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Alhasani R, Janaudis Ferreira T, Marie-France Valois, Singh D, Ahmed S. Enrollment and dropout rates of individuals with chronic obstructive pulmonary disease approached for telehealth interventions: A systematic review and meta-regression analysis. Heliyon 2024; 10:e23776. [PMID: 38230240 PMCID: PMC10789598 DOI: 10.1016/j.heliyon.2023.e23776] [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: 03/19/2023] [Revised: 12/05/2023] [Accepted: 12/13/2023] [Indexed: 01/18/2024] Open
Abstract
Introduction Telehealth interventions have the potential of improving health outcomes for individuals with chronic obstructive pulmonary disease (COPD). However, the precise impact of telehealth on exacerbation and hospital readmissions remains inconclusive. This lack of knowledge on the effectiveness of telehealth for COPD care might be due to lack of clarity regarding which variables are most strongly associated with enrolment and dropout rates. Objectives Among individuals with COPD in telehealth studies, we aimed to: (1) estimate the extent to which trial-related variables are associated with enrolment and dropout rates, and identify reasons for dropouts; (2) estimate the extent to which patients-related and intervention-related variables are associated with dropout rates; (3) estimate the effect of enrolment rate and dropout rate on effect size; (4) estimate the effect of trial-related, patient-related, and intervention-related variables on effect size. Methods A systematic literature search was conducted using four electronic databases. Two independent reviewers screened all retrieved titles, abstracts and full texts according to the inclusion criteria and extracted the data. A random-effect meta-regression analysis was conducted to estimate the overall enrolment and dropout rates, and estimated the different variables' effects on the enrolment rate, dropout rate, and effect sizes in the studies included in the review. Results A total of 56 studies comprising 7530 participants were identified. The estimated enrolment and dropout rates were 50.3 % and 14.9 %, respectively. Trial-related variables influence enrollment and dropout rates, including RCT designs and the recruitments. The patient-related variables, including age and severity of the disease, and intervention-related variables, including the components of the intervention and mode of delivery, influence dropout rates. Studies with low dropout rates had a bigger effect size by 0.23. The main reported reasons for dropping out of the intervention were related to death (21 %) followed by lost to follow-up (14 %). Conclusion Trial, patient, and intervention-related variables were found to influence the enrolment and dropout rates. This would help plan and develop a more appealing telehealth intervention that patients can easily accept and incorporate into their everyday lives. Registration information International Prospective Register of Systematic Reviews (PROSPERO); ID: CRD42017078541.
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Affiliation(s)
- Rehab Alhasani
- Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Tania Janaudis Ferreira
- School of Physical and Occupational Therapy, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, Quebec, Canada
- McGill University Health Center Research Institute, Clinical Epidemiology, Center for Outcome Research and Evaluation (CORE), Montreal, Quebec, Canada
| | | | - Dharmender Singh
- School of Physical and Occupational Therapy, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, Quebec, Canada
| | - Sara Ahmed
- School of Physical and Occupational Therapy, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, Quebec, Canada
- McGill University Health Center Research Institute, Clinical Epidemiology, Center for Outcome Research and Evaluation (CORE), Montreal, Quebec, Canada
- Constance Lethbridge Rehabilitation Center, CIUSSS Centre- Ouest de l'Îile de Montreal, Montreal, Quebec, Canada
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Volpato E, Farver-Vestergaard I, Brighton LJ, Peters J, Verkleij M, Hutchinson A, Heijmans M, von Leupoldt A. Nonpharmacological management of psychological distress in people with COPD. Eur Respir Rev 2023; 32:32/167/220170. [PMID: 36948501 PMCID: PMC10032611 DOI: 10.1183/16000617.0170-2022] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Accepted: 12/31/2022] [Indexed: 03/24/2023] Open
Abstract
Psychological distress is prevalent in people with COPD and relates to a worse course of disease. It often remains unrecognised and untreated, intensifying the burden on patients, carers and healthcare systems. Nonpharmacological management strategies have been suggested as important elements to manage psychological distress in COPD. Therefore, this review presents instruments for detecting psychological distress in COPD and provides an overview of available nonpharmacological management strategies together with available scientific evidence for their presumed benefits in COPD. Several instruments are available for detecting psychological distress in COPD, including simple questions, questionnaires and clinical diagnostic interviews, but their implementation in clinical practice is limited and heterogeneous. Moreover, various nonpharmacological management options are available for COPD, ranging from specific cognitive behavioural therapy (CBT) to multi-component pulmonary rehabilitation (PR) programmes. These interventions vary substantially in their specific content, intensity and duration across studies. Similarly, available evidence regarding their efficacy varies significantly, with the strongest evidence currently for CBT or PR. Further randomised controlled trials are needed with larger, culturally diverse samples and long-term follow-ups. Moreover, effective nonpharmacological interventions should be implemented more in the clinical routine. Respective barriers for patients, caregivers, clinicians, healthcare systems and research need to be overcome.
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Affiliation(s)
- Eleonora Volpato
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
- IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy
- Shared first authorship
| | | | - Lisa Jane Brighton
- Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King's College London, London, UK
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Jeannette Peters
- Department of Pulmonary Diseases, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - Marieke Verkleij
- Department of Paediatric Psychology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | | | - Monique Heijmans
- Netherlands Institute for Health Services Research (Nivel), Utrecht, The Netherlands
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Marks E, Moghaddam N, De Boos D, Malins S. A systematic review of the barriers and facilitators to adherence to
mindfulness‐based
cognitive therapy for those with chronic conditions. Br J Health Psychol 2022; 28:338-365. [PMID: 36310447 DOI: 10.1111/bjhp.12628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 09/20/2022] [Accepted: 09/29/2022] [Indexed: 11/30/2022]
Abstract
PURPOSE Mindfulness-Based Cognitive Therapy (MBCT) can improve the lives of those with a chronic condition and psychological distress, however, high drop-out rates limit benefits. MBCT might be a candidate treatment for this population if nonadherence can be overcome. This review explores the existing literature on the barriers and facilitators to adherence to MBCT for those with chronic conditions. METHOD Databases MEDLINE, PsycINFO, CINAHL and Scopus were searched between 28th May and 11th June 2021. We included empirical papers that identified barriers and/or facilitators to MBCT adherence in patients with chronic conditions-excluding non-English and grey literature. Papers were screened and duplicates removed. Extracted data included: setting, design, aim, sample-size, population and identified barriers/facilitators to MBCT adherence. The Mixed Methods Appraisal Tool (MMAT) was adapted and used to appraise the quality of studies RESULTS: Twenty papers were eligible for review. Synthesis identified six themes (in prevalence order): (1) Practical Factors (e.g., time and other commitments), (2) Motivation (e.g., change-readiness), (3) Patient clinical and demographic characteristics (e.g., current physical health), (4) Connection with Others (facilitators and group members), (5) Credibility (perception of the intervention) and (6) Content difficulty (intervention accessibility). Findings highlight potential adaptations to implementation (e.g., clear treatment rationale, preference matching, and eliciting and responding to individual concerns or obstructive assumptions) that could address barriers and harness facilitators. CONCLUSION This review contributes a higher order understanding of factors that may support/obstruct client adherence to MBCT with implications for future implementation in research and practice. Future research should prioritize open exploration of barriers/facilitators.
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Affiliation(s)
- Eleanor Marks
- Clinical Psychology University of Lincoln Lincoln UK
| | | | | | - Sam Malins
- Clinical Psychology University of Nottingham Nottingham UK
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4
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Nesset MB, Lauvrud C, Meisingset A, Nyhus E, Palmstierna T, Lara-Cabrera ML. Development of nurse-led videoconference-delivered cognitive behavioural therapy for domestic violence: Feasibility and acceptability. J Adv Nurs 2022; 79:1503-1512. [PMID: 35774003 DOI: 10.1111/jan.15347] [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: 02/11/2022] [Revised: 05/21/2022] [Accepted: 06/20/2022] [Indexed: 11/28/2022]
Abstract
AIMS Because of the COVID-19 lockdown, an internet-based adaption of a nurse-led cognitive behavioural group therapy (CGBT) was provided for perpetrators of domestic violence. The aim of this study was to describe the development of the therapy, examine the initial feasibility and impact on patient satisfaction of the programme and evaluate the associated patient-reported experiences. DESIGN Programme development as well as testing its feasibility and acceptability using cross-sectional survey data. METHODS Anonymous data were collected at a university hospital in Norway between October and December 2021. Feasibility was examined by comparing the numbers of patients who agreed to participate, chose not to participate or dropped out during the intervention. There was a self-reporting scale that evaluated patient satisfaction, and the participants were invited to make suggestions for improvement of the intervention. The results of the study are reported in accordance with the STROBE checklist. RESULTS The videoconference-delivered CGBT was feasible. Two of the 67 patients refused to attend therapy delivered in a remote manner (3.0%), and four patients (6.0%) were classified as non-completers. Overall, patients were satisfied with the therapy. CONCLUSIONS This study described a promising nurse-led internet-based intervention for individuals who were domestically violent and had voluntarily sought healthcare help. The participants' satisfaction with the intervention indicates its acceptability and feasibility. However, research on internet-based cognitive behaviour therapy is still in its infancy. These results may guide the future development of internet-based cognitive behavioural therapy (CBT) for individuals who perpetrate domestic violence. Further research is needed on the pros and cons of this mode of service delivery. IMPACT This study addressed the challenges of providing treatment for domestic violence during the COVID-19 pandemic by examining videoconference-delivered CBT for individuals who perpetrate domestic violence.
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Affiliation(s)
- Merete Berg Nesset
- Forensic Department and Research Centre, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Christian Lauvrud
- Forensic Department and Research Centre, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Anne Meisingset
- Forensic Department and Research Centre, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Eskil Nyhus
- Forensic Department and Research Centre, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Tom Palmstierna
- Department of Clinical Neuroscience, Centre for Psychiatric Research, Karolinska Institutet, Stockholm, Sweden.,Faculty of Medicine and Health Sciences, Department of Mental Health, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Mariela Loreto Lara-Cabrera
- Faculty of Medicine and Health Sciences, Department of Mental Health, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,Nidelv Community Mental Health Centre, Division of Psychiatry, St. Olav's University Hospital, Trondheim, Norway
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5
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Kayser J, Hu RX, Rosenscruggs D, Li L, Xiang X. A Systematic Review of the Impact of Select Mindfulness Interventions on Psychological Outcomes among Older Adults with Chronic Health Conditions. Clin Gerontol 2022; 46:302-314. [PMID: 35585039 DOI: 10.1080/07317115.2022.2076636] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVES Chronic medical conditions can increase the likelihood of experiencing psychological distress and mental health problems among older adults. Mindfulness interventions (MIs) are evidence-based treatment approaches that can improve psychological outcomes. This systematic literature review examines MI studies that focused on older adults (≥60 years old) with chronic health conditions. METHODS Five databases were systematically searched for intervention studies that involved older adults with chronic health conditions who received acceptance and commitment therapy, mindfulness-based cognitive therapy, or mindfulness-based stress reduction and that included psychological outcomes. RESULTS A total of 17 studies were identified that met criteria for inclusion. These studies involved interventions for a range of chronic health conditions including chronic pain, stroke, type 2 diabetes, insomnia, cancer, and chronic obstructive pulmonary disease. CONCLUSIONS Early evidence for MIs impact on psychological outcomes is promising, though more work involving randomized control trials is needed. Current studies generally lack methodological rigor and have a high risk of bias. Given the high rates of chronic pain in older adults and the emerging evidence for MIs, future work in this area is of particular value. CLINICAL IMPLICATIONS Practitioners should be guardedly optimistic about the value of MIs and ACT for older adults with chronic health conditions.
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Affiliation(s)
- Jay Kayser
- School of Social Work, University of Michigan, Ann Arbor, Michigan, USA.,Department of Developmental Psychology, University of Michigan, Ann Arbor, Michigan, USA
| | - Rita Xiaochen Hu
- School of Social Work, University of Michigan, Ann Arbor, Michigan, USA.,Department of Developmental Psychology, University of Michigan, Ann Arbor, Michigan, USA
| | - Danielle Rosenscruggs
- Department of Developmental Psychology, University of Michigan, Ann Arbor, Michigan, USA
| | - Lydia Li
- School of Social Work, University of Michigan, Ann Arbor, Michigan, USA
| | - Xiaoling Xiang
- School of Social Work, University of Michigan, Ann Arbor, Michigan, USA
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6
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Navarro O, Escrivá M, Faubel R, Traver V. Empowering Patients Living With Chronic Conditions Using Video as an Educational Tool: Scoping Review. J Med Internet Res 2021; 23:e26427. [PMID: 34255671 PMCID: PMC8292934 DOI: 10.2196/26427] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 03/01/2021] [Accepted: 05/06/2021] [Indexed: 12/14/2022] Open
Abstract
Background Video is used daily for various purposes, such as leisure, culture, and even learning. Currently, video is a tool that is available to a large part of the population and is simple to use. This audio-visual format has many advantages such as its low cost, speed of dissemination, and possible interaction between users. For these reasons, it is a tool with high dissemination and educational potential, which could be used in the field of health for learning about and management of chronic diseases by adult patients. Objective The following review determines whether the use of health educational videos by adult patients with chronic diseases is effective for their self-management according to the literature. Methods An electronic literature search of the PubMed, CINAHL, and MEDLINE (via the EBSCOhost platform) databases up to April 2020 was conducted. The systematic scoping review followed the Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) methodology. Results After reviewing 1427 articles, 12 were selected as the most consistent with the proposed inclusion criteria. After their review, it was found that the studies showed that video is effective as a tool for improving care related to chronic diseases. Conclusions Video is effective in improving the care and quality of life for patients with chronic diseases, whether the initiative for using video came from their health care professionals or themselves.
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Affiliation(s)
- Olga Navarro
- Department of Nursing, Catholic University of Valencia, Valencia, Spain.,Institute of Information and Communication Technologies, Universitat Politècnica de València, Valencia, Spain
| | - Marta Escrivá
- Department of Nursing, Catholic University of Valencia, Valencia, Spain
| | - Raquel Faubel
- Department of Physiotherapy, Universitat de València, Valencia, Spain.,Unidad Mixta de Reingeniería de Procesos Sociosanitarios, IIS La Fe-Universitat Politècnica de València, Valencia, Spain.,Physiotherapy in Motion, Multispeciality Research Group, Department of Physiotherapy, Universitat de València, Valencia, Spain
| | - Vicente Traver
- Institute of Information and Communication Technologies, Universitat Politècnica de València, Valencia, Spain.,Unidad Mixta de Reingeniería de Procesos Sociosanitarios, IIS La Fe-Universitat Politècnica de València, Valencia, Spain
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7
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Zhang Y, Zhao X. Effects of the Health Belief Model-Based Intervention on Anxiety, Depression, and Quality of Life in Chronic Obstructive Pulmonary Disease. Neuroimmunomodulation 2021; 28:129-136. [PMID: 34062535 DOI: 10.1159/000512993] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 11/09/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) is a chronic respiratory condition. COPD causes a heavy burden on the patients through negative impacts on the quality of life and psychological health. The health belief model (HBM) is proposed and modified by several social psychologists and is confirmed to have benefits in the recovery of various diseases. This research aimed to explore the effects of the HBM-based intervention on anxiety, depression, and quality of life in COPD patients entering pulmonary rehabilitation (PR). METHODS This research was conducted at the Tianjin Rehabilitation Recuperate Center of Chinese PLA in 2019. A total of 136 COPD patients were randomized into the intervention group and the control group. In the control group, patients received the PR program. In the intervention group, patients received both PR program and the HBM-based intervention. Quality of life was measured by the COPD assessment test. The outcomes of anxiety and depression were measured by the Hospital Anxiety and Depression Scale. RESULTS The HBM-based intervention decreased both anxiety and depression scores among COPD patients. The COPD assessment test score was declined by the HBM-based intervention, which also decreased the serum levels of interleukin-6 and C-reactive protein in COPD patients entering PR. CONCLUSION The HBM-based intervention alleviates anxiety and depression, enhances quality of life, and inhibits inflammation in COPD patients entering PR.
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Affiliation(s)
- Yating Zhang
- Department of Respiratory, Tianjin Chest Hospital, Tianjin, China
| | - Xiangfang Zhao
- Department of Geriatrics Ward, Tianjin Rehabilitation Recuperate Center of Chinese PLA, Tianjin, China
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Williams MT, Johnston KN, Paquet C. Cognitive Behavioral Therapy for People with Chronic Obstructive Pulmonary Disease: Rapid Review. Int J Chron Obstruct Pulmon Dis 2020; 15:903-919. [PMID: 32425516 PMCID: PMC7186773 DOI: 10.2147/copd.s178049] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2019] [Accepted: 02/21/2020] [Indexed: 12/30/2022] Open
Abstract
Cognitive behavioral therapy (CBT) is increasingly recommended in the management of people living with chronic obstructive pulmonary disease (COPD). This rapid review presents the evidence base for CBT for people with COPD and describes 1) the nature of CBT interventions and comparators in controlled trials (high or low resource intensity); and 2) factors influencing intervention effects on health outcomes (anxiety, depression, breathlessness, quality of life and exercise capacity). Primary studies reporting CBT interventions in adults with COPD were identified with data extracted by a single reviewer (20% of studies checked for data accuracy). Studies were synthesized descriptively with meta-analyses (random effects models) of controlled trials undertaken to report mean standardized effect sizes (95% CI) for health outcomes. Random effects meta-regression models explored whether CBT target, intervention dosage, intensity, facilitator profession, delivery mode, clinically significant anxiety/depression, trial design/quality and sample size predicted effect size. The search identified 33 primary studies published between 1996 and 2019 (controlled trials n=24, single group cohort n=6, case exemplars n=2, phenomenological n=1). Controlled trials frequently compared high-intensity CBT interventions against enhanced/usual care (n=12) or high-intensity CBT interventions against high-intensity comparators (n=11). When all controlled studies were included, small, significant improvements favoring CBT were evident across all health outcomes (SMD ranged from -0.27 to 0.35, p<0.05). When intensity dyads were considered, significant improvements were evident only when high-intensity CBT interventions were compared to enhanced usual care/usual care (SMDs ranged from -0.45 to 0.54, p <0.05). No other variable consistently predicted intervention effect sizes across all health outcomes. Overall, the evidence base supports the use of CBT for a range of health outcomes in people with COPD. Consistent benefits were evident when high-resource-intensive CBT interventions were compared to usual care. Low-resource-intensity CBT warrants further investigation in settings where cost of comprehensive care is prohibitive.
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Affiliation(s)
- Marie T Williams
- Innovation, Implementation and Clinical Translation in Health (IIMPACT), School of Health Sciences, University of South Australia, Adelaide, SA 5000, Australia
| | - Kylie N Johnston
- Innovation, Implementation and Clinical Translation in Health (IIMPACT), School of Health Sciences, University of South Australia, Adelaide, SA 5000, Australia
| | - Catherine Paquet
- Australian Centre of Precision Health, School of Health Sciences, University of South Australia, Adelaide, SA 5000, Australia
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9
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Seng EK, Singer AB, Metts C, Grinberg AS, Patel ZS, Marzouk M, Rosenberg L, Day M, Minen MT, Lipton RB, Buse DC. Does Mindfulness-Based Cognitive Therapy for Migraine Reduce Migraine-Related Disability in People with Episodic and Chronic Migraine? A Phase 2b Pilot Randomized Clinical Trial. Headache 2019; 59:1448-1467. [PMID: 31557329 PMCID: PMC6788949 DOI: 10.1111/head.13657] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/18/2019] [Indexed: 12/19/2022]
Abstract
OBJECTIVE The current Phase 2b study aimed to evaluate the efficacy of mindfulness-based cognitive therapy for migraine (MBCT-M) to reduce migraine-related disability in people with migraine. BACKGROUND Mindfulness-based interventions represent a promising avenue to investigate effects in people with migraine. MBCT teaches mindfulness meditation and cognitive-behavioral skills and directly applies these skills to address disease-related cognitions. METHODS Participants with migraine (6-30 headache days/month) were recruited from neurology office referrals and local and online advertisements in the broader New York City area. During the 30-day baseline period, all participants completed a daily headache diary. Participants who met inclusion and exclusion criteria were randomized in a parallel design, stratified by chronic migraine status, to receive either 8 weekly individual MBCT-M sessions or 8 weeks of waitlist/treatment as usual (WL/TAU). All participants completed surveys including primary outcome evaluations at Months 0, 1, 2, and 4. All participants completed a headache diary during the 30-day posttreatment evaluation period. Primary outcomes were the change from Month 0 to Month 4 in the headache disability inventory (HDI) and the Migraine Disability Assessment (MIDAS) (total score ≥ 21 indicating severe disability); secondary outcomes (headache days/30 days, average headache attack pain intensity, and attack-level migraine-related disability [Migraine Disability Index (MIDI)]) were derived from the daily headache diary. RESULTS Sixty participants were randomized to receive MBCT-M (n = 31) or WL/TAU (n = 29). Participants (M age = 40.1, SD = 11.7) were predominantly White (n = 49/60; 81.7%) and Non-Hispanic (N = 50/60; 83.3%) women (n = 55/60; 91.7%) with a graduate degree (n = 35/60; 55.0%) who were working full-time (n = 38/60; 63.3%). At baseline, the average HDI score (51.4, SD = 19.0) indicated a moderate level of disability and the majority of participants (50/60, 83.3%) fell in the "Severe Disability" range in the MIDAS. Participants recorded an average of 16.0 (SD = 5.9) headache days/30 days, with an average headache attack pain intensity of 1.7 on a 4-point scale (SD = 0.3), indicating moderate intensity. Average levels of daily disability reported on the MIDI were 3.1/10 (SD = 1.8). For the HDI, mean scores decreased more from Month 0 to Month 4 in the MBCT-M group (-14.3) than the waitlist/treatment as an usual group (-0.2; P < .001). For the MIDAS, the group*month interaction was not significant when accounting for the divided alpha, P = .027; across all participants in both groups, the estimated proportion of participants falling in the "Severe Disability" category fell significantly from 88.3% at Month 0 to 66.7% at Month 4, P < .001. For diary-reported headache days/30 days an average headache attack pain intensity, neither the group*month interaction (Ps = .773 and .888, respectively) nor the time effect (Ps = .059 and .428, respectively) was significant. Mean MIDI scores decreased in the MBCT-M group (-0.6/10), whereas they increased in the waitlist/treatment as an usual group (+0.3/10), P = .007. CONCLUSIONS MBCT-M demonstrated efficacy to reduce headache-related disability and attack-level migraine-related disability. MBCT-M is a promising emerging treatment for addressing migraine-related disability.
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Affiliation(s)
- Elizabeth K Seng
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
- Montefiore Headache Center, Montefiore Medical Center, Bronx, NY, USA
| | - Alexandra B Singer
- Psychology Service, VA Connecticut Healthcare System, West Haven, CT, USA
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Christopher Metts
- Pathology and Laboratory Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Amy S Grinberg
- Psychology Service, VA Connecticut Healthcare System, West Haven, CT, USA
| | - Zarine S Patel
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA
| | - Maya Marzouk
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA
| | - Lauren Rosenberg
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA
| | - Melissa Day
- School of Psychology, University of Queensland, Brisbane, QLD, Australia
| | - Mia T Minen
- Department of Neurology, New York University Langone Health, New York, NY, USA
| | - Richard B Lipton
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Dawn C Buse
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
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Crandall A, Cheung A, Young A, Hooper AP. Theory-Based Predictors of Mindfulness Meditation Mobile App Usage: A Survey and Cohort Study. JMIR Mhealth Uhealth 2019; 7:e10794. [PMID: 30900992 PMCID: PMC6450472 DOI: 10.2196/10794] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 11/30/2018] [Accepted: 12/31/2018] [Indexed: 12/31/2022] Open
Abstract
Background Mindfulness meditation has become increasingly popular over the last few years, due in part to the increase in mobile apps incorporating the practice. Although studies have demonstrated the potential of mindfulness meditation to positively impact health, little has been uncovered about what predicts engagement in mindfulness meditation. Understanding the predictors of mindfulness meditation may help practitioners and phone app developers improve intervention strategies and app experience. Objective The purpose of this study was to use the Theory of Planned Behavior and Temporal Self-Regulation Theory to determine factors predicting mindfulness meditation mobile app use. Methods The sample consisted of 85 undergraduate students with no prior mindfulness meditation experience. During their first laboratory visit, participants completed tasks to measure their executive functioning and a survey to measure Theory of Planned Behavior constructs about mindfulness meditation. Over the following 2 weeks, participants logged the days and minutes that they practiced mindfulness meditation using a phone app. Hierarchical regression modeling was used to analyze the data. Results After controlling for demographic factors, participant subjective norms (beta=14.51, P=.001) and intentions (beta=36.12, P=.001) were predictive of the number of minutes practicing mindfulness. Participant executive functioning did not predict mindfulness meditation practice, nor did it moderate the link between intentions and mindfulness meditation practice. Participant attitudes (beta=0.44, P<.001) and perceived control (beta=0.42, P=.002) were positively associated with intentions to practice mindfulness. Conclusions These results suggest that among college student populations, the Theory of Planned Behavior may be useful in predicting the use of mindfulness meditation phone apps. However, participant executive functioning was not a predictor or moderator of mindfulness practice, and Temporal Self-Regulation Theory may be less useful for explaining mindfulness meditation behaviors using phone apps over a short period of time among college students. The results have implications for public health professionals, suggesting that a focus on subjective norms and intentions may promote mindfulness meditation practice using phone apps.
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Affiliation(s)
- AliceAnn Crandall
- Brigham Young University, Department of Public Health, Provo, UT, United States
| | - Aaron Cheung
- Brigham Young University, Department of Public Health, Provo, UT, United States
| | - Ashley Young
- Brigham Young University, Department of Public Health, Provo, UT, United States
| | - Audrey P Hooper
- Brigham Young University, Department of Public Health, Provo, UT, United States
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