Pilot study on increased adherence to physical activity on prescription (PAP) through mindfulness: study protocol (original) (raw)
Related papers
Research Square (Research Square), 2020
Increased physical activity can have health bene ts among inactive individuals. In Sweden, the healthcare system uses Physical Activity on Prescription (PAP) to motivate patients to increase their physical activity level. Mindfulness may further heighten the internal motivation to engage in physical activity. However, previous research has not demonstrated clear evidence of such associations. Aim: Examine the feasibility of the study design as a preparation for a full-scale study, and examine the differences, between three interventions, in change over time in physical activity levels and in related variables. Method: Comparison between three different interventions in an ordinary primary health care setting: PAP, mindfulness, and a combination of PAP and mindfulness. Physical activity was measured with self-report and ACTi Graph GT1X activity monitor. Statistical analysis was performed with a mixed effect model to account for repeated observations and estimate differences between groups at three-and six-months follow-up. Results: Between September 2016 and December 2018, a total of 88 participants were randomised into three groups. The total dropout rate was 20.4%, the attendance rate to the mindfulness courses (52% > 6 times) and the web-based mindfulness training (8% > 800 minutes) was low according to the stated feasibility criteria. Eleven participants were excluded from analysis due to low activity monitor wear time. Neither the activity monitor data nor self-reported physical activity showed any signi cant differences between the groups. Conclusion: The study design needs adjustment for the mindfulness intervention design before a fully scaled study can be conducted. A combination of PAP and mindfulness may increase physical activity and self-rated health more than PAP or mindfulness alone. Trial registration: ClinicalTrials.gov, registration number NCT02869854. Regional Ethical Review Board in Lund registration number 2016/404.
Global Advances in Health and Medicine
Background The burden of depression and anxiety is on the rise globally. Mindfulness-Based Programs (MBPs) are a particular group of psychosocial programs targeting depression and anxiety. There is growing research and practice interest in MBPs internationally, and they are becoming more commonly implemented in a number of countries’ healthcare services. Objective To systematically map the existing provision of MBPs in the Swedish healthcare sector, in order to understand facilitators and barriers to uptake, and so inform future implementation efforts. Methods We assessed the experiences of MBP implementation among relevant stakeholders in Swedish healthcare settings through an online survey. The survey was designed to gather data on (1) the evidence-base of practice being implemented; (2) the context in which implementation was taking place and (3) the process of facilitation. Respondents were identified through snowball sampling of key stakeholders. Results In total, 129 individua...
The role of mindfulness in physical activity: a systematic review
Obesity Reviews, 2018
Despite continued public health campaigns to promote physical activity, a majority of the population is inactive. In recent years, mindfulness-based approaches have been used in health and lifestyle interventions for physical activity promotion. We conducted a systematic literature review using the PRISMA guidelines to investigate the evidence for the potential of mindfulness-based approaches for physical activity. We searched electronic databases for papers that met eligibility criteria and identified 40 studies for inclusion. Evidence from cross-sectional studies (n = 20) indicated a positive relationship between dispositional mindfulness and physical activity, particularly with psychological factors related to physical activity. Five studies found that the mindfulness-physical activity relationship was mediated by stress, psychological flexibility, negative affect and shame, satisfaction, and state mindfulness. Evidence from mindfulness-based interventions (n = 20) suggested positive between-subjects effects on physical activity, but interventions varied in duration, session length, group size, delivery, content, and follow-up. Mindfulnessbased interventions were more likely to be successful if they were physical activityspecific and targeted psychological factors related to physical activity. The body of research shows a need for more methodologically rigorous studies to establish the effect of mindfulness on physical activity and to identify potential mechanisms involved in the mindfulness-physical activity relationship reliably.
PloS one, 2015
Mindfulness-based therapies are being used in a wide range of common chronic conditions in both treatment and prevention despite lack of consensus about their effectiveness in different patient categories. To systematically review the evidence of effectiveness MBSR and MBCT in different patient categories. A systematic review and meta-analysis of systematic reviews of RCTs, using the standardized MBSR or MBCT programs. We used PRISMA guidelines to assess the quality of the included reviews and performed a random effects meta-analysis with main outcome measure Cohen's d. All types of participants were considered. The search produced 187 reviews: 23 were included, covering 115 unique RCTs and 8,683 unique individuals with various conditions. Compared to wait list control and compared to treatment as usual, MBSR and MBCT significantly improved depressive symptoms (d=0.37; 95%CI 0.28 to 0.45, based on 5 reviews, N=2814), anxiety (d=0.49; 95%CI 0.37 to 0.61, based on 4 reviews, N=252...
Mindfulness, 2018
Because they provide data on responsiveness to experimental manipulation, clinical trials involving mindfulness-based interventions are a source of evidence for the construct validity of self-report measures of mindfulness. Within-group and betweengroup changes in mindfulness were examined from randomized clinical trials comparing mindfulness interventions to other bona fide treatment comparison conditions or waitlist control conditions. We also examined changes in clinical outcomes and the magnitude of these changes relative to changes in mindfulness. We included 69 published studies representing 55 unique samples (n = 4743). Self-report mindfulness measures showed relatively larger gains in mindfulness intervention conditions vis-à-vis waitlist comparison conditions at both post-treatment (effect size [ES] = 0.52, 95% CI [0.40, 0.64]) and follow-up (ES = 0.52 [0.20, 0.84]), although the effect at follow-up diminished to non-significance in a trim-and-fill analysis intended to account for publication bias (ES = 0.35 [− 0.03, 0.72]). Measures of mindfulness also showed relatively larger gains in mindfulness intervention conditions vis-à-vis bona fide comparison conditions, but only at post-treatment (ES = 0.25 [0.11, 0.38], 0.10 [− 0.08, 0.28], at post-treatment and follow-up, respectively). All three conditions (mindfulness, bona fide, waitlist) showed relatively larger improvements on measures of clinical outcomes than measures of mindfulness, with the exception of waitlist conditions for which this effect was no longer significant at follow-up. Taken together, findings provide partial support for the unique responsiveness of mindfulness self-report measures to interventions that include promotion of mindfulness meditation practice. Keywords Mindfulness. Self-report measures. Construct validity. Meta-analysis The construct of mindfulness is increasingly visible in psychology in recent decades. Mindfulness-based interventions, such as mindfulness-based stress reduction (MBSR; Kabat-Zinn 1990) and mindfulness-based cognitive therapy (MBCT; Segal, Williams, and Teasdale Segal et al. 2002), are being used to treat a wide variety of psychological and medical conditions (Goldberg et al. 2018; Goyal et al. 2014; Zoogman et al. 2015). In addition, dispositional mindfulness has been associated with a host of psychological characteristics including psychiatric symptoms, well-being (Baer et al. 2008), and personality traits (Giluk 2009), as well as with neurobiological and behavioral markers (Brown, Weinstein, and Creswell Brown et al. 2013; Creswell, Way, Eisenberger, and Lieberman Creswell et al. 2007; Garland, Boettiger, Gaylord, Chanon, and Howard Garland et al. 2011). As mindfulness is incorporated into the psychological canon, it becomes vital that reliable and valid measures of this construct are available (Lutz, Jha, Dunne, and Saron Lutz et al. 2015). To date, several self-report measures of mindfulness Electronic supplementary material The online version of this article (
Psychosomatic Medicine
This manuscript has been accepted by the editors of Psychosomatic Medicine, but it has not yet been copy-edited; information within these pages is therefore subject to change. During the copy-editing and production phases, language usage and any textual errors will be corrected, and pages will be composed into their final format. Please visit the journal's website (www.psychosomaticmedicine.org) to check for a final version of the article. When citing this article, please use the following: Psychosomatic Medicine (in press) and include the article's digital object identifier (DOI).
Mindfulness techniques, including Mindfulness Based Stress Reduction and Mindfulness Based Cognitive Therapy involve a programme of introspective practices based on awareness placed on the movement of the breath or similar meta-awareness of a bio-physiological activity. Avoiding the misdirection of mindfulness toward wrong action or unhelpful behaviour is embedded in traditional Buddhist practice and supervised training, where the potential pitfalls of meditation have been long understood. A range of unwanted consequences of mindfulness practice has been reported, including sleep disturbances, increased anxiety and panic attacks. Questions remain concerning detrimental outcomes: do we now need a more scientifically informed understanding of unwanted psychological side effects and individual suitability for mindfulness metacognitive therapies.