Creating and Optimizing Mindfulness Measures to Enhance and Normalize Clinical Evaluation (COMMENCE)

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PROJECT SUMMARY/ABSTRACT BACKGROUND: Mindfulness-Based Interventions (MBIs) have a prominent place in public health and clinical research, and are the focus of hundreds of NIH-funded trials. Nevertheless, significant gaps exist in how mindfulness is measured as a construct using currently available self-reported outcomes instruments. Due to the sheer number of available mindfulness measurement tools, each measuring different concepts in different ways, it has become difficult to establish whether MBI participants actually develop mindfulness skills and attitudes, and whether health outcomes can be attributed to gains in mindfulness. Further, it is not possible to compare findings from one mindfulness trial with another using the same measurement metric. The Patient Reported Outcomes Measurement Information System (PROMIS) has established a rigorous and systematic instrument development methodology that draws from qualitative, quantitative and advanced psychometric approaches to create brief, precise, flexible, standardized, and clinically-relevant outcomes tools. Further, PROMIS-related applications such as PROsetta Stone, have enabled psychometric score linking between PROMIS and legacy measures using sophisticated cross-walk analytic techniques. OBJECTIVE: To improve the rigor, relevance, and reproducibility of MBI research results by applying PROMIS and PROsetta Stone instrument development methodologies to the field of mindfulness measurement. STUDY DESIGN: We will accomplish our study through the following three aims and related development and analysis activities: AIM 1. Development of New Mindfulness Item Banks. This will include: 1) a literature review, 2) online survey of mindfulness researchers (n=50); 3) individual interviews (n=20) and focus groups (n=48 participants) with new and experienced meditators; 4) item writing and refinement; 6) translatability review; and 7) cognitive interviews (n=30) with mindfulness instructors and community members. AIM 2. Calibration of New Mindfulness Item Banks and Score Linking with Legacy Measures. This will include: 1) testing new mindfulness item banks in a large online general population sample (n=4200) and online sample of mindfulness teachers and students (n=500); 2) evaluating dimensionality and other Item Response Theory (IRT) assumptions; 3) Conducting IRT analyses; and 4) Creating computerized adaptive tests (CATs) and fixed length short forms; 5) Linking new mindfulness item banks with legacy mindfulness measures and creating scoring cross walk tables (n=3000). AIM 3. Validation of New Mindfulness Short Forms in Ongoing Mindfulness Courses. For Classic Test Theory-based validation outcomes (e.g., construct and criterion-related validity), responsiveness to change, and estimation of minimally important differences, we will administer new mindfulness short forms, legacy measures, and a performance-based experiential mindfulness task at baseline, 8-weeks, and 16 weeks in multiple, on-going 8-week MBI courses programs occurring throughout the United States (n=250). RELEVANCE: Applying PROMIS and PROsetta Stone methods to mindfulness measurement could have a major impact on mindfulness research through increasing measurement precision, standardization, and comparability across and between studies: past, present, and future.