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Adolescent Psychiatry

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ISSN (Print): 2210-6766
ISSN (Online): 2210-6774

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Research Article

In-person vs. eHealth Mindfulness-based Intervention for Adolescents with Chronic Illnesses: A Pilot Randomized Trial

Author(s): Nicholas Chadi*, Elli Weisbaum, Catherine Malboeuf-Hurtubise, Sara Ahola Kohut, Christine Viner, Nades Palaniyar, Miriam Kaufman, Jake Locke and Dzung X. Vo

Volume 9, Issue 1, 2019

Page: [11 - 23] Pages: 13

DOI: 10.2174/2210676608666181031102235

Abstract

Background: Mindfulness-Based Interventions (MBIs) can improve mental health and well-being in adolescents with chronic illnesses. However, there are many barriers such as reduced mobility and distance which compromise accessibility to MBIs.

Objective: The aim of this study was to determine the effectiveness of the Mindful Awareness and Resilience Skills for Adolescents (MARS-A) program in youth with chronic illnesses delivered in person or via eHealth.

Methods: In this mixed method randomized controlled trial, participants received weekly 90- minute long MARS-A sessions for 8 weeks, either in person or via a secure eHealth audiovisual platform allowing group interactions in real time. Data was collected at baseline, immediately after and two months post-MBI through saliva analyses, electronic participant logs and validated questionnaires assessing mindfulness skills and mental health outcomes.

Results: Seven participants per group completed the intervention (total n=14, completion rate 77.8%). Paired t-test analyses revealed a significant reduction in depression/anxiety scores immediately post-intervention (p=0.048, Cohen’s d=0.934) and a significant reduction in pre-post mindfulness cortisol levels at week 8 (p=0.022, Cohen’s d=0.534) in the eHealth group. Frequency and duration of weekly individual home practice (eHealth: 6.5 times; 28.8 minutes; in-person: 6.0 times; 30.6 minutes) were similar in both groups and maintained at follow-up.

Conclusion: This is the first study comparing in-person and eHealth delivery of an 8-week MBI for adolescents with chronic illnesses. Although the study was limited by the small size of the sample, our results suggest that eHealth delivery of MBIs may represent a promising avenue for increasing availability in this population.

Keywords: Adolescent, mindfulness, eHealth, chronic illness, randomized controlled trial, MARS-A.

« Previous Next »
Ahola Kohut, S., Stinson, J., Davies-Chalmers, C., Ruskin, D., van Wyk, M. (2017). Mindfulness-based interventions in clinical samples of adolescents with chronic illness: A systematic review. Journal of Alternative and Complementary Medicine.
[http://dx.doi.org/10.1089/acm.2016.0316]
Ali, A., Weiss, T.R., Dutton, A., McKee, D., Jones, K.D., Kashikar-Zuck, S. … Shapiro, E. D. (2017). Mindfulness-based stress reduction for adolescents with functional somatic syndromes: A pilot cohort study. J. Pediatr., 183, 184-190.
[http://dx.doi.org/10.1016/j.jpeds.2016.12.053]
Biegel, G.M., Brown, K.W., Shapiro, S.L., Schubert, C.M. (2009). Mindfulness-based stress reduction for the treatment of adolescent psychiatric outpatients: A randomized clinical trial. J. Consult. Clin. Psychol., 77(5), 855-866.
[http://dx.doi.org/10.1037/a0016241]
Bluth, K., Campo, R.A., Pruteanu-Malinici, S., Reams, A., Mullarkey, M., Broderick, P.C. (2016). A school-based mindfulness pilot study for ethnically diverse at-risk adolescents. Mindfulness, 7(1), 90-104.
[http://dx.doi.org/10.1007/s12671-014-0376-1]
Boggs, J. M., Beck, A., Felder, J. N., Dimidjian, S., Metcalf, C. A., Segal, Z. V. (2014). Web-based intervention in mindfulness meditation for reducing residual depressive symptoms and relapse prophylaxis: A qualitative study. Journal of Medical Internet Research, 16(3), e87.
[http://dx.doi.org/10.2196/jmir. 3129]
Broadbent, E., Wilkes, C., Koschwanez, H., Weinman, J., Norton, S., Petrie, K. J. (2015). A systematic review and meta-analysis of the Brief Illness Perception Questionnaire. Psychology & Health, 30(11), 1361-1385.
[http://dx.doi.org/10.1080/08870446. 2015.1070851]
Brown, K.W., West, A.M., Loverich, T.M., Biegel, G.M. (2011). Assessing adolescent mindfulness: Validation of an adapted mindful attention awareness scale in adolescent normative and psychiatric populations. Psychol. Assess., 23(4), 1023-1033.
[http://dx.doi.org/10.1037/a0021338]
Canadian Agency for Drugs and Technologies in Health. (2015). Mindfulness interventions for the treatment of post-traumatic stress disorder, generalized anxiety disorder, depression, and substance use disorders: A review of the clinical effectiveness and guidelines.(CADTH Rapid Response Service, Ed.). Ottawa, ON.
Chadi, N., Kaufman, M., Weisbaum, E., Malboeuf-Hurtubise, C., Kohut, S.A., Viner, C. … Vo, D. X. (2017). In-person versus ehealth mindfulness-based intervention for adolescents with chronic illness: Protocol for a randomized controlled trial. Journal of Medical Internet Research Research Protocols, 6(11), e241.
[http://dx.doi.org/10.2196/resprot.7700]
Chadi, N., McMahon, A., Vadnais, M., Malboeuf-Hurtubise, C., Djemli, A., Dobkin, P.L. P. L., … Haley, N. (2016). Mindfulness-based intervention for female adolescents with chronic pain: A pilot randomized trial. Journal of the Canadian Academy of Child and Adolescent Psychiatry, 25(3), 159-168. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/27924146
Chadi, N., Weisbaum, E., Malboeuf-Hurtubise, C., Ahola Kohut, S., Viner, C., Kaufman, M. … Vo, D. X. (2018). Can the mindful awareness and resilience skills for adolescents (MARS-A) program be provided online? Voices from the Youth. Children (Basel Switzerland), 5(9)
[http://dx.doi.org/10.3390/ children5090115]
Fjorback, L.O., Carstensen, T., Arendt, M., Ornbol, E., Walach, H., Rehfeld, E., Fink, P. (2013). Mindfulness therapy for somatization disorder and functional somatic syndromes: analysis of economic consequences alongside a randomized trial. J. Psychosom. Res., 74(1), 41-48.
[http://dx.doi.org/10.1016/j.jpsychores.2012.09.010]
Gex-Fabry, M., Jermann, F., Kosel, M., Rossier, M.F., Van der Linden, M., Bertschy, G. … Aubry, J. M. (2012). Salivary cortisol profiles in patients remitted from recurrent depression: one-year follow-up of a mindfulness-based cognitive therapy trial. J. Psychiatr. Res., 46(1), 80-86.
[http://dx.doi.org/10.1016/j.jpsychires.2011.09.011]
Hagborg, W.J. (1993). The Rosenberg Self-Esteem scale and Harter’s Self-Perception profile for adolescents: A concurrent validity study. Psychol. Sch., 30(2), 132-136.
[http://dx.doi.org/10.1002/ 1520-6807(199304)30:2<132:AID-PITS2310300205>3.0.CO;2-Z]
Hesse, T., Holmes, L.G., Kennedy-Overfelt, V., Kerr, L.M., Giles, L.L. (2015). Mindfulness-based intervention for adolescents with recurrent headaches: A pilot feasibility study. Evid. Based Complement. Alternat. Med., 508958
[http://dx.doi.org/10.1155/2015/508958]
Huang, G.C., Unger, J.B., Soto, D., Fujimoto, K., Pentz, M.A., Jordan-Marsh, M., Valente, T.W. (2014). Peer influences: The impact of online and offline friendship networks on adolescent smoking and alcohol use. J. Adolesc. Health, 54(5), 508-514.
[http://dx.doi.org/10.1016/j.jadohealth.2013.07.001]
Jastrowski Mano, K.E., Salamon, K.S., Hainsworth, K.R., Anderson Khan, K.J., Ladwig, R.J., Davies, W.H., Weisman, S.J. (2013). A randomized, controlled pilot study of mindfulness-based stress reduction for pediatric chronic pain. Altern. Ther. Health Med., 19(6), 8-14.
Kabat-Zinn, J. (1982). An outpatient program in behavioral medicine for chronic pain patients based on the practice of mindfulness meditation: Theoretical considerations and preliminary results. Gen. Hosp. Psychiatry, 4(1), 33-47.
Kabat-Zinn, J. (1991). Full catastrophe living: Using the wisdom of your body and mind to face stress, pain, and illness. New York, N.Y.: Dell Pub., a division of Bantam Doubleday Dell Pub. Group.
Kabat-Zinn, J., Massion, A.O., Kristeller, J., Peterson, L.G., Fletcher, K.E., Pbert, L. … Santorelli, S. F. (1992). Effectiveness of a meditation-based stress reduction program in the treatment of anxiety disorders. Am. J. Psychiatry, 149(7), 936-943.
Lovas, D.A., Pajer, K., Chorney, J.M., Vo, D.X., Howlett, M., Doyle, A., Huber, A. (2017). Mindfulness for adolescent chronic pain: a pilot feasibility study. J. Child Adolesc. Ment. Health, 29(2), 129-136.
[http://dx.doi.org/10.2989/17280583.2017.1355807]
Nalla, A.A., Thomsen, G., Knudsen, G.M., Frokjaer, V.G. (2015). The effect of storage conditions on salivary cortisol concentrations using an enzyme immunoassay. Scand. J. Clin. Lab. Invest., 75(1), 92-95.
[http://dx.doi.org/10.3109/00365513.2014.985252]
National Institute on Health and Care Excellence, . (2006). Computerized cognitive behaviour therapy for depression and anxiety: Guidance and guidelines. Retrieved from https://www.nice.org.uk/guidance/ta97
Neinstein, L.S. (2001). The treatment of adolescents with a chronic illness: Physicians must go beyond the medical model. West. J. Med., 175(5), 293-295. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/11694463
Pinquart, M., Teubert, D. (2012). Academic, physical, and social functioning of children and adolescents with chronic physical illness: A meta-analysis. J. Pediatr. Psychol., 37(4), 376-389.
[http://dx.doi.org/10.1093/jpepsy/jsr106]
Rice, V.J., Liu, B., Schroeder, P.J. (2018). Impact of inperson and virtual world mindfulness training on symptoms of post-traumatic stress disorder and attention deficit and hyperactivity disorder. Military Medicine, 183(suppl_1), 413-420.
[http://dx.doi.org/10.1093/milmed/usx227]
Ruskin, D.A., Gagnon, M.M., Kohut, S.A., Stinson, J.N., Walker, K.S. (2017). A mindfulness program adapted for adolescents with chronic pain: Feasibility, acceptability, and initial outcomes. Clin. J. Pain.
[http://dx.doi.org/10.1097/ajp.0000000000 000490]
Ruskin, D., Harris, L., Stinson, J., Kohut, S.A., Walker, K., McCarthy, E. (2017). “I Learned to Let Go of My Pain”. The effects of mindfulness meditation on adolescents with chronic pain: An analysis of participants’ treatment experience. Children (Basel, Switzerland), 4(12)
[http://dx.doi.org/10.3390/children 4120110]
Shaw, T., Campbell, M.A., Runions, K.C., Zubrick, S.R. (2016). Properties of the DASS-21 in an Australian community adolescent population. J. Clin. Psychol.
[http://dx.doi.org/10.1002/jclp.22376]
Spijkerman, M.P.J., Pots, W.T.M., Bohlmeijer, E.T. (2016). Effectiveness of online mindfulness-based interventions in improving mental health: A review and meta-analysis of randomised controlled trials. Clin. Psychol. Rev., 45, 102-114.
[http://dx.doi.org/10.1016/J.CPR.2016.03.009]
Tan, L.B. (2015). A critical review of adolescent mindfulness-based programmes. Clin. Child Psychol. Psychiatry.
[http://dx.doi.org/10.1177/ 1359104515577486]
Teasdale, J.D., Segal, Z.V., Williams, J.M., Ridgeway, V.A., Soulsby, J.M., Lau, M.A. (2000). Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. J. Consult. Clin. Psychol., 68(4), 615-623.
Van Dam, N. T., van Vugt, M. K., Vago, D. R., Schmalzl, L., Saron, C. D., Olendzki, A. … Meyer, D. E. (2018). Mind the hype: A critical evaluation and prescriptive agenda for research on mindfulness and meditation. Perspectives on Psychological Science, 13(1), 36-61.
[http://dx.doi.org/10.1177/17456916 17709589]
Vo, D.X. (2015). The mindful teen. Powerful skill to help you handle stress one moment at a time. The instant help solutions series.. Vancouver, Canada: New Harbinger Publications.
Vo, D.X., Doyle, J., Christie, D. (2014). Mindfulness and adolescence: A clinical review of recent mindfulness-based studies in clinical and nonclinical adolescent populations. Adolesc. Med. State Art Rev., 25(2), 455-472.
Vo, D. X., Locke, J. J., Johnson, A., Marshall, S. K. (2015). 50. The effectiveness of the mindful awareness and resilience skills for adolescents (MARS-A) Intervention on adolescent mental health: A pilot clinical trial. Journal of Adolescent Health, 56(2), S27.
[http://dx.doi.org/10.1016/j.jadohealth.2014. 10.054]
Vogeser, M., Durner, J., Seliger, E., Auernhammer, C. (2006). Measurement of late-night salivary cortisol with an automated immunoassay system. Clin. Chem. Lab. Med., 44(12), 1441-1445.
[http://dx.doi.org/10.1515/cclm.2006.244]
Waelde, L., Feinstein, A., Bhandari, R., Griffin, A., Yoon, I., Golianu, B. (2017). A pilot study of mindfulness meditation for pediatric chronic pain. Children, 4(5), 32.
[http://dx.doi.org/10.3390/children4050032]
Waters, E., Davis, E., Nicolas, C., Wake, M., Lo, S. K. (2008). The impact of childhood conditions and concurrent morbidities on child health and well-being. Child: Care, Health and Development, 34(4), 418- 429.
[http://dx.doi.org/10.1111/j.1365-2214.2008. 00825.x]
Webb, L., Perry-Parrish, C., Ellen, J., Sibinga, E. (2018). Mindfulness instruction for HIV-infected youth: A randomized controlled trial. AIDS Care, 30(6), 688-695.
[http://dx.doi.org/10.1080/09540121.2017.1394434]
Whitehouse, S.R., Lam, P.Y., Balka, E., McLellan, S., Deevska, M., Penn, D. … Paone, M. (2013). Co- Creation With TickiT: Designing and evaluating a clinical ehealth platform for youth. In G. Eysenbach (Ed.), Journal of Medical Internet Research Research Protocols.(Vol. 2). Toronto, Canada.
[http://dx.doi.org/10.2196/resprot.2865]
Yeo, M., Sawyer, S. (2005). Chronic illness and disability. British Medical Journal, 330(7493), 721-723. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/ articles/PMC555640/

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