The overarching goal of this grant is to use stages 0 and 1 of the NIH stage model to determine the extent to which various measures of self-regulation are assessing distinct or overlapping mechanisms involved in behavior change, and whether the measures perform similarly across populations, contexts, laboratories and age groups. The products of this project will be a systematic collection of validated and documented assays of specific self-regulation targets, and Mindfulness-Based Intervention (MBI) characteristics that engage those targets. These assays and tools will be shared with the field for incorporation in clinical studies and MBI development. Specifically, an interdisciplinary team of 12 basic science and clinical mindfulness researchers from 4 universities (Harvard, Brown, UMass, Georgetown) will (1) create a set of working groups that represent 3 domains of self-regulation (attention, emotion regulation, self-related processing), and (2) employ 4 sets of concurrent studies in order to complete the following aims:
Aim 1 : Identify putative self-regulation intervention targets by performing a comprehensive compilation and systematic evaluation of SR target performance in the existing (published) literature (Aim 1a) and from datasets belonging to MRC members or their networks (Aim 1b) using MacLeod and Clarke 2015's method of qualitative meta-analysis.
Aim 2 : Identify the conditions that affect (promote or inhibit) self-regulation target engagement, by comparing target performance across variations in assays, samples/conditions, and interventions (i.e. inter- assay validity and inter-laboratory reliability) (Aim 2a) and leveraging 4 sets of existing or ongoing trials that offer variations of targets, samples, health behaviors, and interventions to assess which conditions maximally engage self-regulation targets (Aim 2b) with resulting impacts on health behaviors and medical regimen adherence.
Aim 3 : Pilot-test the most promising self-regulation targets and intervention modifications gained from the first 2 phases by inserting them into two ongoing MBI trials for managing chronic medical conditions with 2 different treatment variations in 2 different settings. The Mindfulness-Based Hypertension Therapy (MBHT) study will assess self-regulation target engagement in a controlled research setting while the MINDFUL-Primary Care (PC) study will assess the same targets in a primary care setting with clinical service providers.
Aim 4 : Test the relationship between target engagement and medical regimen adherence and health behaviors in larger continuations of the MBHT and Mindful-PC studies.
Aim 5 : Bridge the science-to-service gap by disseminating the knowledge gained about high- (and low-) performing targets through collaborative publications, and by providing training to MBI service providers.

Public Health Relevance

Self-regulation, or the ability to intentionally manage cognitive and emotional resources to accomplish goals, is crucial to addressing a wide range of health problems influenced by common behaviors, such as excessive eating, lack of physical activity, addiction, and poor adherence to medical regimens. Mindfulness interventions have initial evidence to influence self-regulation, however it is still poorly understand what specific elements of mindfulness interventions are most effective at influencing self-regulation, and if those changes in self- regulation translate into clinically meaningful health behavior changes, such as improved medial regimen adherence. This study proposes to analyze several existing datasets to answer these questions, as well as test the ability of customized mindfulness interventions to alter self-regulation and medical regimen adherence in four ongoing studies.

Agency
National Institute of Health (NIH)
Institute
National Center for Complementary & Alternative Medicine (NCCAM)
Type
Exploratory/Developmental Cooperative Agreement Phase I (UH2)
Project #
3UH2AT009145-03S1
Application #
9532402
Study Section
Special Emphasis Panel (ZRG1)
Program Officer
Sabri, Merav
Project Start
2015-09-15
Project End
2018-08-31
Budget Start
2017-09-01
Budget End
2018-08-31
Support Year
3
Fiscal Year
2017
Total Cost
Indirect Cost
Name
Brown University
Department
Public Health & Prev Medicine
Type
Schools of Public Health
DUNS #
001785542
City
Providence
State
RI
Country
United States
Zip Code
02912
Khoury, Nayla M; Lutz, Jacqueline; Schuman-Olivier, Zev (2018) Interoception in Psychiatric Disorders: A Review of Randomized, Controlled Trials with Interoception-Based Interventions. Harv Rev Psychiatry 26:250-263
Kang, Yoona; Rahrig, Hadley; Eichel, Kristina et al. (2018) Gender differences in response to a school-based mindfulness training intervention for early adolescents. J Sch Psychol 68:163-176
Britton, Willoughby B; Davis, Jake H; Loucks, Eric B et al. (2018) Dismantling Mindfulness-Based Cognitive Therapy: Creation and validation of 8-week focused attention and open monitoring interventions within a 3-armed randomized controlled trial. Behav Res Ther 101:92-107
Van Dam, Nicholas T; van Vugt, Marieke K; Vago, David R et al. (2018) Mind the Hype: A Critical Evaluation and Prescriptive Agenda for Research on Mindfulness and Meditation. Perspect Psychol Sci 13:36-61
Levoy, Emily; Lazaridou, Asimina; Brewer, Judson et al. (2017) An exploratory study of Mindfulness Based Stress Reduction for emotional eating. Appetite 109:124-130
Loucks, Eric B; Gilman, Stephen E; Britton, Willoughby B et al. (2016) Associations of Mindfulness with Glucose Regulation and Diabetes. Am J Health Behav 40:258-67
Loucks, Eric B; Britton, Willoughby B; Howe, Chanelle J et al. (2016) Associations of Dispositional Mindfulness with Obesity and Central Adiposity: the New England Family Study. Int J Behav Med 23:224-33
Fulwiler, Carl; Siegel, Julia A; Allison, Jeroan et al. (2016) Keeping Weight Off: study protocol of an RCT to investigate brain changes associated with mindfulness-based stress reduction. BMJ Open 6:e012573
Loucks, Eric B; Schuman-Olivier, Zev; Britton, Willoughby B et al. (2015) Mindfulness and Cardiovascular Disease Risk: State of the Evidence, Plausible Mechanisms, and Theoretical Framework. Curr Cardiol Rep 17:112
Van Dam, Nicholas T; Brown, Anna; Mole, Tom B et al. (2015) Development and Validation of the Behavioral Tendencies Questionnaire. PLoS One 10:e0140867

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