Predictors of Outcomes in MBSR Participants from Teacher Factors

项目摘要 教师技能被广泛认为是正念干预（MBIs）质量的关键，但我们 缺乏关于MBI中哪些教师技能重要的数据。如果没有更好地定义如何衡量教师的技能， 以及哪些技能影响参与者的结果，MBI效应的核心机制仍然是一个“黑匣子”。 定义哪些教师相关因素可以被可行地测量，并显示出预测参与者的结果， 在为MBI研究选择教师和监测干预提供质量方面很重要， 加强研究和临床项目的教师培训。我们的目标是解决MBI中的这一关键差距 通过测试计划的成果措施，教师评级计划和研究程序进行研究， 为大规模R 01研究做准备。在这个R34中，我们计划招募19名MBSR教师， 200名MBSR参与者从教师的班级登记。将在两个核心研究中心进行入组 (UCSF和马萨诸塞大学）和两个社区MBSR项目（在洛杉矶和纽约）。社区网站是 因为我们相信，在我们计划的RO 1中纳入一系列站点将是有价值的。参与者将 在基线（MBSR前）、2个月时完成患者报告结局指标的问卷调查 （完成MBSR）和4个月。我们将致力于实现以下目标。在目标1中，我们将开发一个 正念干预教学评估中评分员培训的标准化方法 标准（MBI：TAC），最近开发的工具，使用专家评分员来评估MBI的六个领域 教师观看两小时教学录像后的技巧。然后我们将测试重要的特征 的MBI：TAC，包括在我们的研究设置评分员间的可靠性。在目标2中，我们将获得利益相关者的投入 参与者结果测量选择，如果需要，改进测量，然后评估可行性， 在我们的n=200研究中计划措施的可接受性和性能，以确保采取适当措施 对于R 01。在目标3中，我们将测试策略，以最大限度地提高MBSR参与者的入学率和保留率。 选择R 01程序的研究;这将包括使用析因试验设计比较两种不同的 在介绍性视频中介绍研究的方法，以及两种参与者报销方法。 这三个目标将为R 01测试可测量的教师因素是否相关奠定基础 更好的参与结果。这一系列计划中的研究有望大大推进我们的 了解如何衡量MBIs中的教师因素，以及这些因素如何与 参与者的成果。如果成功的话，这条研究路线将在MBI研究中打开一个关键的“黑匣子”， 为未来的一系列研究提供具有广泛适用性的工具。

PROJECT SUMMARY Teacher skills are widely regarded as critical to the quality of mindfulness-based interventions (MBIs), but we lack data about which teacher skills matter in MBI. Without better definition of how to measure teacher skills and which skills influence participant outcomes, a central mechanism of MBI effects remains a “black box.” Defining which teacher-related factors can be feasibly measured and shown to predict participant outcomes is important in selection of teachers for MBI research studies and monitoring of intervention delivery quality, and for strengthening teacher training for research and clinical programs. We aim to address this critical gap in MBI research through testing the planned outcome measures, the teacher rating scheme, and study procedures in preparation for a large-scale R01 study. In this R34, we plan to enroll 19 MBSR teachers and approximately 200 MBSR participants enrolled from the teachers' classes. Enrollment will be performed at two core sites (UCSF and UMass) and two community MBSR programs (in Los Angeles and New York). Community sites are included as we believe inclusion of a range of sites will be valuable in our planned RO1. Participants will complete questionnaires with patient reported outcome measures at baseline (before MBSR), 2 months (completion of MBSR) and 4 months. We will address the following aims. In aim 1, we will develop a standardized approach to training raters in use of the Mindfulness-Based Interventions Teaching Assessment Criteria (MBI:TAC), a recently developed instrument that uses expert raters to evaluate six domains of MBI teacher skills after viewing two hours of video recording of teaching. We will then test important characteristics of the MBI:TAC, including inter-rater reliability in our study setting. In aim 2, we will obtain stakeholder input into our participant outcome measure selection, refine measures if needed, and then assess feasibility, acceptability, and performance of the planned measures in our n=200 study to ensure appropriate measures for an R01. In aim 3, we will test strategies to maximize enrollment and retention of MBSR participants in the study to select procedures for a R01; this will include use of a factorial trial design to compare two different approaches to presenting the study in an introductory video, and two participant reimbursement approaches. These three aims will lay the groundwork for an R01 to test whether measurable teacher factors are associated with better participant outcomes. This sequence of planned studies promises to substantially advance our knowledge of how to measure teacher factors in MBIs and how these factors, in turn, are associated with participant outcomes. If successful, this line of research will open up a key “black box” in MBI research and provide tools with broad applicability to a range of future research.