Smartphone-based mindfulness intervention for reducing stressrelated CVD risk

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SUMMARY: Smartphone-based mindfulness intervention for reducing stress-related CVD risk Chronic psychosocial stress has been shown to be associated with increased risk for cardiovascular disease (CVD), and exaggerated stress-related cardiovascular reactivity (CVR) has also been linked with elevated CVD risk. Most of the evidence in these literatures is based upon correlational data to date. Progress in characterizing and ameliorating these effects requires the development of standardized intervention tools designed to alter stress exposure and reactivity. Mobile health interventions may provide a useful approach to this problem. We have identified two specific daily life measures of psychosocial stress and stress reactivity, measured by ambulatory monitoring, that are associated with markers of subclinical atherosclerosis. We have also developed a smartphone-based mindfulness training program that appears to produce significant reductions in related measures of daily life stress and acute stress-related physiological responding. The current study is designed to examine whether this mobile health intervention is feasible and effective in addressing the stress-related targets we have identified, in a population selected for vulnerability to stress and to CVD. We will examine whether additional practice prompts that are presented during daily life (in the spirit of “Just-in-Time Adaptive Interventions” or JITAIs) increase the magnitude or duration of treatment effects, and we will also explore whether we can develop a model to assist us in identifying the circumstances in which automated prompting may be fruitfully employed as part of this treatment. The goal is to produce a scalable mobile health intervention that can be shown to reduce progression of preclinical CVD as part of a subsequent Phase 2 clinical trial. RELEVANCE: Developing interventions for reducing the effects of psychosocial stress on cardiovascular disease is of critical importance for public health.