- ICH GCP
- USA klinikai vizsgálatok nyilvántartása
- Klinikai vizsgálat NCT07573241
Single Arm Trial Identifying Barriers and Facilitators to Mindfulness Practice
A tanulmány áttekintése
Részletes leírás
Chronic pain affects about half of people with multiple sclerosis (PwMS), and standard drug treatments often provide limited relief. Mindfulness-Based Cognitive Therapy (MBCT) is an 8-week program that combines mindfulness practices with cognitive and behavioral coping skills and has shown positive effects on pain severity, pain interference, and pain catastrophizing in PwMS. However, daily home practice is essential to achieving these benefits, and adherence is poor. People with chronic pain complete less than 40 out of every 100 recommended practice sessions. PwMS face unique barriers to practice including pain, fatigue, cognitive difficulties, and mood changes that can fluctuate within a single day. Understanding what drives or interferes with daily practice in this population is critical to improving MBCT outcomes.
This single-arm trial is the first aim of a research project designed to develop and optimize a smartphone-based just-in-time adaptive intervention (JITAI) to support mindfulness practice in PwMS during MBCT for chronic pain (1K23AT013270-01A1, Mistretta, PI). In this aim, 80 PwMS will participate in an 8-week group-based MBCT program delivered via telehealth. Ecological momentary assessment (EMA), a method of collecting real-time self-report data via smartphone, will be used to capture emotional, physical, and environmental factors as they naturally occur in daily life. Participants will complete twice-daily EMA surveys using an EMA smartphone app for 1 week before the program, during the 8-week program, and for 1 week after the program ends. Patient-reported outcome measures will be collected before and after the program.
The primary outcome is whether a participant practiced mindfulness between each EMA survey. Secondary outcomes include minutes practiced, type of practice (formal or informal), and self-rated quality of practice. Time-varying predictors assessed via EMA include positive and negative affect, stress, pain severity, pain interference, fatigue, sleep, location, social context, and time of day. Time-invariant predictors assessed at baseline include pain severity, pain interference, fatigue, pain catastrophizing, dispositional mindfulness, sleep, self-efficacy, depression, and cognitive functioning.
Multilevel modeling will be used to account for the nested data structure (assessments within days, within participants). A two-part modeling approach will assess both whether practice occurred on a given day and, on days when practice did occur, how much practice was completed. Three sets of models will examine same-day, longitudinal, and lagged relationships between predictors and practice outcomes. Predictors demonstrating at least a medium within-person effect on mindfulness practice will be considered as tailoring variables for the JITAI developed in the next phase of this project.
Tanulmány típusa
Beiratkozás (Becsült)
Fázis
- Nem alkalmazható
Kapcsolatok és helyek
Tanulmányi kapcsolat
- Név: Erin G Mistretta, PhD
- Telefonszám: 206-668-4168
- E-mail: emistr@uw.edu
Tanulmányozza a kapcsolattartók biztonsági mentését
- Név: Dawn Ehde, PhD
- Telefonszám: 206-744-2811
- E-mail: edhe@uw.edu
Tanulmányi helyek
-
-
Washington
-
Seattle, Washington, Egyesült Államok, 98104
- Toborzás
- University of Washington
-
Kapcsolatba lépni:
- Erin G Mistretta, PhD
- E-mail: emistr@uw.edu
-
-
Részvételi kritériumok
Jogosultsági kritériumok
Tanulmányozható életkorok
- Felnőtt
- Idősebb felnőtt
Egészséges önkénteseket fogad
Leírás
Inclusion Criteria:
- Have an MS diagnosis of any subtype per record review
- Average pain intensity in past week of at least moderate severity (>3 on the 0-10 numerical rating scale)
- Report pain >50% of days in the past 3 months.
- Are able to comply with study procedures and complete measures independently via self-report (on mobile phone)
Exclusion Criteria:
- Less than 18 years of age
- Score greater than 8 on the Expanded Disability Status Scale
- Have significant cognitive impairment as indicated by 1 or more errors on the 6-item Cognitive Screener
- Change in disease modifying medications in the past 3 months assessed via self-report (although participants will be considered eligible after the 3-month window)
- History of MS relapse within the last 30 days prior to screening assessed via self-report (although participants will be considered eligible after the 3-month window)
- Current suicidal ideation with intent or plan as indicated by a score of 1 or higher on the Patient Health Questionnaire-9 suicide item and further assessment with the Columbia-Suicide Severity Rating Scale (although individuals with suicidal ideation but no intent or plan will be considered eligible)
- Currently engaged in psychotherapy for pain assessed via self-report
- Currently have a "regular" mindfulness practice defined as > 3 days per week assessed via self-report
- Inability to read or speak English
Tanulási terv
Hogyan készül a tanulmány?
Tervezési részletek
- Elsődleges cél: Alapvető tudomány
- Kiosztás: N/A
- Beavatkozó modell: Egyetlen csoportos hozzárendelés
- Maszkolás: Nincs (Open Label)
Fegyverek és beavatkozások
Résztvevő csoport / kar |
Beavatkozás / kezelés |
|---|---|
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Kísérleti: Mindfulness-Based Cognitive Therapy (MBCT)
Participants will attend eight, 2-hour group treatment MBCT sessions delivered using free video-conferencing technology.
Groups will consist of 6-12 people who also have MS and chronic pain.
Participants will be asked to practice skills learned in session between sessions.
MBCT integrates mindfulness meditation practices within a CBT-oriented framework to address not only unhelpful pain cognitions and behaviors but also attentional control, decoupling of attention from emotion, mindful cognitions, and meditative behavior.
|
Participants will attend eight, 2-hour group treatment MBCT sessions delivered using free video-conferencing technology.
Groups will consist of 6-12 people who also have MS and chronic pain.
Participants will be asked to practice skills learned in session between sessions.
MBCT integrates mindfulness meditation practices within a CBT-oriented framework to address not only unhelpful pain cognitions and behaviors but also attentional control, decoupling of attention from emotion, mindful cognitions, and meditative behavior.
|
Mit mér a tanulmány?
Elsődleges eredményintézkedések
Eredménymérő |
Intézkedés leírása |
Időkeret |
|---|---|---|
|
Daily Mindfulness Practice
Időkeret: Twice daily for approximately 10 weeks (1 week before, 8 weeks during, and 1 week after the MBCT program)
|
Whether a participant engaged in any formal (for example, sitting meditation) or informal (for example, mindfully engaging in a daily task) mindfulness practice since the last check-in, assessed via a single yes or now question delivered twice daily through the smartphone app.
This will also be tracked passively by indicating whether participants accessed a guided meditation in the app itself.
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Twice daily for approximately 10 weeks (1 week before, 8 weeks during, and 1 week after the MBCT program)
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Másodlagos eredményintézkedések
Eredménymérő |
Intézkedés leírása |
Időkeret |
|---|---|---|
|
Type of Mindfulness Practice
Időkeret: Twice daily for approximately 10 weeks (1 week before, 8 weeks during, and 1 week after the MBCT program)
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Whether the mindfulness practice completed since the last check-in was formal (for example, sitting meditation using a guided audio recording) or informal (for example, mindfully engaging in a daily task), assessed via a single multiple choice question delivered twice daily through the smartphone app.
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Twice daily for approximately 10 weeks (1 week before, 8 weeks during, and 1 week after the MBCT program)
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Quality of Mindfulness Practice
Időkeret: Twice daily for approximately 10 weeks (1 week before, 8 weeks during, and 1 week after the MBCT program)
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A participant's self-rated quality of their most recent mindfulness practice since the last check-in, assessed via the 1-item Practice Quality-Mindfulness (PQM) scale delivered twice daily through the smartphone app.
A higher score indicates higher self-report practice quality.
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Twice daily for approximately 10 weeks (1 week before, 8 weeks during, and 1 week after the MBCT program)
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Egyéb eredményintézkedések
Eredménymérő |
Intézkedés leírása |
Időkeret |
|---|---|---|
|
Pain Intensity
Időkeret: Pre-intervention and post-intervention (approximately 10 weeks apart)
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Participant-rated pain severity assessed via the 3-item Patient-Reported Outcomes Measurement Information System (PROMIS) Pain Intensity scale at pre- and post-intervention.
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Pre-intervention and post-intervention (approximately 10 weeks apart)
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Pain Interference
Időkeret: Pre-intervention and post-intervention (approximately 10 weeks apart)
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The degree to which pain limits a participant's daily activities and functioning, assessed via the 6-item Patient-Reported Outcomes Measurement Information System (PROMIS) Pain Interference scale at pre- and post-intervention.
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Pre-intervention and post-intervention (approximately 10 weeks apart)
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Együttműködők és nyomozók
Szponzor
Nyomozók
- Kutatásvezető: Erin Mistretta, PhD, University of Washington
Tanulmányi rekorddátumok
Tanulmány főbb dátumok
Tanulmány kezdete (Tényleges)
Elsődleges befejezés (Becsült)
A tanulmány befejezése (Becsült)
Tanulmányi regisztráció dátumai
Először benyújtva
Először nyújtották be, amely megfelel a minőségbiztosítási kritériumoknak
Első közzététel (Tényleges)
Tanulmányi rekordok frissítései
Utolsó frissítés közzétéve (Tényleges)
Az utolsó frissítés elküldve, amely megfelel a minőségbiztosítási kritériumoknak
Utolsó ellenőrzés
Több információ
A tanulmányhoz kapcsolódó kifejezések
További vonatkozó MeSH feltételek
Egyéb vizsgálati azonosító számok
- STUDY00023785
- 1K23AT013270-01A1 (Az Egyesült Államok NIH támogatása/szerződése)
Terv az egyéni résztvevői adatokhoz (IPD)
Tervezi megosztani az egyéni résztvevői adatokat (IPD)?
IPD terv leírása
IPD megosztási időkeret
IPD-megosztási hozzáférési feltételek
Az IPD megosztását támogató információ típusa
- STUDY_PROTOCOL
- NEDV
- ICF
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