Frontline Worker resilience and wellbeing: Regular engagement with the WellMe application will lead to an increase in the resilience and wellbeing levels of Frontline Workers, as indicated by the analysis of application usage data and validated measures for resilience (Brief Resilience Scale) and wellbeing (WHO-5 Well-being Index).
We can foster use of WellMe by Frontline Workers: Although some Frontline Workers may be intrinsically motivated to utilize the application, cost-effective external motivators (such as financial incentives or organizational support like manager check ins or peer learning groups) can increase the number of Frontline Workers that substantially engage with the application.
Improved resilience and wellbeing will improve Frontline Worker retention: By improving Frontline Workers’ resilience and wellbeing, we expect to see a decrease in burnout, which is a significant driver of attrition. This, in turn, will lead to improved retention rates among Frontline Workers.
Improved resilience and wellbeing will improve outcomes for the communities Frontline Workers serve: Burnout can result in a decrease in professional effectiveness. By promoting resilience and wellbeing, we can prevent burnout in Frontline Workers, leading to an improvement in service delivery and outcomes for the communities they serve.
While all four hypotheses are important, only the first two are provable in the short-term, with the last two requiring multi-year and large-scale studies. In 2023, our priority is testing the first two hypotheses through a series of pilot studies, with a total of 1200 frontline workers.
The ability of individual Frontline Workers to manage stress and prevent burnout is crucial for the wellbeing of Frontline Workers and the communities they serve. Ultimately, we hope to enable individual improvements in resilience at scale through the WellMe platform. In 2023, Dimagi will conduct pilot studies to test two hypotheses: (1) that substantial use of WellMe will enhance Frontline Worker resilience and wellbeing, and (2) that we can foster use of the WellMe platform. These pilot studies will provide valuable insights for the development of future versions of WellMe and contribute to research on digital resilience interventions for Frontline Workers. Building on feedback and evidence from our pilots, we hope to lay the groundwork for making WellMe available to Frontline Workers at scale across LMICs.
Apply for a Free Trial of WellMe
Dimagi is offering a limited number of organizations a free trial of WellMe. Organizations selected for the trial will receive a three-month subscription to WellMe, in-person deployment support, workforce orientation, technical support from the Dimagi team, and incentives for Frontline Workers. WellMe is powered by Dimagi’s flagship product CommCare and must be run on an Android phone. To get in touch with the WellMe team, you can write to us at firstname.lastname@example.org.