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Integrating Mindfulness Into the Patient-Centered Medical Home (Phase 3) (MINDFUL-PC-3)

Primary Purpose

Depression, Anxiety Disorders, Stress Related Disorder

Status
Terminated
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Mindfulness Training for Primary Care
Low-Dose Comparator
Sponsored by
Cambridge Health Alliance
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Depression

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Current CHA patient with an enrolled CHA primary care doctor.
  2. CHA patients 18 years of age and older.
  3. Able to tolerate and participate in interviews and engage in all procedures.
  4. Able to give written consent in English OR willing and able to provide consent and complete assessments through a professional language translator when necessary.
  5. Diagnosis eligible to be covered by insurance for group visits (e.g., anxiety disorder, depression, stress disorders including adjustment disorder related to chronic illness, pain, insomnia, etc.).
  6. Must have access to a smartphone that is compatible with the activity tracker application.
  7. Must be willing to use the smartphone application and/or wear a wristband device every day during the study collection periods
  8. Must be able to fill out the study questionnaires daily on a computer or compatible mobile device.
  9. Must be willing to attend the two computer task sessions.

Exclusion Criteria:

  1. Any cognitive impairment that precludes informed consent.
  2. Patients who, in the opinion of the Principal Investigator, pose an imminent risk of suicide or danger to self or others.
  3. Likelihood of potential incarceration such as a conviction or pending charges that may potentially result in imprisonment.
  4. Previous enrollment or randomization of treatment in the present study within the 12 months.
  5. Behaviors that may cause disruption to a mindfulness group.
  6. Patients with symptoms of psychosis, thought disorder, and/or severe mental illness, including schizophrenia, schizoaffective, bipolar disorder, or a current severe episode of major depressive disorder.
  7. Refusal of insurance to cover group psychotherapy treatment may lead to exclusion from participation in groups.
  8. Patients in their third trimester of pregnancy who foresee conflicts that preclude their commitment to completing all activities.
  9. Patients with highly unstable medical problems that put them at a high risk of hospitalization.

Sites / Locations

  • Cambridge Health Alliance

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Other

Arm Label

Mindfulness Training for Primary Care

Low-Dose Comparator

Arm Description

Mindfulness Training for Primary Care (MTPC) is a primary care adaptation that includes core common Mindfulness-Based Intervention (MBI) elements integrated with novel mindfulness-oriented behavior change elements into a format that is adaptable to delivery in primary care health centers.

Comparator arm: Participants receive a 60-minute introduction to mindfulness group plus referral to a list of community mindfulness resources such as private-pay community mindfulness classes, mobile mindfulness applications, books, and online recordings. These participants are added to a 6-month wait-list for a Cambridge Health Alliance mindfulness-based intervention group, but are allowed to receive behavioral, psychiatric, and medical treatments that are consistent with treatment as usual. All participants complete an action planning protocol during Week 7.

Outcomes

Primary Outcome Measures

Difficulty in Emotion Regulation Scale (DERS)
The Difficulties in Emotion Regulation (DERS) Scale is a 36-item self-report scale designed to assess emotional dysregulation using a 5 point Likert scale. The scale assesses 6 aspects of emotional dysregulation: non-acceptance of emotional responses, difficulties engaging in goal directed behavior, impulse control difficulties, lack of emotional awareness, limited access to emotion regulation strategies, and lack of emotional clarity. Subscales are summed and a lower total score represents a better outcome.

Secondary Outcome Measures

Multidimensional Assessment of Interoceptive Awareness (MAIA)
The Multidimensional Assessment of Interoceptive Awareness (MAIA) is a 32-item self-report scale designed to assess multiple aspects of interoception and interoceptive awareness. The 6 point Likert scale (ranging from 0-6) assesses 8 aspects of interoceptive awareness: noticing, not-distracting, not-worrying, attention regulation, emotional awareness, self-regulation, body listening, and trusting. Subscales are averaged, and a higher total score represents a better outcome.
Sustained Attention to Response Task (SART)
Participants complete a computerized test measuring sustained attention and response inhibition. They are asked to press a key in response to rapidly displayed integers (1-9) and withhold a response to a designated "no-go" integer.
Action Plan Initiation Survey (APIS-5)
Patient self-reported Action Plan Initiation is based on two-item in the APIS-5 self-report survey in which patients are asked to list their action plan SMART goal, if they met the goal and how much control they had over meeting the goal. The main outcome is a single-item response determining whether they met or did not meet the goal using a 7-point Likert scale (ranging from 1-7) with scores >=5 representing self-reported initiation of the goal.
Hypothetical Delay Discounting Task (HDDT)
This is a brief delay discounting task performed on a computer that presents a series of 5 discrete choice questions between delayed larger reward and smaller sooner reward in dollars.
Heart Beat Detection Task (HBDT)
This is a behavioral measure of interoceptive awareness. Participants are asked to count their heartbeat during three varying time intervals ranging from 30 to 60 seconds. In parallel, individuals' heart-rate will be measured by Kardia Mobile technology.
Perceived Stress Scale (PSS-14)
The Perceived Stress Scale (PSS-14) (14 items) measures the degree to which situations in life are stressful. Items are designed to evaluate how overloaded, unpredictable, and uncontrollable one finds one's life. Each item is scored on a 5 point Likert scale from 0 (Never) to 4 (Very often).
Five Facet Mindfulness Questionnaire (FFMQ)
The Five Facet Mindfulness Questionnaire (FFMQ) is a 39-item scale that examines five factors that represent aspects of the current empirical conception of mindfulness. These five facets include: "observing, describing, acting with awareness, non-judging of inner experience, and non-reactivity to inner experience." Participants rate their degree of agreement with each of the items on a Likert-type scale ranging from 1 (Never or very rarely true) to 5 (Very often or always true), with higher scores indicating higher experience of mindfulness.
Self-Compassion Scale-Short Form (SCS-SF)
The short-form Self-Compassion Scale (SCS-SF) is an abbreviated 12-item form of the original 26-item Self-Compassion Scale. The scale is scored on a 5 point Likert scale (1 = Almost never; 5 = Almost always), and negative subscale items are reverse scored.
Self-Efficacy for Managing Chronic Disease (SECD-6)
The Self-Efficacy for Managing Chronic Disease Scale (SECD-6) is a 6-item scale that is used to evaluate a participant's ability to self-manage care for a chronic disease. SECD-6 asks participants to rate their confidence in their own ability to do certain activities, on a scale from 1 (not at all confident) to 10 (totally confident).
Patient Reported Outcomes Measurement Information System - Anxiety Short Form (PROMIS-ASF)
The Patient Reported Outcomes Measurement Information System - Anxiety Short Form 8a (PROMIS-ASF) is an 8-item scale used to assess patient-reported health status for anxiety. PROMIS instruments are funded by the National Institutes of Health (NIH) and used to reliably and validly measure patient-reported outcomes for clinical research and practice. Participants are asked to rate their experience of the item in the past seven days on a 5-point scale from 1 (Never) to 5 (Always).
Patient Reported Outcomes Measurement Information System - Depression Short Form (PROMIS-DSF)
The Patient Reported Outcomes Measurement Information System - Depression Short Form 8a (PROMIS-DSF) is an 8-item scale used to assess patient-reported health status for depression. PROMIS instruments are funded by the National Institutes of Health (NIH) and used to reliably and validly measure patient-reported outcomes for clinical research and practice. Participants are asked to rate their experience of the item in the past seven days on a 5-point scale from 1 (Never) to 5 (Always).
Three Factor Eating Questionnaire -Revised 18 (TFEQ-R18) emotional eating subscale
The Three Factor Eating Questionnaire is an 18-item scale measuring eating behavior with 4-point Likert scale (1-4). The questionnaire refers to current dietary practice and measures three different aspects of eating-related behavior: cognitive restraint of eating (CR: 6 items), uncontrolled eating (UE: 9 items) and emotional eating (EE: 3 items). Each score ranges from 0 to 100, with higher score and this study is primarily investigating emotional and uncontrolled eating subscales. indicative of greater level in the eating behavior of interest.
Food, Activity, and Sleep Tracking (FAST) Questionnaire
The Food, Activity, and Sleep Tracking (FAST) is a questionnaire with responsive logic, including up to 45-items. The questionnaire assesses daily sleep behavior, daily activity and exercise, and daily nutritional intake, using validated items from the National Cancer Institute (ASA-24) and National Sleep Foundation Sleep diary. Responses to individual items will be tracked daily and increases in health-promoting activity and decreases in harmful behavior will represent a better outcome.
Mobile Device Accelerometer-Based Activity
Mobile device activity tracking with accelerometry, measuring overall activity, median daily activity count, and minutes of Moderate-to-Vigorous Physical Activity (MVPA)

Full Information

First Posted
July 25, 2018
Last Updated
November 19, 2020
Sponsor
Cambridge Health Alliance
Collaborators
National Center for Complementary and Integrative Health (NCCIH)
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1. Study Identification

Unique Protocol Identification Number
NCT03609450
Brief Title
Integrating Mindfulness Into the Patient-Centered Medical Home (Phase 3)
Acronym
MINDFUL-PC-3
Official Title
Mindfulness Influences on Self-regulation: Mental and Physical Health Implications -- Integrating Mindfulness Into the Patient-Centered Medical Home (Phase 3)
Study Type
Interventional

2. Study Status

Record Verification Date
November 2020
Overall Recruitment Status
Terminated
Why Stopped
COVID-19 Pandemic
Study Start Date
January 30, 2019 (Actual)
Primary Completion Date
April 15, 2020 (Actual)
Study Completion Date
August 1, 2020 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Cambridge Health Alliance
Collaborators
National Center for Complementary and Integrative Health (NCCIH)

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This study compares the effectiveness of an 8-week mindfulness-based intervention (Mindfulness Training for Primary Care[MTPC]) vs. a low-dose mindfulness comparator on self-regulation targets, specifically the primary outcome of emotion regulation. Secondary outcomes include sustained attention/response inhibition and interoceptive awareness. A secondary analysis will investigate the extent to which these self-regulation targets mediate the impact of MTPC group on action plan initiation.
Detailed Description
The current Phase 3 comparative effectiveness randomized controlled trial examines impact of MTPC on specific mechanisms of change such as emotion regulation (primary outcome), interoceptive awareness and sustained attention/response inhibition (secondary outcomes). This study will also investigate the extent to which these self-regulation targets mediate the impact of MTPC group on action plan initiation. Participants randomized to 8-week MTPC are compared with participants randomized to a low-dose mindfulness comparator condition, in which they receive a 1-hour introduction to mindfulness with a referral to community mindfulness resources. Outcome assessments are conducted at baseline and study weeks 8-10. This study builds on the Phase 2 study, which demonstrated that Mindfulness Training for Primary Care enhanced chronic illness self-management action plan initiation among primary care patients receiving care in an urban, community, multi-cultural safety net healthcare system.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Depression, Anxiety Disorders, Stress Related Disorder, Adjustment Disorders, Chronic Illness

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Model Description
Two arms, intervention and low-dose comparator, which are randomly assigned at the same time and are implemented in parallel.
Masking
None (Open Label)
Allocation
Randomized
Enrollment
96 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Mindfulness Training for Primary Care
Arm Type
Active Comparator
Arm Description
Mindfulness Training for Primary Care (MTPC) is a primary care adaptation that includes core common Mindfulness-Based Intervention (MBI) elements integrated with novel mindfulness-oriented behavior change elements into a format that is adaptable to delivery in primary care health centers.
Arm Title
Low-Dose Comparator
Arm Type
Other
Arm Description
Comparator arm: Participants receive a 60-minute introduction to mindfulness group plus referral to a list of community mindfulness resources such as private-pay community mindfulness classes, mobile mindfulness applications, books, and online recordings. These participants are added to a 6-month wait-list for a Cambridge Health Alliance mindfulness-based intervention group, but are allowed to receive behavioral, psychiatric, and medical treatments that are consistent with treatment as usual. All participants complete an action planning protocol during Week 7.
Intervention Type
Behavioral
Intervention Name(s)
Mindfulness Training for Primary Care
Intervention Description
MTPC is a referral-based, insurance-reimbursable 8-week program delivered as group psychotherapy by Patient-Centered Medical Home-integrated behavioral clinicians or as an 8-week primary care group visit delivered by a primary care provider. MTPC groups are 2 hours for 8 weeks with a 7-hour weekend day of silent practice. MTPC emphasizes mindfulness-oriented skills for self-regulation, self-management of chronic illness, and health behavior change. All participants complete an action plan during Week 7. Participants are called every two weeks for the first eight weeks for 5-10 minute engagement calls which focus helping participants cultivate a relationship with study staff, giving participants a place to ask questions, and supporting participants in completing study visits.
Intervention Type
Behavioral
Intervention Name(s)
Low-Dose Comparator
Intervention Description
Participants in the low-dose comparator arm receive a 60-minute introduction to mindfulness. Participants are introduced to the definition(s) of mindfulness, brief mindfulness practices, and discussion. They are also given a list of leading community, online, print, and smartphone mindfulness resources. Participants are called every two weeks for the first eight weeks for 5-10 minute engagement calls which focus helping participants cultivate a relationship with study staff, giving participants a place to ask questions, and supporting participants in completing study visits.
Primary Outcome Measure Information:
Title
Difficulty in Emotion Regulation Scale (DERS)
Description
The Difficulties in Emotion Regulation (DERS) Scale is a 36-item self-report scale designed to assess emotional dysregulation using a 5 point Likert scale. The scale assesses 6 aspects of emotional dysregulation: non-acceptance of emotional responses, difficulties engaging in goal directed behavior, impulse control difficulties, lack of emotional awareness, limited access to emotion regulation strategies, and lack of emotional clarity. Subscales are summed and a lower total score represents a better outcome.
Time Frame
Week 8
Secondary Outcome Measure Information:
Title
Multidimensional Assessment of Interoceptive Awareness (MAIA)
Description
The Multidimensional Assessment of Interoceptive Awareness (MAIA) is a 32-item self-report scale designed to assess multiple aspects of interoception and interoceptive awareness. The 6 point Likert scale (ranging from 0-6) assesses 8 aspects of interoceptive awareness: noticing, not-distracting, not-worrying, attention regulation, emotional awareness, self-regulation, body listening, and trusting. Subscales are averaged, and a higher total score represents a better outcome.
Time Frame
Week 8
Title
Sustained Attention to Response Task (SART)
Description
Participants complete a computerized test measuring sustained attention and response inhibition. They are asked to press a key in response to rapidly displayed integers (1-9) and withhold a response to a designated "no-go" integer.
Time Frame
Week 8
Title
Action Plan Initiation Survey (APIS-5)
Description
Patient self-reported Action Plan Initiation is based on two-item in the APIS-5 self-report survey in which patients are asked to list their action plan SMART goal, if they met the goal and how much control they had over meeting the goal. The main outcome is a single-item response determining whether they met or did not meet the goal using a 7-point Likert scale (ranging from 1-7) with scores >=5 representing self-reported initiation of the goal.
Time Frame
Weeks 8 - 10
Title
Hypothetical Delay Discounting Task (HDDT)
Description
This is a brief delay discounting task performed on a computer that presents a series of 5 discrete choice questions between delayed larger reward and smaller sooner reward in dollars.
Time Frame
Week 8
Title
Heart Beat Detection Task (HBDT)
Description
This is a behavioral measure of interoceptive awareness. Participants are asked to count their heartbeat during three varying time intervals ranging from 30 to 60 seconds. In parallel, individuals' heart-rate will be measured by Kardia Mobile technology.
Time Frame
Week 8
Title
Perceived Stress Scale (PSS-14)
Description
The Perceived Stress Scale (PSS-14) (14 items) measures the degree to which situations in life are stressful. Items are designed to evaluate how overloaded, unpredictable, and uncontrollable one finds one's life. Each item is scored on a 5 point Likert scale from 0 (Never) to 4 (Very often).
Time Frame
Week 8
Title
Five Facet Mindfulness Questionnaire (FFMQ)
Description
The Five Facet Mindfulness Questionnaire (FFMQ) is a 39-item scale that examines five factors that represent aspects of the current empirical conception of mindfulness. These five facets include: "observing, describing, acting with awareness, non-judging of inner experience, and non-reactivity to inner experience." Participants rate their degree of agreement with each of the items on a Likert-type scale ranging from 1 (Never or very rarely true) to 5 (Very often or always true), with higher scores indicating higher experience of mindfulness.
Time Frame
Week 8
Title
Self-Compassion Scale-Short Form (SCS-SF)
Description
The short-form Self-Compassion Scale (SCS-SF) is an abbreviated 12-item form of the original 26-item Self-Compassion Scale. The scale is scored on a 5 point Likert scale (1 = Almost never; 5 = Almost always), and negative subscale items are reverse scored.
Time Frame
Week 8
Title
Self-Efficacy for Managing Chronic Disease (SECD-6)
Description
The Self-Efficacy for Managing Chronic Disease Scale (SECD-6) is a 6-item scale that is used to evaluate a participant's ability to self-manage care for a chronic disease. SECD-6 asks participants to rate their confidence in their own ability to do certain activities, on a scale from 1 (not at all confident) to 10 (totally confident).
Time Frame
Week 8
Title
Patient Reported Outcomes Measurement Information System - Anxiety Short Form (PROMIS-ASF)
Description
The Patient Reported Outcomes Measurement Information System - Anxiety Short Form 8a (PROMIS-ASF) is an 8-item scale used to assess patient-reported health status for anxiety. PROMIS instruments are funded by the National Institutes of Health (NIH) and used to reliably and validly measure patient-reported outcomes for clinical research and practice. Participants are asked to rate their experience of the item in the past seven days on a 5-point scale from 1 (Never) to 5 (Always).
Time Frame
Week 8
Title
Patient Reported Outcomes Measurement Information System - Depression Short Form (PROMIS-DSF)
Description
The Patient Reported Outcomes Measurement Information System - Depression Short Form 8a (PROMIS-DSF) is an 8-item scale used to assess patient-reported health status for depression. PROMIS instruments are funded by the National Institutes of Health (NIH) and used to reliably and validly measure patient-reported outcomes for clinical research and practice. Participants are asked to rate their experience of the item in the past seven days on a 5-point scale from 1 (Never) to 5 (Always).
Time Frame
Week 8
Title
Three Factor Eating Questionnaire -Revised 18 (TFEQ-R18) emotional eating subscale
Description
The Three Factor Eating Questionnaire is an 18-item scale measuring eating behavior with 4-point Likert scale (1-4). The questionnaire refers to current dietary practice and measures three different aspects of eating-related behavior: cognitive restraint of eating (CR: 6 items), uncontrolled eating (UE: 9 items) and emotional eating (EE: 3 items). Each score ranges from 0 to 100, with higher score and this study is primarily investigating emotional and uncontrolled eating subscales. indicative of greater level in the eating behavior of interest.
Time Frame
Week 8
Title
Food, Activity, and Sleep Tracking (FAST) Questionnaire
Description
The Food, Activity, and Sleep Tracking (FAST) is a questionnaire with responsive logic, including up to 45-items. The questionnaire assesses daily sleep behavior, daily activity and exercise, and daily nutritional intake, using validated items from the National Cancer Institute (ASA-24) and National Sleep Foundation Sleep diary. Responses to individual items will be tracked daily and increases in health-promoting activity and decreases in harmful behavior will represent a better outcome.
Time Frame
Weeks 7-8
Title
Mobile Device Accelerometer-Based Activity
Description
Mobile device activity tracking with accelerometry, measuring overall activity, median daily activity count, and minutes of Moderate-to-Vigorous Physical Activity (MVPA)
Time Frame
Weeks 7-8

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Current CHA patient with an enrolled CHA primary care doctor. CHA patients 18 years of age and older. Able to tolerate and participate in interviews and engage in all procedures. Able to give written consent in English OR willing and able to provide consent and complete assessments through a professional language translator when necessary. Diagnosis eligible to be covered by insurance for group visits (e.g., anxiety disorder, depression, stress disorders including adjustment disorder related to chronic illness, pain, insomnia, etc.). Must have access to a smartphone that is compatible with the activity tracker application. Must be willing to use the smartphone application and/or wear a wristband device every day during the study collection periods Must be able to fill out the study questionnaires daily on a computer or compatible mobile device. Must be willing to attend the two computer task sessions. Exclusion Criteria: Any cognitive impairment that precludes informed consent. Patients who, in the opinion of the Principal Investigator, pose an imminent risk of suicide or danger to self or others. Likelihood of potential incarceration such as a conviction or pending charges that may potentially result in imprisonment. Previous enrollment or randomization of treatment in the present study within the 12 months. Behaviors that may cause disruption to a mindfulness group. Patients with symptoms of psychosis, thought disorder, and/or severe mental illness, including schizophrenia, schizoaffective, bipolar disorder, or a current severe episode of major depressive disorder. Refusal of insurance to cover group psychotherapy treatment may lead to exclusion from participation in groups. Patients in their third trimester of pregnancy who foresee conflicts that preclude their commitment to completing all activities. Patients with highly unstable medical problems that put them at a high risk of hospitalization.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Zev Schuman-Olivier, MD
Organizational Affiliation
Cambridge Health Alliance
Official's Role
Principal Investigator
Facility Information:
Facility Name
Cambridge Health Alliance
City
Somerville
State/Province
Massachusetts
ZIP/Postal Code
02143
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
26553897
Citation
Demarzo MM, Montero-Marin J, Cuijpers P, Zabaleta-del-Olmo E, Mahtani KR, Vellinga A, Vicens C, Lopez-del-Hoyo Y, Garcia-Campayo J. The Efficacy of Mindfulness-Based Interventions in Primary Care: A Meta-Analytic Review. Ann Fam Med. 2015 Nov;13(6):573-82. doi: 10.1370/afm.1863.
Results Reference
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PubMed Identifier
26482755
Citation
Loucks EB, Schuman-Olivier Z, Britton WB, Fresco DM, Desbordes G, Brewer JA, Fulwiler C. Mindfulness and Cardiovascular Disease Risk: State of the Evidence, Plausible Mechanisms, and Theoretical Framework. Curr Cardiol Rep. 2015 Dec;17(12):112. doi: 10.1007/s11886-015-0668-7.
Results Reference
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PubMed Identifier
28321194
Citation
Guendelman S, Medeiros S, Rampes H. Mindfulness and Emotion Regulation: Insights from Neurobiological, Psychological, and Clinical Studies. Front Psychol. 2017 Mar 6;8:220. doi: 10.3389/fpsyg.2017.00220. eCollection 2017.
Results Reference
background
PubMed Identifier
22340146
Citation
Farb NA, Anderson AK, Segal ZV. The mindful brain and emotion regulation in mood disorders. Can J Psychiatry. 2012 Feb;57(2):70-7. doi: 10.1177/070674371205700203.
Results Reference
background
PubMed Identifier
26168376
Citation
Holzel BK, Lazar SW, Gard T, Schuman-Olivier Z, Vago DR, Ott U. How Does Mindfulness Meditation Work? Proposing Mechanisms of Action From a Conceptual and Neural Perspective. Perspect Psychol Sci. 2011 Nov;6(6):537-59. doi: 10.1177/1745691611419671.
Results Reference
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PubMed Identifier
25662520
Citation
Mccubbin T, Dimidjian S, Kempe K, Glassey MS, Ross C, Beck A. Mindfulness-based stress reduction in an integrated care delivery system: one-year impacts on patient-centered outcomes and health care utilization. Perm J. 2014 Fall;18(4):4-9. doi: 10.7812/TPP/14-014.
Results Reference
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PubMed Identifier
29725312
Citation
Hallion LS, Steinman SA, Tolin DF, Diefenbach GJ. Psychometric Properties of the Difficulties in Emotion Regulation Scale (DERS) and Its Short Forms in Adults With Emotional Disorders. Front Psychol. 2018 Apr 19;9:539. doi: 10.3389/fpsyg.2018.00539. eCollection 2018.
Results Reference
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Citation
Mehling WE, Price C, Daubenmier JJ, Acree M, Bartmess E, Stewart A. The Multidimensional Assessment of Interoceptive Awareness (MAIA). PLoS One. 2012;7(11):e48230. doi: 10.1371/journal.pone.0048230. Epub 2012 Nov 1.
Results Reference
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PubMed Identifier
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Citation
Jha AP, Morrison AB, Dainer-Best J, Parker S, Rostrup N, Stanley EA. Minds "at attention": mindfulness training curbs attentional lapses in military cohorts. PLoS One. 2015 Feb 11;10(2):e0116889. doi: 10.1371/journal.pone.0116889. eCollection 2015.
Results Reference
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Citation
Gawande R, To MN, Pine E, Griswold T, Creedon TB, Brunel A, Lozada A, Loucks EB, Schuman-Olivier Z. Mindfulness Training Enhances Self-Regulation and Facilitates Health Behavior Change for Primary Care Patients: a Randomized Controlled Trial. J Gen Intern Med. 2019 Feb;34(2):293-302. doi: 10.1007/s11606-018-4739-5. Epub 2018 Dec 3.
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Integrating Mindfulness Into the Patient-Centered Medical Home (Phase 3)

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