Preliminary evidence suggests that 8-week training programs in meditation and exercise lead to reductions in incidence, duration and severity of acute respiratory infection (ARI) illness. In this parallel 3-group trial, women and men aged 30 to 69 will be randomized to: 1) an 8-week behavioral training program in mindfulness meditation, 2) an intensity, duration and location-matched 8-week exercise program, or 3) a wait-list observational control group. Recruitment will target those who do not exercise regularly, have not had training in meditation, and report levels of stress at or above average population levels. The primary outcome will be severity-weighted total days of ARI illness as assessed by self-reports on the validated Wisconsin Upper Respiratory Symptom Survey (WURSS-24). Weekly computer-assisted telephone monitoring for ARI illness will be operated by personnel blinded to intervention group. For each ARI illness episode, nasal samples will be tested with multiplex PCR (polymerase chain reaction) to identify viruses, and will be analyzed for neutrophil count, interleukin-6, and interleukin-8 concentrations. ARI-related visits to health care facilities and time lost from work and school will be documented, and assessed as secondary outcomes. Questionnaire measures assessing perceived stress, positive and negative emotion, self-efficacy, social support, sleep quality and general mental and physical health will be analyzed as potential mediators of causal pathways leading from behavioral training interventions to ARI illness outcomes. This will be a 5-year project, with 4 yearly cohorts of n=99 per cohort randomized into 3 groups of n=33 each. Assuming 9% loss to follow-up, the final sample size will be n=360 study participants, with n=120 in each comparison group. Enrollment, randomization and study interventions will begin in September. Participants will be monitored by weekly self-report through May. Summers will be used for data cleaning, preliminary analyses, and for recruiting the next year's cohort. Zero-inflated multivariate regression models will assess effects of meditation and exercise on ARI illness, health care utilization, and work absenteeism. Psychosocial measures will be assessed as potential mediators of effects of meditation and exercise on ARI illness. Generalized estimating equations, random-effects pattern-mixture models, and hierarchical linear models will be used to assess longitudinal effects, interactions, and covariate mediation.

Public Health Relevance

The primary goal of this project is to determine whether behavioral training in mindfulness meditation or moderate intensity sustained exercise can lead to reductions in acute respiratory infection (ARI) illness, such as common cold and influenza. Our preliminary findings suggest substantial benefit of these interventions in terms of reduced incidence, duration and severity of ARI illness, with corresponding reductions in days of work lost to illness. If the proposed research confirms these findings, there will be major implications for public and private health-related policy and practice, as well as for scientific knowledge regarding health maintenance and disease prevention.

Agency
National Institute of Health (NIH)
Institute
National Center for Complementary & Alternative Medicine (NCCAM)
Type
Research Project (R01)
Project #
5R01AT006970-03
Application #
8690775
Study Section
Biobehavioral Mechanisms of Emotion, Stress and Health Study Section (MESH)
Program Officer
Williamson, John S
Project Start
2012-07-01
Project End
2017-06-30
Budget Start
2014-07-01
Budget End
2015-06-30
Support Year
3
Fiscal Year
2014
Total Cost
Indirect Cost
Name
University of Wisconsin Madison
Department
Family Medicine
Type
Schools of Medicine
DUNS #
City
Madison
State
WI
Country
United States
Zip Code
53715
Barrett, Bruce; Muller, Daniel; Hayer, Supriya et al. (2018) Feeling Loved: A Novel Brief Self-Report Health Measure. Explore (NY) :
Meyer, Jacob D; Torres, Elisa R; Grabow, Maggie L et al. (2018) Benefits of 8-wk Mindfulness-based Stress Reduction or Aerobic Training on Seasonal Declines in Physical Activity. Med Sci Sports Exerc 50:1850-1858
Xie, Yaoguo; Zhang, Zhengjun; Rathouz, Paul J et al. (2018) Multivariate semi-continuous proportionally constrained two-part fixed effects models and applications. Stat Methods Med Res :962280218807730
Barrett, Bruce; Hayney, Mary S; Muller, Daniel et al. (2018) Meditation or exercise for preventing acute respiratory infection (MEPARI-2): A randomized controlled trial. PLoS One 13:e0197778
Goldstein, Ellen; Topitzes, James; Brown, Roger L et al. (2018) Mediational pathways of meditation and exercise on mental health and perceived stress: A randomized controlled trial. J Health Psychol :1359105318772608
Hayney, Mary S; Henriquez, Kelsey M; Barnet, Jodi H et al. (2017) Serum IFN-?-induced protein 10 (IP-10) as a biomarker for severity of acute respiratory infection in healthy adults. J Clin Virol 90:32-37
Henriquez, Kelsey M; Hayney, Mary S; Rakel, David P et al. (2016) Procalcitonin Levels in Acute Respiratory Infection. Viral Immunol 29:128-31
Henriquez, Kelsey M; Hayney, Mary S; Xie, Yaoguo et al. (2015) Association of interleukin-8 and neutrophils with nasal symptom severity during acute respiratory infection. J Med Virol 87:330-7
Maxwell, Lizzie; Barrett, Bruce; Chase, Joseph et al. (2015) Self-Reported Mental Health Predicts Acute Respiratory Infection. WMJ 114:100-4
Obasi, Chidi N; Barrett, Bruce; Brown, Roger et al. (2014) Detection of viral and bacterial pathogens in acute respiratory infections. J Infect 68:125-30