Abstract
Engagement reflects cognitive, emotional, and behavioral investment at work. For senior health care leaders, it is pivotal in shaping culture, morale, and patient experiences, yet remains difficult to elevate amid competing demands. Evidence-based engagement interventions are rare in health care. As a psychological construct, mental toughness (MT) training builds resilience, focus, and confidence, offering leaders tools to persist under pressure and manage competing priorities. Such training may strengthen engagement helping leaders affirm purpose, voice concerns, and build resilience. PURPOSE: To test whether higher attendance (“dose”) in weekly sessions predicted greater engagement gains in senior health care leaders. METHODS: A purposive sample of 12 UofL Health leaders completed six weekly, two-hour MT sessions with topics matched to established subscales. Leaders completed the Mental Toughness Index (MTI) and Employee Engagement Scale (EES; total & subscales) at each session. Within-person change from baseline was modeled using ordinary least squares regression, including both session number and concurrent MT as predictors. Analyses incorporated cluster-robust standard errors by person, cluster bootstrap confidence intervals (2,000 resamples), leave-one-out (LOPO) checks, and permutation testing. RESULTS: Each additional prior session was associated with a +1.49-point increase in engagement (bootstrap 95% CI [+0.53, +2.39]); permutation p ≈ .0005; LOPO analyses were consistently positive. Practically, attending five versus two sessions predicted ≈ +4–5 EES points, suggesting meaningful engagement differences based on attendance. CONCLUSION: Attendance-dependent gains were consistent across small-N safeguards (bootstrap, LOPO, permutation). While exploratory, findings show structured programs can enhance leader engagement when attendance is consistent. Improved leader engagement may cascade to staff and patient care, offering a strategic pathway for sustainable workforce outcomes. Results support sustaining the program and prioritizing conditions that enable full attendance. Future studies should link leader engagement gains to workforce performance, staff well-being, and patient outcomes.
Recommended Citation
Cavan, Spencer A. and Stamatis, Andreas Dr.
(2025)
"Engagement of Senior Leaders in Health Care Increases With Program Participation,"
International Journal of Exercise Science: Conference Proceedings: Vol. 15:
Iss.
7, Article 1.
Available at:
https://digitalcommons.wku.edu/ijesab/vol15/iss7/1