Web-Based Mindfulness-Based Interventions for Well-being: Randomized Comparative Effectiveness Trial.

Autor: Sylvia LG; Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States.; Harvard University, Cambridge, MA, United States., Lunn MR; Stanford University School of Medicine, Stanford, CA, United States., Obedin-Maliver J; Stanford University School of Medicine, Stanford, CA, United States., McBurney RN; Accelerated Cure Project for Multiple Sclerosis, Waltham, MA, United States., Nowell WB; Global Healthy Living Foundation, Upper Nyack, NY, United States., Nosheny RL; University of California San Francisco School of Medicine, San Francisco, CA, United States., Mularski RA; Kaiser Permanente Center for Health Research Northwest Region, Portland, OR, United States., Long MD; University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, United States., Merkel PA; University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States., Pletcher MJ; University of California San Francisco School of Medicine, San Francisco, CA, United States., Tovey RE; Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States., Scalchunes C; Immune Deficiency Foundation, Towson, MD, United States., Sutphen R; University of South Florida, Tampa, FL, United States., Martin AS; Parent Project Muscular Dystrophy, Washington, DC, United States., Horn EJ; Phelan-McDermid Syndrome Foundation, Osprey, FL, United States., O'Boyle M; Phelan-McDermid Syndrome Foundation, Osprey, FL, United States., Pitch L; ImproveCareNow Inc., Burlington, VT, United States., Seid M; Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States., Redline S; Brigham and Women's Hospital, Boston, MA, United States., Greenebaum S; Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States., George N; Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States., French NJ; Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States., Faria CM; Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States., Puvanich N; Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States., Rabideau DJ; Biostatistics, Massachusetts General Hospital, Boston, MA, United States., Selvaggi CA; Biostatistics, Massachusetts General Hospital, Boston, MA, United States., Yu C; Biostatistics, Massachusetts General Hospital, Boston, MA, United States., Faraone SV; State University of New York Upstate Medical University, Syracuse, NY, United States., Venkatachalam S; Global Healthy Living Foundation, Upper Nyack, NY, United States., McCall D; Health eHeart Alliance, San Francisco, CA, United States., Terry SF; Genetic Alliance, Damascus, MD, United States., Deckersbach T; Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States., Nierenberg AA; Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States.; Harvard University, Cambridge, MA, United States.
Jazyk: angličtina
Zdroj: Journal of medical Internet research [J Med Internet Res] 2022 Sep 12; Vol. 24 (9), pp. e35620. Date of Electronic Publication: 2022 Sep 12.
DOI: 10.2196/35620
Abstrakt: Background: Mindfulness can improve overall well-being by training individuals to focus on the present moment without judging their thoughts. However, it is unknown how much mindfulness practice and training are necessary to improve well-being.
Objective: The primary aim of this study was to determine whether a standard 8-session web-based mindfulness-based cognitive therapy (MBCT) program, compared with a brief 3-session mindfulness intervention, improved overall participant well-being. In addition, we sought to explore whether the treatment effects differed based on the baseline characteristics of the participants (ie, moderators).
Methods: Participants were recruited from 17 patient-powered research networks, web-based communities of stakeholders interested in a common research area. Participants were randomized to either a standard 8-session MBCT or a brief 3-session mindfulness training intervention accessed on the web. The participants were followed for 12 weeks. The primary outcome of the study was well-being, as measured by the World Health Organization-Five Well-Being Index. We hypothesized that MBCT would be superior to a brief mindfulness training.
Results: We randomized 4411 participants, 3873 (87.80%) of whom were White and 3547 (80.41%) of female sex assigned at birth. The mean baseline World Health Organization-Five Well-Being Index score was 50.3 (SD 20.7). The average self-reported well-being in each group increased over the intervention period (baseline to 8 weeks; model-based slope for the MBCT group: 0.78, 95% CI 0.63-0.93, and brief mindfulness group: 0.76, 95% CI 0.60-0.91) as well as the full study period (ie, intervention plus follow-up; baseline to 20 weeks; model-based slope for MBCT group: 0.41, 95% CI 0.34-0.48; and brief mindfulness group: 0.33, 95% CI 0.26-0.40). Changes in self-reported well-being were not significantly different between MBCT and brief mindfulness during the intervention period (model-based difference in slopes: -0.02, 95% CI -0.24 to 0.19; P=.80) or during the intervention period plus 12-week follow-up (-0.08, 95% CI -0.18 to 0.02; P=.10). During the intervention period, younger participants (P=.05) and participants who completed a higher percentage of intervention sessions (P=.005) experienced greater improvements in well-being across both interventions, with effects that were stronger for participants in the MBCT condition. Attrition was high (ie, 2142/4411, 48.56%), which is an important limitation of this study.
Conclusions: Standard MBCT improved well-being but was not superior to a brief mindfulness intervention. This finding suggests that shorter mindfulness programs could yield important benefits across the general population of individuals with various medical conditions. Younger people and participants who completed more intervention sessions reported greater improvements in well-being, an effect that was more pronounced for participants in the MBCT condition. This finding suggests that standard MBCT may be a better choice for younger people as well as treatment-adherent individuals.
Trial Registration: ClinicalTrials.gov NCT03844321; https://clinicaltrials.gov/ct2/show/NCT03844321.
(©Louisa G Sylvia, Mitchell R Lunn, Juno Obedin-Maliver, Robert N McBurney, W Benjamin Nowell, Rachel L Nosheny, Richard A Mularski, Millie D Long, Peter A Merkel, Mark J Pletcher, Roberta E Tovey, Christopher Scalchunes, Rebecca Sutphen, Ann S Martin, Elizabeth J Horn, Megan O'Boyle, Lisa Pitch, Michael Seid, Susan Redline, Sophie Greenebaum, Nevita George, Noah J French, Caylin M Faria, Nicha Puvanich, Dustin J Rabideau, Caitlin A Selvaggi, Chu Yu, Stephen V Faraone, Shilpa Venkatachalam, Debbe McCall, Sharon F Terry, Thilo Deckersbach, Andrew A Nierenberg. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 12.09.2022.)
Databáze: MEDLINE
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