Mindfulness-Based Cognitive Therapy Vs. the Health Enhancement Program for Chronic Pain and Early Cognitive Decline; The Feeling of Being Pilot RCT
Mindfulness-based Cognitive Therapy vs the Health Enhancement Program for Chronic Pain and Early Cognitive Decline; The Feeling of Being Pilot Randomized Controlled Trial
The goal of this clinical trial is to pilot a randomized controlled trial comparing an adaptation of mindfulness-based cognitive therapy to the health enhancement program for chronic pain and early cognitive decline. The main questions it aims to answer in a later fully powered randomized controlled trial are:
- Is an adaptation of mindfulness-based cognitive therapy for older Black adults able to improve quality of life?
- Will an adapted mindfulness based cognitive therapy reduce pain interference to a greater degree than a traditional health enhancement program?
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Tony V Pham
- Phone Number: 617-800-9988
- Email: tonyvpham@mgh.harvard.edu
Study Locations
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Massachusetts
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Boston, Massachusetts, United States, 02114
- Massachusetts General Hospital
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Contact:
- Kelly Horan
- Phone Number: 617-726-2000
- Email: khoran@mgb.org
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Older adult (age ≥ 50)
- All individuals who identify with one or more nationalities or ethnic groups originating in any of the Black racial groups of Africa
- Pain in muscles, joints, bones, or associated soft tissues (NRS>4) lasting longer than 3 months
- Early Cognitive Decline (subjective or MCI)
- Telephone Interview for Cognitive Status-41 score ≥ 26
- Functional Activities Questionnaire score < 9
- English fluency/literacy
- Ability and willingness to participate via in-person and video
- Willing to provide informed consent and comply with all aspects of the protocol
Exclusion Criteria:
- Current substance abuse/dependence
- Significant cognitive impairment
- History of more than 8 sessions of cognitive-behavioral therapy
- History of previous training in mindfulness or undergoing counseling more than once a month
- History of or current diagnosis of psychosis
- Active suicidal ideation or self-harm within the past 90 days
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Other
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
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Active Comparator: Health Enhancement Program
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Time- and dose-matched control for Feeling of Being.
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Experimental: Quiet Focus
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Mindfulness-based cognitive therapy adapted for older adults at-risk for chronic pain and early cognitive decline
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
The Credibility and Expectancy Questionnaire
Time Frame: At enrollment
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The Credibility/Expectancy Questionnaire (CEQ) is a 6-item self-report measure assessing treatment credibility (items 1-3) and expectancy (items 4-6).
Items 1-3 and 5 are rated 0 (not at all credible/logical) to 9 (extremely credible/logical), while items 4 and 6 are rated 0% to 100%; subscale scores are standardized and summed (credibility: 3-27 raw equivalent; expectancy similar), with total scores ranging 6-54 after standardization, where higher scores indicate greater credibility and positive outcome expectancy (better outcome).
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At enrollment
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The Client Satisfaction Questionnaire
Time Frame: Administered at the end of treatment at 8 weeks.
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The 3-item version of the Client Satisfaction Questionnaire (CSQ-3) is scored by summing responses from its three core items.
It consists of empirically selected items measuring key aspects of service satisfaction, each rated on a 4-point Likert scale (1 = lowest satisfaction to 4 = highest, with directionality adjusted as needed).
Total scores range from 3 to 12, with higher values indicating greater satisfaction; no reverse scoring or subscales are required.
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Administered at the end of treatment at 8 weeks.
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Modified Patient Global Impression of Change
Time Frame: At end of 8 week program (post test) and again at 3 month follow up visit.
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The Modified Patient Global Impression of Change (mPGIC) adapts the standard single-item Patient Global Impression of Change (PGIC), a validated patient-reported outcome measure of overall perceived change since intervention, by assessing change across six specific domains.
Each domain uses a single ordinal item rated on a 7-point scale: Very Much Improved (coded 1), Much Improved (2), Minimally Improved (3), No Change (4), Minimally Worse (5), Much Worse (6) or Very Much Worse (7).
The range per domain is 0 (worst, Much Worse) to 5 (best, Very Much Improved), with higher scores indicating greater perceived improvement.
Domains are analyzed individually as mean scores (no total computed), where values <4 reflect net positive change.
Domains include coping strategies, physical activity, social activity, level of stress, memory and thinking, and pain.
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At end of 8 week program (post test) and again at 3 month follow up visit.
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Numerical Rating Scale
Time Frame: From enrollment to 3 months from the end of treatment at 8 weeks.
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The Numerical Rating Scale (NRS) for pain intensity is an 11-point scale from 0 (no pain) to 10 (worst imaginable pain), assessing average pain over the past week.
Higher scores indicate greater pain intensity (worse outcome), lower scores less pain (better); single-item total score.
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From enrollment to 3 months from the end of treatment at 8 weeks.
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PROMIS Emotional Support
Time Frame: From enrollment to 3 months from the end of treatment at 8 weeks
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The PROMIS Short Form V2.0 - Emotional Support 8a (PROMIS Emotional Support SF 8a v2.0) is an 8-item patient-reported outcome measure assessing perceived availability of supportive interpersonal relationships over the past 7 days, including listening, confiding, appreciation, understanding, and trust.
It uses a 5-point Likert response scale per item: Never (1), Rarely (2), Sometimes (3), Often (4), or Always (5).
Raw total scores range from 8 (minimal support, worst outcome) to 40 (strong support, best outcome); these convert via scoring tables to T-scores (mean=50, SD=10 in U.S. population), where higher T-scores indicate greater emotional support.
No subscales are computed; the total score reflects overall perceived support.
T-score range: 25-75 for the 8a short form.
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From enrollment to 3 months from the end of treatment at 8 weeks
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Measure of Current Status Part A
Time Frame: From enrollment to 3 months from the end of treatment at 8 weeks.
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The Measure of Current Status Part A (MOCS-A) is a self-report questionnaire that measures ability to manage stress.
The Measure of Current Status Part A (MOCS-A) comprises 13 items rated 0 (cannot do at all) to 4 (extremely well), summed for total score 0-52, with four subscales: relaxation, tension awareness, assertiveness, coping confidence (higher total/subscale scores indicate better stress management ability, better outcome).
Each item is rated on a 5-point Likert scale where 0 = "I cannot do this at all" and 4 = "I can do this extremely well," with higher scores reflecting greater confidence in coping skills.
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From enrollment to 3 months from the end of treatment at 8 weeks.
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Chronic Pain Acceptance Questionnaire
Time Frame: From enrollment to 3 months from the end of treatment at 8 weeks.
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The Chronic Pain Acceptance Questionnaire (CPAQ) sums 20 items rated 0 (never true) to 6 (always true) for total raw score 0-120, with two subscales: Activity Engagement (0-66) and Pain Willingness (0-54), both/totals higher indicating greater pain acceptance (better outcome).
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From enrollment to 3 months from the end of treatment at 8 weeks.
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Pain Catastrophizing Scale
Time Frame: From enrollment to 3 months from the end of treatment at 8 weeks.
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The Pain Catastrophizing Scale (PCS) sums 13 items rated 0 (not at all) to 4 (all the time) for total 0-52, with subscales: Rumination (0-16), Magnification (0-12), Helplessness (0-24); higher scores indicate greater catastrophizing (worse outcome).
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From enrollment to 3 months from the end of treatment at 8 weeks.
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PROMIS Depression
Time Frame: From enrollment to 3 months from the end of treatment at 8 weeks.
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The PROMIS Short Form V1.0 - Emotional Distress Depression 8b (PROMIS Depression SF 8b v1.0) is an 8-item patient-reported outcome measure assessing self-reported depressive symptoms over the past 7 days, including feelings of worthlessness, helplessness, sadness, failure, depression, unhappiness, and hopelessness.
It uses a 5-point Likert response scale per item: Never (1), Rarely (2), Sometimes (3), Often (4), or Always (5).
Raw total scores range from 8 (minimal depression, best outcome) to 40 (severe depression, worst outcome); these convert via scoring tables to T-scores (mean=50, SD=10 in U.S. population), where higher T-scores indicate greater depression severity.
No subscales are computed; the total score reflects overall depressive distress.
T-score range: 42-84.
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From enrollment to 3 months from the end of treatment at 8 weeks.
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PROMIS Physical Function
Time Frame: From enrollment to 3 months from the end of treatment at 8 weeks.
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The PROMIS Short Form V2.0 - Physical Function 8B (PROMIS PF 8B v2.0) is an 8-item patient-reported outcome measure assessing self-reported capability in physical activities, including upper extremity function (e.g., hand/arm tasks), lower extremity function (e.g., walking), central body function, and daily activities.
It uses a 5-point Likert response scale per item: Without any difficulty (5), With little difficulty (4), With some difficulty (3), With much difficulty (2), or Unable to do/Cannot do (1).
Raw total scores range from 8 (severe difficulty, worst outcome) to 40 (no difficulty, best outcome); these convert via scoring tables to T-scores (mean=50, SD=10 in U.S. population), where higher T-scores indicate better physical function.
No subscales are computed; the total score reflects overall physical function.
The T-score range for the PROMIS SF V1.2 is 10-65.
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From enrollment to 3 months from the end of treatment at 8 weeks.
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Pain Self-Efficacy Questionnaire
Time Frame: From enrollment to 3 months from the end of treatment at 8 weeks
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The Pain Self-Efficacy Questionnaire (PSEQ) consists of 10 items rated 0 (not at all confident) to 6 (completely confident), summed for total 0-60.
Higher scores indicate greater self-efficacy despite pain (better outcome); single total score.
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From enrollment to 3 months from the end of treatment at 8 weeks
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PROMIS Anxiety
Time Frame: The PROMIS Short Form V1.0 - Emotional Distress Anxiety 8a (PROMIS Anxiety SF 8a v1.0) is an 8-item patient-reported outcome measure assessing self-reported anxiety symptoms over the past 7 days, including fear, nervousness, worry, dread, and feeling ten
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From enrollment to 3 months from the end of treatment at 8 weeks
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The PROMIS Short Form V1.0 - Emotional Distress Anxiety 8a (PROMIS Anxiety SF 8a v1.0) is an 8-item patient-reported outcome measure assessing self-reported anxiety symptoms over the past 7 days, including fear, nervousness, worry, dread, and feeling ten
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Cognitive and Affective Mindfulness Scale-Revised
Time Frame: From enrollment to 3 months from the end of treatment at 8 weeks.
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The Cognitive and Affective Mindfulness Scale-Revised (CAMS-R) is a 12-item scale rated 1 (rarely/not at all) to 4 (almost always), total score summed 12-48 (higher scores indicate greater mindfulness ability, better outcome); unidimensional total score.
Scoring: Items 2, 6, and 7 are reverse-scored.
After appropriate reversals, sum values for items 1-12.
Higher values reflect greater mindful qualities.
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From enrollment to 3 months from the end of treatment at 8 weeks.
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Tampa Kinesiophobia Scale
Time Frame: From enrollment to 3 months from the end of treatment at 8 weeks
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The Tampa Scale of Kinesiophobia (TSK-11) sums 11 items rated 1 (strongly disagree) to 4 (strongly agree), with no reverse-coded items.
Total score range: 11-44 (higher scores greater kinesiophobia/fear of movement, worse outcome).
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From enrollment to 3 months from the end of treatment at 8 weeks
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Telephone Interview for Cognitive Status (41-point version)
Time Frame: From enrollment to 3 months from the end of treatment at 8 weeks.
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The Telephone Interview for Cognitive Status (41-point version) sums 11 items (e.g., orientation, memory, attention) for total score 0-41, with higher scores indicating better global cognitive function (better outcome).
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From enrollment to 3 months from the end of treatment at 8 weeks.
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The Everyday Cognition Scale (12-item version)
Time Frame: From enrollment to 3 months from the end of treatment at 8 weeks.
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The Everyday Cognition Scale (ECog-12) is a 12-item informant-rated questionnaire assessing self-reported changes in everyday cognitive and functional abilities, sensitive to early decline in domains like memory, executive function, and organization.
Each item uses a 4-point ordinal scale: 1 = No change (better or same), 2 = Occasionally worse, 3 = Consistently worse, 4 = Much worse.
Higher ratings indicate greater perceived decline; "don't know" responses are typically prorated or handled per study protocol.
The total score is the mean (average) of the 12 item scores, accounting for any missing data by dividing the sum by completed items.
Scores range from 1.0 (no decline) to 4.0 (maximum impairment), with means around 1.5-2.0 in cognitively unimpaired participants.
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From enrollment to 3 months from the end of treatment at 8 weeks.
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Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Tony V Pham, Massachusetts General Hospital
Study record dates
Study Major Dates
Study Start (Estimated)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 2026P002003
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
IPD Sharing Supporting Information Type
- STUDY_PROTOCOL
- SAP
- ICF
- ANALYTIC_CODE
- CSR
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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