Can the Mindful Awareness and Resilience Skills for Adolescents (MARS-A) Program Be Provided Online? Voices from the Youth

Abstract

Mindfulness-based interventions (MBIs) have been shown to improve health and well-being in adolescents with chronic illnesses. Because they are most often delivered in person in a group setting, there are several barriers that limit access to MBIs for youth with limited mobility or who cannot access in-person MBIs in their communities. The objective of this study was to determine if eHealth is a viable platform to increase accessibility to MBIs for teens with chronic illnesses. This study reports the qualitative results of a mixed method randomized trial describing the experience of the Mindful Awareness and Resilience Skills for Adolescents (MARS-A) program, an eight-week MBI, delivered either in person or via eHealth. Participants were adolescents between the ages of 13 and 18 with a chronic illness recruited at a tertiary pediatric hospital in Toronto, Canada. Individual semi-structured post-participation audio-video interviews were conducted by a research assistant. A multiple-pass inductive process was used to review interview transcripts and interpret emergent themes from the participants’ lived experiences. Fifteen participants (8 online and 7 in person) completed post-participation interviews. Four distinct themes emerged from participants in both groups: Creation of a safe space, fostering peer support and connection, integration of mindfulness skills into daily life, and improved well-being through the application of mindfulness. Direct quotations representative of those four themes are reported. Results from this study suggest that eHealth delivery of an adapted MBI for adolescents with chronic illnesses may be an acceptable and feasible mode of delivery for MBIs in this population. EHealth should be considered in future studies of MBIs for adolescents with chronic illnesses as a promising avenue to increase access to MBIs for youth who might not be able to access in-person programs.

A Systematic Review of the Adherence to Home-Practice Meditation Exercises in Patients with Chronic Pain

“…It is worth mentioning that four studies were conducted on samples of adolescents: Ali et al [62] and Hesse et al [59] studied a sample of adolescents with primary chronic pain conditions, and Chadi et al [54,57] tested the effects of an MBI on samples of teenagers with chronic pain as a result of a medical condition. The adherence to home practice in these studies was notable in terms of days per week (ranging from 4 to 6.5 on average), but the amount of time invested each day was generally very low (ranging between 4 and 8 min per day on average).…”

“…Among the interventions tested in the reviewed studies, three of them [38,54,63] were eHealth programs, i.e., health services delivered or enhanced through the Internet and related technologies (e.g., telehealth, mobile apps, etc.) [72][73][74].…”

“…On the other hand, some studies used physical books, CDs, and DVDs, and in which the practices that the participants had to carry out at home were compiled [26,[39][40][41][42][43][44][45][46][47]. However, despite the relevance of this aspect, some studies did not specify how the participants received the instructions and resources to practice between sessions [48][49][50][51][52][53][54][55][56][57][58].…”

“…On the other hand, some studies used other strategies to collect home practice but without specifying the timing. One study collected the information through a qualitative interview once the intervention had finished [62]; two studies created an ad hoc item for home practice time that was included as part of a post-intervention questionnaire [37,54]; one study used a logbook created specifically for the study but without specifying its characteristics [57];…”

Paediatric and parenting technologies: possibilities and priorities

“…These technologies have been used to address a plethora of healthrelated information for parents and families such as childhood development and behaviour management, improving health literacy and chronic illness self-management, pain management, promoting mental health and psychological wellbeing, and supporting the transition between paediatric and adult healthcare. [1][2][3][4] The global COVID-19 pandemic has also brought a surge in the use of digital health information; however, as these technologies proliferate, research into their effectiveness needs to keep pace to ensure emerging products are credible and evidence-based. 5 For health professionals considering recommending technologies to children and young people, it is imperative to consider whether the technology is specifically designed for the target age group, and to ensure privacy and security of data.…”