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.
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.
