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Perceptions of health care and the use of physical activity and mindfulness to cope with grief in racial/ethnic minority women who have experienced stillbirth: Informing interventions

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Introduction/Purpose: the purpose of this study was to explore the perception of care after stillbirth and the use of physical activity and/or mindful approaches (e.g., yoga) to cope with grief in women of racial/ethnic minority who have experienced stillbirth.

Introduction/Purpose: the purpose of this study was to explore the perception of care after stillbirth and the use of physical activity and/or mindful approaches (e.g., yoga) to cope with grief in women of racial/ethnic minority who have experienced stillbirth.
Methods: This was an exploratory qualitative research study. Participants were African American, Hispanic, Asian, and American Indian women, between the ages of 26 and 38, who have experienced stillbirth within the past 3 years. Participants completed a 20-30 minute phone interview.
Results: Fourteen women participated in the study (M age = 31.02 ± 5.97 years; M time since stillbirth = 1.47 ± 0.94 years). Women’s perceptions about physical activity and mindfulness to cope with grief were coded into the following major themes: perception of health care after stillbirth (satisfaction with the level of care provided), recommendations about inter-conception health care from physician (relating to mental, emotional, and physical health), grief (comfort with communicating with the physician), coping mechanisms, perception of the relationship between physical activity and mood, barriers to participating in physical activity (social and behavioral), pre-pregnancy physical activity, and perception of mindful approach (e.g., yoga) as a coping mechanism.
Conclusion: This was the first study to explore perceptions of health care and the use of physical activity and/or mindful approaches (e.g., yoga) to cope with grief after stillbirth in women of racial/ethnic minority. Findings from this study may help inform health care professionals alter their care practices and introduce physical activity and mindfulness based approaches as coping mechanisms to mothers of stillborn babies.

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2015-05

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Calm Pregnancy: Feasibility of Mindfulness-Based Prenatal Stress Reduction

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The purpose of this study was to determine the feasibility of a mindfulness-based intervention among pregnant women (12-20 weeks’ gestation) using a mobile meditation app, Calm. This study involved 100 participants who were recruited nationally due to the COVID-19 pandemic.

The purpose of this study was to determine the feasibility of a mindfulness-based intervention among pregnant women (12-20 weeks’ gestation) using a mobile meditation app, Calm. This study involved 100 participants who were recruited nationally due to the COVID-19 pandemic. This study was reviewed and approved by the Institutional Review Board of Arizona State University (STUDY STUDY00010467). All participants were provided an informed consent document and provided electronic consent prior to enrollment and participation in this study. This study was a randomized, controlled trial (trial registration: ClinicalTrials.gov NCT04264910). Participants randomized to the intervention group were asked to participate in a minimum of 10 minutes of daily meditation using a mindfulness meditation mobile app (i.e., Calm) for the duration of their pregnancy. Participants randomized to the standard of care control group were given access to the app after they gave birth. Both the intervention and control groups were administered surveys that measured feasibility outcomes, perceived stress, mindfulness, self-compassion, impact from COVID-19, pregnancy-related anxiety, depression, emotional regulation, sleep, and childbirth experience at four time points: baseline (12-20 weeks gestation), midline (24 weeks gestation), postintervention (36 weeks gestation), and follow-up survey (3-5 weeks postpartum). Data is currently being analyzed for publication.

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2021-05

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Feasibility and Preliminary Effects of Using a Mobile App (i.e., Calm) to Decrease Overall Stress in Middle-Aged Men and Women Who Report Elevated Stress

Description

Background: Unmanaged stress is a major contributing factor to the development of disease in both men and women. Middle-aged adults (40-64) have some of the highest stress of all age groups and the use of meditation may provide relief for

Background: Unmanaged stress is a major contributing factor to the development of disease in both men and women. Middle-aged adults (40-64) have some of the highest stress of all age groups and the use of meditation may provide relief for conditions such as stress. A smartphone application (app) may help limit the magnitude of the perceived challenges of meditation. The purpose of this study is to determine the feasibility of a consumer-based meditation app (i.e., Calm) to reduce stress in middle-aged adults who self-report elevated stress. The preliminary effects of Calm on stress and health outcomes related to stress were explored as well as the preliminary effects of Calm on mindfulness and coping behaviors for stress were explored.

Methods: Adults were recruited to a 4-week app-based health and well-being study. Participants were randomized into either a mindfulness meditation (i.e. Calm) group or a health education (POD) control group. Participants were asked to participate at least 10 minutes per day. Assessments were conducted for stress, anxiety, depression, mindfulness, physical activity, eating habits, and coping behaviors at pre- and post-intervention and voluntary phone interviews were held post-intervention. App usage data were collected subjectively through weekly participation logs and through objective app usage data provided by Calm.

Results: Eighty-three participants were enrolled into the study and 60 completed the intervention and were analyzed. Feasibility and demand benchmarks were met with 96% of participants satisfied with the intervention and 93% found it enjoyable, appropriate, and useful. There was a 70% adherence (minutes/week) to the meditation intervention. Recruitment of men into the intervention group was 38.1% and retention of men was 81.3%. Significant changes were not observed in stress, anxiety, depression, or mindfulness, physical activity, eating habits, and coping behaviors.

Conclusion: The findings of this study support the feasibility of a 4-week, mobile app-based mindfulness meditation intervention (i.e. Calm) in middle-aged adults. These finding do not demonstrate preliminary efficacy of Calm to reduce stress, anxiety, and depression or improvement of mindfulness, physical activity, eating habits, or coping behaviors among middle-aged adults who report elevated stress. These results can be applied for improved design of future studies.

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Date Created
2020

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Reducing Polypharmacy with Mobile Apps Among Mental Health Patients

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Polypharmacy among psychiatric patients is a concerning trend. From 2007-2010, 58.2% of women and 41.8% of men reported taking five or more prescription drugs within the last 30 days (CDC, 2014). Negative outcomes include prescription drug abuse, side effects, interactions,

Polypharmacy among psychiatric patients is a concerning trend. From 2007-2010, 58.2% of women and 41.8% of men reported taking five or more prescription drugs within the last 30 days (CDC, 2014). Negative outcomes include prescription drug abuse, side effects, interactions, treatment failure, patient dissatisfaction, and lack of treatment control. The associated practice challenges have led to the following PICOT question. In persons with mental health issues receiving care at an outpatient mental health clinic, does engaging in mindfulness practice versus no mindfulness practice change polypharmacy use over a 3-month period?

The project purpose was to evaluate the effectiveness of Insight Timer mobile mindfulness app at helping patients self-manage distressing symptoms and reduce polypharmacy. Over three weeks, mental health clinic nurse practitioners (NPs) voluntarily recruited patients (n=12) over age 18 using as needed prescriptions (PRNs), and agreed to use Insight Timer mobile mindfulness app for adjunct symptom management. Consenting participants downloaded the mobile app, and completed a brief questionnaire measuring PRN use at the start of app use, and PRN use at their next visit. A Wilcoxon signed-rank test indicated a 10-week mindfulness app trial did not significantly lower total PRN doses compared with pre-app dosing (Z = -.534, p = .593). Paired t-tests revealed no significant change in pre (M = 65.17, SD = 28.64) versus post (M = 67.75, SD = 20.22) OQ45 life functionality results (t(11) = -.420, p = .683) (d = .121) as a result of app use.

Clinically relevant results illustrated 83.33% of participants taking greater than nine PRN doses over the study period used the app six times or more in place of medication. High PRN users employed the app frequently in place of medication regardless of total PRN doses taken. Practice implications and sustainability recommendations include incorporating mobile app use in treatment plans for high PRN users and educating NP’s on the tangible benefits of mindfulness apps in reducing polypharmacy and easing symptom distress on an ongoing basis.
Keywords: mindfulness, mhealth, mobile apps, mobile smart phone, online, RCT, behavior change, polypharmacy.

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2019-04-29