Focusing on Close Relationships Associated With Improved Outcomes in a Workplace Gratitude Randomized Controlled Trial

Objective Gratitude programs may improve well-being among health care workers, but it is unknown whether the content of practices matters. Methods We conducted a text-based randomized controlled trial of “Three Good Things” (3GT) in a large academic primary care department. Participants responded to texts thrice weekly for 3 weeks and listed good things that happened that day. We measured depression, positive affect, gratitude, and life satisfaction for “immediate intervention” and “delayed” intervention groups. We coded >4600 entries and used multivariable regression to control for department age, role, and gender to see if content affected well-being. Results A total of 223 of 468 individuals (48%) enrolled. Close relationships and identifying valuable people in one's life were associated with the strongest benefits, but not all “good things” improved outcomes. Conclusions Focusing gratitude on relationships may be most impactful.