Smartphone-based mindfulness intervention for reducing stressrelated CVD risk

摘要： 基于智能手机的正念干预降低压力相关心血管疾病风险 慢性心理社会压力已被证明与心血管疾病风险增加有关 (CVD)，而过度的应激相关心血管反应性(CVR)也与CVD升高有关 风险。这些文献中的大部分证据都是基于迄今为止的相关数据。表征性研究进展 而要改善这些影响，需要开发标准化的干预工具，旨在改变 压力暴露和反应能力。流动卫生干预可能为解决这一问题提供一种有用的方法。我们 已经确定了心理社会压力和压力反应性的两种具体的日常生活衡量标准，由 与亚临床动脉粥样硬化标志物相关的动态监测。我们还开发了 一种基于智能手机的正念训练计划，似乎显著减少了相关的 测量日常生活应激和急性应激相关的生理反应。目前的研究旨在 检查这种流动健康干预在应对应激相关目标方面是否可行和有效 我们已经确定，在一个容易受到压力和心血管疾病影响的人群中。我们将研究是否 在日常生活中提供的其他练习提示(本着“即时适应”的精神 干预措施“或JITAI)增加了治疗效果的大小或持续时间，我们还将探讨 我们可以开发一个模型来帮助我们识别自动提示可能出现的情况 作为这种治疗的一部分，卓有成效地使用。其目标是产生一种可扩展的移动健康干预 作为随后的第二阶段临床试验的一部分，可以显示出可以减少临床前心血管疾病的进展。 相关性： 开发减少心理社会应激对心血管疾病的影响的干预措施至关重要 对公众健康的重要性。

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.