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Remskar M, Western MJ, Ainsworth B. Mindfulness improves psychological health and supports health behaviour cognitions: Evidence from a pragmatic RCT of a digital mindfulness-based intervention. Br J Health Psychol 2024. [PMID: 39169217 DOI: 10.1111/bjhp.12745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 08/08/2024] [Indexed: 08/23/2024]
Abstract
BACKGROUND Mindfulness-based interventions can improve psychological health; yet the mechanisms of change are underexplored. This pre-registered remote RCT evaluated a freely accessible digital mindfulness programme aiming to improve well-being, mental health and sleep quality. Health behaviour cognitions were explored as possible mediators. METHODS Participants from 91 countries (N = 1247, Mage = 27.03 [9.04]) were randomized to 30 days of mindfulness practice or attention-matched control condition. Measures of well-being, depression, anxiety, stress, sleep quality, barriers self-efficacy, self-regulation and behavioural predictors (e.g., attitudes and behavioural intentions) were taken at baseline, 1-month (post-intervention) and 2-months (follow-up). Linear regression examined intervention effects between and within groups. Longitudinal mediation analyses explored indirect effects through health behaviour cognitions. RESULTS Three hundred participants completed post-intervention measures. Those receiving mindfulness training reported significantly better well-being (Mdifference = 2.34, 95%CIs .45-4.24, p = .016), lower depression (Mdifference = -1.47, 95%CIs -2.38 to -.56, p = .002) and anxiety symptoms (Mdifference = -.77, 95%CIs -1.51 to -.02, p = .045) than controls. Improvements in well-being and depression were maintained at follow-up. Intervention effects on primary outcomes were mediated by attitudes towards health maintenance and behavioural intentions. Mediating effects of attitudes remained when controlling for prior scores in models of depression and well-being. CONCLUSIONS Digital, self-administered mindfulness practice for 30 days meaningfully improved psychological health, at least partially due to improved attitudes towards health behaviours and stronger behavioural intentions. This trial found that digital mindfulness is a promising and scalable well-being tool for the general population, and highlighted its role in supporting health behaviours.
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Affiliation(s)
- Masha Remskar
- Bath Centre for Mindfulness and Community, Department of Psychology, University of Bath, Bath, UK
- Centre for Motivation and Health Behaviour Change, Department for Health, University of Bath, Bath, UK
| | - Max J Western
- Centre for Motivation and Health Behaviour Change, Department for Health, University of Bath, Bath, UK
| | - Ben Ainsworth
- School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
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Cho A, Cha C, Baek G. Development of an Artificial Intelligence-Based Tailored Mobile Intervention for Nurse Burnout: Single-Arm Trial. J Med Internet Res 2024; 26:e54029. [PMID: 38905631 PMCID: PMC11226930 DOI: 10.2196/54029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 12/21/2023] [Accepted: 05/07/2024] [Indexed: 06/23/2024] Open
Abstract
BACKGROUND Nurse burnout leads to an increase in turnover, which is a serious problem in the health care system. Although there is ample evidence of nurse burnout, interventions developed in previous studies were general and did not consider specific burnout dimensions and individual characteristics. OBJECTIVE The objectives of this study were to develop and optimize the first tailored mobile intervention for nurse burnout, which recommends programs based on artificial intelligence (AI) algorithms, and to test its usability, effectiveness, and satisfaction. METHODS In this study, an AI-based mobile intervention, Nurse Healing Space, was developed to provide tailored programs for nurse burnout. The 4-week program included mindfulness meditation, laughter therapy, storytelling, reflective writing, and acceptance and commitment therapy. The AI algorithm recommended one of these programs to participants by calculating similarity through a pretest consisting of participants' demographics, research variables, and burnout dimension scores measured with the Copenhagen Burnout Inventory. After completing a 4-week program, burnout, job stress, stress response using the Stress Response Inventory Modified Form, the usability of the app, coping strategy by the coping strategy indicator, and program satisfaction (1: very dissatisfied; 5: very satisfied) were measured. The AI recognized the recommended program as effective if the user's burnout score reduced after the 2-week program and updated the algorithm accordingly. After a pilot test (n=10), AI optimization was performed (n=300). A paired 2-tailed t test, ANOVA, and the Spearman correlation were used to test the effect of the intervention and algorithm optimization. RESULTS Nurse Healing Space was implemented as a mobile app equipped with a system that recommended 1 program out of 4 based on similarity between users through AI. The AI algorithm worked well in matching the program recommended to participants who were most similar using valid data. Users were satisfied with the convenience and visual quality but were dissatisfied with the absence of notifications and inability to customize the program. The overall usability score of the app was 3.4 out of 5 points. Nurses' burnout scores decreased significantly after the completion of the first 2-week program (t=7.012; P<.001) and reduced further after the second 2-week program (t=2.811; P=.01). After completing the Nurse Healing Space program, job stress (t=6.765; P<.001) and stress responses (t=5.864; P<.001) decreased significantly. During the second 2-week program, the burnout level reduced in the order of participation (r=-0.138; P=.04). User satisfaction increased for both the first (F=3.493; P=.03) and second programs (F=3.911; P=.02). CONCLUSIONS This program effectively reduced burnout, job stress, and stress responses. Nurse managers were able to prevent nurses from resigning and maintain the quality of medical services using this AI-based program to provide tailored interventions for nurse burnout. Thus, this app could improve qualitative health care, increase employee satisfaction, reduce costs, and ultimately improve the efficiency of the health care system.
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Affiliation(s)
- Aram Cho
- College of Nursing & Graduate Program in System Health Science and Engineering, Ewha Womans University, Seoul, Republic of Korea
| | - Chiyoung Cha
- College of Nursing & Graduate Program in System Health Science and Engineering, Ewha Womans University, Seoul, Republic of Korea
| | - Gumhee Baek
- College of Nursing & Graduate Program in System Health Science and Engineering, Ewha Womans University, Seoul, Republic of Korea
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Ledoux AA, Zemek R, Cairncross M, Silverberg N, Sicard V, Barrowman N, Goldfield G, Gray C, Harris AD, Jaworska N, Reed N, Saab BJ, Smith A, Walker L. Smartphone App-Delivered Mindfulness-Based Intervention for Mild Traumatic Brain Injury in Adolescents: Protocol for a Feasibility Randomized Controlled Trial. JMIR Res Protoc 2024; 13:e57226. [PMID: 38602770 PMCID: PMC11046387 DOI: 10.2196/57226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 02/27/2024] [Accepted: 03/04/2024] [Indexed: 04/12/2024] Open
Abstract
BACKGROUND Concussion in children and adolescents is a significant public health concern, with 30% to 35% of patients at risk for prolonged emotional, cognitive, sleep, or physical symptoms. These symptoms negatively impact a child's quality of life while interfering with their participation in important neurodevelopmental activities such as schoolwork, socializing, and sports. Early psychological intervention following a concussion may improve the ability to regulate emotions and adapt to postinjury symptoms, resulting in the greater acceptance of change; reduced stress; and recovery of somatic, emotional, and cognitive symptoms. OBJECTIVE The primary objective of this study is to assess the feasibility of conducting a parallel-group (1:1) randomized controlled trial (RCT) to evaluate a digital therapeutics (DTx) mindfulness-based intervention (MBI) in adolescents aged 12 to <18 years. The attention-matched comparator intervention (a math game also used in previous RCTs) will be delivered on the same DTx platform. Both groups will be provided with the standard of care guidelines. The secondary objective is to examine intervention trends for quality of life; resilience; self-efficacy; cognition such as attention, working memory, and executive functioning; symptom burden; and anxiety and depression scores at 4 weeks after concussion, which will inform a more definitive RCT. A subsample will be used to examine whether those randomized to the experimental intervention group have different brain-based imaging patterns compared with those randomized to the control group. METHODS This study is a double-blind Health Canada-regulated trial. A total of 70 participants will be enrolled within 7 days of concussion and randomly assigned to receive the 4-week DTx MBI (experimental group) or comparator intervention. Feasibility will be assessed based on the recruitment rate, treatment adherence to both interventions, and retention. All outcome measures will be evaluated before the intervention (within 7 days after injury) and at 1, 2, and 4 weeks after the injury. A subset of 60 participants will undergo magnetic resonance imaging within 72 hours and at 4 weeks after recruitment to identify the neurophysiological mechanisms underlying the potential benefits from MBI training in adolescents following a concussion. RESULTS The recruitment began in October 2022, and the data collection is expected to be completed by September 2024. Data collection and management is still in progress; therefore, data analysis is yet to be conducted. CONCLUSIONS This trial will confirm the feasibility and resolve uncertainties to inform a future definitive multicenter efficacy RCT. If proven effective, a smartphone-based MBI has the potential to be an accessible and low-risk preventive treatment for youth at risk of experiencing prolonged postconcussion symptoms and complications. TRIAL REGISTRATION ClinicalTrials.gov NCT05105802; https://classic.clinicaltrials.gov/ct2/show/NCT05105802. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/57226.
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Affiliation(s)
- Andrée-Anne Ledoux
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
- Department of Cellular Molecular Medicine, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
- School of Psychology, Faculty of Social Sciences, University of Ottawa, Ottawa, ON, Canada
- University of Ottawa Brain and Mind Research Institute, University of Ottawa, Ottawa, ON, Canada
| | - Roger Zemek
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
- University of Ottawa Brain and Mind Research Institute, University of Ottawa, Ottawa, ON, Canada
- Department of Pediatrics, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Molly Cairncross
- Department of Psychology, Simon Fraser University, Burnaby, BC, Canada
- BC Children's Hospital Research Institute, Vancouver, BC, Canada
| | - Noah Silverberg
- BC Children's Hospital Research Institute, Vancouver, BC, Canada
- Department of Psychology, University of British Columbia, Vancouver, BC, Canada
- Rehabilitation Research Program, Centre for Aging SMART, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada
| | - Veronik Sicard
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
| | - Nicholas Barrowman
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
| | - Gary Goldfield
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
- School of Psychology, Faculty of Social Sciences, University of Ottawa, Ottawa, ON, Canada
- University of Ottawa Brain and Mind Research Institute, University of Ottawa, Ottawa, ON, Canada
- Department of Pediatrics, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Clare Gray
- Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
- Department of Psychiatry, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Ashley D Harris
- Department of Radiology, Hotchkiss Brain Institute, Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
| | - Natalia Jaworska
- Department of Cellular Molecular Medicine, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
- University of Ottawa Brain and Mind Research Institute, University of Ottawa, Ottawa, ON, Canada
- Royal Ottawa Mental Health Centre, Ottawa, ON, Canada
| | - Nick Reed
- Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto, ON, Canada
| | | | - Andra Smith
- School of Psychology, Faculty of Social Sciences, University of Ottawa, Ottawa, ON, Canada
- University of Ottawa Brain and Mind Research Institute, University of Ottawa, Ottawa, ON, Canada
| | - Lisa Walker
- School of Psychology, Faculty of Social Sciences, University of Ottawa, Ottawa, ON, Canada
- University of Ottawa Brain and Mind Research Institute, University of Ottawa, Ottawa, ON, Canada
- The Ottawa Hospital, Ottawa, ON, Canada
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O'Kane KMK, Otamendi T, Silverberg ND, Choi E, Sicard V, Zemek R, Healey K, Brown O, Butterfield L, Smith A, Goldfield G, Kardish R, Saab BJ, Ledoux AA, Cairncross M. Development of Therapeutic Alliance and Social Presence in a Digital Intervention for Pediatric Concussion: Qualitative Exploratory Study. JMIR Form Res 2024; 8:e49133. [PMID: 38517472 PMCID: PMC10998177 DOI: 10.2196/49133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 01/28/2024] [Accepted: 01/29/2024] [Indexed: 03/23/2024] Open
Abstract
BACKGROUND Despite the promising benefits of self-guided digital interventions for adolescents recovering from concussion, attrition rates for such interventions are high. Evidence suggests that adults can develop therapeutic alliance with self-guided digital interventions, which is in turn associated with intervention engagement. However, no research has examined whether adolescents develop therapeutic alliance with self-guided digital interventions and what factors are important to its development. Additionally, social presence-the extent to which digital encounters feel like they are occurring in person-may be another relevant factor to understanding the nature of the connection between adolescents and a self-guided digital intervention, though this has yet to be explored. OBJECTIVE This qualitative study explored the extent to which adolescents recovering from concussion developed therapeutic alliance and social presence during their use of a self-guided digital mindfulness-based intervention. Additionally, this study aimed to determine factors important to adolescents' development of therapeutic alliance and social presence with the intervention. METHODS Adolescents aged between 12 and 17.99 years who sustained a concussion were recruited from 2 sites: a pediatric emergency department up to 48 hours after a concussion and a tertiary care clinic over 1 month following a concussion to capture adolescents who had both acute and persisting symptoms after concussion. Participants (N=10) completed a 4-week mindfulness-based intervention delivered through a smartphone app. Within the app, participants listened to audio recordings of mindfulness guides (voice actors) narrating psychoeducation and mindfulness practices. At 4 weeks, participants completed questionnaires and a semistructured interview exploring their experience of therapeutic alliance and social presence with the mindfulness guides in the intervention. RESULTS Themes identified within the qualitative results revealed that participants developed therapeutic alliance and social presence by "developing a genuine connection" with their mindfulness guides and "sensing real people." Particularly important to the development of therapeutic alliance and social presence were the mindfulness guides' "personal backgrounds and voices," such that participants felt more connected to the guides by knowing information about them and through the guides' calm tone of voice in audio recordings. Quantitative findings supported qualitative results; participants' average score for therapeutic alliance was far above the scale midpoint, while the mixed results for social presence measures aligned with qualitative findings that participants felt that the mindfulness guides seemed real but not quite as real as an in-person connection would. CONCLUSIONS Our data suggest that adolescents can develop therapeutic alliance and social presence when using digital interventions with no direct human contact. Adolescents' development of therapeutic alliance and social presence with self-guided digital interventions can be bolstered by increasing human-like qualities (eg, real voices) within interventions. Maximizing therapeutic alliance and social presence may be a promising way to reduce attrition in self-guided digital interventions while providing accessible treatment.
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Affiliation(s)
- Kiarah M K O'Kane
- Department of Psychology, University of British Columbia, Vancouver, BC, Canada
| | - Thalia Otamendi
- Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada
| | - Noah D Silverberg
- Department of Psychology, University of British Columbia, Vancouver, BC, Canada
| | - Esther Choi
- Department of Psychology, University of British Columbia, Vancouver, BC, Canada
| | - Veronik Sicard
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
| | - Roger Zemek
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
- Department of Pediatrics and Emergency Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Katherine Healey
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
| | - Olivier Brown
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
- School of Psychology, Faculty of Social Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Lauren Butterfield
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
- Department of Neuroscience, Carleton University, Ottawa, ON, Canada
| | - Andra Smith
- School of Psychology, Faculty of Social Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Gary Goldfield
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
| | - Rachel Kardish
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
| | | | - Andrée-Anne Ledoux
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
- School of Psychology, Faculty of Social Sciences, University of Ottawa, Ottawa, ON, Canada
- Department of Neuroscience, Carleton University, Ottawa, ON, Canada
- Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Molly Cairncross
- Department of Psychology, Simon Fraser University, Burnaby, BC, Canada
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Finck C, Avila A, Jiménez-Leal W, Botero JP, Shambo D, Hernandez S, Reinoso-Carvalho F, Andonova V. A multisensory mindfulness experience: exploring the promotion of sensory awareness as a mindfulness practice. Front Psychol 2023; 14:1230832. [PMID: 38023042 PMCID: PMC10666737 DOI: 10.3389/fpsyg.2023.1230832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 10/09/2023] [Indexed: 12/01/2023] Open
Abstract
Objectives In this preliminary and multidisciplinary exploratory study, we assessed whether a mindfulness practice could be enhanced through a multisensory experience design that mimics the "beginner's mind," relying on sensory awareness and biofeedback processes as participants interact with the experience. Methods We piloted and designed two conditions, being (a) a guided mindfulness practice based on the senses as an anchor to the present moment, using audio instruction only; and (b) an experience of mindfulness practice with successive sensory stimulation (olfactory, audio, and visual stimulation) followed by an interactive experience with biofeedback that provides a visual representation of the person's heartbeat in real-time. For each of the conditions we assessed anxiety (state and trait), as well as other psychological variables pre- and post-experience. Additionally, we measured the heart rate variability (HRV) at baseline, during each stage of the experience as well as post intervention. Results We collected valid data for a total of 68 individuals. Both groups were similar regarding mean age, sex, and occupation and had similar prior experience with mindfulness. There were no significant differences regarding prior state or trait anxiety between the groups. Analysis of the physiological variables showed that for both groups there was an increase in the parasympathetic activity after the multisensory experience, with small differences in the conditions of stimulation. We did not observe significant differences between the pre and post measures for state of test anxiety. The observed parasympathetic activity variations after both experiences compared with pre and post-surveys demonstrate the importance of physiological vs psychological inspection beyond the common human rational experience that is not always resonate with the body's response and impacts the needed literacy to self-awareness of emotional well-being. Conclusion Participants in both conditions could effectively connect with the experience, while achieving a physiological response different from their baseline state. The acceptance of the designed stimuli was very high, although more research is still needed to uncover its full potential. In sum, the design of multisensory experiences using technology to create an interactive connection with the sensory stimulus, is a promising field in mindfulness and especially in practices involving sensory awareness through the monitoring of parasympathetic activity as an inference indicator of the present-moment connection.
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Affiliation(s)
- Carolyn Finck
- Department of Psychology, Faculty of Social Sciences, University of Los Andes, Bogotá, Colombia
| | - Alba Avila
- Department of Electrical and Electronics Engineering, Faculty of Engineering, University of Los Andes, Bogotá, Colombia
- Center for Microelectronics (CMUA), Faculty of Engenieering, University of Los Andes, Bogotá, Colombia
| | - William Jiménez-Leal
- Department of Psychology, Faculty of Social Sciences, University of Los Andes, Bogotá, Colombia
| | - Juan Pablo Botero
- Department of Biomedical Engineering, College of Engineering, University of Utah, Salt Lake City, UT, United States
| | - Daniel Shambo
- School of Management, University of Los Andes, Bogotá, Colombia
| | - Susana Hernandez
- Department of Psychology, Faculty of Social Sciences, University of Los Andes, Bogotá, Colombia
| | | | - Veneta Andonova
- School of Management, University of Los Andes, Bogotá, Colombia
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Davis JA, Ohan JL, Gregory S, Kottampally K, Silva D, Prescott SL, Finlay-Jones AL. Perinatal Women's Perspectives of, and Engagement in, Digital Emotional Well-Being Training: Mixed Methods Study. J Med Internet Res 2023; 25:e46852. [PMID: 37847537 PMCID: PMC10618893 DOI: 10.2196/46852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 07/30/2023] [Accepted: 08/22/2023] [Indexed: 10/18/2023] Open
Abstract
BACKGROUND Psychological distress in the early postpartum period can have long-lasting deleterious effects on a mother's well-being and negatively affect her infant's development. Intervention approaches based in contemplative practices such as mindfulness and loving-kindness and compassion are intended to alleviate distress and cultivate well-being and can be delivered effectively as digital mental health interventions (DMHIs). OBJECTIVE To understand the feasibility of engaging perinatal women in digital interventions, this study aimed to document participants' experiences in the Mums Minds Matter (MMM) study, a pilot randomized controlled trial comparing mindfulness, loving-kindness and compassion, and progressive muscle relaxation training delivered in a digital format and undertaken during pregnancy. To assess the different stages of engagement during and after the intervention, we adapted the connect, attend, participate, enact (CAPE) framework that is based on the idea that individuals go through different stages of engagement before they are able to enact change. METHODS The MMM study was nested within a longitudinal birth cohort, The ORIGINS Project. We aimed to recruit 25 participants per randomization arm. Data were collected sequentially during the intervention through regular web-based surveys over 8 weeks, with opportunities to provide regular feedback. In the postintervention phase, qualitative data were collected through purposive sampling. RESULTS Of 310 eligible women, 84 (27.1% [connect rate]) enrolled to participate in MMM. Of the remaining 226 women who did not proceed to randomization, 223 (98.7%) failed to complete the baseline surveys and timed out of eligibility (after 30 weeks' gestation), and 3 (1.3%) displayed high psychological distress scores. Across all program groups, 17 (20% [attend rate]) of the 84 participants actively opted out, although more may have disengaged from the intervention but did not withdraw. The main reasons for withdrawal were busy life and other priorities. In this study, we assessed active engagement and ongoing skills use (participate and enact) through postintervention interviews. We undertook 15 participant interviews, conducted 1 month to 3 months after the intervention. Our results provide insights into participant barriers and enablers as well as app changes, such as the ability to choose topics, daily reminders, case studies, and diversity in sounds. Implementing a DMHI that is brief, includes frequent prompts or nudges, and is easily accessible is a key strategy to target perinatal women. CONCLUSIONS Our research will enable future app designs that are sufficiently nuanced to maximize the uptake, engagement, and application of mental health skills and contemplative practices in the perinatal period. Providing convenient access to engaging and effective prevention programs is critical and should be part of prenatal self-care. Our research underscores the appeal and feasibility of digital intervention approaches based in contemplative practices for perinatal women. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry (ANZCTR) 12620000672954p; https://anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12620000672954p. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/19803.
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Affiliation(s)
- Jacqueline A Davis
- Telethon Kids Institute, Nedlands, Australia
- Medical School (Paediatrics), University of Western Australia, Crawley, Australia
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia
| | - Jeneva L Ohan
- Medical School (Paediatrics), University of Western Australia, Crawley, Australia
| | | | - Keerthi Kottampally
- Telethon Kids Institute, Nedlands, Australia
- Medical School (Paediatrics), University of Western Australia, Crawley, Australia
| | - Desiree Silva
- Telethon Kids Institute, Nedlands, Australia
- Medical School (Paediatrics), University of Western Australia, Crawley, Australia
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia
| | - Susan L Prescott
- Medical School (Paediatrics), University of Western Australia, Crawley, Australia
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia
- Nova Institute for Health, Baltimore, MD, United States
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Osborne EL, Ainsworth B, Hooper N, Atkinson MJ. Experiences of Using Digital Mindfulness-Based Interventions: Rapid Scoping Review and Thematic Synthesis. J Med Internet Res 2023; 25:e44220. [PMID: 37768709 PMCID: PMC10570895 DOI: 10.2196/44220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 07/05/2023] [Accepted: 08/01/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Digital mindfulness-based interventions (MBIs) are a promising approach to deliver accessible and scalable mindfulness training and have been shown to improve a range of health outcomes. However, the success of digital MBIs is reliant on adequate engagement, which remains a crucial challenge. Understanding people's experiences of using digital MBIs and identifying the core factors that facilitate or act as barriers to engagement is essential to inform intervention development and maximize engagement and outcomes. OBJECTIVE This study aims to systematically map the literature on people's experiences of using digital MBIs that target psychosocial variables (eg, anxiety, depression, distress, and well-being) and identify key barriers to and facilitators of engagement. METHODS We conducted a scoping review to synthesize empirical qualitative research on people's experiences of using digital MBIs. We adopted a streamlined approach to ensure that the evidence could be incorporated into the early stages of intervention development. The search strategy identified articles with at least one keyword related to mindfulness, digital, user experience, and psychosocial variables in their title or abstract. Inclusion criteria specified that articles must have a qualitative component, report on participants' experiences of using a digital MBI designed to improve psychosocial variables, and have a sample age range that at least partially overlapped with 16 to 35 years. Qualitative data on user experience were charted and analyzed using inductive thematic synthesis to generate understandings that go beyond the content of the original studies. We used the Quality of Reporting Tool to critically appraise the included sources of evidence. RESULTS The search identified 530 studies, 22 (4.2%) of which met the inclusion criteria. Overall, the samples were approximately 78% female and 79% White; participants were aged between 16 and 69 years; and the most used measures in intervention studies were mindfulness, psychological flexibility, and variables related to mental health (including depression, anxiety, stress, and well-being). All studies were judged to be adequately reported. We identified 3 themes characterizing barriers to and facilitators of engagement: responses to own practice (ie, negative reactions to one's own practice are common and can deplete motivation), making mindfulness a habit (ie, creating a consistent training routine is essential yet challenging), and leaning on others (ie, those engaging depend on someone else for support). CONCLUSIONS The themes identified in this review provide crucial insights as to why people frequently stop engaging with digital MBIs. Researchers and developers should consider using person-based coparticipatory methods to improve acceptability of and engagement with digital MBIs, increase their effectiveness, and support their translation to real-world use. Such strategies must be grounded in relevant literature and meet the priorities and needs of the individuals who will use the interventions.
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Affiliation(s)
| | - Ben Ainsworth
- Department of Psychology, University of Bath, Bath, United Kingdom
- School of Psychology, University of Southampton, Southampton, United Kingdom
| | - Nic Hooper
- School of Psychology, Cardiff University, Cardiff, United Kingdom
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Vieth E, von Stockhausen L. Effects of short mindful breathing meditations on executive functioning in two randomized controlled double-blinded experiments. Acta Psychol (Amst) 2023; 239:104006. [PMID: 37591155 DOI: 10.1016/j.actpsy.2023.104006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 06/21/2023] [Accepted: 08/07/2023] [Indexed: 08/19/2023] Open
Abstract
While current models of mindfulness propose benefits to the executive functions of inhibition, updating and shifting through mindful breathing meditations, empirical findings on the effects of short mindful breathing meditations are inconclusive regarding their specificity and dose-response relations. Therefore, we compared short mindful breathing meditations (Experiment 1, 45 min over three sessions; Experiment 2, 80 min over four sessions) with relaxation trainings (progressive muscle relaxation; active control) and listening to podcasts (passive control) in two randomized controlled double-blinded trials. Reaction time tasks were used to assess the executive functions of updating (N-Back), inhibition (CPT-II), and shifting (Number-Letter Task). Results of both experiments suggest no mindfulness-specific improvements in executive functions. We conclude that effects following the first stages of mindfulness training may not be specific to the practice or too transient to be reliably measured in pre-post intervention designs. Implications for research in the field are discussed.
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Affiliation(s)
- Elena Vieth
- Department of Psychology, University of Duisburg-Essen, Universitätsstraße 2, 45141 Essen, Germany.
| | - Lisa von Stockhausen
- Department of Psychology, University of Duisburg-Essen, Universitätsstraße 2, 45141 Essen, Germany
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9
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Schwartz K, Ganster FM, Tran US. Mindfulness-Based Mobile Apps and Their Impact on Well-Being in Nonclinical Populations: Systematic Review of Randomized Controlled Trials. J Med Internet Res 2023; 25:e44638. [PMID: 37540550 PMCID: PMC10439468 DOI: 10.2196/44638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 03/16/2023] [Accepted: 06/21/2023] [Indexed: 08/05/2023] Open
Abstract
BACKGROUND Mindfulness-based mobile apps have become popular tools for enhancing well-being in today's fast-paced world. Their ability to reduce geographical, financial, and social barriers makes them a promising alternative to traditional interventions. OBJECTIVE As most available apps lack a theoretical framework, this review aimed to evaluate their effectiveness and assess their quality. We expected to find small sample sizes, high dropout rates, and small effect sizes in the included studies. METHODS A systematic literature search was conducted using PsycInfo, PsycNet, PubMed, an institutional search engine (u:search), and Google Scholar. Randomized controlled trials assessing the impact of mobile mindfulness apps on well-being in nonclinical samples were included. Study selection, risk of bias (using the version 2 of the Cochrane risk-of-bias tool for randomized trials), and reporting quality (using selected CONSORT [Consolidated Standards of Reporting Trials] statement criteria) assessments were performed by 2 authors independently and discussed until a consensus was reached. RESULTS The 28 included randomized controlled trials differed in well-being measures, apps, and intervention duration (7 to 56 days; median duration 28 days). A wide range of sample sizes (12 to 2282; median 161) and attrition rates (0% to 84.7%; median rate 23.4%) were observed. Most studies (19/28, 68%) reported positive effects on at least one aspect of well-being. The effects were presented using different metrics but were primarily small or small to medium in size. Overall risk of bias was mostly high. CONCLUSIONS The wide range of sample sizes, attrition rates, and intervention periods and the variation in well-being measures and mobile apps contributed to the limited comparability of the studies. Although most studies (16/28, 57%) reported small or small to medium effects for at least one well-being outcome, this review demonstrates that the generalizability of the results is limited. Further research is needed to obtain more consistent conclusions regarding the impact of mindfulness-based mobile apps on well-being in nonclinical populations.
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Affiliation(s)
- Katrin Schwartz
- Department of Cognition, Emotion, and Methods in Psychology, Faculty of Psychology, University of Vienna, Vienna, Austria
| | - Fabienne Marie Ganster
- Department of Cognition, Emotion, and Methods in Psychology, Faculty of Psychology, University of Vienna, Vienna, Austria
| | - Ulrich S Tran
- Department of Cognition, Emotion, and Methods in Psychology, Faculty of Psychology, University of Vienna, Vienna, Austria
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10
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Lim CW, Othman A, Hashim HA. The Effect of Online-Delivered Guided Imagery Relaxation on Stress and Well-Being of Primary School Children. Malays J Med Sci 2023; 30:102-115. [PMID: 37655146 PMCID: PMC10467597 DOI: 10.21315/mjms2023.30.4.10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 10/20/2022] [Indexed: 09/02/2023] Open
Abstract
Background In the context of the coronavirus (COVID-19) pandemic, effectively coping with daily stressors is crucial for children who experience restrictions on physical movement and social activities. We examined the effects of the online-delivered guided imagery relaxation (GIR) technique on the stress and well-being of primary school children. Methods Thirty-four (N = 34) 11-year-old students were randomly assigned to either intervention (n = 17) or waitlist-control (n = 17) groups. The participants from the intervention group were required to attend a 4-week online GIR session and practice the techniques daily for 5 min-10 min. The Stress in Children (SiC) questionnaire, the Strengths and Difficulties Questionnaire-Parent Reported (SDQ-PR) and tracking form were administered pre- and post-intervention. Results Eleven (64.7%) participants attended all sessions and eight (47.0%) completed daily practices. Mixed-model ANOVA indicated no significant difference between participants from intervention and waitlist-control groups across pre- and post-intervention time points, with P-values greater than 0.05 for stress and well-being. Conclusion Issues regarding online intervention, including managing children's activities from a distance, Internet connectivity, and time limitations might have affected their adherence and the research outcome. Nonetheless, the online-delivered GIR technique is a promising intervention modality. However, its implementation should be improvised to be more impactful.
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Affiliation(s)
- Chean Wei Lim
- Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
| | - Azizah Othman
- Department of Pediatrics, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
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11
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Abbott D, Lack CW, Anderson P. Does Using a Mindfulness App Reduce Anxiety and Worry? A Randomized-Controlled Trial. J Cogn Psychother 2023; 37:26-42. [PMID: 36787997 DOI: 10.1891/jcpsy-d-20-00058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
Objectives: the availability of smartphone-based mindfulness training applications (apps) may circumvent many barriers to receiving in-person help, but little controlled research has been conducted on them. This study sought to evaluate the effectiveness of a widely used -mindfulness training app, Headspace, at reducing anxiety and worry. Methods: this study used a randomized-controlled design to examine the app using a 3 (Time; baseline, 4 weeks, 8 weeks) × 2 (Access; immediate, delayed for 4 weeks) design. Participants who reported moderate to high anxiety or worry were randomly assigned to receive -either -immediate access or delayed access to the app. For null hypothesis significance testing (NHST), analyses of variance were used to test the hypotheses that app access for 4 and 8 weeks would reduce anxiety and worry as compared to waitlist or baseline and that app access for 8 weeks would reduce anxiety and worry as compared to 4 weeks. Bayes estimates were used to -determine the level of evidence for the hypothesis that app access reduces anxiety and worry. Results: four weeks of app access significantly reduced anxiety symptoms, as did 8 weeks, but NHST indicated there were no significant difference between 4 and 8 weeks of access. We failed to reject the null for the analysis of variance on worry, but Bayesian estimates indicated substantial evidence for the hypothesis that the mindfulness training app reduces worry. Conclusions: this research shows that using Headspace can reduce anxiety and worry, but that there does not appear to be a consistent dose relation.
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Affiliation(s)
- Deah Abbott
- University of Central Oklahoma, Edmond, Oklahoma, USA
| | - Caleb W Lack
- University of Central Oklahoma, Edmond, Oklahoma, USA
| | - Page Anderson
- Georgia State University, Department of Psychology, Atlanta, Georgia, USA
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12
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Mavragani A, Basso JC. Effects of a Neuroscience-Based Mindfulness Meditation Program on Psychological Health: Pilot Randomized Controlled Trial. JMIR Form Res 2023; 7:e40135. [PMID: 36656631 PMCID: PMC9896358 DOI: 10.2196/40135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 11/09/2022] [Accepted: 11/17/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Mindfulness and meditation have a rich historical tradition, and a growing scientific base of evidence supports their use in creating positive psychological and neuroplastic changes for practitioners. Although meditation can be taught in various ways, the scientific community has yet to systematically study the impact of different types of meditation on neuropsychological outcomes, especially as it pertains to digital implementation. Therefore, it is critical that the instruction of mindfulness be evidence based because meditation is being used in both scientific and clinical settings. OBJECTIVE This study investigated the use of teacher cueing and the integration of neuroscience education into a meditation program. Compassion cueing was chosen as the element of experimental manipulation because traditional lineages of Buddhist meditation teach compassion for self and others as one of the primary outcomes of meditation. We hypothesized that participants receiving compassion cueing would have enhanced neuropsychological outcomes compared with those receiving functional cueing and that gains in neuroscience knowledge would relate to positive neuropsychological outcomes. METHODS Participants (n=89) were randomized to receive either functional cueing (control group) or compassion cueing (experimental group) and engaged with five 10-minute meditation sessions a week for 4 weeks. All intervention sessions were administered through digital presentation. All participants completed ecological momentary assessments before and after the daily intervention, as well as pre- and postintervention questionnaires. RESULTS Participants demonstrated significant benefits over time, including increased mindfulness and self-compassion, decreased depression, and gains in neuroscience content (all P<.001); however, no significant between-group differences were found. Daily scores from each day of the intervention showed a statistically significant shift from active toward settled. Importantly, long-term increases in mindfulness were positively correlated to changes in compassion (r=0.326; P=.009) and self-compassion (r=0.424; P<.001) and negatively correlated to changes in anxiety (r=-0.266; P=.03) and depression (r=-0.271; P=.03). Finally, the acute effects of meditation were significantly correlated to the longitudinal outcomes (with a small-to-medium effect size), especially those relevant to mindfulness. CONCLUSIONS We developed a novel neuroscience-based education-meditation program that enhanced self-regulation as evidenced by improved mindfulness, self-compassion, and mood state. Our findings demonstrate the behavioral importance of engaging with mindfulness meditation and reinforce the idea that the benefits of meditation are independent of teacher cueing behavior. Future studies will need to investigate the brain-based changes underlying these meditation-induced outcomes.
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Affiliation(s)
| | - Julia C Basso
- Department of Human Nutrition, Foods and Exercise, Virginia Tech, Blacksburg, VA, United States.,School of Neuroscience, Virginia Tech, Blacksburg, VA, United States.,Center for Health Behaviors Research, Fralin Biomedical Research Institute at Virginia Tech, Roanoke, VA, United States
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13
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Parkinson B, Lawrence M, McElhinney E, Booth J. Online Mindfulness with Care Partnerships Experiencing Anxiety and Depression Symptoms after Stroke: Mixed Methods Case Study Research. J Holist Nurs 2022; 41:185-199. [DOI: 10.1177/08980101221135723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Purpose: To investigate the experience and outcomes for care partnerships (e.g., spouses, caregivers) who have post-stroke anxiety and/or depression symptoms and used an online mindfulness-based intervention (MBI) together. Design: Explanatory sequential mixed methods case study research. Methods: 5 care partnerships (10 participants) received online MBI, and data was collected in weeks 0, 4, and 8. Data collection involved the Hospital Anxiety Depression Scale, the Mutuality Scale, the Mindful Attention Awareness Scale, and post-intervention interviews. Clinical effectiveness was evaluated using minimal clinically important difference (MCID). Findings: Participants improved mindfulness (80%) and mutuality (30%). MCID was achieved for anxiety symptoms (50%) and depression symptoms (20%). IPA found evidence of conflicting and contradictory experiences so dialectical tension was used to articulate the continuum of perspectives and themes produced in the analysis. Conclusion: Care partnerships using online MBIs can experience improvements in mindfulness, mutuality, anxiety symptoms, and depression symptoms. The findings are complex but show the potential value of online MBI for some care partnerships living with stroke.
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Affiliation(s)
| | | | | | - Jo Booth
- Glasgow Caledonian University, Glasgow, UK
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14
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Gupta S, Kumar P, Tekchandani RK. Facial emotion recognition based real-time learner engagement detection system in online learning context using deep learning models. MULTIMEDIA TOOLS AND APPLICATIONS 2022; 82:11365-11394. [PMID: 36105662 PMCID: PMC9461440 DOI: 10.1007/s11042-022-13558-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 05/14/2022] [Accepted: 07/14/2022] [Indexed: 06/15/2023]
Abstract
The dramatic impact of the COVID-19 pandemic has resulted in the closure of physical classrooms and teaching methods being shifted to the online medium.To make the online learning environment more interactive, just like traditional offline classrooms, it is essential to ensure the proper engagement of students during online learning sessions.This paper proposes a deep learning-based approach using facial emotions to detect the real-time engagement of online learners. This is done by analysing the students' facial expressions to classify their emotions throughout the online learning session. The facial emotion recognition information is used to calculate the engagement index (EI) to predict two engagement states "Engaged" and "Disengaged". Different deep learning models such as Inception-V3, VGG19 and ResNet-50 are evaluated and compared to get the best predictive classification model for real-time engagement detection. Varied benchmarked datasets such as FER-2013, CK+ and RAF-DB are used to gauge the overall performance and accuracy of the proposed system. Experimental results showed that the proposed system achieves an accuracy of 89.11%, 90.14% and 92.32% for Inception-V3, VGG19 and ResNet-50, respectively, on benchmarked datasets and our own created dataset. ResNet-50 outperforms all others with an accuracy of 92.3% for facial emotions classification in real-time learning scenarios.
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Affiliation(s)
- Swadha Gupta
- Department of Computer Science and Engineering, Thapar Institute of Engineering and Technology, Patiala, India
| | - Parteek Kumar
- Department of Computer Science and Engineering, Thapar Institute of Engineering and Technology, Patiala, India
| | - Raj Kumar Tekchandani
- Department of Computer Science and Engineering, Thapar Institute of Engineering and Technology, Patiala, India
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15
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Muñoz-Martínez AM, Otto-Scheiber CS, Zuluaga-Jassir S, Medina-Díaz A, Pulido-Rozo J, Venegas-Ramírez M, Igua-Jojoa A. Scalability of an ACT-Based strategy for improving well-being in health care providers: A mix-method and preliminary evaluation of efficacy. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2022; 25:136-144. [PMID: 35966007 PMCID: PMC9359768 DOI: 10.1016/j.jcbs.2022.07.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Revised: 07/19/2022] [Accepted: 07/22/2022] [Indexed: 02/01/2023]
Abstract
The burden of the COVID-19 pandemic has been mainly carried by health care providers. Technology-Mediated Interventions (TMI) seem to be a feasible alternative to increase access to behavioral health resources in this population. However, scaling-up treatments into TMI requires developing user-friendly, accepted, and accessible formats. A two-stage study was conducted to assess scalability of an Acceptance and Commitment Therapy (ACT) based strategy (named FACE COVID) delivered using technology. First, a mix-method design connected qualitative and quantitative data from health providers and ACT experts by which changes were performed to enhance scalability. Second, a pretest-posttest study was conducted to preliminary evaluate the efficacy of FACE COVID intervention on well-being, psychological distress, and psychological flexibility. Results showed a positive impact on well-being, but not distress and psychological flexibility. While this intervention has promising results, changes in dose intensity, social support, and mental health literacy could improve retention as well as increase opportunities to target distress and psychological flexibility in future studies.
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Affiliation(s)
| | - Clara S Otto-Scheiber
- Hospital Universitario Fundación Santa Fe de Bogotá, Cra 7 # 117-15, Bogotá, Colombia
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16
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Acceptability of A Virtual Mind-Body Group Intervention for Teen Siblings of Children with Autism Spectrum Disorder. J Autism Dev Disord 2022; 52:5243-5252. [PMID: 35657446 DOI: 10.1007/s10803-022-05500-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/23/2022] [Indexed: 10/18/2022]
Abstract
Teenage siblings of children with autism spectrum disorder (ASD) are at risk of worse mental health outcomes than their peers, yet there have been few interventions focused on improving their psychosocial wellbeing. This study explored the acceptability of an 8-session virtual group mind-body resiliency intervention for teen siblings of children with ASD. We used mixed methods to assess quantitative and qualitative survey results. Participants reported that the intervention had the right amount of sessions (88%), structure (74%), and duration (89%). Most participants felt comfortable during sessions (74%), found it helpful to learn mind-body exercises (74%), and that the intervention helped in coping with stress (71%). Though participants were satisfied with the opportunity to meet peers, they desired more social connection.
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17
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Evaluating an ACT-Based Brief Intervention for Educators Treatment Package on Reported Well-Being and ACT-Consistent Language in the Classroom. Behav Anal Pract 2022; 16:156-171. [PMID: 35401945 PMCID: PMC8985392 DOI: 10.1007/s40617-022-00707-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/18/2022] [Indexed: 11/24/2022] Open
Abstract
Educators continue to experience stress and burnout, both of which have been negatively impacted by the COVID-19 pandemic, and there continues to be a need to develop interventions that support not only educators’ well-being, but a climate within school buildings that fosters psychological well-being for students and school staff alike. Acceptance and Commitment Therapy (ACT) is one promising approach to interventions for both educator and student psychological well-being. The present study sought to evaluate the effect of a low-dosage, online, and remotely delivered ACT intervention for educators on self-reported burnout, psychological flexibility, ACT knowledge, and frequency of use of ACT-consistent language while teaching in an alternative educational setting. The ACT-based intervention targeted the development of educator psychological flexibility, but the analysis provided an evaluation of non-targeted participants’ use of ACT-consistent language in the classroom, as well. Results suggest an overall improvement in participants’ self-reported burnout and psychological flexibility, an increase in participants’ ACT knowledge following each phase of the study, and an increase in the frequency of ACT-consistent language for all participants following the onset of a feedback component. We discuss potential implications of practical ACT-based interventions for educators in an applied setting and related increases in ACT-consistent verbal stimuli within the classroom setting.
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18
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Growing pains: Lessons learned from a failed mobile mindfulness clinical trial for patients with complex care needs. Contemp Clin Trials Commun 2022; 26:100858. [PMID: 35079658 PMCID: PMC8777278 DOI: 10.1016/j.conctc.2021.100858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 11/04/2021] [Accepted: 11/09/2021] [Indexed: 11/22/2022] Open
Abstract
This paper discusses lessons learned from a failed clinical trial investigating the use of a mobile application (app) to deliver a mindfulness intervention to middle-aged and older adults receiving services at a rehabilitation hospital in Ontario, Canada. A randomized controlled trial with 82 participants was planned, with the experimental group receiving access to a mindfulness app and a wait-list control group receiving access to the app after 4 weeks; however, the study could not be completed due to low recruitment rates. This implementation failure was considered from the perspective of the PARIHS framework. More specifically, Three key recruitment challenges were identified, and recommendations for future research provided. Firstly, the increasingly complex care needs of the study population appeared to influence eligibility; it would be beneficial for future research to consider adopting strategies to better understand the needs of the target population. Secondly, participants’ stage of care and readiness of change likely negatively influenced compliance and retention in this study, and should be assessed in future research. Finally, a lack of clinician integration into the research team negatively impacted recruitment in this study; future studies should consider integrating direct service providers into the research team as this may increase buy-in and referral rates. The challenges and recommendations outlined can inform design and implementation of future studies in this area.
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19
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Liu Z, Li M, Jia Y, Wang S, Zheng L, Wang C, Chen L. A randomized clinical trial of guided self-help intervention based on mindfulness for patients with hepatocellular carcinoma: effects and mechanisms. Jpn J Clin Oncol 2022; 52:227-236. [PMID: 35088079 DOI: 10.1093/jjco/hyab198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 11/26/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Compared with face-to-face mindfulness-based interventions (MBIs), online mindfulness interventions may be more convenient for patients with limited resources and can provide self-help mindfulness methods to improve the quality of life of cancer patients. This study investigated the effects of guided self-help mindfulness-based interventions (GSH-MBIs) on psychological distress, quality of life and sleep quality in patients with hepatocellular carcinoma and explored the underlying mechanisms. METHODS A total of 122 patients with hepatocellular carcinoma were randomly divided into the intervention group or the conventional treatment group. Psychological distress, quality of life, sleep quality, psychological flexibility and perceived stress were evaluated in the groups before the intervention at baseline, after the intervention, at 1-month follow-up and 3-month follow-up. The intervention's effects over time and the potential mediating effects were analysed using generalized estimating equations (GEE). RESULTS GEE results indicated significant time-group interaction effects on psychological distress (P < 0.001) and sleep quality (P < 0.001). The intervention significantly improved psychological flexibility (β, -2.066; 95% CI, -3.631, -0.500) and reduced perceived stress (β, -2.639; 95% CI, -4.110, -1.169). Psychological flexibility and perceived stress played a mediating role in the observed results. CONCLUSION GSH-MBIs can improve psychological distress and sleep quality via changing the psychological flexibility and perceived stress in hepatocellular carcinoma patients.
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Affiliation(s)
- Zengxia Liu
- School of Nursing, Jilin University, Changchun
- School of Nursing, Changchun University of Chinese Medicine, Changchun
| | - Min Li
- Invasive Technology Department, The First Hospital of Jilin University, Changchun, China
| | - Yong Jia
- School of Nursing, Jilin University, Changchun
| | - Shuo Wang
- School of Nursing, Jilin University, Changchun
| | | | - Cong Wang
- School of Nursing, Jilin University, Changchun
| | - Li Chen
- School of Nursing, Jilin University, Changchun
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20
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Mechanisms Underlying Cognitive Effects of Inducing a Mindful State. J Cogn 2022; 5:13. [PMID: 36072102 PMCID: PMC9400668 DOI: 10.5334/joc.205] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 12/26/2021] [Indexed: 12/03/2022] Open
Abstract
Mindfulness is understood as a state or practice of guiding attention to the present moment without judgment. While some studies on mindfulness-based interventions demonstrate beneficial effects on cognitive functions (e.g. Chiesa et al., 2011; Yakobi et al., 2021) it still appears challenging to identify underlying mechanisms due to the wide range of research designs and dependent measures used, as well as the frequent absence of active control conditions. Relatedly, processes underlying the effects of short inductions of a mindful state may be unspecific to mindfulness and attainable through other means, such as relaxation (Fell et al., 2010). Therefore, the current study compared the effects of a brief mindfulness induction with a relaxation induction (via progressive muscle relaxation; active control condition) and listening to podcasts (passive control condition) in a pre-post experimental design. 78 participants without recent meditation experience were randomly assigned to the experimental conditions (mindfulness = 25; progressive muscle relaxation = 24; podcast listening = 30) and received corresponding instructions for a total of 40 minutes (2 × 20 minutes) a maximum of 3 days apart. Executive functions of inhibition, updating and switching as well as attentional networks were assessed with the continuous performance task, n-back task, number-letter task, and attention network task, respectively. While updating and executive attention similarly benefited from meditation and relaxation compared to podcast listening, inhibition and shifting measures indicate differential effects of mindfulness induction. Alerting and orienting were not affected by any induction. Implications for mechanisms underlying the effects of mindfulness are discussed.
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21
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Winter N, Russell L, Ugalde A, White V, Livingston P. Engagement Strategies to Improve Adherence and Retention in Web-Based Mindfulness Programs: Systematic Review. J Med Internet Res 2022; 24:e30026. [PMID: 35019851 PMCID: PMC8792770 DOI: 10.2196/30026] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 08/09/2021] [Accepted: 09/12/2021] [Indexed: 12/14/2022] Open
Abstract
Background Web-based mindfulness programs may be beneficial in improving the well-being outcomes of those living with chronic illnesses. Adherence to programs is a key indicator in improving outcomes; however, with the digitization of programs, it is necessary to enhance engagement and encourage people to return to digital health platforms. More information is needed on how engagement strategies have been used in web-based mindfulness programs to encourage adherence. Objective The aim of this study is to develop a list of engagement strategies for web-based mindfulness programs and evaluate the impact of engagement strategies on adherence. Methods A narrative systematic review was conducted across the MEDLINE Complete, CINAHL Complete, APA PsycINFO, and Embase databases and followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines. Articles were screened using the population, intervention, comparator, and outcome framework. Adults aged >18 years with chronic health conditions were included in the study. Mindfulness interventions, including those in combination with mindfulness-based cognitive therapy, delivered on the web through the internet or smartphone technology were included. Interventions lasted at least 2 weeks. Studies with a randomized controlled trial design or a pilot randomized controlled trial design were included. Engagement strategies, including web-based program features and facilitator-led strategies, adherence, and retention, were included. Results A total of 1265 articles were screened, of which 19 were relevant and were included in the review. On average, 70.98% (2258/3181) of the study participants were women with a mean age of 46 (SD 13) years. Most commonly, mindfulness programs were delivered to people living with mental health conditions (8/19, 42%). Of the 19 studies, 8 (42%) used only program features to encourage adherence, 5 (26%) used facilitator-led strategies, and 6 (32%) used a combination of the two. Encouraging program adherence was the most common engagement strategy used, which was used in 77% (10/13) of the facilitator-led studies and 57% (8/14) of the program feature studies. Nearly two-thirds (63%) of the studies provided a definition of adherence, which varied between 50% and 100% completion across studies. The overall mean participant compliance to the mindfulness programs was 56% (SD 15%). Most studies (10/19, 53%) had a long-term follow-up, with the most common follow-up period being 12 weeks after intervention (3/10, 30%). After the intervention, the mean retention was 78% (SD 15%). Conclusions Engagement strategies in web-based mindfulness programs comprise reminders to use the program. Other features may be suitable for encouraging adherence to interventions, and a facilitator-led component may result in higher retention. There is variance in the way adherence is measured, and intervention lengths and follow-up periods are inconsistent. More thorough reporting and a standardized framework for measuring adherence are needed to more accurately assess adherence and engagement strategies.
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Affiliation(s)
- Natalie Winter
- Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Deakin University, Geelong, Australia
| | - Lahiru Russell
- Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Deakin University, Geelong, Australia.,School of Nursing and Midwifery, Deakin University, Geelong, Australia.,Centre for Quality and Patient Safety Research - Eastern Health Partnership, Deakin University, Melbourne, Australia
| | - Anna Ugalde
- Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Deakin University, Geelong, Australia
| | - Victoria White
- School of Psychology, Faculty of Health, Deakin University, Geelong, Australia
| | - Patricia Livingston
- Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Deakin University, Geelong, Australia.,Faculty of Health, Deakin University, Geelong, Australia
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Luberto CM, Perez GK, Finkelstein-Fox L, Millstein RA, Fell L, Chad-Friedman E, Park ER, Kuhlthau KA. Acceptability of a Virtual Mind-Body Intervention for Parents of Children With Autism or Learning Disabilities. Glob Adv Health Med 2021; 10:21649561211047804. [PMID: 34917419 PMCID: PMC8669114 DOI: 10.1177/21649561211047804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 08/14/2021] [Accepted: 09/02/2021] [Indexed: 11/16/2022] Open
Abstract
Objective Parents of children with learning/attentional disabilities (LAD) and autism spectrum disorder (ASD) are at elevated risk for chronic stress. Types of stress and treatment needs differ between these parent groups. We adapted our evidence-based mind–body intervention (SMART-3RP) for parents of children with LAD and ASD, delivered via videoconferencing. Preliminary results from our two wait-list randomized pilot trials suggest the programs were feasible and efficacious. To gain an in-depth understanding of acceptability, the purpose of this secondary analysis from the RCTs is to (1) explore feedback regarding the virtual SMART-3RP and (2) compare feedback across LAD and ASD parents. Methods Participants were randomized to immediate or delayed SMART-3RP (separate groups for LAD and ASD) and completed a feedback questionnaire post-intervention (N = 33 LAD, N = 37 ASD; 93% female, 93% white, Mage = 45.52, SD = 6.50). Results Participants reported the intervention had the right number of sessions (69%), session duration (83%), and amount of structure (83%). They felt comfortable during sessions (89%) and found mind–body skills helpful (89%). There were no significant differences between parent groups other than a trend for more ASD parents reporting sessions were too long (22% ASD vs. 6% LAD, X2 = 5.67, p =0.06). Qualitative themes were similar across parents and included that video delivery had some technical challenges but enabled participation; group support and mind–body skills were helpful; and further SMART-3RP sessions or therapy is needed. Conclusion LAD and ASD parents found a synchronous video-based mind–body resiliency program acceptable. Technology limitations notwithstanding, online delivery was very satisfactory and overcame obstacles to participation.
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Affiliation(s)
- Christina M Luberto
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.,Department of Psychiatry, Benson-Henry Institute for Mind-Body Medicine, Boston, MA, USA
| | - Giselle K Perez
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.,Department of Psychiatry, Benson-Henry Institute for Mind-Body Medicine, Boston, MA, USA
| | - Lucy Finkelstein-Fox
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Rachel A Millstein
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.,Department of Psychiatry, Benson-Henry Institute for Mind-Body Medicine, Boston, MA, USA
| | - Lucy Fell
- Department of Pediatrics, Massachusetts General Hospital for Children, Boston, MA, USA
| | - Emma Chad-Friedman
- Department of Psychiatry, Benson-Henry Institute for Mind-Body Medicine, Boston, MA, USA.,Department of Psychology, University of Maryland, College Park, MD, USA
| | - Elyse R Park
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.,Department of Psychiatry, Benson-Henry Institute for Mind-Body Medicine, Boston, MA, USA
| | - Karen A Kuhlthau
- Department of Pediatrics, Massachusetts General Hospital for Children, Boston, MA, USA.,Department of Pediatrics, Harvard Medical School, Boston, MA, USA
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23
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Kirk MA, Pirbaglou M, Weerasekera R, Ritvo P. Effectiveness of online cognitive behavioral interventions that include mindfulness for clinically-diagnosed anxiety and depressive disorders: A systematic review and meta-analysis. INTERNATIONAL JOURNAL OF MENTAL HEALTH 2021. [DOI: 10.1080/00207411.2021.1959807] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Megan A. Kirk
- School of Kinesiology and Health Science, York University, Toronto, Canada
| | - Meysam Pirbaglou
- School of Kinesiology and Health Science, York University, Toronto, Canada
| | - Rasanjala Weerasekera
- Donnelly Centre for Cellular and Biomolecular Research, University of Toronto, Toronto, Canada
| | - Paul Ritvo
- School of Kinesiology and Health Science, York University, Toronto, Canada
- Department of Psychology, York University, Toronto, Canada
- Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
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24
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Guo J, Wang H, Ge L, Valimaki M, Wiley J, Whittemore R. Effectiveness of a nurse-led mindfulness stress-reduction intervention on diabetes distress, diabetes self-management, and HbA1c levels among people with type 2 diabetes: A pilot randomized controlled trial. Res Nurs Health 2021; 45:46-58. [PMID: 34741544 DOI: 10.1002/nur.22195] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 10/05/2021] [Accepted: 10/24/2021] [Indexed: 11/09/2022]
Abstract
People with diabetes frequently have elevated diabetes distress. Although mindfulness-based stress reduction (MBSR) therapy has been shown effective in reducing diabetes distress, it has only been delivered by psychologists or a multidisciplinary team with an attrition rate of up to 39%, which limits its dissemination to a broader audience. This study was aimed to pilot evaluate the feasibility of a nurse-led MBSR therapy and explore its potential efficacy amongst people with type 2 diabetes mellitus. A total of 100 participants were randomly allocated either to the intervention group (nurse-led MBSR therapy + regular diabetes education) or the control group (regular diabetes education). Data on diabetes distress, diabetes self-efficacy, and diabetes self-management were collected at baseline, 8 and 12 weeks. Hemoglobin A1c (HbA1c) was collected at baseline and 12 weeks. A generalized estimating equation analysis for repeated measures was used to determine intervention and time effects. As predicted, the nurse-led MBSR therapy had a significant time-by-group interaction effect on diabetes distress total score (95% confidence interval [CI]: 0.58-0.77, p < 0.001), diabetes self-efficacy (95% CI: -0.93 to -0.74, p < 0.001), diabetes self-management (95% CI: -10.80 to -7.83, p < 0.001), and HbA1c levels (95% CI: 0.04-1.14, p = 0.03) in the intervention group compared with the control group over 12 weeks. This is the first nurse-led MBSR therapy in a hospital setting that is feasible and has the potential to improve health outcomes. This approach may offer an innovative model to deliver MBSR therapy. A randomized controlled trial comparing the nurse-led MBSR plus usual diabetes education with usual diabetes education along with a mechanism to equalize intervention attention between the groups is indicated.
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Affiliation(s)
- Jia Guo
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Hongjuan Wang
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Lin Ge
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China.,Department of endocrinology, The Second People's Hospital of Hunan Province, Changsha, Hunan, China
| | - Maritta Valimaki
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - James Wiley
- Department of Family and Community Medicine, Institute for Health Policy Research, University of California, San Francisco, California, USA
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25
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Dragomanovich HM, Dhruva A, Ekman E, Schoenbeck KL, Kubo A, Van Blarigan EL, Borno HT, Esquivel M, Chee B, Campanella M, Philip EJ, Rettger JP, Rosenthal B, Van Loon K, Venook AP, Boscardin C, Moran P, Hecht FM, Atreya CE. Being Present 2.0: Online Mindfulness-Based Program for Metastatic Gastrointestinal Cancer Patients and Caregivers. Glob Adv Health Med 2021; 10:21649561211044693. [PMID: 35174001 PMCID: PMC8842457 DOI: 10.1177/21649561211044693] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
PURPOSE A metastatic cancer diagnosis is associated with high levels of distress in patients and caregivers, which may be alleviated by mindfulness interventions. Research on scalable, tailored, online mindfulness training programs is needed. We sought to test the feasibility and acceptability of a remotely delivered 8-week mindfulness-based intervention, Being Present 2.0 (BP2.0). METHODS We performed a single-arm feasibility study of BP2.0 among patients with any metastatic gastrointestinal cancer receiving chemotherapy, with or without an informal caregiver. Participants were instructed to practice mindfulness using pre-recorded guided meditations 5 times per week using a study-specific website and to attend a weekly live, interactive virtual meeting facilitated by a trained instructor. The web-based platform enabled direct measurement of adherence. RESULTS The study enrolled 46 of 74 (62%) patients contacted, together with 23 caregivers (69 participants total), from May to October 2018. Median patient age was 52 (range 20-70 years), 39% were male, 67% non-Hispanic white, 65% had colorectal cancer, and 78% lived outside of San Francisco. The top reasons cited for participation were to reduce stress/anxiety and learn how to meditate. Mean baseline National Comprehensive Cancer Network Distress Thermometer (NCCN DT) scores were 4.7 (patients) and 5.8 (caregivers). The study discontinuation rate was 20% (eight patients and six caregivers). Among the remaining 55 participants, 43 (78%) listened to at least one audio recording and/or attended at least one virtual meeting, although adherence data was incomplete. The retention rate was 71%, with 39 participants completing at least one follow-up assessment. In post-intervention qualitative interviews, 88% of respondents reported a positive experience. Compared to baseline, participants reported significantly reduced post-intervention NCCN DT scores (mean 3.1; P = .012). CONCLUSION The BP2.0 online mindfulness-based program is feasible and acceptable for patients with metastatic gastrointestinal cancer and caregivers. These results will guide plans for a follow-up efficacy study. ClinicalTrials.gov Identifier: NCT03528863.
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Affiliation(s)
- Hannah M. Dragomanovich
- University of California, San Francisco (UCSF) Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA
- College of Osteopathic Medicine, Touro University California, Vallejo, CA, USA
| | - Anand Dhruva
- University of California, San Francisco (UCSF) Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA
- UCSF Osher Center for Integrative Medicine, CA, USA
- UCSF Department of Medicine, CA, USA
| | - Eve Ekman
- UCSF Osher Center for Integrative Medicine, CA, USA
- Greater Good Science Center, University of California Berkeley, Berkeley, CA, USA
| | - Kelly L. Schoenbeck
- University of California, San Francisco (UCSF) Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA
- UCSF Department of Medicine, CA, USA
| | - Ai Kubo
- Kaiser Permanente Division of Research, CA, USA
| | | | - Hala T. Borno
- University of California, San Francisco (UCSF) Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA
- UCSF Department of Medicine, CA, USA
| | - Mikaela Esquivel
- University of California, San Francisco (UCSF) Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA
| | - Bryant Chee
- University of California, San Francisco (UCSF) Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA
- College of Osteopathic Medicine, Touro University California, Vallejo, CA, USA
| | - Matthew Campanella
- University of California, San Francisco (UCSF) Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA
| | | | - John P. Rettger
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Blake Rosenthal
- University of California, San Francisco (UCSF) Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA
- UCSF Benioff Children’s Hospital Oakland, CA, USA
| | - Katherine Van Loon
- University of California, San Francisco (UCSF) Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA
- UCSF Department of Medicine, CA, USA
| | - Alan P. Venook
- University of California, San Francisco (UCSF) Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA
- UCSF Department of Medicine, CA, USA
| | | | - Patricia Moran
- University of California, San Francisco (UCSF) Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA
- UCSF Osher Center for Integrative Medicine, CA, USA
| | - Frederick M. Hecht
- UCSF Osher Center for Integrative Medicine, CA, USA
- UCSF Department of Medicine, CA, USA
| | - Chloe E. Atreya
- University of California, San Francisco (UCSF) Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA
- UCSF Osher Center for Integrative Medicine, CA, USA
- UCSF Department of Medicine, CA, USA
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26
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Aithal S, Karkou V, Makris S, Karaminis T, Powell J. Impact of Dance Movement Psychotherapy on the wellbeing of caregivers of children with Autism Spectrum Disorder. Public Health 2021; 200:109-115. [PMID: 34717164 DOI: 10.1016/j.puhe.2021.09.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 07/16/2021] [Accepted: 09/16/2021] [Indexed: 01/04/2023]
Abstract
OBJECTIVES Sustaining the wellbeing of caregivers of children with Autism Spectrum Disorder (ASD) can be highly demanding. This study explored the impact of Dance Movement Psychotherapy (DMP) intervention on the wellbeing of caregivers in comparison with their standard care routine. STUDY DESIGN This pilot evaluation study used a quasi-experimental design. METHODS Thirty-seven caregivers of children with ASD were recruited from two special educational needs settings and were allocated to the DMP intervention or the control group depending on their availability to attend the sessions. The participants in the intervention group received five DMP sessions lasting 90 min each. Adult Wellbeing Scale (AWS) and Parenting Stress Index-Short Form (PSI-SF) were the two outcome measures administered before and after DMP to measure the impact of DMP intervention on caregivers' wellbeing and parental stress. RESULTS The retention rates were poor, with only 50% of participants in the DMP intervention arm attending at least 70% of the sessions until its end. The Minimal Clinically Important Difference (MCID) was achieved for a small effect size in both outcome measures in the DMP intervention group but not in the control group. Results from the Analyses of Covariance (ANCOVAs) showed a significant difference in post-intervention scores between the DMP intervention and the control group for AWS (F1,33 = 106.474, P < 0.001) but not for PSI-SF. In addition, a significant association was found between pre-intervention scores and the number of sessions attended with the postintervention scores of both AWS and PSI-SF. CONCLUSIONS The results of this pilot DMP study are promising. However, before running a larger randomised controlled trial, strategies to support caregivers to attend the intervention need to be considered carefully.
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Affiliation(s)
- S Aithal
- Research Centre for Arts and Wellbeing, Edge Hill University, Ormskirk, United Kingdom; Faculty of Health, Social Care and Medicine, Edge Hill University, Ormskirk, United Kingdom.
| | - V Karkou
- Research Centre for Arts and Wellbeing, Edge Hill University, Ormskirk, United Kingdom; Faculty of Health, Social Care and Medicine, Edge Hill University, Ormskirk, United Kingdom
| | - S Makris
- Research Centre for Arts and Wellbeing, Edge Hill University, Ormskirk, United Kingdom; Department of Psychology, Edge Hill University, Ormskirk, United Kingdom
| | - T Karaminis
- Research Centre for Arts and Wellbeing, Edge Hill University, Ormskirk, United Kingdom; Department of Psychology, Edge Hill University, Ormskirk, United Kingdom
| | - J Powell
- Research Centre for Arts and Wellbeing, Edge Hill University, Ormskirk, United Kingdom; Department of Psychology, Edge Hill University, Ormskirk, United Kingdom
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27
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Taylor H, Strauss C, Cavanagh K. Can a little bit of mindfulness do you good? A systematic review and meta-analyses of unguided mindfulness-based self-help interventions. Clin Psychol Rev 2021; 89:102078. [PMID: 34537665 DOI: 10.1016/j.cpr.2021.102078] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 06/30/2021] [Accepted: 08/24/2021] [Indexed: 12/18/2022]
Abstract
Over the last decade there has been an explosion of interest in mindfulness-based self-help (MBSH) interventions. While widely available and extensively promoted, there is little consensus on their impact in public health or healthcare contexts. We present a systematic review and meta-analyses of 83 randomized controlled trials, comparing unguided MBSH to control conditions on outcomes of depression, mindfulness, anxiety, stress and/or wellbeing/ quality of life. A random effects model was used to compute post-intervention, between-groups effect sizes for each outcome. MBSH demonstrated small, statistically significant effects at post-interventions for outcomes of depression (g = -0.23), mindfulness (g = 0.37) anxiety (g = -0.25), stress (g = -0.41) and wellbeing/ quality of life (g = 0.34). Significant effects were retained at follow-up for mindfulness, stress and wellbeing/ quality of life but not for depression or anxiety. Planned moderator analyses demonstrated significantly larger effects of MBSH when compared to inactive, versus active-control conditions on all outcomes except wellbeing/ quality of life, and non-digital MBSH interventions demonstrated significantly greater effects on depression, mindfulness and wellbeing/ quality of life outcomes than digitally-delivered MBSH. When studies that utilised samples selected for mental and physical health-related difficulties were respectively compared to studies that utilised unselected samples, no significant moderation effects were observed. In sum, these findings provide evidence for the effectiveness of unguided MBSH in public health settings and the practical, access-related implications of this are discussed.
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Affiliation(s)
- Heather Taylor
- School of Psychology, University of Sussex, Falmer, Brighton BN1 9QJ, UK.
| | - Clara Strauss
- School of Psychology, University of Sussex, Falmer, Brighton BN1 9QJ, UK; R&D Department, Sussex Partnership NHS Foundation Trust, Sussex Education Centre, Hove, BN3 7HZ, UK.
| | - Kate Cavanagh
- School of Psychology, University of Sussex, Falmer, Brighton BN1 9QJ, UK; R&D Department, Sussex Partnership NHS Foundation Trust, Sussex Education Centre, Hove, BN3 7HZ, UK.
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28
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Jiang A, Rosario M, Stahl S, Gill JM, Rusch HL. The Effect of Virtual Mindfulness-Based Interventions on Sleep Quality: A Systematic Review of Randomized Controlled Trials. Curr Psychiatry Rep 2021; 23:62. [PMID: 34297230 PMCID: PMC8300082 DOI: 10.1007/s11920-021-01272-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/04/2021] [Indexed: 11/05/2022]
Abstract
PURPOSE OF REVIEW We summarized peer-reviewed literature investigating the effect of virtual mindfulness-based interventions (MBIs) on sleep quality. We aimed to examine the following three questions: (1) do virtual MBIs improve sleep quality when compared with control groups; (2) does the effect persist long-term; and (3) is the virtual delivery method equally feasible compared to the in-person delivery method? RECENT FINDINGS Findings suggest that virtual MBIs are equivalent to evidence-based treatments, and to a limited extent, more effective than non-specific active controls at reducing some aspects of sleep disturbance. Overall, virtual MBIs are more effective at improving sleep quality than usual care controls and waitlist controls. Studies provide preliminary evidence that virtual MBIs have a long-term effect on sleep quality. Moreover, while virtual MBI attrition rates are comparable to in-person MBI attrition rates, intervention adherence may be compromised in the virtual delivery method. This review highlights virtual MBIs as a potentially effective alternative to managing sleep disturbance during pandemic-related quarantine and stay-at-home periods. This is especially relevant due to barriers of accessing in-person interventions during the pandemic. Future studies are needed to explore factors that influence adherence and access to virtual MBIs, with a particular focus on diverse populations.
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Affiliation(s)
- Amanda Jiang
- National Institute of Nursing Research, National Institutes of Health, Bethesda, MD, USA
| | - Michael Rosario
- Washington University School of Medicine, St. Louis, MO, USA
| | - Sara Stahl
- TEACCH Autism Program, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jessica M Gill
- National Institute of Nursing Research, National Institutes of Health, Bethesda, MD, USA
| | - Heather L Rusch
- National Institutes of Health, 3 Center Drive, Building 3, Room 5E/26, Bethesda, MD, 20892, USA.
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29
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Davis JA, Gibson LY, Bear NL, Finlay-Jones AL, Ohan JL, Silva DT, Prescott SL. Can Positive Mindsets Be Protective Against Stress and Isolation Experienced during the COVID-19 Pandemic? A Mixed Methods Approach to Understanding Emotional Health and Wellbeing Needs of Perinatal Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:6958. [PMID: 34209693 PMCID: PMC8297209 DOI: 10.3390/ijerph18136958] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 06/23/2021] [Accepted: 06/25/2021] [Indexed: 11/23/2022]
Abstract
The aim of this study was to explore the relationship between emotional health and wellbeing and support needs of perinatal women during the COVID-19 pandemic, and to understand their experiences and need for support. This is a potentially vulnerable group and a critical developmental phase for women and infants. A mixed methods design was used to collect quantitative and qualitative data that provided a robust insight into their unique needs. A total of 174 women who were either pregnant or post-birth participated. The main findings demonstrated that women in this cohort experienced varying levels of stress and isolation but also positive experiences. Exploring the relationship between mental health (perceived stress and wellbeing) and resilience (mindfulness and self-compassion) revealed an association between positive mental health and higher levels of mindfulness and self-compassion. Positive mindsets may be protective against psychological distress for the mother and her child, suggesting that meditation-based or similar training might help support expectant and post-birth mothers during times of crisis, such as a pandemic. This information could be used to make recommendations for future planning for practitioners and policymakers in preparing for prospective infection waves, pandemics, or natural disasters, and could be used to develop targeted tools, support, and care.
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Affiliation(s)
- Jacqueline A. Davis
- Telethon Kids Institute, 15 Hospital Avenue, Nedlands, WA 6009, Australia; (L.Y.G.); (A.L.F.-J.); (J.L.O.); (D.T.S.); (S.L.P.)
- School of Medicine, The University of Western Australia, Perth, WA 6009, Australia
- School of Public Health, Curtin University, Bentley, WA 6102, Australia
| | - Lisa Y. Gibson
- Telethon Kids Institute, 15 Hospital Avenue, Nedlands, WA 6009, Australia; (L.Y.G.); (A.L.F.-J.); (J.L.O.); (D.T.S.); (S.L.P.)
- School of Medicine, The University of Western Australia, Perth, WA 6009, Australia
- School of Medical and Health Sciences, Edith Cowan University, Perth, WA 6027, Australia
| | - Natasha L. Bear
- Institute for Health Research, Notre Dame University, Fremantle, WA 6160, Australia;
| | - Amy L. Finlay-Jones
- Telethon Kids Institute, 15 Hospital Avenue, Nedlands, WA 6009, Australia; (L.Y.G.); (A.L.F.-J.); (J.L.O.); (D.T.S.); (S.L.P.)
- School of Medicine, The University of Western Australia, Perth, WA 6009, Australia
| | - Jeneva L. Ohan
- Telethon Kids Institute, 15 Hospital Avenue, Nedlands, WA 6009, Australia; (L.Y.G.); (A.L.F.-J.); (J.L.O.); (D.T.S.); (S.L.P.)
- School of Medicine, The University of Western Australia, Perth, WA 6009, Australia
| | - Desiree T. Silva
- Telethon Kids Institute, 15 Hospital Avenue, Nedlands, WA 6009, Australia; (L.Y.G.); (A.L.F.-J.); (J.L.O.); (D.T.S.); (S.L.P.)
- School of Medicine, The University of Western Australia, Perth, WA 6009, Australia
- School of Public Health, Curtin University, Bentley, WA 6102, Australia
- School of Medical and Health Sciences, Edith Cowan University, Perth, WA 6027, Australia
- Joondalup Health Campus, Joondalup, WA 6027, Australia
| | - Susan L. Prescott
- Telethon Kids Institute, 15 Hospital Avenue, Nedlands, WA 6009, Australia; (L.Y.G.); (A.L.F.-J.); (J.L.O.); (D.T.S.); (S.L.P.)
- School of Medicine, The University of Western Australia, Perth, WA 6009, Australia
- School of Public Health, Curtin University, Bentley, WA 6102, Australia
- School of Medical and Health Sciences, Edith Cowan University, Perth, WA 6027, Australia
- Institute for Health Research, Notre Dame University, Fremantle, WA 6160, Australia;
- inVIVO Planetary Health, Worldwide Universities Network (WUN), West New York, NJ 10704, USA
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30
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Orosa-Duarte Á, Mediavilla R, Muñoz-Sanjose A, Palao Á, Garde J, López-Herrero V, Bravo-Ortiz MF, Bayón C, Rodríguez-Vega B. Mindfulness-based mobile app reduces anxiety and increases self-compassion in healthcare students: A randomised controlled trial. MEDICAL TEACHER 2021; 43:686-693. [PMID: 33645416 DOI: 10.1080/0142159x.2021.1887835] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To compare the effect of a mindfulness-based mobile application versus an in-person mindfulness-based training program in terms of reducing anxiety and increasing empathy, self-compassion, and mindfulness in a population of healthcare students. METHODS The authors conducted a single-blind, randomised controlled trial with three parallel groups. Participants were allocated to the mobile app, the in-person mindfulness-based program (IMBP), or a control group. Assessments at baseline and postintervention (8 weeks) included measures of anxiety, empathy, self-compassion, and mindfulness. RESULTS Of 168 students randomised, 84 were analysed on an intention-to-treat basis (app: n = 31; IMBP: n = 23; control: n = 30). The mobile app group showed a large effect size for reductions in trait anxiety compared with controls (g = 0.85, p = 0.003), and a medium, nonsignificant effect compared with the IMBP group (g = 0.52, p = 0.152). Participants from both interventions experienced a significant increase in self-compassion and mindfulness compared with controls. Levels of empathy remained unchanged for the 3 arms. CONCLUSIONS A mobile app can be as effective as an IMBP in reducing anxiety and increasing self-compassion and mindfulness among healthcare students.
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Affiliation(s)
- Álvaro Orosa-Duarte
- Psychiatry, Clinical Psychology and Mental Health Department, La Paz University Hospital, Madrid, Spain
- Faculty of Medicine, Autonomous University of Madrid, Madrid, Spain
| | - Roberto Mediavilla
- Psychiatry, Clinical Psychology and Mental Health Area, La Paz University Hospital Institute for Health Research (IdiPAZ), Madrid, Spain
- Faculty of Psychology, National University of Distance Education (UNED), Madrid, Spain
| | - Ainoa Muñoz-Sanjose
- Psychiatry, Clinical Psychology and Mental Health Department, La Paz University Hospital, Madrid, Spain
- Psychiatry, Clinical Psychology and Mental Health Area, La Paz University Hospital Institute for Health Research (IdiPAZ), Madrid, Spain
| | - Ángela Palao
- Psychiatry, Clinical Psychology and Mental Health Department, La Paz University Hospital, Madrid, Spain
- Faculty of Medicine, Autonomous University of Madrid, Madrid, Spain
- Psychiatry, Clinical Psychology and Mental Health Area, La Paz University Hospital Institute for Health Research (IdiPAZ), Madrid, Spain
| | - Joaquín Garde
- Psychiatry, Clinical Psychology and Mental Health Department, La Paz University Hospital, Madrid, Spain
- Faculty of Medicine, Autonomous University of Madrid, Madrid, Spain
| | | | - María-Fe Bravo-Ortiz
- Psychiatry, Clinical Psychology and Mental Health Department, La Paz University Hospital, Madrid, Spain
- Faculty of Medicine, Autonomous University of Madrid, Madrid, Spain
- Psychiatry, Clinical Psychology and Mental Health Area, La Paz University Hospital Institute for Health Research (IdiPAZ), Madrid, Spain
| | - Carmen Bayón
- Psychiatry, Clinical Psychology and Mental Health Department, La Paz University Hospital, Madrid, Spain
- Faculty of Medicine, Autonomous University of Madrid, Madrid, Spain
- Psychiatry, Clinical Psychology and Mental Health Area, La Paz University Hospital Institute for Health Research (IdiPAZ), Madrid, Spain
| | - Beatriz Rodríguez-Vega
- Psychiatry, Clinical Psychology and Mental Health Department, La Paz University Hospital, Madrid, Spain
- Faculty of Medicine, Autonomous University of Madrid, Madrid, Spain
- Psychiatry, Clinical Psychology and Mental Health Area, La Paz University Hospital Institute for Health Research (IdiPAZ), Madrid, Spain
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31
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Siebenhüner AR, Mikolasek M, Witt CM, Barth J. Improvements in Health Might Contradict Adherence to Mobile Health Interventions: Findings from a Self-Care Cancer App Study. J Altern Complement Med 2021; 27:S115-S123. [PMID: 33788602 DOI: 10.1089/acm.2020.0111] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Background: Cancer patients often suffer from high levels of distress. Mobile health (mHealth) applications might be an innovative way to deliver mindfulness and relaxation interventions for cancer patients. However, data about the implementation of apps in health care are lacking. Adherence to mHealth interventions is an important indicator for a successful implementation and might be needed to maximize treatment effects. However, the decrease in distress might reduce the motivation of patients to engage in such self-care tools in the long run. Therefore, the aim of this analysis was to investigate the association between the course of distress over time and the adherence to a relaxation self-care app in cancer patients. Methods: We developed an app for cancer patients (CanRelax) and 83 patients who participated in the prospective observational study used the app at least once. The evaluation was guided by the RE-AIM framework, and this analysis focused on the implementation of the app. Patients were grouped into five subgroups according to their course of distress over 10 weeks (Distress Thermometer). These subgroups of patients were compared with each other to identify different user groups. Findings: About half of the patients were adherent over 10 weeks. However, a decrease in distress was associated with lower adherence to the app intervention, whereas patients with moderate distress or an increase in distress showed more adherence. Conclusion: Adherence to an app intervention might be also driven by patients' distress level. A decrease in distress might reduce patients' motivation to continue with a self-care intervention. The interplay between adherence and treatment outcomes should be explored in upcoming mHealth trials to get a better understanding for the implementation of such interventions. Encouraging patients to continue self-care interventions is a major challenge in integrative medicine if they are delivered digitally. The Clinical Trial Registration number: DRKS00010481.
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Affiliation(s)
- Alexander R Siebenhüner
- Clinic for Medical Oncology and Hematology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Michael Mikolasek
- Institute for Complementary and Integrative Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Claudia M Witt
- Institute for Complementary and Integrative Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland.,Institute for Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Berlin, Germany.,Center for Integrative Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Jürgen Barth
- Institute for Complementary and Integrative Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
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Leyro TM, Versella MV, Yang MJ, Brinkman HR, Hoyt DL, Lehrer P. Respiratory therapy for the treatment of anxiety: Meta-analytic review and regression. Clin Psychol Rev 2021; 84:101980. [PMID: 33540222 PMCID: PMC8302658 DOI: 10.1016/j.cpr.2021.101980] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 11/30/2020] [Accepted: 01/19/2021] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Respiratory abnormalities are a hallmark of anxiety symptomatology and may serve as clinically useful modifiers for alleviating anxiety symptoms. However, gold-standard anxiety treatments (e.g., cognitive-behavioral interventions) often do not directly address respiratory components despite their theoretical utility and clinical accessibility. This review examined the clinical effectiveness of respiratory interventions, interventions that directly target respiration abnormalities and processes, in treating trait anxiety symptoms. METHODS The final analysis included 40 randomized controlled trials including at least one measure of trait anxiety, a respiratory-focused intervention group, and a non-respiratory control-group (active or inactive treatment). Overall effects of respiratory focused interventions were examined, as well as the effect of hypothesized moderators. RESULTS Respiratory component interventions yielded significantly greater improvements (moderate to large effect) in anxiety symptoms than controls, with the stronger effects observed in comparison to inactive, rather than active, control conditions. Significant heterogeneity in findings suggests that variability in intervention design, population, and control comparison may obfuscate interpretation of findings. CONCLUSIONS Evidence supports the clinical utility of respiratory interventions as either an independent anxiety treatment, or as an adjunct to other interventions. Clinical and research implications of findings along with recommendations for ongoing investigations in this domain are discussed.
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Affiliation(s)
- Teresa M Leyro
- Department of Psychology, Rutgers, The State University of New Jersey, United States.
| | - Mark V Versella
- Department of Psychology, Rutgers, The State University of New Jersey, United States
| | - Min-Jeong Yang
- Department of Psychology, Rutgers, The State University of New Jersey, United States; Department of Health Outcomes and Behavior, Moffitt Cancer Center, United States
| | - Hannah R Brinkman
- Department of Psychology, Rutgers, The State University of New Jersey, United States
| | - Danielle L Hoyt
- Department of Psychology, Rutgers, The State University of New Jersey, United States
| | - Paul Lehrer
- Department of Psychiatry, Rutgers Robert Wood Johnson Medical School, United States
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A randomized controlled trial of an app-delivered mindfulness program among university employees: effects on stress and work-related outcomes. INTERNATIONAL JOURNAL OF WORKPLACE HEALTH MANAGEMENT 2021. [DOI: 10.1108/ijwhm-04-2020-0046] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeThe purpose of this paper is to evaluate the impact on stress and work-related outcomes of an app-delivered mindfulness-based program (MBP; Headspace®) offered to employees in a UK higher education (HE) institution.Design/methodology/approachUsing a randomized waitlist control trial design, participants were randomly allocated to be offered a mindfulness-based program (MBP) immediately for 2 months or after a waiting list period of 2 months (WLC). Data were analyzed using Intention to Treat (ITT; MBP n = 62; WLC n = 63); with supplementary analysis restricting to those who completed all measures; (MBP n = 45; WLC n = 56) and then further restricting the MBP group to those who completed at least foundation level 1 of the app; (MBP n = 31; WLC n = 56).FindingsThe ITT analysis showed significant increases in several aspects of mindfulness and a significant reduction in perceived stress but no significant effects for work-related outcomes. Analysis restricted to MBP participants who completed the app foundation course showed a similar pattern but in addition showed significant increases in work-life balance and the emotional aspect of job engagement.Practical implicationsThe offer of the Headspace® app in the HE sector may result in reduced perceived stress. If improvements in work-related outcomes are also to be seen, then users need to be encouraged to complete a minimum level of practice.Originality/valueEffect size estimates for stress and work-related outcomes of an app-delivered MBP contribute to the evolving picture of MBPs in the workplace.
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Mikolasek M, Witt CM, Barth J. Effects and Implementation of a Mindfulness and Relaxation App for Patients With Cancer: Mixed Methods Feasibility Study. JMIR Cancer 2021; 7:e16785. [PMID: 33439132 PMCID: PMC7840285 DOI: 10.2196/16785] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2019] [Revised: 03/13/2020] [Accepted: 11/18/2020] [Indexed: 12/15/2022] Open
Abstract
Background Cancer diagnosis and cancer treatment can cause high levels of distress, which is often not sufficiently addressed in standard medical care. Therefore, a variety of supportive nonpharmacological treatments have been suggested to reduce distress in patients with cancer. However, not all patients use these interventions because of limited access or lack of awareness. To overcome these barriers, mobile health may be a promising way to deliver the respective supportive treatments. Objective The aim of this study is to evaluate the effects and implementation of a mindfulness and relaxation app intervention for patients with cancer as well as patients’ adherence to such an intervention. Methods In this observational feasibility study with a mixed methods approach, patients with cancer were recruited through the web and through hospitals in Switzerland. All enrolled patients received access to a mindfulness and relaxation app. Patients completed self-reported outcomes (general health, health-related quality of life, anxiety, depression, distress, mindfulness, and fear of progression) at baseline and at weeks 4, 10, and 20. The frequency of app exercise usage was gathered directly through the app to assess the adherence of patients. In addition, we conducted interviews with 5 health professionals for their thoughts on the implementation of the app intervention in standard medical care. We analyzed patients’ self-reported outcomes using linear mixed models (LMMs) and qualitative data with content analysis. Results A total of 100 patients with cancer (74 female) with a mean age of 53.2 years (SD 11.6) participated in the study, of which 25 patients used the app regularly until week 20. LMM analyses revealed improvements in anxiety (P=.04), distress (P<.001), fatigue (P=.01), sleep disturbance (P=.02), quality of life (P=.03), and mindfulness (P<.001) over the course of 20 weeks. Further LMM analyses revealed a larger improvement in distress (P<.001), a moderate improvement in anxiety (P=.001), and a larger improvement in depression (P=.03) in patients with high levels of symptoms at baseline in the respective domains. The interviews revealed that the health professionals perceived the app as a helpful addition to standard care. They also made suggestions for improvements, which could facilitate the implementation of and adherence to such an app. Conclusions This study indicates that a mindfulness and relaxation app for patients with cancer can be a feasible and effective way to deliver a self-care intervention, especially for highly distressed patients. Future studies should investigate if the appeal of the app can be increased with more content, and the effectiveness of such an intervention needs to be tested in a randomized controlled trial.
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Affiliation(s)
- Michael Mikolasek
- Institute for Complementary and Integrative Medicine, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Claudia Margitta Witt
- Institute for Complementary and Integrative Medicine, University Hospital Zurich and University of Zurich, Zurich, Switzerland.,Institute for Social Medicine, Epidemiology and Health Economics, Charité, Universitätsmedizin Berlin, Berlin, Germany.,Center for Integrative Medicine, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Jürgen Barth
- Institute for Complementary and Integrative Medicine, University Hospital Zurich and University of Zurich, Zurich, Switzerland
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Světlák M, Linhartová P, Knejzlíková T, Knejzlík J, Kóša B, Horníčková V, Jarolínová K, Lučanská K, Slezáčková A, Šumec R. Being Mindful at University: A Pilot Evaluation of the Feasibility of an Online Mindfulness-Based Mental Health Support Program for Students. Front Psychol 2021; 11:581086. [PMID: 33505332 PMCID: PMC7829670 DOI: 10.3389/fpsyg.2020.581086] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 11/30/2020] [Indexed: 12/15/2022] Open
Abstract
University study can be a life period of heightened psychological distress for many students. The development of new preventive and intervention programs to support well-being in university students is a fundamental challenge for mental health professionals. We designed an 8-week online mindfulness-based program (eMBP) combining a face-to-face approach, text, audio, video components, and support psychotherapy principles with a unique intensive reminder system using the Facebook Messenger and Slack applications in two separate runs (N = 692). We assessed the program's effect on mindful experiencing, perceived stress, emotion regulation strategies, self-compassion, negative affect, and quality of life. The results of the presented pilot study confirmed that eMBP is a feasible and effective tool in university students' mental health support. The students who completed the eMBP reported a reduction of perceived stress with a large effect size ( p η2 = 0.42) as well as a decrease of negative affect experience frequency and intensity ( p η2 = 0.31), an increase of being mindful in their life (Five Facet Mindfulness Questionnaire subscales: p η2 = 0.21, 0.27, 0.25, 0.28, 0.28), and a higher rate of self-compassion ( p η2 = 0.28) with a medium effect size. A small effect size was found in the frequency of using a cognitive reappraisal strategy ( p η2 = 0.073). One new result is the observation of an eMBP effect ( p η2 = 0.27) on the decrease in attributed importance to the quality-of-life components replicated in two consecutive runs of the program. The study affirms that mindfulness-based interventions can be effectively delivered in an eHealth form to university students.
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Affiliation(s)
- Miroslav Světlák
- Department of Psychiatry, Faculty of Medicine, Masaryk University, Brno, Czechia.,Department of Psychology and Psychosomatics, Faculty of Medicine, Masaryk University, Brno, Czechia
| | - Pavla Linhartová
- Department of Psychiatry, Faculty of Medicine, Masaryk University, Brno, Czechia
| | - Terezia Knejzlíková
- Department of Psychiatry, Faculty of Medicine, Masaryk University, Brno, Czechia.,Department of Psychology and Psychosomatics, Faculty of Medicine, Masaryk University, Brno, Czechia
| | - Jakub Knejzlík
- Department of Psychology and Psychosomatics, Faculty of Medicine, Masaryk University, Brno, Czechia
| | - Barbora Kóša
- Department of Psychology and Psychosomatics, Faculty of Medicine, Masaryk University, Brno, Czechia
| | - Veronika Horníčková
- Department of Psychology, Faculty of Arts, Masaryk University, Brno, Czechia
| | - Kristýna Jarolínová
- Department of Psychology, Faculty of Arts, Masaryk University, Brno, Czechia
| | - Klaudia Lučanská
- Department of Psychology, Faculty of Arts, Masaryk University, Brno, Czechia
| | - Alena Slezáčková
- Department of Psychology and Psychosomatics, Faculty of Medicine, Masaryk University, Brno, Czechia.,Department of Psychology, Faculty of Arts, Masaryk University, Brno, Czechia
| | - Rastislav Šumec
- Department of Psychology and Psychosomatics, Faculty of Medicine, Masaryk University, Brno, Czechia.,First Department of Neurology, Faculty of Medicine, Masaryk University and St. Anne's University Hospital, Brno, Czechia
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Lunsky Y, Albaum C, Baskin A, Hastings RP, Hutton S, Steel L, Wang W, Weiss J. Group Virtual Mindfulness-Based Intervention for Parents of Autistic Adolescents and Adults. J Autism Dev Disord 2021; 51:3959-3969. [PMID: 33420938 PMCID: PMC7796683 DOI: 10.1007/s10803-020-04835-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/08/2020] [Indexed: 12/05/2022]
Abstract
Mindfulness-based approaches have been shown to be effective in improving the mental health of parents of youth and adults with autism and other developmental disabilities, but prior work suggests that geography and caregiving demands can make in-person attendance challenging. The purpose of this study was to evaluate the feasibility, acceptability and preliminary outcomes of a mindfulness-based group intervention delivered to parents virtually. It was feasible to deliver this manualized intervention. Twenty-one of 39 parents completed the intervention and completers reported high satisfaction ratings. Parents reported reduced levels of distress, maintained at 3-month follow-up, and increased mindfulness. Changes reported following intervention were similar to changes reported in a prior study of parents competing an in person mindfulness group.
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Affiliation(s)
- Y Lunsky
- Azrieli Adult Neurodevelopmental Centre, Centre for Addiction and Mental Health, 1025 Queen Street West, Toronto, ON, Canada.
- Department of Psychiatry, University of Toronto, Medical Sciences Building, 1 King's College Cir, Toronto, ON, Canada.
| | - C Albaum
- Department of Psychology, York University, Department of Psychology Room 291. Behavioural Sciences Building 4700 Keele Street, Toronto, ON, Canada
| | - A Baskin
- Azrieli Adult Neurodevelopmental Centre, Centre for Addiction and Mental Health, 1025 Queen Street West, Toronto, ON, Canada
| | - R P Hastings
- Centre for Educational Development, Appraisal and Research, University of Warwick, Coventry, CV4 7AL, UK
- Department of Psychiatry, Centre for Developmental Psychiatry and Psychology, Monash University, Clayton, VIC, 3168, Australia
| | - S Hutton
- Azrieli Adult Neurodevelopmental Centre, Centre for Addiction and Mental Health, 1025 Queen Street West, Toronto, ON, Canada
| | - L Steel
- Azrieli Adult Neurodevelopmental Centre, Centre for Addiction and Mental Health, 1025 Queen Street West, Toronto, ON, Canada
| | - W Wang
- Centre for Addiction and Mental Health, 1001 Queen Street West, Toronto, ON, Canada
| | - J Weiss
- Department of Psychology, York University, Department of Psychology Room 291. Behavioural Sciences Building 4700 Keele Street, Toronto, ON, Canada
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Kang C, Sun S, Yang Z, Fan X, Yuan J, Xu L, Wei Y, Tong H, Yang J. The Psychological Effect of Internet-Based Mindfulness-Based Stress Reduction on the Survivors of Breast Cancer During the COVID-19. Front Psychiatry 2021; 12:738579. [PMID: 34658972 PMCID: PMC8514713 DOI: 10.3389/fpsyt.2021.738579] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 09/01/2021] [Indexed: 12/28/2022] Open
Abstract
Objective: To examine the efficacy and the role of engagement of an internet-based Mindfulness-based Stress Reduction (iMBSR) for survivors of breast cancer (BC) during the COVID-19 period from January to March in 2020 in China. Methods: 48 survivors of BC were divided into the absentees group and the iMBSR groups according to their attending to the standardized, group-based, 8-week iMBSR. Based on practice time, survivors of BC in the iMBSR were categorized into three subgroups: group 1 (<30 min/day), group 2 (30-60 min/day), and group 3 (>60 min/day). In addition, participants were classified as partial attendees (<4 sessions) and completers (more than 4 sessions) of the iMBSR groups. All participants were evaluated for symptoms of depression, anxiety and insomnia at baseline, mid-intervention, and post-intervention. Results: After an 8-week iMBSR practice, at mid-intervention and post-intervention, participants in iMBSR group had significant improvement in scores and reduction rates of depression, anxiety, and insomnia compared to absentees. Scores of depression and insomnia, reduction rates of depression at post-intervention, scores of anxiety, reduction rates of anxiety and insomnia at mid-intervention and post-intervention, had significant differences among subgroups of practice time. Daily practice time was positively related to reduction rates of depression, anxiety and insomnia at post-intervention in the iMBSR group. Conclusion: Internet-based MBSR showed efficacy in reducing psychological symptoms among survivors of BC. For survivors of BC, iMBSR practice has a potential dose-response efficacy, with a threshold of >30 min daily practice for most optimal symptoms reduction. Trial Registration: Registration number is [ChiCTR2100044309].
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Affiliation(s)
- Chuanyuan Kang
- Department of Psychosomatic Medicine, Tongji University School of Medicine, Shanghai East Hospital, Shanghai, China
| | - Shufang Sun
- Mindfulness Center at Brown University, Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, United States
| | - Zhuangqing Yang
- The 3rd Department of Breast Surgery, Breast Cancer Centre of Yunnan Cancer Hospital, The Third Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Xinxin Fan
- Department of Psychiatry, The Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Jing Yuan
- Department of Psychiatry, The Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Li Xu
- Department of Psychiatry, The Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Yujun Wei
- Department of Psychiatry, The Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Huiqi Tong
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, United States
| | - Jianzhong Yang
- Department of Psychiatry, The Second Affiliated Hospital of Kunming Medical University, Kunming, China
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Shao D, Zhang H, Cui N, Sun J, Li J, Cao F. The efficacy and mechanisms of a guided self-help intervention based on mindfulness in patients with breast cancer: A randomized controlled trial. Cancer 2020; 127:1377-1386. [PMID: 33332582 DOI: 10.1002/cncr.33381] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 10/13/2020] [Accepted: 11/25/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND Mindfulness-based interventions (MBIs) can alleviate psychological distress in patients with cancer. However, face-to-face MBIs may be inconvenient for patients. Therefore, guided self-help interventions may be more accessible. The authors investigated the effects of a guided self-help MBI for depression, anxiety, and sleep disorder symptoms in patients with breast cancer and explored the potential underlying mechanisms. METHODS One hundred forty-four postoperative patients with breast cancer were randomly assigned to an intervention group (6-week guided self-help MBI; n = 72) or a wait-list control group (routine treatment; n = 72). Self-reported depression, anxiety, sleep disorder symptoms, and rumination and worry as potential mediators were assessed at baseline and postintervention. Outcomes were then assessed at 1-month and 3-month follow-up. The intervention's effects over time and the potential mediating effect were analyzed using generalized estimating equations. The trial was registered at the Chinese Clinical Registry (ChiCTR-IOR-16008073). RESULTS Significant improvements in depression and sleep disorder symptoms occurred in the intervention group compared with wait-list controls, and the improvements were maintained at 1-month and 3-month follow-up. Changes in rumination and worry mediated the intervention's effects on changes in depression and sleep disorder symptoms. CONCLUSIONS A guided self-help MBI reduced depressive and sleep disorder symptoms by mitigating rumination and worry in patients with breast cancer. These findings support benefits of this accessible psychological intervention in oncology and provide insight into possible mechanisms of action. The current research contributes to discovering effective and widely accessible means for people with physical health conditions and may remove barriers that otherwise would have precluded participation in face-to-face psychological interventions.
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Affiliation(s)
- Di Shao
- Center for Health Management and Policy, School of Public Health, National Health Commission Key Laboratory of Health Economics and Policy, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Huihui Zhang
- Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Naixue Cui
- School of Nursing, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Jiwei Sun
- School of Nursing, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Jie Li
- Center for Health Management and Policy, School of Public Health, National Health Commission Key Laboratory of Health Economics and Policy, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Fenglin Cao
- School of Nursing, Cheeloo College of Medicine, Shandong University, Jinan, China
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Lucas-Thompson RG, Rayburn S, Seiter NS, Broderick PC, Smyth JM, Coatsworth JD, Henry KL. Learning to BREATHE "Plus": A Multi-Modal Adaptive Supplement to an Evidence-Based Mindfulness Intervention for Adolescents. Front Public Health 2020; 8:579556. [PMID: 33282814 PMCID: PMC7705247 DOI: 10.3389/fpubh.2020.579556] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 10/19/2020] [Indexed: 01/03/2023] Open
Abstract
Incorporating technological supplements into existing group mindfulness-based interventions (MBIs), particularly for use with adolescents, is an important next step in the implementation of MBIs. Yet there is little available content. Herein we present the development and content of a technological supplement for MBIs, which incorporates multiple technological elements to support (a) skill transfer from the group MBI to daily life, (b) the establishment of a formal mindfulness practice, and (c) the use of mindfulness during periods of high stress. A mixed-methods approach was used to develop this multi-method adaptive supplement. Findings about the use of this supplement will be disseminated scientifically and/or publicly as appropriate.
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Affiliation(s)
- Rachel G Lucas-Thompson
- Department of Human Development and Family Studies, Colorado State University, Fort Collins, CO, United States
| | - Stephanie Rayburn
- Department of Human Development and Family Studies, Colorado State University, Fort Collins, CO, United States
| | - Natasha S Seiter
- Department of Human Development and Family Studies, Colorado State University, Fort Collins, CO, United States
| | - Patricia C Broderick
- Bennett-Pierce Prevention Research Center, Pennsylvania State University, University Park, PA, United States
| | - Joshua M Smyth
- Biobehavioral Health and Medicine, Pennsylvania State University, University Park, PA, United States
| | - J Douglas Coatsworth
- Department of Human Development and Family Studies, Colorado State University, Fort Collins, CO, United States
| | - Kimberly L Henry
- Department of Psychology, Colorado State University, Fort Collins, CO, United States
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Matis J, Svetlak M, Slezackova A, Svoboda M, Šumec R. Mindfulness-Based Programs for Patients With Cancer via eHealth and Mobile Health: Systematic Review and Synthesis of Quantitative Research. J Med Internet Res 2020; 22:e20709. [PMID: 33196452 PMCID: PMC7704284 DOI: 10.2196/20709] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 09/22/2020] [Accepted: 09/30/2020] [Indexed: 01/07/2023] Open
Abstract
Background eHealth mindfulness-based programs (eMBPs) are on the rise in complex oncology and palliative care. However, we are still at the beginning of answering the questions of how effective eMBPs are and for whom, and what kinds of delivery modes are the most efficient. Objective This systematic review aims to examine the feasibility and efficacy of eMBPs in improving the mental health and well-being of patients with cancer, to describe intervention characteristics and delivery modes of these programs, and to summarize the results of the included studies in terms of moderators, mediators, and predictors of efficacy, adherence, and attrition. Methods In total, 4 databases (PubMed, PsycINFO, Scopus, and Web of Knowledge) were searched using relevant search terms (eg, mindfulness, program, eHealth, neoplasm) and their variations. No restrictions were imposed on language or publication type. The results of the efficacy of eMBPs were synthesized through the summarizing effect estimates method. Results
A total of 29 published papers describing 24 original studies were included in this review. In general, the results indicate that eMBPs have the potential to reduce the levels of stress, anxiety, depression, fatigue, sleep problems, and pain, and improve the levels of mindfulness, posttraumatic growth, and some parameters of general health. The largest median of Cohen d effect sizes were observed in reducing anxiety and depression (within-subject: median −0.38, IQR −0.62 to −0.27; between-group:
median −0.42, IQR −0.58 to −0.22) and facilitating posttraumatic growth (within-subject: median 0.42, IQR 0.35 to 0.48;
between-group: median 0.32, IQR 0.22 to 0.39). The efficacy of eMBP may be comparable with that of parallel, face-to-face
MBPs in some cases. All studies that evaluated the feasibility of eMBPs reported that they are feasible for patients with cancer.
Potential moderators, mediators, and predictors of the efficacy, attrition, and adherence of eMBPs are discussed.
Conclusions Although the effects of the reviewed studies were highly heterogeneous, the review provides evidence that eMBPs are an appropriate way for mindfulness practice to be delivered to patients with cancer. Thus far, existing eMBPs have mostly attempted to convert proven face-to-face mindfulness programs to the eHealth mode. They have not yet fully exploited the potential of eHealth technology.
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Affiliation(s)
- Juraj Matis
- Department of Psychology, Faculty of Arts, Masaryk University, Brno, Czech Republic
| | - Miroslav Svetlak
- Department of Psychology and Psychosomatics, Faculty of Medicine, Masaryk University, Brno, Czech Republic.,Department of Psychiatry, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Alena Slezackova
- Department of Psychology, Faculty of Arts, Masaryk University, Brno, Czech Republic.,Department of Psychology and Psychosomatics, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Marek Svoboda
- Department of Comprehensive Cancer Care, Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - Rastislav Šumec
- Department of Psychology and Psychosomatics, Faculty of Medicine, Masaryk University, Brno, Czech Republic.,First Department of Neurology, Faculty of Medicine, Masaryk University and St. Anne's University Hospital, Brno, Czech Republic
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Coster S, Gould RL, Coulson M, Norman IJ. An online mindfulness intervention to enhance compassion in nursing practice: A feasibility and acceptability study with nursing students. INTERNATIONAL JOURNAL OF NURSING STUDIES ADVANCES 2020; 2:100004. [PMID: 38745902 PMCID: PMC11080300 DOI: 10.1016/j.ijnsa.2020.100004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 06/06/2020] [Accepted: 06/08/2020] [Indexed: 12/18/2022] Open
Abstract
Background Compassion is an important component of nursing care, but public enquiries into care failures have noted that it is not always evident. Mindfulness interventions have the potential to support compassion. However, the feasibility of delivering a mindfulness intervention at scale to nursing students has not been established. Objectives To develop and test the feasibility and acceptability of a tailored mindfulness based online intervention to foster compassion in nursing students within clinical practice. Design A randomised feasibility study with a waiting list control. Setting A UK nursing faculty within a large university. Participants Post-graduate, post-registration and pre-registration nursing students (N = 77). Methods An online five module mindfulness based intervention (Mindful Nursing Online) was developed and tailored to support compassion in clinical nursing. The feasibility study comprised 77 participants randomised in a 2:1 ratio into an immediate access group (intervention, n = 50) or a delayed access group (waiting list control, n = 27). Data on feasibility through completion, attrition and practice rates, were collected through follow-up questionnaires at post-intervention, and 14 and 20 weeks after baseline. Acceptability data was collected through semi-structured interviews with 12 participants. Results Non-completion rates were high with all five modules completed by only 28% (n = 14) of participants, and three modules completed by only 46% (n = 23). The most commonly cited reason for non-completion was lack of time. However, the interview data suggested those who completed the intervention were using mindfulness techniques in practice. They described feeling less stressed on the ward, having an increased focus on patients and a greater appreciation of the importance of self-care. Evaluative feedback therefore showed that the intervention was perceived to be effective at promoting mindfulness skills and was relevant to nursing work. Conclusion Minimising attrition and enhancing engagement with the intervention should be the key objectives of a future study. Feedback from participants who completed the intervention indicates that a brief mindfulness intervention delivered online may support the delivery of compassionate nursing care.
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Affiliation(s)
- Samantha Coster
- Research Fellow, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London
| | - Rebecca L. Gould
- Lecturer, Division of Psychiatry, Faculty of Brain Sciences, University College London, London
| | - Mark Coulson
- Associate Professor of Psychology, School of Psychology, Faculty of Social Sciences, University of East Anglia, London
| | - Ian James Norman
- Executive Dean, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London
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Kantrowitz-Gordon I, McCurry SM, Landis CA, Lee R, Wi D. Online prenatal trial in mindfulness sleep management (OPTIMISM): protocol for a pilot randomized controlled trial. Pilot Feasibility Stud 2020; 6:128. [PMID: 32944276 PMCID: PMC7488736 DOI: 10.1186/s40814-020-00675-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 09/01/2020] [Indexed: 11/10/2022] Open
Abstract
Background Sleep deficiency affects a majority of pregnant women with significant impact on daily function, mood, and pregnancy and birth outcomes. This ongoing study combines two evidence-based strategies for improving sleep and mood, mindfulness meditation and cognitive-behavioral therapy for insomnia (CBT-I), in a unique online format to address the particular needs of pregnant women. The purpose of this study is to test the feasibility and estimate the efficacy of this novel 6-week online mindfulness meditation intervention to help pregnant women in remission from depression self-manage insomnia. Methods This is a two-arm, parallel group randomized controlled trial. A total of 50 pregnant women between 12 and 28 weeks gestation will be recruited from the community and randomly assigned to a mindfulness or education-only control group in a 1:1 ratio. During the study, all participants will complete six weekly online modules, daily sleep diaries, and optional participation in a treatment-specific online discussion forum. Feasibility outcome measures will include study recruitment, retention, intervention adherence (number of online modules completed, number of meditation days per week), and intervention acceptability (8-item questionnaire). The primary clinical outcome measure will be sleep quality measured with the Pittsburgh Sleep Quality Index. Secondary outcome measures will include sleep measured with actigraphy and diaries (sleep efficiency, total sleep time, total wake time), Patient-Reported Outcomes Measurement Information System (PROMIS) measures (fatigue, sleep-related impairment, sleep disturbance); mood (depression, anxiety, positive affect, quality of life); and self-management and behavior change (potential self-efficacy, self-regulation, sleep problem acceptance, and trait mindfulness). Assessments will occur at baseline and post-intervention; an additional acceptability survey will be completed 4 weeks postpartum. Analyses will examine within-group differences in outcome change scores from baseline to post-intervention. Open-ended feedback will be analyzed using qualitative content analysis. Discussion This research is innovative in addressing sleep in pregnancy using a self-management research design and methods that can be accessible and cost-effective for large numbers of pregnant women. The results from this study will inform intervention refinement and efficacy testing of the intervention in a larger randomized controlled trial. Trial registration ClinicalTrials.gov, NCT04016428. Registered on 11 July 2019. Updated version registered on 26 July 2019.
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Affiliation(s)
- Ira Kantrowitz-Gordon
- Child, Family, and Population Health Nursing, University of Washington, Box 357262, Seattle, WA 98195 USA
| | - Susan M McCurry
- Child, Family, and Population Health Nursing, University of Washington, Box 357262, Seattle, WA 98195 USA
| | - Carol A Landis
- Biobehavioral Nursing and Health Informatics, University of Washington, Box 357266, Seattle, WA 98195 USA
| | - Rachel Lee
- Child, Family, and Population Health Nursing, University of Washington, Box 357262, Seattle, WA 98195 USA
| | - Dahee Wi
- Child, Family, and Population Health Nursing, University of Washington, Box 357262, Seattle, WA 98195 USA
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Abbott DJ, Lack CW. Conventional versus Mindfulness-based Interventions for Anxiety and Worry: A Review and Recommendations. CURRENT PSYCHIATRY RESEARCH AND REVIEWS 2020. [DOI: 10.2174/2666082216666200220121648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Anxiety disorders are among the most prevalent and most functionally impairing psychiatric
problems experienced by the population. Both pharmacological and psychological evidencebased
treatments exist for a number of specific disorders, but may fail to fully relieve symptoms,
pointing to the need for additional treatment options. Often considered to be part of the “third wave”
of cognitive-behavioral therapies, treatments incorporating mindfulness have emerged in the past
two decades as increasingly popular with clinicians and frequently sought out by consumers. The
present article reviews the extant literature regarding the efficacy and effectiveness of mindfulnessbased
treatments for anxiety, worry, and related problems. Although they have not attained the solid
empirical status of CBT or certain pharmacological treatments, the extant research shows mindfulness-
based interventions appear to be a promising and useful treatment for people suffering from
anxiety and worry. Further work should be done, levels 3-5 of the NIH stage model to determine
whether or not they should be further implemented.
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Affiliation(s)
- Deah Jo Abbott
- Department of Psychology, Georgia State University, Atlanta, GA 30302, United States
| | - Caleb Wayne Lack
- Department of Psychology, University of Central Oklahoma, Edmond, OK 73034, United States
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Hearn JH, Finlay KA, Sheffield D. ‘Trying to bring attention to your body when you’re not sure where it is’: An interpretative phenomenological analysis of drivers and barriers to mindfulness for people with spinal cord injury. Br J Health Psychol 2020; 26:161-178. [DOI: 10.1111/bjhp.12462] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 07/01/2020] [Indexed: 01/12/2023]
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Tang R, Braver TS. Towards an Individual Differences Perspective in Mindfulness Training Research: Theoretical and Empirical Considerations. Front Psychol 2020; 11:818. [PMID: 32508702 PMCID: PMC7248295 DOI: 10.3389/fpsyg.2020.00818] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Accepted: 04/02/2020] [Indexed: 11/13/2022] Open
Abstract
A growing body of research indicates that mindfulness training can have beneficial effects on critical aspects of psychological well-being, cognitive function, and brain health. Although these benefits have been generalized to the population level, individual variability in observed effects of mindfulness training has not been systematically investigated. Research on other similar forms of psychological intervention demonstrates that individual differences are prominent in terms of intervention responsiveness and outcomes. Furthermore, individual characteristics such as personality traits have been shown to play a crucial role in influencing the effects of intervention. In light of these lines of evidence, we review representative work on individual differences in mindfulness training and advocate for an individual difference perspective in mindfulness training research. We discuss relevant empirical evidence of individual differences potentially influencing behavioral outcomes of mindfulness training, focusing on both cognitive function and psychological well-being. Finally, theoretical considerations and potentially fruitful research strategies and directions for studying individual differences in mindfulness training are discussed, including those involving cognitive neuroscience methods.
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Affiliation(s)
- Rongxiang Tang
- Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, MO, United States
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Patel A, Sharma PSVN, Kumar P. Application of Mindfulness-Based Psychological Interventions in Infertility. J Hum Reprod Sci 2020; 13:3-21. [PMID: 32577063 PMCID: PMC7295259 DOI: 10.4103/jhrs.jhrs_51_19] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 06/25/2019] [Accepted: 11/22/2019] [Indexed: 11/25/2022] Open
Abstract
Living mindfully helps one gain a deeper understanding into realities of life. It enables people to witness suffering, desire, attachments, and impermanence without any fear, anxiety, anger, or despair. This is considered the hallmark of true psychological insight. As a skill, mindfulness can be inculcated by anyone. Mindfulness helps in attending, getting aware and understanding experiences in a compassion and open-minded way. Research suggests that applying mindfulness in daily life has been known to tame our emotional mind and enabled people to perceive things “as they are” without ascribing expectations, judgments, cynicism, or apprehensions to them. This review unravels the therapeutic power of mindfulness meditation in the context of infertility distress. It serves to integrate the evidence on the effectiveness of mindfulness-based psychological interventions to improve the emotional well-being and biological outcomes in Infertility.
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Affiliation(s)
- Ansha Patel
- Department of Psychiatry, Kasturba Medical College, MAHE, Manipal, Karnataka, India
| | - P S V N Sharma
- Department of Psychiatry, Kasturba Medical College, MAHE, Manipal, Karnataka, India
| | - Pratap Kumar
- Department of Obstetrics and Gynaecology, Manipal Assisted Reproduction Centre, Kasturba Medical College, MAHE, Manipal, Karnataka, India
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Abstract
Initially inspired by Buddhist philosophy and practice, mindfulness has become ubiquitous in psychotherapy, counseling, and popular psychology. Several mindfulness interventions have been developed and investigated, many of them attaining strong empirical support for a variety of conditions. However, the authors argue that mindfulness interventions should not be used uncritically and indiscriminately, because, for instance, there is not enough efficacy evidence for all the uses and applications of mindfulness (e.g., mobile apps). Second, following the definition of the concept, the authors argue that detachment may decrease motivational relevance in the face of personal goals and may encourage low intensity affect in cases where this would not be either needed or desirable. On the other hand, they argue that mindfulness-based interventions can be particularly useful treating chronic and severe cases, particularly in depression, pain conditions, and addictions.
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Affiliation(s)
- Simona Stefan
- Department of Clinical Psychology and Psychotherapy, Babes-Bolyai University, Cluj-Napoca, Romania
| | - Daniel David
- Department of Clinical Psychology and Psychotherapy, Babes-Bolyai University, Cluj-Napoca, Romania
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Mindfulness for Preventing Psychosocial Risks in the Workplace: A Systematic Review and Meta-Analysis. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10051851] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Organizations today are implementing psychological interventions to promote the job performance and wellbeing of their employees. Mindfulness-based interventions (MBIs) can contribute to providing workers with competencies and skills and develop their strengths. MBIs are therefore becoming more and more present in the workplace, sometimes using online intervention programs, which offer a promising direction in prevention and intervention for health. The objective of this study is to analyze the efficacy of MBIs on psychological variables in the workplace. For this purpose, a search for scientific articles published from 2009 to 2019 was made in the Psicodoc, PsycINFO, and Web of Science databases, where a total of 468 articles were found. After filtering with preestablished inclusion criteria, 24 studies were included in the systematic review and meta-analysis. The results of the meta-analysis suggest that intervention in mindfulness positively influences psychological variables related to employee health and wellbeing. However, it is recommended to continue performing new studies to confirm this finding.
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Apolinário-Hagen J, Drüge M, Fritsche L. Cognitive Behavioral Therapy, Mindfulness-Based Cognitive Therapy and Acceptance Commitment Therapy for Anxiety Disorders: Integrating Traditional with Digital Treatment Approaches. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020; 1191:291-329. [DOI: 10.1007/978-981-32-9705-0_17] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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Lippmann M, Laudel H, Heinzle M, Narciss S. Relating Instructional Design Components to the Effectiveness of Internet-Based Mindfulness Interventions: A Critical Interpretive Synthesis. J Med Internet Res 2019; 21:e12497. [PMID: 31774413 PMCID: PMC6906627 DOI: 10.2196/12497] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 08/17/2019] [Accepted: 09/26/2019] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Internet-based mindfulness interventions are a promising approach to address challenges in the dissemination and implementation of mindfulness interventions, but it is unclear how the instructional design components of such interventions are associated with intervention effectiveness. OBJECTIVE The objective of this study was to identify the instructional design components of the internet-based mindfulness interventions and provide a framework for the classification of those components relative to the intervention effectiveness. METHODS The critical interpretive synthesis method was applied. In phase 1, a strategic literature review was conducted to generate hypotheses for the relationship between the effectiveness of internet-based mindfulness interventions and the instructional design components of those interventions. In phase 2, the literature review was extended to systematically explore and revise the hypotheses from phase 1. RESULTS A total of 18 studies were identified in phase 1; 14 additional studies were identified in phase 2. Of the 32 internet-based mindfulness interventions, 18 were classified as more effective, 11 as less effective, and only 3 as ineffective. The effectiveness of the interventions increased with the level of support provided by the instructional design components. The main difference between effective and ineffective interventions was the presence of just-in-time information in the form of reminders. More effective interventions included more supportive information (scores: 1.91 in phases 1 and 2) than less effective interventions (scores: 1.00 in phase 1 and 1.80 in phase 2), more part-task practice (scores: 1.18 in phase 1 and 1.60 in phase 2) than less effective interventions (scores: 0.33 in phase 1 and 1.40 in phase 2), and provided more just-in-time information (scores: 1.35 in phase 1 and 1.67 in phase 2) than less effective interventions (scores: 0.83 in phase 1 and 1.60 in phase 2). The average duration of more effective, less effective, and ineffective interventions differed for the studies of phase 1, with more effective interventions taking up more time (7.45 weeks) than less effective (4.58 weeks) or ineffective interventions (3 weeks). However, this difference did not extend to the studies of phase 2, with comparable average durations of effective (5.86 weeks), less effective (5.6 weeks), and ineffective (7 weeks) interventions. CONCLUSIONS Our results suggest that to be effective, internet-based mindfulness interventions must contain 4 instructional design components: formal learning tasks, supportive information, part-task practice, and just-in-time information. The effectiveness of the interventions increases with the level of support provided by each of these instructional design components.
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Affiliation(s)
- Marie Lippmann
- Department of Psychology, California State University, Chico, CA, United States
| | - Helena Laudel
- Psychology of Learning and Instruction, Faculty of Psychology - School of Science, Technische Universität Dresden, Dresden, Germany
| | - Marlene Heinzle
- Department of Media, Cognition and Communication, Faculty of Humanities, University of Copenhagen, Copenhagen, Denmark
| | - Susanne Narciss
- Psychology of Learning and Instruction, Faculty of Psychology - School of Science, Technische Universität Dresden, Dresden, Germany
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