- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02968238
Tranquil Moments II-CBT vs. Yoga for Worry
Cognitive-behavioral Therapy Versus Yoga for the Treatment of Worry in Anxious Older Adults: A Randomized Preference Trial
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
The primary aim of this study is to compare the effects of CBT and yoga on worry in older adults (as assessed by the PSWQ-A measured at post-intervention, Week 11). Secondary aims are to compare the effects of these treatments on anxiety and sleep (as assessed by the PROMIS anxiety scale and the ISI, respectively, measured at post-intervention, Week 11). Exploratory aims are to determine participant preference for CBT vs. yoga; examine participant preference effects on worry, anxiety, sleep, adherence to treatment, and attrition rates; and examine selection effects on worry, anxiety, sleep, adherence to treatment, and attrition rates. All analyses will be repeated for measures assessed at Week 37.
The treatment effect for the primary aim will be estimated by comparing mean PSWQ-A scores between CBT and yoga groups in the random group (N=250, 125 per group) using constrained mixed-model repeated measures analysis of covariance with an unstructured covariance matrix to account for the fact that the multiple measurements (at baseline-Week 0, mid-intervention-Week 6, post-intervention-Week 11) from participants are not independent. The model will contain terms for baseline psychotropic medication use, gender and race (both related to depression), and intervention effects that are specific to each follow-up time. Because this arm of the trial has been randomized, we will constrain the pre-randomization intervention-specific outcome means to be the same. A contrast will be used to test the primary hypothesis at the post-intervention (Week 11) time point using a two-sided 0.05 significance level. In the primary analysis, all randomized participants will be included in their original study group for analysis regardless of the final mode of intervention or the extent of compliance with the study protocol; that is, the primary analysis will follow an "intent to treat" philosophy.
As part of the secondary aims, the estimation of selection and preference effects will be performed with mixed models based on the complete sample using data collected in both preference and randomized arms of the trial. Therefore, these analyses will be based on a sample size of 500 individuals. The adjusted means and variance-covariance matrix needed to compute these effects and their standard error will be estimated from the fitted model. The standard error associated with the preference and selection effects will be derived using the delta-method and/or a bootstrapping approach, as needed.
Consistency of intervention effects will be explored within the following baseline subgroups: 1) depressive symptoms from PROMIS measure (none or mild vs. moderate or severe), 2) use of psychotropic meds (any vs none), 3) age (60-79 vs 80+), 4) gender (female/male), and 5) race (White vs. other races).
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
North Carolina
-
Winston-Salem, North Carolina, United States, 27157
- Wake Forest University Health Sciences
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Age 60 years and older
- Moderate to severe levels of worry
Exclusion Criteria:
- Currently receiving psychotherapy
- Currently practicing yoga
- Active alcohol/substance abuse
- Dementia
- Current psychotic symptoms
- Active suicidal ideation with plan and intent
- Hearing loss that would prevent a person from participating in telephone/class sessions
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Factorial Assignment
- Masking: Single
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: CBT preference arm
CBT preference arm consists of participants who are randomized to the preference condition and choose to receive cognitive-behavioral therapy (CBT).
CBT consists of 10 weeks of weekly treatment.
|
10 weekly sessions of cognitive-behavioral therapy
Other Names:
|
Active Comparator: Yoga preference arm
Yoga preference arm consists of participants who are randomized to the preference condition and choose to receive yoga.
Yoga consists of 10 weeks of bi-weekly treatment (total = 20 treatments).
|
10 weeks of biweekly yoga sessions (N = 20)
|
Active Comparator: CBT randomized arm
CBT randomized arm consists of participants who are randomized to the random condition and are randomized to receive cognitive-behavioral therapy (CBT).
CBT consists of 10 weeks of weekly treatment.
|
10 weekly sessions of cognitive-behavioral therapy
Other Names:
|
Active Comparator: Yoga randomized arm
Yoga randomized arm consists of participants who are randomized to the random condition and are randomized to receive yoga.
Yoga consists of 10 weeks of bi-weekly treatment (total = 20 treatments).
|
10 weeks of biweekly yoga sessions (N = 20)
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Penn State Worry Questionnaire-Abbreviated
Time Frame: Week 11
|
worry symptoms
|
Week 11
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
PROMIS Anxiety
Time Frame: Week 11, Week 37
|
anxiety symptoms
|
Week 11, Week 37
|
Insomnia Sleep Index
Time Frame: Week 11, Week 37
|
sleep problems
|
Week 11, Week 37
|
Penn State Worry Questionnaire-Abbreviated
Time Frame: Week 6, Week 37
|
worry symptoms
|
Week 6, Week 37
|
PROMIS 29
Time Frame: Week 11, Week 37
|
29-item self-report measure with 4 items each for the following: physical function, anxiety, depression, fatigue, sleep, social function, pain interference; 1 item for average pain intensity
|
Week 11, Week 37
|
PROMIS Depression
Time Frame: Week 11, Week 37
|
depressive symptoms
|
Week 11, Week 37
|
PROMIS Physical Function with Mobility Aid
Time Frame: Week 11, Week 37
|
Self-report measure of current capability for physical activities
|
Week 11, Week 37
|
GAD-7
Time Frame: Week 11, Week 37
|
Self-report symptoms of Generalized Anxiety Disorder
|
Week 11, Week 37
|
Cornell Medical Services Index
Time Frame: Week 11, Week 37
|
measure of medical care utilization
|
Week 11, Week 37
|
Client Satisfaction Questionnaire
Time Frame: Week 11
|
self-report measure of satisfaction with treatment
|
Week 11
|
Working Alliance Inventory, Client and Therapist
Time Frame: Week 11, Week 37
|
assesses therapist-patient working alliance; measures are completed by the participant and the therapist
|
Week 11, Week 37
|
Adherence to the intervention as assessed by the number of sessions attended
Time Frame: Week 11
|
adherence to treatment
|
Week 11
|
Attrition from the intervention as assessed by the number of participants who do not complete study assessments at Week 11 and Week 37
Time Frame: Week 11, Week 37
|
attrition from study
|
Week 11, Week 37
|
FES-I
Time Frame: Week 11, Week 37
|
falls self-efficacy
|
Week 11, Week 37
|
Falls
Time Frame: Week 11, Week 37
|
self-report incidence of falls
|
Week 11, Week 37
|
Penn State Worry Questionnaire-Abbreviated
Time Frame: Week 37
|
worry symptoms
|
Week 37
|
Collaborators and Investigators
Collaborators
Investigators
- Principal Investigator: Gretchen Brenes, PhD, Wake Forest University Health Sciences
Publications and helpful links
General Publications
- Danhauer SC, Miller ME, Divers J, Anderson A, Hargis G, Brenes GA. Long-Term Effects of Cognitive-Behavioral Therapy and Yoga for Worried Older Adults. Am J Geriatr Psychiatry. 2022 Sep;30(9):979-990. doi: 10.1016/j.jagp.2022.02.002. Epub 2022 Feb 6.
- Sohl SJ, Brenes GA, Krucoff C, Hargis G, Anderson A, Miller ME, Danhauer SC. Ensuring Yoga Intervention Fidelity in a Randomized Preference Trial for the Treatment of Worry in Older Adults. J Altern Complement Med. 2021 Jun;27(6):489-495. doi: 10.1089/acm.2020.0476. Epub 2021 Mar 8.
- Brenes GA, Divers J, Miller ME, Danhauer SC. A randomized preference trial of cognitive-behavioral therapy and yoga for the treatment of worry in anxious older adults. Contemp Clin Trials Commun. 2018 May 4;10:169-176. doi: 10.1016/j.conctc.2018.05.002. eCollection 2018 Jun. Erratum In: Contemp Clin Trials Commun. 2020 Jan 03;19:100517. Contemp Clin Trials Commun. 2020 Dec 10;20:100688.
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Other Study ID Numbers
- IRB00041530
- CER-1511-33007 (Other Grant/Funding Number: Patient-Centered Outcomes Research Institute (PCORI))
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
Clinical Trials on Anxiety
-
AstraZenecaCompletedAnxiety Disorders | Anxiety | Anxiety Neuroses | Anxiety StatesUnited States
-
Prisma Health-UpstateCompletedAnxiety | Anxiety, Separation | Separation Anxiety | Anxiety Generalized
-
Ann & Robert H Lurie Children's Hospital of ChicagoUniversity of California, Los Angeles; University of CincinnatiRecruitingAnxiety, Separation | Anxiety, Social | Anxiety, GeneralizedUnited States
-
Yale UniversityNational Institute of Mental Health (NIMH)Active, not recruitingGeneralized Anxiety Disorder | Anxiety Disorder of Childhood | Separation Anxiety Disorder of Childhood | Social Anxiety Disorder of ChildhoodUnited States
-
Nazife Begüm KARANCompletedDental Anxiety | Sedative; Anxiety DisorderTurkey
-
Loyola UniversityCompletedAnxiety | Anxiety State | Procedural AnxietyUnited States
-
Eli Lilly and CompanyCompletedAnxiety Neuroses | Anxiety States, Neurotic | Neuroses, AnxietyUnited States, Mexico, South Africa
-
UCLH/UCL Joint Research OfficeMedical Research Council; Camden and Islington NHS Trust; Central and North West...RecruitingAnxiety Disorders | Anxiety | Anxiety Depression | CBT | Anxiety Disorders and Symptoms | Anxiety Generalized | Generalised Anxiety Disorder | Anxiety Disorder; Mixed With Depression (Mild) | Anxiety Disorder GeneralizedUnited Kingdom
-
Dr. Nazanin AlaviActive, not recruitingGeneralized Anxiety Disorder | AnxietyCanada
-
ProofPilotFisher WallaceActive, not recruitingGeneralized Anxiety Disorder | Anxiety | Generalized AnxietyUnited States
Clinical Trials on Cognitive-behavioral therapy
-
Eleos HealthMissouri Department of Mental HealthCompletedMood Disorders | Anxiety DisordersUnited States
-
Regionsenter for barn og unges psykiske helseThe Research Council of NorwayCompletedGeneralized Anxiety Disorder | Social Phobia | Separation Anxiety DisorderNorway
-
Claremont McKenna CollegeUniversity of California, Los AngelesCompleted
-
University of South FloridaObsessive Compulsive FoundationCompletedObsessive Compulsive Disorder | Stepped Care Cognitive Behavioral TherapyUnited States
-
University of North Carolina, Chapel HillNational Institute of Mental Health (NIMH)Completed
-
University of RochesterNational Institute of Nursing Research (NINR)CompletedDepression | Sleep | Stress Disorders, Post-TraumaticUnited States
-
University of PittsburghWithdrawnPsychosis | Prodromal Symptoms | Prodromal Stage | Prodromal StatesUnited States
-
Duke UniversityCompleted
-
The University of Texas Health Science Center at...59th Medical Wing; Brooke Army Medical Center; South Texas Veterans Health Care...CompletedCombat Disorders | Post-Traumatic Stress Disorders | Stress DisordersUnited States
-
UConn HealthCompletedObsessive-Compulsive DisorderUnited States