Online Mindfulness-based Interventions Research Articles

The Western Australian medical schools mindfulness project: a randomised controlled trial

BackgroundEvidence for the longer-term benefits of online mindfulness training for medical students, including in the reduction of stress and improved wellbeing, is limited. This study aimed to evaluate the impact of a novel online mindfulness training program on trait mindfulness, wellbeing and study engagement of medical students at program completion and 6-month follow-up.MethodsThis was a randomised waitlist control study of an 8-week, online, mindfulness-based intervention versus normal curriculum alone for medical students (N = 114). The primary outcome measures were the changes from baseline to program completion at Week 8 for self-reported trait mindfulness (Freiburg Mindfulness Inventory), perceived stress (Perceived Stress Scale), self-compassion (Self-Compassion Scale) and study engagement scores (Utrecht Work Engagement Scale for Students). The secondary outcome measures were these score changes from baseline to 6-month follow up. Intervention and control students completed surveys at all three time points. Program adherence (Mindfulness Adherence Questionnaire) was also measured in the intervention group.ResultsThe intervention group experienced modest but statistically significant improvements in mindfulness (9%, p = 0.0002), self-compassion (5%, p = 0.026), and study engagement (4%, p = 0.035) from baseline to Week 8. They also reported a sustained improvement of 5% (p = 0.017) in mindfulness scores at 6 months. The control group reported no significant changes at Week 8 or 6 Months. Between-group comparisons showed that compared to the control group, the intervention group improved significantly more in mindfulness (p = 0.0076), and statistically marginally more in study engagement (p = 0.0534) at Week 8. No statistically significant between-group differences were observed at 6 months.ConclusionsThese results add to the small but growing body of evidence suggesting that online mindfulness-based interventions with minimal contact can improve, albeit in modest magnitude, mindfulness and possibly study engagement in medical students for the duration of a mindfulness program. Further refinements to the program may be important to maintain improvements in the longer-term.Trial registrationRegistration number ACTRN12624000783527.

A Pilot and Feasibility Study on a Mindfulness-Based Intervention Adapted for LGBTQ+ Adolescents.

(1) Background: Lesbian, gay, bisexual, transgender, queer and other gender and sexual minority-identified (LGBTQ+) adolescents face mental and physical health disparities compared to their heterosexual and cisgender counterparts. Mindfulness-based interventions (MBIs) may be a potential method to intervene upon health disparities in this population. This pilot study explores the initial acceptability and feasibility, along with the descriptive health changes of an online MBI, Learning to Breathe-Queer (L2B-Q), which was adapted to meet the needs of LGBTQ+ adolescents. (2) Methods: Twenty adolescents completed baseline and post-intervention assessments of mental health, stress-related health behaviors, physical stress, and LGBTQ+ identity indicators. In addition, the adolescents participated in a post-intervention focus group providing qualitative feedback regarding the acceptability of L2B-Q. (3) Results: L2B-Q demonstrated feasible recruitment and assessment retention, acceptability of content with areas for improvement in delivery processes, and safety/tolerability. From baseline to post-intervention, adolescents reported decreased depression and anxiety and improved intuitive eating, physical activity, and LGBTQ+ identity self-awareness with moderate-to-large effects. (4) Conclusions: These findings underscore the need and the benefits of adapted interventions among LGBTQ+ youth. L2B-Q warrants continued optimization and testing within the LGBTQ+ adolescent community.

Being Present-CML: A mindfulness-based intervention for patients with chronic myeloid leukemia taking tyrosine kinase inhibitors.

353 Background: Tyrosine kinase inhibitors (TKIs) prolong the lives of patients with chronic phase chronic myeloid leukemia (CP-CML) but can cause side effects that negatively impact quality of life. Mindfulness-based interventions (MBIs) have improved symptoms in patients with solid tumors but have not been studied in patients with CP-CML. We sought to determine if a MBI is feasible and acceptable to patients with CP-CML and explored its preliminary efficacy. Methods: Being Present-CML is a prospective, single-arm clinical trial of an 8-week, online MBI developed for patients with GI cancers (Atreya, et al. PLoS One, 2018) and adapted to include qigong. Participants were recruited from a single academic institution. Eligibility included adult patients with CP-CML taking TKIs. Participants played audio-guided meditations at least 5 times per week on a secure website and participated in weekly, instructor-led meditation and qigong sessions on Zoom. Feasibility was assessed through measurement of recruitment and attrition. Adherence was determined by web capture. Acceptability was determined from surveys and qualitative interviews. Preliminary efficacy was evaluated by patient-reported outcome measures (PROMs) at baseline (week 0) and post-intervention (week 8). Descriptive statistics and two-tailed paired t-tests (p<0.05) were used to summarize the data. Interim results were presented previously; here we report the final results. Results: Between October 2020-September 2021, 121 eligible participants were approached to participate, and 46 patients (38%) consented. The median age was 49.5 years (range 23-75), 54.3% (n=25/46) were male, and 82.6% (n=38/46) were non-Hispanic White. At time of study start, 82.6% (n=38/36) were taking dasatinib, 84.7% (n=39/46) had a BCR-ABL1 PCR transcript ≤1%, and a median time since diagnosis of 70.5 months (range 1-234). Of 46 participants, 35 (76.1%) completed end of study procedures. The median number of audio meditations listened to per participant was 28.7 with an average of 4.1 per week. The median number of 8 weekly classes attended and/or recordings viewed per participant was 7 (range 0-8). At baseline, participants had an average NCCN Distress Thermometer score of 4.86 (range 0-8), which improved to 3.5 by week 8 (p=0.02). Nearly all participants would recommend the to others (median score of 9 on a 1-10 scale; 10=extremely likely). Conclusions: Patients with CP-CML taking TKIs found the MBI to be feasible and acceptable. PROM results suggest potential for distress reduction in this patient population. Clinical trial information: NCT04605211 .

Online Mindfulness-Based Interventions for Healthcare Professionals: A Scoping Review.

Healthcare professionals work in challenging environments with extended working hours and excessive workloads to provide high-quality care. However, they hardly get the time to care for themselves. Online mindfulness-based interventions-which are not restricted by time or location-can be a powerful strategy to help healthcare professionals. This scoping review aims to explore the current evidence about online mindfulness-based interventions for healthcare professionals. A scoping review was conducted. A literature search was conducted to retrieve articles published between October 2016 and March 2023 in seven databases, including backward and forward citation tracking from the included articles. Among 1,278 articles retrieved, 33 met the criteria for review. Two-thirds of the studies utilized commercialized mindfulness programs (n = 22). Duration of the mindfulness interventions varied from 1 week to 4 months, and half of the studies used audio-guided programs. Online mindfulness-based intervention studies were targeted to reduce burnout (n = 26), and the majority reported reduction in burnout (n = 18). Most studies used individual audio-guided programs that warrant the use of diverse delivery methods such as video media, simulation, and virtual reality for interactions in the future. Although the literature has accumulated evidence for commercialized online mindfulness-based interventions, further studies are needed to develop and test tailored interventions for healthcare professionals.

Effectiveness of Web-Based Mindfulness-Based Interventions for Patients With Cancer: Systematic Review and Meta-Analyses.

Cancer has emerged as a considerable global health concern, contributing substantially to both morbidity and mortality. Recognizing the urgent need to enhance the overall well-being and quality of life (QOL) of cancer patients, a growing number of researchers have started using online mindfulness-based interventions (MBIs) in oncology. However, the effectiveness and optimal implementation methods of these interventions remain unknown. This study evaluates the effectiveness of online MBIs, encompassing both app- and website-based MBIs, for patients with cancer and provides insights into the potential implementation and sustainability of these interventions in real-world settings. Searches were conducted across 8 electronic databases, including the Cochrane Library, Web of Science, PubMed, Embase, SinoMed, CINAHL Complete, Scopus, and PsycINFO, until December 30, 2022. Randomized controlled trials involving cancer patients aged ≥18 years and using app- and website-based MBIs compared to standard care were included. Nonrandomized studies, interventions targeting health professionals or caregivers, and studies lacking sufficient data were excluded. Two independent authors screened articles, extracted data using standardized forms, and assessed the risk of bias in the studies using the Cochrane Bias Risk Assessment Tool. Meta-analyses were performed using Review Manager (version 5.4; The Cochrane Collaboration) and the meta package in R (R Foundation for Statistical Computing). Standardized mean differences (SMDs) were used to determine the effects of interventions. The Reach, Effectiveness, Adoption, Implementation, and Maintenance framework was used to assess the potential implementation and sustainability of these interventions in real-world settings. Among 4349 articles screened, 15 (0.34%) were included. The total population comprised 1613 participants, of which 870 (53.9%) were in the experimental conditions and 743 (46.1%) were in the control conditions. The results of the meta-analysis showed that compared with the control group, the QOL (SMD 0.37, 95% CI 0.18-0.57; P<.001), sleep (SMD -0.36, 95% CI -0.71 to -0.01; P=.04), anxiety (SMD -0.48, 95% CI -0.75 to -0.20; P<.001), depression (SMD -0.36, 95% CI -0.61 to -0.11; P=.005), distress (SMD -0.50, 95% CI -0.75 to -0.26; P<.001), and perceived stress (SMD -0.89, 95% CI -1.33 to -0.45; P=.003) of the app- and website-based MBIs group in patients with cancer was significantly alleviated after the intervention. However, no significant differences were found in the fear of cancer recurrence (SMD -0.30, 95% CI -1.04 to 0.44; P=.39) and posttraumatic growth (SMD 0.08, 95% CI -0.26 to 0.42; P=.66). Most interventions were multicomponent, website-based health self-management programs, widely used by international and multilingual patients with cancer. App- and website-based MBIs show promise for improving mental health and QOL outcomes in patients with cancer, and further research is needed to optimize and customize these interventions for individual physical and mental symptoms. PROSPERO CRD42022382219; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=382219.

Multimodal digital health treatments for Chronic Migraine associated with Medication Overuse Headache: a literature appraisal and results of a single-arm open trial (the BE-HOME program).

Mindfulness-based treatments gained popularity for migraine treatment. In this manuscript we report the results of a single-arm open pilot study that evaluated the impact of a multimodal web-based intervention combining home-based medication withdrawal, patients' education, and online mindfulness-based interventions. We aimed to address whether our program had the ability to show a change in the observed parameters and the study should therefore be intended as an early phase trial. Consecutive patients with chronic migraine associated with medication overuse headache were enrolled, followed-up for 12months, in a program that included home-based medication withdrawal, education on the correct use of drugs and lifestyle issues, prescription of tailored pharmacological prophylaxis, and attendance to six online mindfulness-based sessions. We tested the effect of the program on improving headache frequency, medication intake, quality of life (QoL), headache impact, depression, self-efficacy, and pain catastrophizing. A total of 37 patients completed the study (10 dropped out). We observed a large improvement in headache frequency, medication intake, headache impact, and QoL, a moderate improvement in pain catastrophizing and a mild improvement in depression symptoms; 70% to 76% of patients achieved 50% or more reduction in headache frequency from baseline to each follow-up (p < .01). The results of our multimodal program showed significant improvements in headache frequency, medication intake, and patient-reported outcomes. Future studies are needed to better identify patients who might benefit most from Digital Health Interventions and to demonstrate at least an equivalence in outcome with in-person programs carried out in hospital settings.

Effects of Two Online Mindfulness-Based Interventions for Early Adolescents for Attentional, Emotional, and Behavioral Self-Regulation.

(1) Background: Mindfulness-based interventions (MBIs) have shown interesting preliminary effects on self-regulation processes in early adolescence. However, programs have typically combined different types of interventions with no understanding of the specific effect of each intervention type on attentional, emotional, and behavioral regulation. The objective of this research was to evaluate the effect of two MBIs-one focused on classic attentional practices and another focused on the recognition and expression of emotions-on attentional, emotional, and behavioral self-regulation in early adolescents. (2) Method: An experimental paradigm was used. A sample of 74 children aged between 8 and 12 years old were randomly assigned to three experimental conditions: (1) an MBI with a focus on attentional practices, (2) an MBI with a focus on recognition and expression of emotions, and (3) a control group. The interventions lasted 8 weeks, with a weekly, 1 h online synchronous session plus home practices. Children were evaluated before starting the intervention and at the end of the 8-week period. The assessed outcomes were (1) mindfulness; (2) emotional regulation; (3) attentional regulation, and (4) behavioral regulation. (3) Results: Children who participated in both intervention programs increased their mindfulness and emotional and behavioral regulation scores. Only children who participated in the MBI with a focus on attention showed significant changes in their ability to self-regulate attention. (4) Conclusions: The use of online MBIs, with attention to external and internal stimuli practices, can be a good strategy to strengthen self-regulation skills for attention, emotions, and behavior in early adolescence.

Training-related improvements in mental well-being through reduction in negative interpretation bias: A randomized trial of online socio-emotional dyadic and mindfulness interventions

BackgroundEffects of online contemplative practices, especially partner-based practices, on psychological well-being remain mixed, with sparse understanding of potential affective-cognitive mechanisms. The study aimed to assess the efficacy of two online contemplative interventions in improving depression, anxiety, emotion regulation (ER), and resilience, and to evaluate the mechanistic role of negative attention and interpretation biases. MethodsEmploying a randomized controlled design (n = 285), we compared the efficacy of 10-week online mindfulness-based and partner-based socio-emotional dyadic interventions, both supported by weekly coaching sessions. Mental health aspects were assessed using validated self-report measures and negative biases using the mouse-contingent Scrambled Sentences Task. ResultsBoth interventions, compared to waitlist control, led to reductions in depression and ER difficulties, while trait anxiety decreased only after mindfulness training. Increases in multidimensional resilience were observed only after socio-emotional training and in stress recovery only after mindfulness-based training, both compared to waitlist control. Socio-emotional training led to significant reductions in negative interpretation bias and this mediated reductions in depression and trait anxiety. Neither training led to reductions in state anxiety or negative attention bias. LimitationsThe subclinical nature and overrepresentation of females in the sample limits generalizability. ConclusionsFindings indicate that online mindfulness-based and socio-emotional partner-based interventions, supported by online coaching sessions, can reduce depression and ER difficulties. Though mindfulness practice reduced trait anxiety and enhanced stress recovery, socio-emotional training increased multidimensional resilience. Socio-emotional training reduced negative interpretation bias, which emerged as an intervention-specific mechanism. These findings highlight the potential benefits of online contemplative intervention approaches for psychological well-being.

Contextualising an online mindfulness-based intervention for young people with cancer: A qualitative study

BackgroundDespite improved prognosis, living with cancer can still negatively impact young people’s psychosocial wellbeing. Mindfulness-based interventions (MBI) have been shown to help manage cancer-related stress but tailored interventions for young people are warranted. In addition, attendance at intensive face-to-face mindfulness-based interventions is often a barrier to access and adherence. AimThis study aims to contextualise an online MBI, for young people with cancer (YPWC). MethodsThis study modified an online MBI using a qualitative research approach through several phases, including a discussion with experts, a workshop with YPWC (n=6), followed by focus groups with health professionals (n=5) and YPWC (n=7). FindingsThe qualitative thematic analysis of data from the workshop discussion and focus groups identified two key themes, which were 1) developing mindfulness skill and adopting into daily living and appropriateness; and 2) accessibility of design and delivery of an MBI eBook. The participants in the workshop and focus group provided various recommendations and as a result of this data, the modules were modified and further tailored both at the design level and the module contents. DiscussionThis study contextualised a self-directed, online MBI through the participation from YPWC and health care providers. This participatory approach enabled the development of a young people friendly intervention which incorporated cancer focused case studies with mindful reflections, all of which were well received by YPWC. ConclusionThe involvement of end users in the development phase significantly improved the acceptability of this intervention design. The tailored MBI potentially aids the psychosocial well-being of young people with cancer.

The effectiveness of mindfulness-based interventions in treating mental health and addiction: a cross-sectional study

Objective: This study aimed to provide a snapshot of the current landscape, drawing upon existing research to evaluate the extent to which online mindfulness-based interventions (MBIs) have been integrated into mainstream treatment paradigms and their observed outcomes. Methods: The initial month of the full mindfulness virtual community (F-MVC) intervention included 12 video modules focusing on students&amp;apos; known stressors and mindfulness exercises; private online forums for peer discussions; and 20-minute live video conferences led by professionals in anonymous groups. During the next four weeks of F-MVC, participants were limited to watching modules in video format. The online surveys were conducted at T1, T2, and T3 - 4 weeks and 8 weeks, respectively. Results: Out of the 113 students who gave T1 data, there were 28 male and 85 female students, with an average age of 24.8 years. At the T3 follow-up, after making adjustments for comparison purposes, there were notable decreases in depression scores for F-MVC (change in score of -4.03; P

Tele-Health Psychological Interventions in Breast Cancer at the Time of Coronavirus: A Narrative Review

Introduction: During the recent pandemic-related health emergency of COVID-19, the health system care has undergone several substantial and sudden changes to benefit the populations of patients affected by COVID-19 delaying the diagnosis and treatment of all other patients. One of the most vulnerable populations during this period was the oncological population. The use of telemedicine has become necessary to compensate for all this by forging medical and psychological support at a distance.&#x0D; Objectives: The purpose of this narrative review is to offer an overview of the literature on present scientific papers regarding tele-health psychological interventions aimed at breast cancer patients during the pandemic period of COVID-19 and discussing the reported effects.&#x0D; Methods: This narrative review has been realized through a revision of the scientific literature conducted from August to October 2023 using the following electronic databases: “PubMed”, “Science Direct” and “Google Scholar” typing keywords related to the pandemic period, breast cancer population and telehealth psychological interventions. For the evaluation of the effects of the interventions, the statistical indices of p-value and effect size measures were considered.&#x0D; Results: Online mindfulness-based interventions have been found to be significant in reducing anxiety, depression and sleep problems, and in improving self-perception of body image, quality of life, and self-efficacy. No significant results are detected in the reduction of depression symptoms and stress levels between groups.&#x0D; Discussions: Very limited studies investigated the topic. Further research is needed to better understand the efficacy of telepsychology during the pandemic period and deepen research in terms of other therapeutic approaches and other methods of treatment delivery. In addition, interventions based on a systemic approach, that involve both health care workers and caregivers, can be more effective for the overall well-being of breast cancer patients.

Effectiveness of online mindfulness-based interventions for cancer patients: a systematic review and meta-analysis.

Cancer is the second leading cause of mortality worldwide. Cancer negatively affects individuals' quality of life and overall health. Mindfulness-based interventions appear to be promising in the reduction of cancer- and treatment-related symptoms. This review aimed to determine the effectiveness of online mindfulness-based interventions on distress, anxiety, depression, stress, mindfulness, sleep disturbance, quality of life, rumination, fear of cancer recurrence, fatigue and post-traumatic growth among adult cancer patients. A literature search was conducted across five electronic databases. Only randomized controlled trials were eligible. Two reviewers independently screened the studies, extracted data, and performed quality assessment using the Cochrane risk of bias assessment tool. Meta-analyses were conducted using review manager software, and standardized mean difference was used to determine intervention effects. Heterogeneity was examined using the I2 statistics. Ten studies were included with a total of 962 participants. Analyses revealed that online mindfulness-based interventions was effective in reducing distress (I2 = 98%；standardized mean difference = -2.21，95% confidence interval: -3.84 to 0.57；P = 0.008)， depression (I2 = 45%；standardized mean difference = -0.33，95% confidence interval: -0.64 to -0.03；P = 0.03), stress (I2 = 97%；standardized mean difference = -2.14，95% confidence interval: -4.24 to -0.03；P = 0.05) and sleep disturbance (I2 = 54%；standardized mean difference = -0.30，95% confidence interval: -0.59 to -0.01；P = 0.04), and improving quality of life (I2 = 94%；standardized mean difference = 0.92，95% confidence interval: 0.09-1.76；P = 0.03). The online mindfulness-based interventions had no significant effects on anxiety, mindfulness, rumination, fear of cancer recurrence, fatigue and post-traumatic growth. Subgroup analyses revealed that online mindfulness-based interventions resulted in higher effect sizes for distress when delivered by website than application, significantly higher effect sizes were also found for online mindfulness-based interventions with guidance, but not on treatment or cancer type. For sleep disturbance, and quality of life, no significant differences between subgroups were found. These results provide preliminary support that online mindfulness-based interventions may be feasible and acceptable, which can be used as an adjuvant therapy for the management of cancer-related symptoms among cancer patients.

Effects of online mindfulness-based interventions (MBIs) on anxiety symptoms in adults: a systematic review and meta-analysis

BackgroundAn increasing number of studies have documented the effectiveness on various types of face-to-face and online mindfulness-based interventions (MBIs) in reducing anxiety among general population, but there is a scarcity of systematic reviews evaluating evidence of online MBIs on anxiety in adults. Therefore, we examined the effects of online mindfulness-based interventions (MBIs) on anxiety symptoms in adults and explored the moderating effects of participant, methods, and intervention characteristics.MethodsWe systematically searched nine databases through May 2022 without date restrictions. Inclusion criteria were primary studies evaluating online mindfulness-based interventions with adults with anxiety measured as an outcome, a comparison group, and written in English. We used random-effects model to compute effect sizes (ESs) using Hedges’ g, a forest plot, and Q and I2 statistics as measures of heterogeneity; we also examined moderator analyses.ResultsTwenty-six primary studies included 3,246 participants (39.9 ± 12.9 years old). Overall, online mindfulness-based interventions showed significantly improved anxiety (g = 0.35, 95%CI 0.09, 0.62, I2 = 92%) compared to controls. With regards to moderators, researchers reported higher attrition, they reported less beneficial effects on anxiety symptoms (β=-0.001, Qmodel=4.59, p = .032). No other quality indicators moderated the effects of online mindfulness-based interventions on anxiety.ConclusionOnline mindfulness-based interventions improved anxiety symptoms in adult population. Thus, it might be used as adjunctive or alternative complementary treatment for adults. However, our findings must be interpreted with caution due to the low and unclear power of the sample in primary studies; hence, high-quality studies are needed to confirm our findings.

The role of experiential avoidance in the early stages of an online mindfulness-based intervention: Two mediation studies

ABSTRACT Objectives There is evidence to suggest that only 2–4 weeks of mindfulness-based interventions (MBIs) can already alleviate emotional stress. The current studies sought to examine whether experiential avoidance mediated the effects of MBIs on emotional distress during an early stage of the intervention. Methods: Chinese participants with high emotional distress were recruited. Study 1 included 324 participants, randomly assigned to an online MBI (N = 171) or a control group (N = 153). Experiential avoidance and general emotional distress were measured at baseline and after the 3rd week of the intervention. Study 2 included 158 participants, randomly assigned to an online MBI (N = 79) or a control group (N = 79). Experiential avoidance and emotional distress were measured at baseline and weekly in the first three weeks. Results: Compared to the control group, experiential avoidance and emotional distress were significantly improved in the MBI group during the first three weeks of the intervention (Cohen’s d = 0.22–0.63). Moreover, changes in experiential avoidance mediated the effects of MBI on emotional distress in the early stage in both contemporary and lagged mediation models. Discussion: Experiential avoidance is an important mediator during the early-stage of MBIs for alleviating emotional distress.

Effectiveness of Online Mindfulness-Based Intervention on Depression in Pregnancy

The high prevalence of depression in developed and developing countries requires a relevant intervention to suppress its incidence. Mindfulness-based intervention is given online as a new complementary intervention that can help reduce symptoms of depression. This study aimed to determine the effectiveness of online mindfulness-based interventions in reducing depressive symptoms in pregnancy. This research method used a randomized control trial, with 66 participants consisting of the mindfulness-based Intervention (MBI) group of 33 participants and the control group of 33 participants. The MBI intervention was provided for eight weeks online. The study uses simple random sampling. Depression was assessed using DASS 42. Data were tested using the Mann-Whitney U Test and t-test and processed with SPSS version 23. The results showed that there was a significant decrease in depression levels in the online MBI group after being given intervention compared to the control group (7.55 ± 2.181 vs 11.00 ± 2.345) p=0.000. Mindfulness-based intervention online can reduce depressive symptoms in pregnant women, so that the intervention becomes a feasible, cheap and easy intervention for pregnant women in improving mental health. In the future, this research can develop other types of complementary interventions to improve maternal and fetal health.

Effects of an online program including mindfulness, exercise therapy and patient education compared to online exercise therapy and patient education for people with Patellofemoral Pain: protocol for a randomized clinical trial

BackgroundPatellofemoral pain (PFP) is a common knee disorder that causes persistent pain, lower self-reported function and quality of life. People with PFP also present with altered psychological factors, which are associated with higher levels of pain and dysfunction. Mindfulness-based interventions (MBI) generally consist of meditative practices developed to provide a holistic approach to chronic conditions. However, the effects of MBI on clinical and psychological outcomes for people with PFP remains understudied.MethodsThis assessor-blinded, parallel, two-arm randomized clinical trial aims to investigate the effects of adding an 8-week online MBI program to exercise therapy and patient education on clinical and psychological factors for people with PFP. We also aim to investigate whether psychological factors mediate changes in pain and function. Sixty-two participants with PFP will be recruited and randomized into one of two treatment groups (Mindfulness or Control group). Both groups will receive an 8-week intervention involving exercise therapy and education delivered through an online platform. The Mindfulness group will additionally receive a MBI component including formal and informal practices. Outcomes will be assessed online at baseline, intervention endpoint (follow-up 1) and 12 months after intervention completion (follow-up 2). Comparisons between groups will be performed at all time points with linear mixed models. A mediation analysis will be performed using a 3-variable framework.DiscussionExercise therapy and patient education are considered the “best management” options for PFP. However, unsatisfactory long-term prognosis remains an issue. It is known that people with PFP present with altered psychological factors, which should be considered during the evaluation and treatment of people with PFP. Adding a MBI to the current best treatment for PFP may improve short and long-term effects by addressing the underlying psychological factors.Trial registrationRegistro Brasileiro de Ensaios Clínicos (ReBEC) RBR-4yhbqwk, registered in April 6, 2021.

Feasibility of Implementing a Mindfulness-Based Online Program for Latina Immigrants and the Staff that Work with Them.

Post-migration stress and trauma impact the way Latino/a immigrants in the USA experience everyday life. Mindfulness-based interventions (MBIs) reduce stress and strengthen mental health by improving the response to stressors and promoting physical and psychological well-being; however, they have not been tested extensively with Latino/a immigrants in the USA, particularly MBIs implemented online. Thus, more information is needed about the feasibility of online MBIs adapted for Latino/a immigrants. This study focuses on the feasibility of an online MBI for Latina mothers and community staff members working with them (n = 41). Qualitative (three focus groups) data were collected to assess feasibility, appropriateness, acceptability, and quantitative (questionnaires) data asking about self-reported changes on stress, mindfulness, mind-body connection, subjective well-being, and perceived physical and mental health after the program. Participants in the three groups indicated the program was appropriate, feasible, and acceptable for Latina immigrant mothers and the staff serving them. Mothers' and Promotoras' (community health workers) mean scores for subjective well-being and perceived physical and mental health increased significantly from baseline to post-test. No significant changes were observed in surveys completed by the staff, even though focus group participants reported meaningful improvement. Overall, the feasibility study was well received and relevant for the organization and the population they serve. The study's findings provide guidance to others who are implementing online mindfulness practices with Latina immigrants and the staff that work with them. This study is not preregistered. The online version contains supplementary material available at 10.1007/s12671-023-02123-6.

Effects of risk exposure on emotional distress among Chinese adults during the COVID-19 pandemic: The moderating role of disruption of life and perceived controllability.

COVID-19 affects not only the physical health of individuals but also their mental health and different types of risk exposures are believed to have different effects on individual emotional distress. This study explores the relationships between risk exposure, disruption of life, perceived controllability, and emotional distress among Chinese adults during the COVID-19 outbreak. This study is based on an online survey conducted during the COVID-19 pandemic, from 1 to 10 February 2020, with a total of 2,993 Chinese respondents recruited through convenience and snowball sampling. Multiple linear regression analysis were used to examine the relationships among risk exposure, disruption of life, perceived controllability, and emotional distress. This study found that all types of risk exposures were significantly associated with emotional distress. Individuals with neighborhood infection, family member infection/close contact, and self-infection/close contact had higher levels of emotional distress (B = 0.551, 95% CI: -0.019, 1.121; B = 2.161, 95% CI: 1.067, 3.255; B = 3.240, 95% CI: 2.351, 4.129) than those without exposure. The highest levels of emotional distress occurred among individuals experiencing self-infection/close contact, while the lowest levels of emotional distress occurred among individuals experiencing neighborhood infection and the moderate levels of emotional distress occurred among individuals experiencing family member infection (Beta = 0.137; Beta = 0.073; Beta = 0.036). Notably, the disruption of life aggravated the effect of self-infection/close contact on emotional distress and family member infection/close contact on emotional distress (B = 0.217, 95% CI: 0.036, 0.398; B = 0.205, 95% CI: 0.017, 0.393). More importantly, perceived controllability lowered the strength of the association between self-infection/close contact and emotional distress, as well as family member infection/close contact and emotional distress (B = -0.180, 95% CI: -0.362, 0.002; B = -0.187, 95% CI: -0.404, 0.030). These findings shed light on mental health interventions for people exposed to or infected with COVID-19 near the beginning of the pandemic, particularly those who themselves had COVID or had family members with COVID-19 risk exposure, including being infected/having close contact with an infected person. We call for appropriate measures to screen out individuals or families whose lives were, or remain, more severely affected by COVID-19. We advocate providing individuals with material support and online mindfulness-based interventions to help them cope with the after-effects of COVID-19. It is also essential to enhance the public's perception of controllability with the help of online psychological intervention strategies, such as mindfulness-based stress reduction programs and mindfulness-oriented meditation training programs.

Online mindfulness-based intervention for women with pregnancy distress: A randomized controlled trial

BackgroundPregnancy distress among childbearing women is common and can negatively affect both mother and infant. Mindfulness-based interventions (MBIs) may have a positive effect on pregnancy distress but randomized controlled trials with sufficient power are lacking. The current study examined the effectiveness of an online self-guided MBI in pregnant women with pregnancy distress. MethodsPregnant women with elevated pregnancy distress levels at 12 weeks of pregnancy, measured with the Edinburgh Depression Scale (EDS) and Tilburg Pregnancy Distress Scale negative affect (TPDS-NA), were randomized into an intervention group (online MBI, N = 109) or control group (care as usual, N = 110). The primary outcome was the change in pregnancy distress post-intervention and at eight-weeks-follow-up. Secondary outcomes were mindfulness skills (Three Facet Mindfulness Questionnaire-Short Form), rumination (Rumination-Reflection Questionnaire), and self-compassion (Self-Compassion Scale-Short Form) at post-intervention and follow-up in the intervention group. ResultsSignificant improvements were found in pregnancy distress scores, but no significant differences between intervention and control group appeared. The MBI group showed improvements in mindfulness skills, rumination, and self-compassion. LimitationsLow adherence to the intervention and assessment of secondary outcome measures in the intervention group only. ConclusionsAn intervention trial with one of the largest samples (N = 219) provided no evidence of a significant effect of an online self-guided MBI in distressed pregnant women. An online MBI may be associated with an improvement in mindfulness skills, rumination, and self-compassion. Future research should address the effectiveness of MBI's with different formats (online and group-based combined) and examine a possible delayed effect. Trial registrationClinicalTrials.gov: NCT03917745, registered on 4 March 2019.

Psychological PPE – Reflections on How to Implement Mindful Interventions to Protect the Healthcare Workforce

Interest in Mindfulness-based interventions (MBIs) with healthcare professionals has become increasingly popular. However, healthcare professionals’ busy schedules and low help-seeking behaviour requires the intervention to be easily accessible, convenient, and practical. This paper explores the reflections of multidisciplinary healthcare professionals regarding implementing a brief online MBI to draw on lessons learned that could guide future implementation and interventions in similar multicultural, resource-constrained settings. An online MBI was implemented with healthcare professionals (HCPs) working in urban and rural hospitals in South Africa during the first wave of Covid-19. Fifty-five healthcare professionals from various disciplines participated in a four-week online training programme via the Zoom platform. Participant reflections and feedback were collected via WhatsApp and Zoom room chats. The data collected were thematically analysed. Reflections from the implementation of the MBI were classified into questions of where, when, who, what, why, and how. The results reflect that a four-hour online mindfulness-based intervention could work more effectively if departments offered and supported the programme during work hours. The findings also reveal the greater potential for a brief online MBI to enhance resiliency in HCPs, especially during a pandemic emergency, as demonstrated in the study. The study proposes that mindfulness training could be offered to HCPs at many levels to help with psychological first aid and task shifting to reduce stress and prevent burnout.