Understanding components of mind-body exercise for physical activity engagement in metabolic syndrome

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PROJECT SUMMARY This K23 award will support the candidate’s training and development for an independent clinical research career focused on understanding mechanisms of mind-body exercise interventions to optimize them for health behavior promotion in medical populations. BACKGROUND. Rates of physical inactivity are alarmingly high, particularly in patients with cardiometabolic conditions. Mind-body exercise interventions are promising for promoting physical activity because they engage key health behavior change processes. While the multidimensionality of mind-body exercise interventions is a strength, it also poses challenges for understanding how individual therapeutic components engage health behavior change processes. Disentangling the relative contribution of therapeutic components is critical for optimizing mind-body exercise interventions for physical activity promotion. SPECIFIC AIMS. Using metabolic syndrome as a model, the proposed study aims to: (1) refine the content and procedures of a factorial design to dismantle two mind-body exercise components, exercise and mindful attention, via feedback from focus groups with sedentary patients with metabolic syndrome and an interdisciplinary expert panel; (2) evaluate the feasibility and acceptability of the factorial design in a pilot RCT; and (3) explore within-group patterns of change in self-regulation, cardiopulmonary physiology, and physical activity levels across three timepoints. TRAINING. The candidate will receive training in three areas to develop expertise critical to her overall career goals: (1) optimization- focused clinical trial design and implementation; (2) qualitative research and longitudinal data analysis (mediation); and (3) cardiopulmonary physiology research. These training aims will be supported by vast institutional resources, as well as coursework, trainings, research seminars/meetings, and scientific conferences. MENTORSHIP. The candidate will be supported by an expert mentoring team: Gloria Yeh, MD, MPH (primary mentor), Peter Wayne, PhD (co-mentor), Long Ngo, PhD (collaborator), Chung-Kang Peng, PhD (collaborator), Daniel Forman, MD (consultant), Erick Loucks, PhD (consultant), and Karen Kilgore, PhD (consultant). IMPACT. In line with NCCIH priorities, skills acquired through this K23 proposal will promote an independent research career focused on understanding how mind-body exercise interventions promote health and optimizing these interventions to foster health promotion. While initial studies will focus on metabolic syndrome and physical activity engagement, findings from this project will allow the candidate to develop a model to study mind-body exercise for other medical populations known to struggle with initiating and sustaining healthy behaviors. This K23 award will provide preliminary data for a R61/R33 application to examine relative contributions of mind-body exercise components on health behavior change processes and whether changes in these processes lead to downstream improvements in physical activity engagement.