ORIGINAL RESEARCH article
Front. Public Health
Sec. Occupational Health and Safety
This article is part of the Research TopicNew Perspectives in Workplace Safety and Employee Well-Being in the Age of Technology, Sustainability, and DigitalizationView all 6 articles
HRV-based Workplace Consultation for Managers: A randomized controlled trial on enhancing biopsychosocial awareness and reducing perceived stress
Provisionally accepted
Elisabeth Maria Balint1,2,3,4*
Christin Braun1
Charlotte Muemken1Franziska Kessemeier2,5
Thomas Buckley6Eva Katharina Urban7Falko Papenfuss7
Harald Gündel1,2
Marc N. Jarczok1- 1Universitatsklinikum Ulm Klinik fur Psychosomatische Medizin und Psychotherapie, Ulm, Germany
- 2Leadership Personality Center Ulm (LPCU), Universitat Ulm, Ulm, Germany
- 3Privatklinik Meiringen AG, Meiringen, Switzerland
- 4Universitat Bern, Bern, Switzerland
- 5Universitat Witten/Herdecke, Witten, Germany
- 6The University of Sydney School of Medicine, Sydney, Australia
- 7Robert Bosch GmbH, Gerlingen-Schillerhöhe, Germany
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Abstract Effective tools are needed to communicate the biopsychosocial model of health at the workplace, emphasizing the interplay between mind, body, and environment. A 24-hour heart rate variability (HRV) spectrogram, combined with a diary, was used to provide individualized feedback on these interactions. One hundred managers from a manufacturing and engineering company in Southern Germany were randomized into an intervention (IG) or control group (CG). The IG underwent a 24-hour ECG measurement, documented daily events, and completed questionnaires. These data informed a 50-minute consultation, focusing on the connection between emotions, thoughts, recorded situations, and HRV. Questionnaires were repeated after three months. Changes in the primary outcome—awareness of biopsychosocial interactions—were analysed using repeated-measures ANOVA. Data from 81 participants were included in the final analysis. Participants (94% male, mean ±SD age 48±8.6 years) in the IG reported significantly increased awareness of mind-body interactions (p=0.032, η²=0.057) and were more likely to respond to their body's needs (p=0.008, η²=0.085). Perceived stress was significantly reduced only in the IG (p=0.017, η²=0.071). This approach, integrating HRV visualization with diary-based reflection, proved to be a feasible and effective method for enhancing awareness of biopsychosocial processes, supporting self-regulation, promoting behavioural change and reducing perceived stress in occupational settings.
Keywords: biofeedback, Heart rate variability, managers, Primary Prevention, psychosomatic, Self-regulation, stress management, Workplace health
Received: 17 Sep 2025; Accepted: 09 Dec 2025.
Copyright: © 2025 Balint, Braun, Muemken, Kessemeier, Buckley, Urban, Papenfuss, Gündel and Jarczok. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Elisabeth Maria Balint
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