Stress and Recovery


The COVID-19 pandemic reflects a unique natural experimental condition where frontline workers are exposed to substantial stress. Their on shift time provides a naturally occurring “stress on” period, and their off shift time provides a “stress off” period and an opportunity to follow an individual's recovery from stress. The goal of the Stress and Recovery study was to determine the feasibility of tracking “digital stress responses” to benefit frontline workers in the future in the development of tools that might offer early warning signs of risky health states.

Description of the study:

The Stress and Recovery study is a Bill and Melinda Gates Foundation funded feasibility cohort study aimed at informing better understanding of individual stress responses and recovery from stress and the impact of the COVID-19 pandemic on frontline healthcare workers. This study launched in May, 2020 and was completed in Nov, 2020 and enrolled 365 frontline healthcare workers ranging from medical doctors to registered nurses recruited digitally through a variety of social media outlets and email notifications through medical based organizations such as the Mayo Clinic and the American Nurses Association. This study used the Oura smart ring, (worn off-shift) to collect semi-continuous passive and intermittent active biometric measurements alongside daily to monthly surveys and active tasks completed from a study smartphone app for 4-6 months. Some participants completed sub-arms involving a choice of a 4-week lifestyle intervention (exercise vs meditation), providing a hair sample for cortisol analysis, and the continuous wear of a Garmin smartwatch (worn on shift) for 4-weeks.

Size and Timing:
365 frontline healthcare workers. Participants were enrolled over a 4 month period, and followed for 4-6 months.

4YouandMe and Bill and Melinda Gates Foundation

Clinical Partner(s):
Virtual study not associated with a particular institution.

Coalition and Collaboration Partners:
Evidation Health, Vector Institute, Cambridge Cognition, and the Center for International Emergency Medical Services (CIEMS).