ThriveCircles for Well-Being at CU SOM

The ThriveCircle Study is a pragmatic, hybrid Type 1 effectiveness-implementation project designed to evaluate a structured yet self-facilitated small-group program intended to improve well-being among faculty at the University of Colorado School of Medicine (CU SOM). The initiative adapts core elements from previous peer-support interventions-most notably the COMPASS model-into a format optimized for scalability, flexibility across faculty roles, and sustainable integration into institutional culture.

Study Purpose and Rationale Clinician and scientist burnout continues to rise nationally, with consequences that extend beyond individual distress to workforce instability, increased turnover intention, and patient-safety risks. Existing evidence highlights the potential of relational, community-building interventions to reduce emotional exhaustion and depersonalization and to increase professional fulfillment. However, most prior studies were conducted before 2024, in resource-intensive facilitated formats, or without examining broader outcomes such as sense of belonging, self-valuation, or imposter phenomenon.

ThriveCircle seeks to address these gaps by evaluating a contemporary, low-resource, peer-led model that emphasizes social connection, reflective dialogue, and collegial support. The program integrates commensality (shared meals), which has demonstrated additional benefit in prior studies by lowering barriers to participation and promoting trust and engagement.

Intervention Model ThriveCircle consists of six structured small-group sessions delivered over six months. Groups include approximately 6-8 faculty members and are self-facilitated by a participant who receives basic orientation and a standardized guide. The curriculum centers on meaning in work, professional identity, collegial connection, and shared challenges, with optional adaptations for scientists and for specific professional cultures. Sessions are held in person and incorporate shared meals to support accessibility and sociability.

The intervention is "light-touch," requiring minimal external facilitation, and is designed to be portable across diverse academic units. The study includes a wait-list crossover structure to ensure all participants experience the program while enabling comparative analysis of early versus delayed exposure.

Study Structure and Flow Participants complete surveys at baseline, 6 months, 9 months, and 12 months to assess changes in well-being, relational factors, and other constructs relevant to burnout and professional fulfillment. Throughout the intervention period, groups maintain attendance logs and brief session check-ins documenting fidelity to core elements and any adaptations made to improve fit.

Qualitative components-including facilitator debriefs and a purposive sample of participant interviews-provide insight into mechanisms of action, contextual influences, barriers and facilitators of engagement, and perspectives on long-term sustainment.

The design acknowledges both individual-level and group-level processes. Participants are nested within groups, and analyses account for clustering and heterogeneity across departments, faculty roles, and career stages.

Implementation Evaluation To complement the assessment of effectiveness, the study incorporates a structured implementation evaluation using principles from the RE-AIM framework.

Qualitative and Mixed-Methods Components The qualitative strategy includes semi-structured interviews with facilitators and selected participants, designed to explore lived experience within circles, perceived benefits, suggestions for improvement, and contextual factors shaping group dynamics. Adaptations made during the program, team cohesion elements, perceived psychological safety, and reflections on professional meaning serve as central thematic domains. Analyses use iterative coding, triangulation, and integration with quantitative findings to enhance explanatory understanding.

Intervention Environment and Support Structure The study is situated within CU SOM's broader well-being strategy. Facilitators receive orientation, session materials, scheduling resources, and administrative support. Meal reimbursement and modest facilitator incentives support feasibility. A turnkey toolkit-including discussion guides, fidelity checklists, scheduling templates, reimbursement workflows, and adaptation logs-supports standardized yet flexible implementation.

Study staff provide ongoing communication, troubleshoot logistical issues, and monitor fidelity through routine check-ins. While groups are largely autonomous, this infrastructure promotes consistency and ensures adherence to core program components.

Data Handling and Confidentiality Practices Data collection uses secure, encrypted institutional platforms, with restricted access for authorized study personnel. Identifiers are stored separately from response data, and participant confidentiality is emphasized in both surveys and group settings. No clinical records or health information are collected. As part of institutional well-being initiatives, coded identifiers may be shared with an external survey vendor to link participation with existing biennial faculty well-being survey datasets; only de-identified data return to investigators.

Safety Considerations The intervention is non-clinical and low risk. Sessions involve reflective dialogue, which may occasionally evoke discomfort or emotional reactions. Facilitators are trained to recognize distress and direct participants to appropriate institutional resources. Adverse events-though unlikely-are documented according to institutional standards, with prompt reporting of unanticipated problems.

Participants may withdraw consent or discontinue group participation at any time. Group-level issues (e.g., persistent conflict) may prompt restructuring or, rarely, discontinuation of a circle, with continued follow-up for research purposes when appropriate.

Overall Significance The ThriveCircle Study aims to contribute rigorous, contemporary evidence on peer-led approaches to addressing burnout among faculty in academic medical centers. By pairing effectiveness testing with implementation evaluation, the project will inform scalable, sustainable strategies for promoting well-being, belonging, and retention in health sciences environments. The findings will also contribute to national conversations on how institutions can support clinicians and scientists through relational and community-based approaches rather than relying solely on individual-level interventions.

• Patient Reported Outcomes Measurement Information System (PROMIS) Short Form v2.0 Social Isolation 4a scale [Time frame: From enrollment to the end of the intervention at 6 months and follow-up at 9 months and 12 months.]
• Belonging (Investigator developed) [Time frame: From enrollment to end of intervention at 6 months and follow-up at 9 months and 12 months.]
• Stanford Professional Fulfillment Index [Time frame: Fulfillment subscale: from enrollment to end of intervention at 6 months and follow-up at 9 months and 12 months. Work exhaustion and interpersonal disengagement subscales: collected at 12 months.]
• Stanford Self-Valuation Scale [Time frame: From enrollment to end of intervention at 6 months and follow-up at 9 months and 12 months.]
• 4-item version of the Clance Imposter Phenomenon Scale [Time frame: Enrollment to post intervention at 6 months and follow-up at 9 months and 12 months.]
• Self-Reported Intent to leave [Time frame: Collected at enrollment and 12 months]