Meditation smartphone application effects on prehypertensive adults’ blood pressure: Dose-response feasibility trial.

Adams, Zachary W.; Sieverdes, John C.; Brunner-Jackson, Brenda; Mueller, Martina; Chandler, Jessica; Díaz, Vanessa A.; Patel, Sachin; Sox, Luke; Wilder, Spencer; Treiber, Frank A.

doi:10.1037/hea0000584

Cited by 35 publications

(54 citation statements)

References 43 publications

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“…Research staff contacted interested participants via telephone to determine interest and schedule the first of three potential BP screening visits. Details of the BP protocol used at the BP screenings and subsequent clinical evaluations are published elsewhere [21]. Of the 388 individuals screened, 306 were found to be ineligible due to SBP being below the pre-HTN range during one of the three evaluations.…”

Section: Participantsmentioning

confidence: 99%

“…Based upon results from our previous dose-response trial [21], each TT participant was instructed to complete two 15-min daily sessions for the first month, decrease to two 10-min daily sessions for months 2 and 3, and then decrease to 5-min sessions for the remainder of the 12-month trial. If desired, one could engage in more than the 2 sessions/day dosage, however our analysis only included adherence to the prescribed dosage, which was determined to be most efficacious in a previous trial [21]. For example, if a participant engaged in an extra session each day (i.e., 3 sessions instead of the prescribed 2), they received the same adherence score as a participant who completed the prescribed dosage, with each receiving a score of 1.0.…”

Section: Tension Tamer (Tt) Intervention Groupmentioning

confidence: 99%

“…As in our earlier BAM feasibility trials including several involving the TT app, adherence was defined as completion of 2 entire sessions per day [19][20][21]. Partial adherence (0.5) was allotted for completion of one of two assigned sessions for the day.…”

Section: Adherence To Tt and Runkeeper Dosage Ratesmentioning

confidence: 99%

“…Following a successful proof of concept study with high acceptability and usability ratings, adherence to twice-daily sessions for 3 months (0.75-1.00 per month) and clinically relevant reductions in resting SBP in pre-hypertensives [20], we conducted a 6-month feasibility trial using the Tension Tamer (TT) smartphone app. The trial sought to determine the optimal dose of BAM comparing three twice-daily dosage schedules (5, 10, and 15 min sessions) upon changes in stress and SBP among JNC8-defined pre-hypertensive adults [21]. Guided by the results from that feasibility trial, we recently completed a small-scale two-arm efficacy RCT to determine BAM's effects on BP and perceived stress among JNC8 defined pre-hypertensive adults.…”

Section: Introductionmentioning

confidence: 99%

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Impact of 12-Month Smartphone Breathing Meditation Program upon Systolic Blood Pressure among Non-Medicated Stage 1 Hypertensive Adults

Chandler

Sox

Díaz

et al. 2020

IJERPH

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(1) Background: Hypertension (HTN) affects ~50% of adults and is a major risk factor for stroke and cardiovascular disease. In 2017, the SPRINT trial outcomes led to lowering of HTN cutoffs by the American College of Cardiology (ACC) and American Heart Association (AHA). The Joint National Committee (JNC8) and National High BP Education Program recommend that lifestyle modifications be used as first-line HTN treatment. Chronic stress is a risk factor for HTN and cardiovascular disease. A recently completed 12 month randomized controlled trial (RCT) of a breathing meditation smart phone app (Tension Tamer, TT) involving JNC8 designated pre-HTN adults provided an opportunity to examine its impact upon individuals now classified as having stage 1 HTN. The TT app captures continuous real-time heart rate (HR) from a user’s fingertip placed over a video camera lens during sessions. Users receive immediate feedback graphs after each session, showing their HR changes. They also receive motivational and social reinforcement SMS text messages the following day based upon levels of adherence. We conducted ancillary analyses of a 2-arm, 12-month, small-scale efficacy RCT among a subgroup of our total sample of participants, who are now classified as having stage 1 non-medicated systolic HTN. Primary outcome was change in resting systolic blood pressure (SBP). Secondary outcomes were change in resting diastolic blood pressure, adherence to the TT protocol, and perceived stress levels. (2) Methods: 30 adults (mean age: 45.0 years; 15 males; 16 White; 14 Black) with ACC/AHA 2017 defined systolic HTN (130–139 mmHg) on 3 consecutive sessions (mean SBP: 132.6 mmHg) were randomly assigned to TT or lifestyle education program delivered via smartphone (SPCTL). Each group received a twice-daily dosage schedule of TT or walking (month 1: 15 min; months 2 and 3: 10 min; months 4–12: 5 min). (3) Results: Mixed modeling results revealed a significant group x time effect for SBP (p<.01). The TT group showed greater SBP reductions at months 3 (−8.0 vs. −1.9), 6 (−10.0 vs. −0.7), and 12: (−11.6 vs. −0.4 mmHg; all p-values <0.04). (4) Conclusion: The TT app was beneficial in reducing SBP levels among adults with stage 1 systolic HTN. The TT app may be a promising, scalable first-line tactic for stage 1 HTN. Preparations are underway for an efficacy RCT involving uncontrolled stage 1 HTN patients.

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Section: Participantsmentioning

confidence: 99%

Section: Tension Tamer (Tt) Intervention Groupmentioning

confidence: 99%

Section: Adherence To Tt and Runkeeper Dosage Ratesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Impact of 12-Month Smartphone Breathing Meditation Program upon Systolic Blood Pressure among Non-Medicated Stage 1 Hypertensive Adults

Chandler

Sox

Díaz

et al. 2020

IJERPH

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“…Mindfulness meditation practice is a central treatment ingredient in MBIs and standardized MBIs often recommend participants engage in a substantial amount of home practice (e.g., 45 minutes per day, six days per week; Kabat-Zinn, 2013). However, overly burdensome home practice requirements may limit treatment adherence and acceptability (Adams et al, 2018). Thus, research investigating this aspect of MBIs is important at the current stage of research, both for a deeper understanding of treatment mechanisms and exploring potential facilitators and barriers to dissemination and implementation (Crane & Kuyken, 2013;Dimidjian & Segal, 2015).…”

mentioning

confidence: 99%

Does practice quality mediate the relationship between practice time and outcome in mindfulness-based stress reduction?

Goldberg¹,

Knoeppel²,

Flook³

et al. 2019

Preprint

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Interventions based on mindfulness meditation are increasingly common and evidence exists supporting their use. However, questions remain regarding treatment mechanisms accounting for beneficial effects. The current study examined one candidate mechanismmindfulness practice qualityas a mediator of the link between practice time and outcome within mindfulness-based stress reduction (MBSR). Participants (n=96) completed measures of mindfulness and psychological symptoms at baseline and post-treatment. A weekly questionnaire assessed practice time and quality over the eight weeks of MBSR. Multilevel models accounted for nesting within participants, MBSR groups, and instructors. Results generally supported the reliability and validity of a weekly single-item practice quality measure.Greater practice time was associated with improved practice quality (r=.48). Increases in practice quality predicted improvements in self-report mindfulness and psychological symptoms (s=.35, .30, and -.19, ps<.05,), but not behavioral mindfulness (=-.02, p = .879). In multilevel mediation models, improved practice quality mediated the link between practice time and changes in self-report mindfulness, suggesting improved practice quality functions as a mechanism linking practice time and outcome in MBSR. Future research evaluating practice quality in clinical samples, in tandem with intensive sampling paradigms (e.g., experience sampling) and objective (behavioral, physiological) outcomes may be warranted.

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An integrative review and theoretical examination of chronic illness mHealth studies using the Middle‐Range Theory of Self‐care of Chronic Illness

Buck

Shadmi

Topaz

et al. 2020

Research in Nursing & Health

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Self‐management, or self‐care, by individuals and/or families is a critical element in chronic illness management as more care shifts to the home setting. Mobile device‐enhanced health care, or mHealth, is being touted as a means to support self‐care. Previous mHealth reviews examined the effect of mHealth on patient outcomes, however, none used a theoretical lens to examine the interventions themselves. The aims of this integrative review were to examine recent (e.g., last 10 years) chronic illness mHealth empiric studies and (1) categorize self‐care behaviors engaged in the intervention according to the Middle‐Range Theory of Self‐care of Chronic Illness, and (2) conduct an analysis of gaps in self‐care theory domains and behaviors utilized. Methods included: (1) Best practice study identification, collection, and data extraction procedures and (2) realist synthesis techniques for within and across case analysis. From a pool of 652 records, 33 primarily North American clinical trials, published between 2010 and 2019 were examined. Most mHealth interventions used apps, clinician contact, and behavioral prompts with some wireless devices. Examination found self‐care maintenance behaviors were supported in most (n = 30) trials whereas self‐care monitoring (n = 12) and self‐care management behaviors (n = 8) were less so. Few trials (n = 2) targeted all three domains. Investigation of specific behaviors uncovered an overexamination of physical activity and diet behaviors and an underexamination of equally important behaviors. By examining chronic illness mHealth interventions using a theoretical lens we have categorized current interventions, conducted a gap analysis uncovering areas for future study, and made recommendations to move the science forward.

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Meditation smartphone application effects on prehypertensive adults’ blood pressure: Dose-response feasibility trial.

Abstract: Smartphone-implemented BAM appears to reduce SBP and can be a low-cost method to reach large populations. (PsycINFO Database Record

Cited by 35 publications

References 43 publications

Impact of 12-Month Smartphone Breathing Meditation Program upon Systolic Blood Pressure among Non-Medicated Stage 1 Hypertensive Adults

Impact of 12-Month Smartphone Breathing Meditation Program upon Systolic Blood Pressure among Non-Medicated Stage 1 Hypertensive Adults

Does practice quality mediate the relationship between practice time and outcome in mindfulness-based stress reduction?

An integrative review and theoretical examination of chronic illness mHealth studies using the Middle‐Range Theory of Self‐care of Chronic Illness

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