Mindfulness Influences on Self-Regulation: Mental and Physical Health Implications

 描述（由申请人提供）：该补助金的首要目标是使用NIH阶段模型的第0和第1阶段，以确定各种自我调节措施评估行为变化所涉及的不同或重叠机制的程度，以及这些措施在人群，环境，实验室和年龄组中的表现是否相似。该项目的产品将是一个系统的收集验证和记录的具体自我调节目标的测定，和基于正念的干预（MBI）的特点，从事这些目标。这些检测和工具将与临床研究和MBI开发领域共享。具体来说，来自4所大学的12名基础科学和临床正念研究人员组成的跨学科团队（哈佛、布朗大学、马萨诸塞大学、乔治敦大学）将（1）创建一组代表自我监管3个领域的工作组（注意、情绪调节、自我相关处理）;（2）采用4组并行研究，以完成以下目标：使用麦克劳德和Clarke 2015的定性荟萃分析方法，通过对现有（已发表）文献（目标1a）和MRC成员或其网络（目标1b）的数据集中的SR目标性能进行全面汇编和系统评价，确定推定的自我调节干预目标。 目标二：确定影响的条件（促进或抑制）自我调节靶点接合，通过比较测定、样品/条件和干预措施中变化的靶点性能（即试验间有效性和实验室间可靠性）（目标2a），并利用4组现有或正在进行的试验，这些试验提供不同的靶点、样本、健康行为，和干预措施，以评估哪些条件最大限度地参与自我调节目标（目标2b），从而对健康行为和医疗方案的依从性产生影响。 目标3：通过将前2个阶段获得的最有希望的自我调节目标和干预修改插入到两项正在进行的MBI试验中，以在2种不同的环境中使用2种不同的治疗变化来管理慢性疾病。基于正念的高血压治疗（MBHT）研究将在对照研究环境中评估自我调节目标参与，而MINDFUL-初级保健（PC）研究将在初级保健环境中与临床服务提供者评估相同的目标。 目标4：测试 目标参与和医疗方案的依从性和健康行为之间的关系，在更大的MBHT和正念PC研究的延续。 目标5：通过合作出版物传播关于高（和低）绩效目标的知识，并通过向MBI服务提供者提供培训，弥合科学与服务之间的差距。

 DESCRIPTION (provided by applicant): The overarching goal of this grant is to use stages 0 and 1 of the NIH stage model to determine the extent to which various measures of self-regulation are assessing distinct or overlapping mechanisms involved in behavior change, and whether the measures perform similarly across populations, contexts, laboratories and age groups. The products of this project will be a systematic collection of validated and documented assays of specific self-regulation targets, and Mindfulness-Based Intervention (MBI) characteristics that engage those targets. These assays and tools will be shared with the field for incorporation in clinical studies and MBI development. Specifically, an interdisciplinary team of 12 basic science and clinical mindfulness researchers from 4 universities (Harvard, Brown, UMass, Georgetown) will (1) create a set of working groups that represent 3 domains of self-regulation (attention, emotion regulation, self-related processing), and (2) employ 4 sets of concurrent studies in order to complete the following aims: Aim 1: Identify putative self-regulation intervention targets by performing a comprehensive compilation and systematic evaluation of SR target performance in the existing (published) literature (Aim 1a) and from datasets belonging to MRC members or their networks (Aim 1b) using MacLeod and Clarke 2015's method of qualitative meta-analysis. Aim 2: Identify the conditions that affect (promote or inhibit) self-regulation target engagement, by comparing target performance across variations in assays, samples/conditions, and interventions (i.e. inter- assay validity and inter-laboratory reliability) (Aim 2a) and leveraging 4 sets of existing or ongoing trials that offer variations of targets, samples, health behaviors, and interventions to assess which conditions maximally engage self-regulation targets (Aim 2b) with resulting impacts on health behaviors and medical regimen adherence. Aim 3: Pilot-test the most promising self-regulation targets and intervention modifications gained from the first 2 phases by inserting them into two ongoing MBI trials for managing chronic medical conditions with 2 different treatment variations in 2 different settings. The Mindfulness-Based Hypertension Therapy (MBHT) study will assess self-regulation target engagement in a controlled research setting while the MINDFUL-Primary Care (PC) study will assess the same targets in a primary care setting with clinical service providers. Aim 4: Test the relationship between target engagement and medical regimen adherence and health behaviors in larger continuations of the MBHT and Mindful-PC studies. Aim 5: Bridge the science-to-service gap by disseminating the knowledge gained about high- (and low-) performing targets through collaborative publications, and by providing training to MBI service providers.