Development of a Novel Intervention (Mindful Steps) to Promote Long-Term Walking Behavior in Chronic Cardiopulmonary Disease: Protocol for a Randomized Controlled Trial

Daniel Litrownik, Elizabeth A Gilliam, Peter M Wayne, Caroline R Richardson, Reema Kadri, Pamela M Rist, Marilyn L Moy, Gloria Y Yeh, Daniel Litrownik, Elizabeth A Gilliam, Peter M Wayne, Caroline R Richardson, Reema Kadri, Pamela M Rist, Marilyn L Moy, Gloria Y Yeh

Abstract

Background: Despite current rehabilitation programs, long-term engagement in physical activity remains a significant challenge for patients with chronic obstructive pulmonary disease (COPD) and heart failure (HF). Novel strategies to promote physical activity in these populations are greatly needed. Emerging literature on the benefits of both mind-body interventions and web-based interventions provide the rationale for the development of the Mindful Steps intervention for increasing walking behavior.

Objective: This study aims to develop a novel multimodal mind-body exercise intervention through adaptation of an existing web-based physical activity intervention and incorporation of mind-body exercise, and to pilot test the delivery of the new intervention, Mindful Steps, in a randomized controlled feasibility trial in older adults with COPD and/or HF.

Methods: In phase 1, guided by a theoretical conceptual model and review of the literature on facilitators and barriers of physical activity in COPD and HF, we convened an expert panel of researchers, mind-body practitioners, and clinicians to inform development of the novel, multimodal intervention. In phase 2, we are conducting a pilot randomized controlled feasibility trial of the Mindful Steps intervention that includes in-person mind-body exercise classes, an educational website, online mind-body videos, and a pedometer with step-count feedback and goals to increase walking behavior in patients with COPD and/or HF. Outcomes include feasibility measures as well as patient-centered measures.

Results: The study is currently ongoing. Phase 1 intervention development was completed in March 2019, and phase 2 data collection began in April 2019.

Conclusions: Through the integration of components from a web-based physical activity intervention and mind-body exercise, we created a novel, multimodal program to impact long-term physical activity engagement for individuals with COPD and HF. This developmental work and pilot study will provide valuable information needed to design a future clinical trial assessing efficacy of this multimodal approach.

Trial registration: ClinicalTrials.gov NCT03003780; https://ichgcp.net/clinical-trials-registry/NCT03003780.

International registered report identifier (irrid): DERR1-10.2196/27826.

Keywords: COPD; behavior change; heart failure; internet-mediated intervention; mind–body exercise; physical activity.

Conflict of interest statement

Conflicts of Interest: PW is the founder and sole owner of the Tree of Life Tai Chi Center. PW’s interests were reviewed and are managed by the Brigham and Women’s Hospital and Partners HealthCare in accordance with their conflict of interest policy. No other authors have conflicts to declare. The Tree of Life Tai Chi Center did not participate in developing or administering the intervention for this study.

©Daniel Litrownik, Elizabeth A Gilliam, Peter M Wayne, Caroline R Richardson, Reema Kadri, Pamela M Rist, Marilyn L Moy, Gloria Y Yeh. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 29.04.2021.

Figures

Figure 1
Figure 1
Conceptual model. PA; physical activity; QOL: quality of life.
Figure 2
Figure 2
Mindful Steps home page.

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