Protocol for a Nested Randomized Controlled Trial to Evaluate the Feasibility and Preliminary Efficacy of the Mindfulness Based Health Promotion Program on the Quality of Life of Older Adults Assisted in Primary Care—“The MBHP-Elderly Study”

Mapurunga, Marcelo Vasconcelos; Andreoni, Solange; Oliveira, Daniela Rodrigues de; Sarubbi, Vicente; Bonilha, Ana Cláudia; D’Almeida, Vânia; Tomita, Luciana Yuki; Ramos, Luiz Roberto; Demarzo, Marcelo

doi:10.3389/fmed.2020.563099

Cited by 6 publications

(3 citation statements)

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“…Pilot studies are necessarily the first steps in exploring interventions, and further investigation and implementation of culturally relevant adaptations to underserved minorities is pivotal to enhance engagement and mitigate health disparities in the country. This continuous process should be approached with a beginner's mind and in close collaboration with culturally appropriate community members (33,(106)(107)(108)(109). Additionally, MTPC-Portuguese might potentially decrease depression and anxiety symptoms, improve emotional regulation, and facilitate health behavior change among the sample studied.…”

Section: Discussionmentioning

confidence: 99%

“…The potential mental health benefits described herein are aligned with a small but growing literature described by Cotter et al ( 97 ) in a recent review of MBI research among U.S. immigrants with origins in countries from Ibero-America, largely represented by uncontrolled trials, where five of six studies found a significant reduction in depressive symptoms ( 82 , 98 – 101 ) and five of eight studies reported a significant impact on anxiety symptomatology ( 80 , 82 , 99 , 100 , 102 ) after mindfulness training. Research conducted in Brazil also suggests salutary effects of mindfulness training on depression and anxiety ( 103 – 105 ), though investigation in primary care settings is needed ( 106 , 107 ). Though patients with a current severe episode of major depression were excluded, the extensive prevalence of major depression disorder combined with substantial symptomatology revealed by the percentage of individuals presented with at least mild depression and anxiety (scores >55 on PROMIS-DSF and PROMIS-ASF) denotes the sample mental and emotional suffering severity and may have contributed to the magnitude of the findings.…”

Section: Discussionmentioning

confidence: 99%

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Mindfulness Training for Primary Care for Portuguese-Speaking Immigrants: A Pilot Study

et al. 2021

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Background: Portuguese-speaking immigrants are a growing underserved population in the Unites States who experience high levels of psychological distress and increased vulnerability to mental health disorders such as depression and anxiety. Current evidence shows that mindfulness-based interventions (MBIs) are effective to promote physical and mental health among educated English speakers; nonetheless, the lack of diversity in the mindfulness literature is a considerable limitation. To our knowledge, the feasibility and acceptability of MBIs among Portuguese-speaking immigrants have not yet been investigated.Methods: This single-arm pilot study (N = 30) explored the feasibility, acceptability, and cultural aspects of Mindfulness Training for Primary Care (MTPC)-Portuguese among Portuguese-speaking immigrants in the Boston area. MTPC is an 8-week, primary care-adapted, referral-based, insurance-reimbursable, trauma-informed MBI that is fully integrated into a healthcare system. The study also examined intervention preliminary effectiveness on mental health outcomes (depression and anxiety symptoms) and self-regulation (emotional regulation, mindfulness, self-compassion, interoceptive awareness), and initiation of health behavior was explored.Results: Primary care providers referred 129 patients from 2018 to 2020. Main DSM-5 primary diagnoses were depression (76.3%) and anxiety disorders (6.7%). Participants (N = 30) attended a mean of 6.1 (SD 1.92) sessions and reported a mean of 213.7 (SD = 124.3) min of practice per week. All survey finishers would recommend the program to a friend, found the program helpful, and rated the overall program as “very good” or “excellent,” and 93% would participate again, with satisfaction mean scores between 4.6 and 5 (Likert scale 0–5). Participants and group leaders provided feedback to refine MTPC-Portuguese culturally responsiveness regarding materials language, settings, time, food, and community building. Patients exhibited reductions in depression (d = 0.67; p < 0.001) and anxiety (d = 0.48; p = 0.011) symptoms, as well as enhanced emotional regulation (d = 0.45; p = 0.009), and among survey finishers, 50% initiated health behavior change through action plan initiation.Conclusion: This pilot study suggests that MTPC-Portuguese is feasible, acceptable, and culturally appropriate among Portuguese-speaking patients in the Boston area. Furthermore, the intervention might potentially decrease depression and anxiety symptoms, facilitate health behavior change, and improve emotional regulation. MTPC-Portuguese investigation with larger samples in controlled studies is warranted to support its dissemination and implementation in the healthcare system.Clinical Trial Registration: Identifier: NCT04268355.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Mindfulness Training for Primary Care for Portuguese-Speaking Immigrants: A Pilot Study

et al. 2021

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“…Mindfulness-Based Health Promotion (MBHP) is inspired by MBSR but adapted to the Brazilian context with has a shorter, 8-week duration; it stands out for its comprehensive approach to health promotion, unrestricted to speci c pathologies [4], [5]. Accordingly, MBHP has shown bene ts in diverse contexts and populations, such as improved anxiety and depression in police o cers [6], burnout symptoms in primary health care providers [7], stress, resilience, and immune function in teachers [8], muscular pain in nurses [9], and overweight in women [10].…”

Section: Introductionmentioning

confidence: 99%

Mindfulness predicts reduced aberrant salience and improves stress management

Wießner,

Souza,

Demarzo

et al. 2024

Preprint

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Mindfulness can improve mental health and clinical conditions including psychosis, and modulate attentional processes including salience, an automatic mechanism to guide attention towards outstanding elements or ideas. Aberrant salience, the exaggerated assignment of salience, is associated with psychotic experiences, but the effects of mindfulness on aberrant salience are unexplored. To address this, we conducted a pre-post-intervention pilot study, with 21 participants undergoing an 8-week course of Mindfulness-Based Health Promotion (MBHP). Quantitative and qualitative measurements were conducted before (T0), immediately after (T1), and three months after the course (T2). Primary outcome was aberrant salience (Aberrant Salience Inventory, ASI). Secondary outcomes included quantitative scales on mindful attention (Mindful Attention Awareness Scale, MAAS) and decentering (Experiences Questionnaire, EQ), and qualitative reports on participation motivations, preferred practices, learnings, and stress management. Correlations included quantitative changes over time (T1-T0, T2-T0, and T2-T1). The results show that the ASI factor Heightened Cognition increased post-course (T1-T0), while ASI Heightened Emotionality (T2-T0) and total aberrant salience (T2-T1) decreased. MAAS and EQ scores increased (T1-T0, T2-T0). MAAS scores (T1-T0, T2-T0) correlated negatively with ASI Heightened Emotionality (T2-T0). Qualitative analyses indicated consistent stressors but improved stress management, applying the course contents and integrating mindfulness into everyday life, even three months afterward. In conclusion, along with improved well-being and stress management, mindfulness might modify pre-attentional and attentional processes such as reduced aberrant salience, besides enhanced mindful attention and decentering. Importantly, mindful attention might predict and promote aberrant salience reductions, warranting future research on treatment approaches and mechanisms of mindfulness in psychosis.

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Primary-level and community worker interventions for the prevention of mental disorders and the promotion of well-being in low- and middle-income countries

Purgato,

Prina,

Ceccarelli

et al. 2023

Cochrane Database of Systematic Reviews

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Background There is a significant research gap in the field of universal, selective, and indicated prevention interventions for mental health promotion and the prevention of mental disorders. Barriers to closing the research gap include scarcity of skilled human resources, large inequities in resource distribution and utilization, and stigma. Objectives To assess the effectiveness of delivery by primary workers of interventions for the promotion of mental health and universal prevention, and for the selective and indicated prevention of mental disorders or symptoms of mental illness in low‐ and middle‐income countries (LMICs). To examine the impact of intervention delivery by primary workers on resource use and costs. Search methods We searched CENTRAL, MEDLINE, Embase, CINAHL, Global Index Medicus, PsycInfo, WHO ICTRP, and ClinicalTrials.gov from inception to 29 November 2021. Selection criteria Randomized controlled trials (RCTs) of primary‐level and/or community health worker interventions for promoting mental health and/or preventing mental disorders versus any control conditions in adults and children in LMICs. Data collection and analysis Standardized mean differences (SMD) or mean differences (MD) were used for continuous outcomes, and risk ratios (RR) for dichotomous data, using a random‐effects model. We analyzed data at 0 to 1, 1 to 6, and 7 to 24 months post‐intervention. For SMDs, 0.20 to 0.49 represented small, 0.50 to 0.79 moderate, and ≥ 0.80 large clinical effects. We evaluated the risk of bias (RoB) using Cochrane RoB2. Main results Description of studies We identified 113 studies with 32,992 participants (97 RCTs, 19,570 participants in meta‐analyses) for inclusion. Nineteen RCTs were conducted in low‐income countries, 27 in low‐middle‐income countries, 2 in middle‐income countries, 58 in upper‐middle‐income countries and 7 in mixed settings. Eighty‐three RCTs included adults and 30 RCTs included children. Cadres of primary‐level workers employed primary care health workers (38 studies), community workers (71 studies), both (2 studies), and not reported (2 studies). Interventions were universal prevention/promotion in 22 studies, selective in 36, and indicated prevention in 55 RCTs. Risk of bias The most common concerns over risk of bias were performance bias, attrition bias, and reporting bias. Intervention effects 'Probably', 'may', or 'uncertain' indicates 'moderate‐', 'low‐', or 'very low‐'certainty evidence. *Certainty of the evidence (using GRADE) was assessed at 0 to 1 month post‐intervention as specified in the review protocol. In the abstract, we did not report results for outcomes for which evidence was missing or very uncertain. Adults Promotion/universal prevention, compared...

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Protocol for a Nested Randomized Controlled Trial to Evaluate the Feasibility and Preliminary Efficacy of the Mindfulness Based Health Promotion Program on the Quality of Life of Older Adults Assisted in Primary Care—“The MBHP-Elderly Study”

Cited by 6 publications

References 80 publications

Mindfulness Training for Primary Care for Portuguese-Speaking Immigrants: A Pilot Study

Mindfulness Training for Primary Care for Portuguese-Speaking Immigrants: A Pilot Study

Mindfulness predicts reduced aberrant salience and improves stress management

Primary-level and community worker interventions for the prevention of mental disorders and the promotion of well-being in low- and middle-income countries

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