Effectiveness of a Mindfulness-Based Mental Health Promotion Program Provided by Health Coaches: A Controlled Multisite Field Trial

Lyssenko, Lisa; Müller, G.; Kleindienst, Nikolaus; Schmahl, Christian; Berger, Thomas; Eifert, Georg H.; Kölle, Alexander; Nesch, Siegmar; Ommer-Hohl, Jutta; Wenner, Michael T.; Bohus, Martin

doi:10.1159/000447012

Cited by 8 publications

(6 citation statements)

References 7 publications

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“…Growing interest in broader adoption of MT for military service members (Deuster & Schoomaker 2015) has prompted interest in determining if individuals who have military context familiarity and experience training service members, but no prior experience with MT or MT delivery, can be trained to effectively deliver short-form MT to military service members. Indeed, there has been recent interest in "trainthe-trainer" (TTT) delivery of mindfulness-informed programs by context-familiar trainers in the civilian (Lyssenko et al 2016) and military (Zhang et al 2018) literature. These studies showed that TTT delivery decreased self-reported emotional distress (Lyssenko et al 2016) and increased self-reported mindfulness (Zhang et al 2018).…”

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confidence: 99%

“…Indeed, there has been recent interest in "trainthe-trainer" (TTT) delivery of mindfulness-informed programs by context-familiar trainers in the civilian (Lyssenko et al 2016) and military (Zhang et al 2018) literature. These studies showed that TTT delivery decreased self-reported emotional distress (Lyssenko et al 2016) and increased self-reported mindfulness (Zhang et al 2018). Yet, no prior studies have examined if TTT delivery of MT effectively promotes cognitive resilience in active-duty service members.…”

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confidence: 99%

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Bolstering Cognitive Resilience via Train-the-Trainer Delivery of Mindfulness Training in Applied High-Demand Settings

et al. 2019

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Objectives Mindfulness training (MT) guidelines recommend that trainers have familiarity and knowledge of the training group as well as extensive MT expertise. Herein, a "train-the-trainer" (TTT) dissemination model was investigated for military service members whose access to MT is threatened by a scarcity of qualified trainers. Methods US Army Master Resilience Trainer-Performance Experts (PEs), who had extensive familiarity with soldiers but no prior MT experience, participated in an MT practicum, and then delivered a 4-week MT program (Mindfulness-Based Attention Training, MBAT) contextualized for military personnel. Soldiers (n = 180) undergoing intensive military field training over the study interval were recruited as participants. MBAT was delivered to soldiers by PEs (n = 89) or by a trainer with extensive MT experience (Mindfulness Expert; ME, n = 45) but no military familiarity. The remaining participants served as no-training controls (NTC, n = 46). Soldiers' performance on sustained attention and working memory (WM) tasks was assessed before (week 0, T1) and after MBAT delivery (week 5, T2), and again 4 weeks later (week 10, T3). Results For all participants, sustained attention and WM performance declined over the high-demand field training interval (p < 0.001). Yet, the PE group declined significantly less in attentional (p = 0.040) and WM (p < 0.001) performance relative to the other groups. Conclusions These results suggest that TTT delivery of short-form MT by context-familiar trainers may be an expeditious route by which to increase access to MT in the service of promoting cognitive resilience in high-demand groups.

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Bolstering Cognitive Resilience via Train-the-Trainer Delivery of Mindfulness Training in Applied High-Demand Settings

et al. 2019

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“…Data from a passive control cohort of a large health promotion intervention study were used, which was conducted in 2013 and 2014 in 43 locations in Southern Germany [35][36][37]. The study has been registered in the German Register of Clinical Trials (DRKS) and was approved by the Ethics Review Committee at the University of Heidelberg, Germany (Study Registration: DRKS00006216).…”

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confidence: 99%

Socio-economic consequences of mental distress: quantifying the impact of self-reported mental distress on the days of incapacity to work and medical costs in a two-year period: a longitudinal study in Germany

Müller

Bombana

Heinzel-Gutenbrenner³

et al. 2021

BMC Public Health

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Background Mental disorders are related to high individual suffering and significant socio-economic burdens. However, it remains unclear to what extent self-reported mental distress is related to individuals’ days of incapacity to work and their medical costs. This study aims to investigate the impact of self-reported mental distress for specific and non-specific days of incapacity to work and specific and non-specific medical costs over a two-year span. Method Within a longitudinal research design, 2287 study participants’ mental distress was assessed using the Hospital Anxiety and Depression Scale (HADS). HADS scores were included as predictors in generalized linear models with a Tweedie distribution with log link function to predict participants’ days of incapacity to work and medical costs retrieved from their health insurance routine data during the following two-year period. Results Current mental distress was found to be significantly related to the number of specific days absent from work and medical costs. Compared to participants classified as no cases by the HADS (2.6 days), severe case participants showed 27.3-times as many specific days of incapacity to work in the first year (72 days) and 10.3-times as many days in the second year (44 days), and resulted in 11.4-times more medical costs in the first year (2272 EUR) and 6.2-times more in the second year (1319 EUR). The relationship of mental distress to non-specific days of incapacity to work and non-specific medical costs was also significant, but mainly driven from specific absent days and specific medical costs. Our results also indicate that the prevalence of presenteeism is considerably high: 42% of individuals continued to go to work despite severe mental distress. Conclusions Our results show that self-reported mental distress, assessed by the HADS, is highly related to the days of incapacity to work and medical costs in the two-year period. Reducing mental distress by improving preventive structures for at-risk populations and increasing access to evidence-based treatments for individuals with mental disorders might, therefore, pay for itself and could help to reduce public costs.

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“…Main objective of the study was to investigate what effects can be achieved with a group-based universal prevention program in a real-world community setting. The clinical evaluation implies a significant overall reduction of emotional distress after three months, as well as at the one-year-follow-up [27, 28]. In the 12-month follow-up, new cases of psychopathological symptoms were prevented in 1 of 16 participants [28].…”

Section: Introductionmentioning

confidence: 99%

Cost-effectiveness of a mindfulness-based mental health promotion program: economic evaluation of a nonrandomized controlled trial with propensity score matching

et al. 2019

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Background Mental health promotion programs have been shown to reduce the burden associated with mental distress and prevent the onset of mental disorders, but evidence of cost-effectiveness is scarce. Objective To evaluate the cost-effectiveness of a mindfulness-based mental health prevention program provided by health coaches in a multi-site field setting in Germany. Methods The single-study based economic evaluation was conducted as part of a nonrandomized controlled trial, comparing the effects of a group-based prevention program to usual care based on propensity score matching. Participants (N = 1166) were recruited via a large statutory health insurance fund. Health outcome was assessed with the Hospital Anxiety and Depression Scale (HADS). Cost outcomes were actually incurred costs compiled from the health insurance’ records. Incremental cost-effectiveness ratios (ICER) were analyzed from a societal and a health care perspective for a 12-month time horizon with sampling uncertainty being handled using nonparametric bootstrapping. A cost-effectiveness acceptability curve was graphed to determine the probability of cost-effectiveness at different willingness-to-pay ceiling ratios. Results From a societal perspective, prevention was cost-effective compared to usual-care by providing larger effects of 1.97 units on the HADS (95% CI [1.14, 2.81], p < 0.001) at lower mean incremental total costs of €-57 (95% CI [− 634, 480], p = 0.84), yielding an ICER of €-29 (savings) per unit improvement. From a health care perspective, the incremental health benefits were achieved at additional direct costs of €181 for prevention participants (95% CI [40, 318], p = 0.01) with an ICER of €91 per unit improvement on the HADS. Willingness-to-pay for the prevention program to achieve a 95% probability of being cost-effective compared to usual-care, was estimated at €225 per unit improvement on the HADS score from a societal, and €191 from a health care perspective respectively. Sensitivity analyses suggested differential cost-effect-ratios depending on the initial distress of participants. Limitations Due to the complexity of the field trial, it was not feasible to randomize participants and offer an active control condition. This limitation was met by applying a rigorous matching procedure. Conclusions Our results indicate that universal mental health promotion programs in community settings might be a cost-effective strategy to enhance well-being. Differences between the societal and health care perspective underline the call for joint funding in the dissemination of preventive services. Trial registration German Clinical Trials Registration ID: DRKS00006216 (2014/06/11, retrospective registration).

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Effectiveness of a Mindfulness-Based Mental Health Promotion Program Provided by Health Coaches: A Controlled Multisite Field Trial

Cited by 8 publications

References 7 publications

Bolstering Cognitive Resilience via Train-the-Trainer Delivery of Mindfulness Training in Applied High-Demand Settings

Bolstering Cognitive Resilience via Train-the-Trainer Delivery of Mindfulness Training in Applied High-Demand Settings

Socio-economic consequences of mental distress: quantifying the impact of self-reported mental distress on the days of incapacity to work and medical costs in a two-year period: a longitudinal study in Germany

Cost-effectiveness of a mindfulness-based mental health promotion program: economic evaluation of a nonrandomized controlled trial with propensity score matching

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