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Title: Increasing home practice engagement during a mindfulness-based intervention for people with long-term conditions : an exploratory randomised controlled trial
Author: O'Shea, Darragh James
ISNI:       0000 0004 7658 2510
Awarding Body: University of the West of England
Current Institution: University of the West of England, Bristol
Date of Award: 2019
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Background: Regular and sustained mindfulness practice (home practice) is considered a key component by which mindfulness-based interventions (MBIs) exert their positive effects (Parsons, Crane, Parsons, Fjorback, & Kuyken, 2017). However, participants often report struggling with home practice during and following MBIs (Jon Kabat-Zinn, 2017a). As such, this study explores whether the addition of a narrative health communication intervention (MABIL in the City) to an existing MBI could support participants home practice during and following the intervention. In addition, this trial aimed to explore whether greater engagement with home practice led to better outcomes immediately following the intervention and at follow-up. Design: The study adopted a single-blind randomised controlled design. Participants were randomised to either an experimental group (MBI + 'MABIL in the City') or an active control group (MBI). Method: Forty-four adults with at least one long-term health condition, were included in the trial. Participants in both groups completed a battery of mood & mindfulness questionnaires including the PHQ-9; GAD-7 & FFMQ-SF (Bohlmeijer, Klooster, Fledderus, Veehof, & Baer, 2011; Kroenke, Spitzer, & Williams, 2001; Spitzer, Kroenke, Williams, & Löwe, 2006) at the beginning, end and 3-months following the intervention. In addition, participants in both groups completed weekly home practice logs. Results: There was no statistically significant association between group and frequency of practice (³ 3 days of < 3 days) during the course, p = .705, or at follow-up, p = .743. Finally, no statistically significant differences in PHQ-9, GAD-7 & FFMQ-SF ratings were observed for participants who practiced on average ³ 3 days a week during the course compared to participants who practiced on average < 3 days a week during the course. However, 3-months following the intervention, participants who reported practicing on average ³ 3 days a week had statistically significant improvements in PHQ-9 & GAD-7 ratings compared to participants who practiced less frequently i.e. < 3 days a week, p = .039., d =.79 (medium effect; Cohen, 1988), p = .047., d =.82 (large effect; Cohen, 1988). Conclusions: Overall, MABIL in the City failed to increase participants home practice engagement as intended. However, the finding which indicated that participants who practiced more regularly 3-months following the intervention had greater improvements in PHQ-9 and GAD-7 ratings compared to participants who practiced less frequently is an important finding which provides support for the value of ongoing mindfulness practice - however these findings should be interpreted in light of the studies limitations.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (D.Health Psych.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available
Keywords: mindfulness ; home practice ; behaviour change