Most Americans will experience stress at some point in their lives. The top sources of stress are inherent to living: financial challenges, work, family responsibilities, and health concerns. These stresses can put “wear and tear” on a person’s body. The burden from stress can be associated with poor sleep, hypertension, heart disease, breast cancer, depression, and other health conditions. Thus, it is imperative to have better methods for people to reduce stress to improve overall well-being.
The evidence gap is that the briefest, least burdensome intervention to effectively decrease stress and enhance an overall sense of well-being is not known. Among the most acceptable and effective interventions for improving well-being are mindfulness-based treatments. The efficacy of mindfulness treatments has been well-documented for a wide variety of problems (e.g., pain, depression, anxiety, stress). Most empirically tested variants of mindfulness include a curriculum of guided meditation exercises that are taught in sequence over the course of two to three months in weekly sessions; however, we do not know the minimally effective “dose” of mindfulness.
This study will randomize participants to either eight sessions of online mindfulness-based treatment (“standard”) or a briefer, three-session online mindfulness-based treatment (“light”) to compare the treatments’ efficacy and acceptability across a wide range of conditions and special populations. Given the substantial time and effort associated with standard (eight to 12 sessions) treatments, it is of interest whether standard mindfulness treatment is indeed superior to shorter mindfulness treatment. It is also important to determine who responds better to which treatment (i.e., standard vs. light).
The importance of this topic has been recognized as one of the top priority areas for comparative effectiveness research by the Institute of Medicine, which recommended that researchers compare the effectiveness of mindfulness-based interventions (e.g., yoga, meditation, deep-breathing training) for treating anxiety and depression, pain, cardiovascular risk factors, and chronic diseases. The proposed dose-finding study can help patients, parents, and caregivers (as well as clinicians) know the best dose of mindfulness to manage stress and increase wellness, with a substantial impact on care.
This study will also leverage the already-established active and engaged patient and other stakeholder partners of each participating site, the patient-powered research networks (PPRNs). Specifically, we have created a governance structure for this study that consists of seven committees (steering, operations, stakeholder, information technology, safety, diversity, communication and dissemination) comprising all types of stakeholders and representing all of the PPRNs. Through this oversight, patients and other stakeholders will help make the implementation and dissemination of this study a success.