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Minding Goals: An Internet-Assisted Mind-Body Behavior Program for Blood Pressure Control

思维目标：用于血压控制的互联网辅助身心行为计划

基本信息

批准号：
9268038
负责人：
KATHLEEN M MCTIGUE
金额：
$ 7.32万
依托单位：
UNIVERSITY OF PITTSBURGH AT PITTSBURGH
依托单位国家：
美国
项目类别：
财政年份：
2015
资助国家：
美国
起止时间：
2015-05-15 至 2018-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9268038
关键词：
21 year old Adult Affect Attention Awareness Behavior Behavior Therapy Behavioral Blood Pressure Body Weight decreased Caring Charge Chronic Disease Clinical Clinical Trials Counseling Data Diet Eating Education Educational Intervention Educational process of instructing Effectiveness Eligibility Determination Enrollment Ensure Feedback Future Goals Health Health Promotion Hypertension Internet Intervention Joints Life Style Measurement Medicine Meditation Mental Health Methods Mind Mind-Body Intervention Mind-Body Method Modeling Nature Office Visits Online Systems Outcome Outcome Assessment Participant Patient Care Patient Education Patient Noncompliance Patient-Centered Care Patients Pharmaceutical Preparations Physical activity Population Preparation Primary Care Physician Primary Health Care Protocols documentation Provider Randomized Randomized Controlled Trials Recommendation Recruitment Activity Risk Factors Self Management Side Sodium-Restricted Diet Son Stress Testing Time Training Update Weight Weight maintenance regimen arm base blood pressure reduction blood pressure regulation body-mind cardiovascular risk factor compliance behavior design diet and exercise evidence base health information technology healthy lifestyle improved innovation interest medication compliance mindfulness mindfulness meditation mindfulness-based stress reduction patient oriented physical conditioning programs public health relevance stress management support tools tool trial comparing virtual

项目摘要

DESCRIPTION (provided by applicant): Efficacious hypertension therapies are well-documented, yet 40% of treated patients do not meet the blood pressure goals set by the Joint National Committee. This gap between scientific evidence and clinical outcomes in part reflects low patient adherence to lifestyle recommendations (e.g., physical activity, weight and diet), as well as medication non-adherence. Accordingly, growing attention is focused on the need to provide patients with effective self-management support tools. In addition to finding ways to help patients adhere to currently prescribed hypertension care, it is useful to consider the range of treatment options that are offered. Evidence- based reviews have identified stress reduction as an effective tool for reducing blood pressure, yet such approaches are typically not implemented in practice. This omission represents a chance to improve the quality of hypertension care by adding stress management self-management tools. Furthermore, since patients have demonstrated a clear interest in mindfulness, the incorporation of a holistic mind-body intervention is an innovative approach to inherently patient-centered care. Increasing data supports the use of mindfulness for treating health concerns. Its holistic nature may be particularly well-suited to developing and maintaining healthy lifestyles, since lifestyle impacts diverse aspects of physical and psychological health. Yet the potential for mindfulness in health self-management has not been realized. Limited but promising data demonstrate the effectiveness of web-based counseling for behavior modification to improve common chronic disease risk factors. It is an ideal solution to provider time constraints and a potential solutionto patient non-adherence to lifestyle recommendations. Health information technology provides a way to make self-management support affordable, convenient and feasible. We have developed a convenient behavioral self-management support platform, "Goal-oriented Online Access to Lifestyle Support" (GOALS) for primary care patients, which has promoted weight loss and improved blood pressure control among primary care patients with weight-related cardiovascular risk factors. To maximize the ability of patients to achieve blood pressure goals, we propose to add an online mind-body-behavior program to GOALS: "Minding GOALS." We will evaluate the feasibility of using this program for self-management support in coordination with primary care, in a group of 76 patients with uncontrolled hypertension. In preparation for an RCT comparing the online tool to online traditional self-management support, we will assess implementation and determine 1) the availability of eligible and willing subjects using the proposed recruitment methods, 2) the feasibility of delivering the proposed interventions in the population of interest, and 3) the viability of our proposed measurement protocols. We will modify study protocols as needed, identifying and correcting problems, to strengthen the design of the future RCT and help ensure that it contributes meaningfully to the advancement of patient-centered hypertension self-management support.