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An experimental study to inform adoption of mindfulness-based stress reduction in chronic low back pain

BACKGROUND: Chronic low back pain is a common and sometimes disabling condition, and mindfulness-based stress reduction is recommended as a first line of therapy. This study tested whether different descriptions of mindfulness training altered based on influential intervention characteristics increa...

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Autores principales: Jones, Salene M. W., Sherman, Karen J., Bermet, Zoe, Palazzo, Lorella G., Lewis, Cara C.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9356436/
https://www.ncbi.nlm.nih.gov/pubmed/35933438
http://dx.doi.org/10.1186/s43058-022-00335-w
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author Jones, Salene M. W.
Sherman, Karen J.
Bermet, Zoe
Palazzo, Lorella G.
Lewis, Cara C.
author_facet Jones, Salene M. W.
Sherman, Karen J.
Bermet, Zoe
Palazzo, Lorella G.
Lewis, Cara C.
author_sort Jones, Salene M. W.
collection PubMed
description BACKGROUND: Chronic low back pain is a common and sometimes disabling condition, and mindfulness-based stress reduction is recommended as a first line of therapy. This study tested whether different descriptions of mindfulness training altered based on influential intervention characteristics increased adoption intentions. METHODS: People with chronic low back pain (n = 452) were randomized to review one of four mindfulness training descriptions in an online survey using a 2 × 2 factorial design. The first factor was evidence strength and quality with relative advantage (ER). The second factor was adaptability, trialability, complexity, and design quality and packaging (AD). Each factor had two levels: a description of standardized mindfulness training that described each intervention characteristic and a patient-centered description emphasizing flexibility and patient testimonials. The primary outcomes were intentions to try mindfulness training and practice mindfulness at home. Using structural equation modeling with a bootstrapped distribution, we tested six mediators, three of which are Theory of Planned Behavior predictors of intention—self-efficacy, norms, and attitudes— and the other three are predictors of adoption—feasibility, appropriateness, and acceptability. RESULTS: Overall, the mindfulness training descriptions were not associated with an increase in intentions compared to the classic vignette (11/12 p’s > 0.05). Most descriptions were unrelated to mediators except the classic ER with patient-centered AD was associated with higher self-efficacy/control and feasibility (p’s ≤ 0.05; standardized effect range: 0.111–0.125). Self-efficacy/control (training standardized coefficient: 0.531, home: 0.686), norms (training: 0.303, home: 0.256), and attitudes (training: 0.316, home: 0.293) were all positively associated with intentions to adopt mindfulness training and home practice. Feasibility (training: 0.185; home: 0.293) and acceptability (training: 0.639; home: 0.554) were positively related to intentions to adopt mindfulness training. Appropriateness was related to intentions to adopt home practice (0.187) but not mindfulness training (0.100). None of the indirect effects from experimental group to intentions was significant (all p’s > 0.05). CONCLUSIONS: Self-efficacy/control and acceptability may be key mediators for increasing patient adoption of mindfulness. Because experimental manipulation did not substantially change intentions to adopt mindfulness, the presentation and delivery of MBSR may need to be tailored to the individual patient’s needs rather than a specific format for chronic low back pain. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s43058-022-00335-w.
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spelling pubmed-93564362022-08-07 An experimental study to inform adoption of mindfulness-based stress reduction in chronic low back pain Jones, Salene M. W. Sherman, Karen J. Bermet, Zoe Palazzo, Lorella G. Lewis, Cara C. Implement Sci Commun Research BACKGROUND: Chronic low back pain is a common and sometimes disabling condition, and mindfulness-based stress reduction is recommended as a first line of therapy. This study tested whether different descriptions of mindfulness training altered based on influential intervention characteristics increased adoption intentions. METHODS: People with chronic low back pain (n = 452) were randomized to review one of four mindfulness training descriptions in an online survey using a 2 × 2 factorial design. The first factor was evidence strength and quality with relative advantage (ER). The second factor was adaptability, trialability, complexity, and design quality and packaging (AD). Each factor had two levels: a description of standardized mindfulness training that described each intervention characteristic and a patient-centered description emphasizing flexibility and patient testimonials. The primary outcomes were intentions to try mindfulness training and practice mindfulness at home. Using structural equation modeling with a bootstrapped distribution, we tested six mediators, three of which are Theory of Planned Behavior predictors of intention—self-efficacy, norms, and attitudes— and the other three are predictors of adoption—feasibility, appropriateness, and acceptability. RESULTS: Overall, the mindfulness training descriptions were not associated with an increase in intentions compared to the classic vignette (11/12 p’s > 0.05). Most descriptions were unrelated to mediators except the classic ER with patient-centered AD was associated with higher self-efficacy/control and feasibility (p’s ≤ 0.05; standardized effect range: 0.111–0.125). Self-efficacy/control (training standardized coefficient: 0.531, home: 0.686), norms (training: 0.303, home: 0.256), and attitudes (training: 0.316, home: 0.293) were all positively associated with intentions to adopt mindfulness training and home practice. Feasibility (training: 0.185; home: 0.293) and acceptability (training: 0.639; home: 0.554) were positively related to intentions to adopt mindfulness training. Appropriateness was related to intentions to adopt home practice (0.187) but not mindfulness training (0.100). None of the indirect effects from experimental group to intentions was significant (all p’s > 0.05). CONCLUSIONS: Self-efficacy/control and acceptability may be key mediators for increasing patient adoption of mindfulness. Because experimental manipulation did not substantially change intentions to adopt mindfulness, the presentation and delivery of MBSR may need to be tailored to the individual patient’s needs rather than a specific format for chronic low back pain. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s43058-022-00335-w. BioMed Central 2022-08-06 /pmc/articles/PMC9356436/ /pubmed/35933438 http://dx.doi.org/10.1186/s43058-022-00335-w Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Jones, Salene M. W.
Sherman, Karen J.
Bermet, Zoe
Palazzo, Lorella G.
Lewis, Cara C.
An experimental study to inform adoption of mindfulness-based stress reduction in chronic low back pain
title An experimental study to inform adoption of mindfulness-based stress reduction in chronic low back pain
title_full An experimental study to inform adoption of mindfulness-based stress reduction in chronic low back pain
title_fullStr An experimental study to inform adoption of mindfulness-based stress reduction in chronic low back pain
title_full_unstemmed An experimental study to inform adoption of mindfulness-based stress reduction in chronic low back pain
title_short An experimental study to inform adoption of mindfulness-based stress reduction in chronic low back pain
title_sort experimental study to inform adoption of mindfulness-based stress reduction in chronic low back pain
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9356436/
https://www.ncbi.nlm.nih.gov/pubmed/35933438
http://dx.doi.org/10.1186/s43058-022-00335-w
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