Mind-body Medicine Intervention Research Articles

Evaluating a peer-support mind-body medicine intervention for healthcare leaders.

Mind-body medicine (MBM) is an evidence-based intervention associated with trauma and stressful events. The MBM intervention alleviates symptoms of work-related stress and builds resilience by utilizing self-care techniques facilitated in small group settings. Healthcare leaders who experienced traumatic stress through the COVID-19 pandemic may benefit from interventions aimed at their needs. We evaluated the effects of a peer support MBM intervention on perceived stress, resilience, well-being, and empathy for nurse leaders and compassionate care leaders. A pre-post intervention was conducted via 7 virtual and 2 on-site groups, recruiting from a large multihospital health system in the United States. Participants engaged in an 8-week program facilitated by a certified faculty group leader from The Center for Mind-Body Medicine and engaged in resilience skills building activities along with facilitated sharing. Validated instruments were used to measure outcomes at pre, post, 1 month, and 6 month follow-up intervals. Surveys included open-ended questions for qualitative feedback related to facilitators, barriers, and group experiences. Seventy-three leaders completed the MBM program, and 22 completed the four research surveys; all qualitative responses were included for feedback. Perceived stress decreased after the intervention (p < .008) and was maintained for 6 months post intervention (p < .005). Resilience increased after the intervention (p < .034) and for 1 month (p < .049) but decreased after 6 months. Qualitative responses showed that time and workload factors were the most significant barrier to participation, while the benefits included protected time with peers, learning well-being skills, and having a safe place to process emotions. Healthcare leaders face unique challenges, including workplace trauma and crises. Interventions that support their stress response, resilience, and overall well-being should take into consideration the nature of their work, the balance of time demands, and the need for peer support to overcome barriers to sustainable interventions.

Mind-Body Medicine in the Treatment of Depression: A Narrative Review of Efficacy, Safety and Mechanisms.

This narrative review examines the efficacy, mechanisms and safety of mind-body medicine (MBM) in the treatment of depression. We reviewed the potential effects of various MBM interventions such as yoga, tai chi, qigong, mindfulness-based interventions and nutrition on clinical and subthreshold depressive symptoms. Current studies indicate a growing interest in the use of MBM for psychiatric disorders, including depression. MBM interventions demonstrate efficacy in reducing depressive symptoms with fewer adverse effects and costs compared to pharmacological treatments. MBM has significant potential to improve mental health outcomes for depression. These interventions encourage self-care and stress management through behavioural, exercise, relaxation and nutritional approaches. While existing data are promising, further, more rigorous studies are required to confirm long-term effectiveness and to determine the role of MBM in comprehensive depression treatment strategies.

Effect of Meditation, Mindfulness-Based Stress Reduction, and Relaxation Techniques as Mind-Body Medicine Practices to Reduce Blood Pressure in Cardiac Patients: A Systematic Review and Meta-Analysis.

Elevated blood pressure is one of the major risk factors for cardiovascular diseases. Available evidence on mind-body medicine (MBM) techniques on blood pressure is inconclusive and provides conflicting results. The objective of the current systematic review and meta-analysis is to evaluate the effect of MBM techniques on blood pressure in patients with cardiovascular disease. Randomized control trials (RCTs) done between the years 2000 and 2020 on cardiovascular disease, using MBM techniques such as meditation, mindfulness-based stress reduction and relaxation techniques were searched through electronic databases such as PubMed, Cumulative Index to Nursing & Allied Health (CINAHL), EMBASE and Cochrane Library. Three authors independently performed article selection, data extraction and validation. Meta-analysis was performed using a random effect model and standardized mean difference (SMD) with 95% confidence interval (CI) estimated for the effect size. Fifteen RCTs with 927 patients were included in the meta-analysis. Heterogeneity among the studies was very high for all analyses (I2>94%). For studies comparing systolic blood pressure, MBM interventions show a significant (p=0.01) effect when compared to conventional treatment, an overall estimated effect size of SMD - 0.78 (95% CI: -1.36, -0.20). For studies comparing the diastolic blood pressure, MBM intervention did not show any significant effect when compared to the conventional treatment, an overall effect size of SMD -0.26 (95% CI: -0.91, 0.39). The findings of the meta-analysis suggest that MBM interventions may improve systolic blood pressure alone in patients with cardiac diseases. With high heterogeneity and low quality of the included studies, more robust evidence is required before suggesting MBM as an effective treatment modality for reducing blood pressure in cardiovascular diseases.

Developing a digital mind body medicine supportive care intervention for people with amyotrophic lateral sclerosis using stakeholder engagement and design thinking

Background Amyotrophic lateral sclerosis disease (ALS) is also called the disease of a thousand farewells. Consequently, it is important to offer supportive care interventions that can be applied continuously during the whole course of the disease. People with ALS are interested in complementary and integrative medicine. Due to ALS’ progressive nature, digital solutions might be most feasible and accessible for people with ALS in the long-term. Objectives In our study, we explored with stakeholders which digital complementary and integrative medicine interventions and formats are considered as supportive for people with ALS, and which settings are needed by the people with ALS to incorporate the interventions in everyday life. Methods We used a participatory research approach and conducted a stakeholder engagement process, applying a design thinking process with qualitative research methods (interviews, workshops). Results Due to the unpredictable course of the disease on their loss of abilities, people with ALS welcome online settings because they are accessible and easy to implement in their daily life. Stakeholders considered the following implementation factors for a complementary and integrative medicine intervention as essential: short-term realization of planned interventions, short duration of interventions, and user-friendliness in terms of accessibility and applicability. Concerning the complementary and integrative medicine interventions, the people with ALS preferred mind body medicine interventions, such as breathing, mindfulness and relaxation exercises. Conclusions Short-term treatment intervals and short online mind body medicine interventions align with the needs of people with ALS. The complementary and integrative medicine interventions as well as the digital infrastructure must meet the special accessibility and applicability needs of people with ALS.

Breathing-based meditation (Sudarshan Kriya Yoga) increases sense of coherence. No-cost stress prevention

Background and aimOur society deals with multiple challenges such as psychological stress, anxiety, and depression, as well as disasters, crises including the pandemic crisis, and the current war. Excess stress can manifest itself in a variety of emotional, behavioral, and even physical symptoms, which strongly correlate with deterioration of health and a decrease in quality of life. Sense of coherence (SOC) is a central pillar of Antonovsky’s salutogenic model of health and it is focused on the relationship between health, stress, and coping. The SOC scale comprises the evaluation of the sense of comprehensibility (SC), the sense of manageability (SM), and the sense of meaningfulness (SMF), which are associated with both physical and psychological health. MethodsThe Mind-Body Medicine intervention breathing-based meditation (SKY-Sudarshan Kriya Yoga) was evaluated to assess its impact on the sense of coherence of practitioners in a pilot trial. The study groups consisted of 132 practitioners of SKY during the Youth Empowerment Seminar (YES!+) and 128 not participating/not practicing (260 in total). Both groups filled out SOC-29 questionnaire twice, on day first and sixth. Based on the SOC-29 test, SOC, SC, SM, and SMF have been evaluated in both groups. Results and conclusionExperience with the SKY breathing technique showed a statistically significant (p < 0.05) increase of the sense of coherence of practitioners. Also, the senses of comprehensibility, manageability, and meaningfulness increased by 12%. The SKY exercise does not require any additional preparation, or equipment and may present a no-cost solution to help deal with stress and life demands.

Who Benefits Most? Interactions between Personality Traits and Outcomes of Four Incremental Meditation and Yoga Treatments.

Mind–Body Medicine (MBM) includes a broad range of interventions with proven preventive and clinical value, such as yoga and meditation. However, people differ in their preferences and response to different MBM treatments and it remains unclear who benefits most from what type of practice. Thus, finding moderators of treatment outcome seems to be a promising approach. This was the aim of the present study. We conducted a single-case multiple-baseline study investigating the outcomes and moderators of four different MBM treatments. Fifty-seven healthy participants with no prior experience were randomly assigned to three baselines (7, 14, and 21 days) and four eight-week treatments: mantra meditation alone, meditation plus physical yoga, meditation plus ethical education and meditation plus yoga and ethical education. We analysed the data using effect size estimation, multiple regression and cluster analyses. High anxiety, high absorption, low spirituality, low openness and younger age were associated with a range of positive outcomes, such as increased wellbeing or decentering and decreased mind wandering. Receiving ethical education consistently improved wellbeing, while engaging in physical yoga reduced mind wandering. In the cluster analysis, we found that participants with a more maladaptive personality structure enhanced their emotion regulation skills more. Consequently, people do differ in their response to MBM interventions and more vulnerable people, or those high in absorption, seem to benefit more. These findings could support the development of custom-tailored MBM interventions and help clinicians to make scientifically sound recommendations for their patients.

The BERN Framework of Mind-Body Medicine: Integrating Self-Care, Health Promotion, Resilience, and Applied Neuroscience.

Background: Mind-body medicine (MBM) focuses on improving our understanding of how the interactions between the brain, mind, body, and behavior can be used to promote health. In this narrative review, we present the basic principles of MBM, including the introduction of a rational framework for the implementation of MBM-based interventions. We also discuss the contributions of MBM to motivation and reward systems in the brain including those that may specifically involve the mitochondria.Results: MBM can be used to promote health in patients with chronic diseases, especially conditions identified as lifestyle-related. MBM builds on salutogenesis, which is a paradigm that focuses on health (as opposed to disease) determinants and the development of individual resilience and coherence factors as a means to reduce stress, decrease the burden of disease, and improve the quality of life. This approach involves several well-known principles of self-healing and self-care. MBM interventions typically include behavioral modification techniques in conjunction with cognitive work focused on stress regulation, exercise, relaxation, meditation, and nutrition. We suggest the use of the acronym “BERN” (Behavior, Exercise, Relaxation, and Nutrition) to summarize the operational framework of this approach.Discussion: Different BERN techniques act via shared autoregulatory central nervous system (CNS) reward and motivation circuitries. These systems rely on numerous neurobiological signaling pathways with overlapping effector molecules that converge, e.g., on nitric oxide (NO) as a common effector molecule. NO is critically coupled to reward physiology, stress reduction, and self-regulation as it modulates the responses of various mitochondrial, nuclear, and chromosomal processes within brain cells. NO has also been implicated in relevant outcomes (e.g., the placebo response).Conclusions: MBM interventions typically follow the BERN model and aim to strengthen health and resilience, and reduce stress. The mechanisms of action of these processes involve the CNS reward systems and correlate with placebo and self-healing pathways.

Improvements in Sleep Quality and Duration Following a Meditation Retreat: an Open-Trial Pilot Study

PurposeDisturbed sleep and other sleep-related problems have a negative impact on the human mind and body. Meditation practices are reported to improve physiological functions and might also have a positive impact on regulating sleep. This research investigates the efficacy of an advanced mind–body medicine intervention, called Hollow and Empty Meditation (HEM), on improving sleep quality.MethodsThe study was a single-arm open-trial pilot study which assessed 413 adults who underwent a 4-day meditation retreat offered by the Art of Living, called the Advanced Meditation Program (AMP), and experienced a novel meditation—HEM. Results were measured using a self-report questionnaire, the Pittsburgh Sleep Quality Index (PSQI), which was administered to the participants thrice: on the first day of the program (pre-intervention), immediately after program (post-intervention/Day 4), and on Day 40 (D40) after the program.ResultsThere was a significant difference in pre–post and pre–D40 scores in the population. Both sleep quality and sleep duration showed an improvement immediately after the AMP (post), and the residual impact was still experienced at D40, especially with the group with age > 36 years.ConclusionsThe use of HEM resulted in improvement in sleep quality not just immediately after the program, but had longer-term effects that extended over several weeks, helping remediate sleep problems among younger adults as well as older ones. It resulted in improvement in sleep quality as well as reduction in sleep-related daytime impairment, which have substantial constructive implications for well-being, everyday functioning and quality of life.

Do as I Do: Physician- and Learner-Led Mind-Body Medicine Group Visits.

Care of patients with chronic medical and mental health conditions can be a source of frustration for primary care clinicians and may present a challenge in modeling effective interventions for medical learners. Mind-body medicine (MBM) interventions have shown success for a variety of conditions, and training in MBM has been associated with decreased burnout and improved professional satisfaction.8 We piloted MBM collaborative visits led by faculty physicians and facilitated by medical learners. We then assessed their efficacy treating patients with complex needs. We conducted a series of eight weekly 2.5-hour MBM interventions for groups of five to eight participants (52 in total) with chronic health conditions. Matched-pair hypothesis t tests analyzed nine health indicators measured pre- and postintervention: the Patient Health Questionnaire-9 (PHQ-9) as well as participants' perceived mental and physical health, stress and stress coping, agency, and capacity to connect with others. We made conservative calculations of effect size using Hedges' g. Participants showed significant, large improvements in their PHQ-9 scores ( P<.005, g=0.807), and moderate improvements in ability to cope with stress (P<.005, g=0.502), sense of control over their diagnoses (P<.05, g=0.413), and perceived overall mental health (P<.05, g=0.424). Other outcomes were nonsignificant, including a small improvement in participants' perceived overall health ( P=.071, g=0.286). Patients completing the intervention enjoyed largely improved outcomes despite unchanged stress at work and home. Physician-led MBM collaborative visits comprise a feasible, reproducible, and reimbursable treatment option for improving patient care. They also immerse medical learners in an evidence-based practice model supportive of professional satisfaction.

Chromosomal Processes in Mind-Body Medicine: Chronic Stress, Cell Aging, and Telomere Length.

Stress affects cellular aging and inflammatory and chromosomal processes, including telomere length, thereby potentially compromising health and facilitating disease onset and progression. Stress-related diseases and strategies to manage stress usually require integrative or behavioral therapeutic approaches that also operate on cellular levels. Mind-body medicine (MBM) uses the interaction between the mind, body, behavior, and the environment to correct physical and psychological malfunctions, thus ameliorating disease states and improving health. The relaxation response (RR) is a physiological opponent of stress and the stress response (SR) (i.e., fight-or-flight response), also invoking molecular anti-stress processes. Techniques that elicit the RR are at the core of practically all MBM interventions. We surmise that these techniques can also affect chromosomal and telomere processes, molecular aging, and the modulation of inflammatory states on cellular levels.

Mindfulness meditation and improvement in sleep quality and daytime impairment among older adults with sleep disturbances: a randomized clinical trial.

Sleep disturbances are most prevalent among older adults and often go untreated. Treatment options for sleep disturbances remain limited, and there is a need for community-accessible programs that can improve sleep. To determine the efficacy of a mind-body medicine intervention, called mindfulness meditation, to promote sleep quality in older adults with moderate sleep disturbances. Randomized clinical trial with 2 parallel groups conducted from January 1 to December 31, 2012, at a medical research center among an older adult sample (mean [SD] age, 66.3 [7.4] years) with moderate sleep disturbances (Pittsburgh Sleep Quality Index [PSQI] >5). A standardized mindful awareness practices (MAPs) intervention (n = 24) or a sleep hygiene education (SHE) intervention (n = 25) was randomized to participants, who received a 6-week intervention (2 hours per week) with assigned homework. The study was powered to detect between-group differences in moderate sleep disturbance measured via the PSQI at postintervention. Secondary outcomes pertained to sleep-related daytime impairment and included validated measures of insomnia symptoms, depression, anxiety, stress, and fatigue, as well as inflammatory signaling via nuclear factor (NF)-κB. Using an intent-to-treat analysis, participants in the MAPs group showed significant improvement relative to those in the SHE group on the PSQI. With the MAPs intervention, the mean (SD) PSQIs were 10.2 (1.7) at baseline and 7.4 (1.9) at postintervention. With the SHE intervention, the mean (SD) PSQIs were 10.2 (1.8) at baseline and 9.1 (2.0) at postintervention. The between-group mean difference was 1.8 (95% CI, 0.6-2.9), with an effect size of 0.89. The MAPs group showed significant improvement relative to the SHE group on secondary health outcomes of insomnia symptoms, depression symptoms, fatigue interference, and fatigue severity (P < .05 for all). Between-group differences were not observed for anxiety, stress, or NF-κB, although NF-κB concentrations significantly declined over time in both groups (P < .05). The use of a community-accessible MAPs intervention resulted in improvements in sleep quality at immediate postintervention, which was superior to a highly structured SHE intervention. Formalized mindfulness-based interventions have clinical importance by possibly serving to remediate sleep problems among older adults in the short term, and this effect appears to carry over into reducing sleep-related daytime impairment that has implications for quality of life. clinicaltrials.gov Identifier: NCT01534338.

Mind-Body Medicine for Schizophrenia and Psychotic Disorders

Over half of psychiatric patients use some kind of Complementary and Alternative Medicine, with Mind-Body Medicine (MBM) being the most commonly used collective modality. To date however, to our knowledge, no overarching review exists examining MBM for psychotic disorders. Thus the purpose of this paper is to present the first review in this area. A MEDLINE search was conducted of articles written in English from 1946 up to January 15, 2011 using a range of MBM and psychotic disorder search terms. Human clinical trials and, where available, pertinent meta-analyses and reviews were included in this paper. Forty-two clinical studies and reviews of MBMs were located, revealing varying levels of evidence. All studies included used MBMs as an adjunctive therapy to usual care, including medication. Overall, supportive evidence was found for music therapy, meditation and mindfulness techniques. Some positive studies were found for yoga and breathing exercises, general relaxation training, and holistic multi-modality MBM interventions. Due to insufficient data, a conclusion cannot be reached for hypnosis, thermal or EMG biofeedback, dance or drama therapy, or art therapy. No clinical trials were found for guided imagery, autogenic training, journal writing, or ceremony practices. For many techniques, the quality of research was poor, with many studies having small samples, no randomization, and no adequate control. While the above techniques are likely to be safe and tolerable in this population based on current data, more research is required to decisively assess the validity of applying many MBMs in the mainstream treatment of psychotic disorders.

P02.173. Objective and subjective adherence in mindfulness meditation trials

Purpose Home practice is frequently prescribed as part of mindbody medicine interventions although rarely objectively measured. As part of our ongoing mind-body medicine research program, we created iMINDr, a custom monitoring software program to collect objective adherence data. The goals for these analyses were to assess: 1) any differences in objective versus subjective adherence, and 2) which baseline measures predict adherence in ongoing mindfulness meditation randomized clinical trials being conducted at our lab.

Fatigue in Breast Cancer Survivors: The Impact of a Mind-Body Medicine Intervention

To evaluate a mind-body medicine (MBM) program for its impact on persistent fatigue following breast cancer treatment. Quasiexperimental. An urban community hospital and a health department in a semirural county, both in Maryland. 68 breast cancer survivors who were at least six months postadjuvant chemotherapy and/or radiation therapy and had a baseline fatigue score of 50 or lower per the vitality subscale of the SF-36® Health Survey. A 10-week group-based MBM program for breast cancer survivors with persistent fatigue was evaluated using a pretest/post-test study design. Sustained change in fatigue severity as measured by the Piper Fatigue Scale (PFS), SF-36 vitality subscale, and 10 cm visual analog scale (VAS). Participants were 2.6 years post-treatment, with a mean age of 56.8 years. Overall, fatigue scores improved by 40%. The mean PFS improved from a score of 6 (SD = 1.6) at baseline to 4.2 (SD = 2) at the end of the program (p < 0.001), with additional improvement at two months and sustained at six months (X = 3.6, SD = 2, p < 0.001). Results from the SF-36 and VAS also showed significant improvement in fatigue (p < 0.001). The findings support the use of a holistic MBM intervention to reduce persistent fatigue in breast cancer survivors. Results should be confirmed with a randomized clinical trial. Nurses and other healthcare team members can effectively impact persistent fatigue in breast cancer survivors through the use of a multipronged MBM program.

One Method for Objective Adherence Measurement in Mind–Body Medicine

Home practice is frequently prescribed as part of mind-body medicine interventions, although rarely objectively measured. This brief methods report describes one method for objectively measuring home practice adherence using a custom monitoring software program. Methods for objectively measuring adherence were developed as part of a randomized controlled trial on the mechanisms of mindfulness meditation. The study was conducted at Oregon Health & Science University, Portland, Oregon. The subjects comprised 11 combat veterans with post-traumatic stress disorder. The method used was mindfulness meditation. There were subjective and objective adherence measurements of mindfulness meditation home practice. The first iteration of objective adherence monitoring used an iPod device and had limitations in participant usage and correctly capturing data. In the second iteration, objective data were easily collected, uploaded, and viewed using the custom software application, iMINDr. Participants reported that iMINDr was straightforward to use, and they returned the monitoring units as directed. The iMINDr is an example of a simple objective adherence measurement system that may help mind-body researchers examine how home practice adherence may affect outcomes in future clinical trials.

Abstract A63: Effectiveness of a holistic mind-body intervention to treat fatigue in breast cancer survivors: Does race make a difference?

Abstract Introduction: Persistent fatigue affects up to 40% of breast cancer survivors and has multiple contributing factors including pain, sleep disturbance, depression, anxiety, decreased physical activity, weight gain, and treatment-induced menopausal symptoms. A holistic mind-body medicine intervention was developed by the Mercy Medical Center Prevention and Research Center team to address fatigue and its many contributing factors among breast cancer survivors. Overall, the intervention was shown to effectively decrease levels of self-reported fatigue among breast cancer survivors. The purpose of this analysis was to examine whether the effectiveness of the group-based mind-body medicine program differed by race, as little research has assessed the role of race in fatigue improvement among breast cancer survivors. Design: Quasi-experimental design using a before/after evaluation to assess change in fatigue scores. Population: 206 breast cancer survivors (154 Caucasians; 52 African-Americans) with a chief complaint of fatigue. Outcome Measures: Change in severity of fatigue as measured by a 10 cm visual analog scale (0=no fatigue; 10=most fatigue). Fatigue was measured at baseline, end-of-program, two and six months post-program completion. Results: African-Americans reported higher levels of fatigue than Caucasians at baseline and at the three follow-up time points; however, these differences were not statistically significant. African-Americans’ mean score from the visual analog scale showed improvement from 6.3 (SD 1.8) at baseline to 4.4 (SD 2.5) at end-of-program (p&amp;lt;0.001). Results were similar for Caucasians who scored 5.5 (SD 2.2) at baseline compared to 3.6 (2.2) after the intervention (p&amp;lt;0.001). Fatigue improvement was maintained for both groups at two and six month follow up evaluations. Conclusion: A group-based holistic mind-body medicine intervention effectively improved fatigue across both African-American and Caucasian breast cancer survivors. Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):A63.

Inner Correspondence and Peacefulness with Practices among Participants in Eurythmy Therapy and Yoga: A Validation Study

Several mind body medicine interventions require an active participation of the practitioners. We intended to develop a questionnaire to operationalize and measure the “inner correspondence” of individuals practicing Yoga or Eurythmy Therapy. In an anonymous cross-sectional study we enrolled 501 individuals (61% yoga). Exploratory factor analysis (study 1) of the 12-item instrument (Cronbach's alpha = .84) pointed to a 3-factor solution, with one major scale and good internal consistency (alpha = .83) and two minor scales with weak internal consistency. To improve the quality of the main scale, we added 8 new items which were tested in a sample of 135 individuals (study 2: 71% Yoga). Factor analysis confirmed a 12-item single factor (alpha = .95), that is, Inner Correspondence/Peaceful Harmony with Practices (ICPH). The scale correlated strongly with mindfulness (FMI; r > .50), moderately with life and patient satisfaction (BMLSS; r between .32 and .43), and weakly negative with symptom score (VAS; r = −.23). In conclusion, the scale ICPH was confirmed as a relevant tool to measure the inner correspondence and feelings of peacefulness with practices. It can be used in clinical studies to assess the efficacy of mind-body practices involving physical movements.

Abstract B22: Effectivness of a family-focused intervention to treat persistent fatigue in breast cancer surivivors: A pilot randomized trial

Abstract B22 Background Thirty to forty percent of breast cancer survivors suffer from persistent fatigue lingering months to years after adjuvant therapy is completed. This persistent fatigue affects family dynamics feeding a continuing cycle of additional stress and resultant fatigue. We developed a mind-body medicine group intervention and demonstrated a forty percent reduction in fatigue with benefits persisting six months post intervention. A pilot randomized trial was conducted to test if combining the mind-body medicine group intervention with a family-focused intervention is more effective in reducing fatigue for breast cancer survivors than the group intervention only. For the family intervention, family members attended two of the eight weekly sessions and had two family-based counseling sessions with the clinical research therapist. Methodology Subjects who were at least three months post-completion of adjuvant chemotherapy and/or radiation therapy for breast cancer with a baseline fatigue score of &amp;lt;50 as measured by the vitality subscale of the SF-36 Health Survey were randomized to either the group mind-body medicine program or the group program with the integrated family intervention. Thirty-six women entered the pilot study but three dropped out after attending less than two of the eight weekly sessions and were not able to be evaluated. The primary outcome assessed was change in severity of fatigue as measured by the Piper Fatigue Scale. Results Seventeen women were randomized to the family intervention and nineteen to the comparison group intervention. There was no statistically significant difference between the groups by age, martial status or years of education. Those randomized to the family group were on average 4.8 years from the diagnosis of breast cancer compared to 2.8 for the comparison group intervention. Participants in both groups had a statistically significant improvement in fatigue scores at end-of-program with further improvement at two-month follow-up compared to baseline. Mean fatigue scores for the family intervention arm: (baseline-5.7; end -of-program-3.1; two-month-1.4; p&amp;lt;0.001). Fatigue scores for comparison group (baseline-6.5; end-of-program-3.4; two-month-2.7; p&amp;lt;0.001). Comparing the two intervention arms, there were no statistically significant differences at end-of-program (p=0.71) or at two-month follow-up (p=0.14). Recruitment for the trial was challenging, primarily due to the time commitment required from both the survivors and family members. Conclusions A holistic mind-body medicine intervention significantly improved fatigue but augmenting the program with an additional family component did not result in significant incremental improvement in fatigue. Qualitative data from interviews with participants noted that both family members and survivors found benefit in shared learning about fatigue and effective interventions and in discussing their feelings and concerns during counseling sessions. Although this pilot study had limited power to detect a difference between the two arms, the challenges in recruitment for the study suggest that future interventions require a more efficient method to incorporate family members into the program. Citation Information: Cancer Prev Res 2008;1(7 Suppl):B22.

Inpact of a ten week mind-body medicine intervention on peristent fatigue following breast cancer treatment: 6 month follow- up

9062 Background: Persistent fatigue following breast cancer treatment, which affects up to 40% of breast cancer patients, is the result of diverse patient and treatment factors. The multi-dimensional underlying etiology of fatigue calls for broad based interventions aimed at managing stress, improving diet and exercise patterns and short term cognitive therapy supporting attitudinal and behavioral changes. A pilot study was conducted to obtain preliminary efficacy information for a ten week group-based mind body intervention to treat persistent fatigue among breast cancer survivors. Methods: The quasi-experimental study design used a before/after evaluation of fatigue scores. Subjects were women who were between six months and five years post-completion of adjuvant chemotherapy and/or radiation therapy for breast cancer and who had a baseline fatigue score of ≤ 50 as measured by the vitality subscale of the SF-36 Health Survey. Twenty- one women entered the study. Three participants dropped out after attending only two of the ten weekly sessions and are excluded from the analysis. Main outcome measures were change in severity of fatigue as measured by the Piper Fatigue Scale and vitality subscale score of the SF-36. Results: At baseline, the mean age of participants was 52.7 years; 66.7% were Caucasian and 23.7% were African-American. Median time since breast cancer diagnosis was 2.9 years. The mean Piper fatigue score improved from 6.0 (SD 1.5) at baseline to 4.0 (SD 2.1) at the end of the ten week intervention (p&lt; 0.001). Fatigue scores at two and six months post-intervention were 3.2 (SD 2.9; p= 0.001) and 4.1 (SD 2.1; p= 0.02), respectively. Similarly the SF-36 vitality subscale score improved following the intervention with persistent improvement at 6 months (p=0.02). Conclusion: A holistic integrated mind body medicine intervention holds promise for long-term impact on reducing fatigue following breast cancer treatment. Sponsored by Susan G. Komen Breast Cancer Foundation No significant financial relationships to disclose.