The HEADS: UP Development Study: Working with Key Stakeholders to Adapt a Mindfulness-Based Stress Reduction Course for People with Anxiety and Depression after Stroke.
Maggie Lawrence, Bridget Davis, Leyla De Amicis, Jo Booth, Sylvia Dickson, Nadine Dougall, Madeleine Grealy, Bhautesh Jani, Margaret Maxwell, Ben Parkinson, Matilde Pieri, Stewart W Mercer
Healthcare January 26, 2023 DOI: 10.3390/healthcare11030355 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Qualitative co-development study Peer reviewed |
|---|---|
| Sample size | 35 |
| Population | Stroke survivors and their family members with symptoms of anxiety and/or depression |
| Topics | Anxiety Depression Meditation |
| Keywords | Adaptation Stroke Mindfulness-based stress reduction Complex intervention Co-development |
| Key findings | Framework analysis of stroke survivors' and family members' views informed adaptations to MBSR delivery, practices, and materials, resulting in a stroke-specific course called HEADS: UP (Helping Ease Anxiety and Depression after Stroke). The authors suggest HEADS: UP may be a feasible, appropriate, and meaningful self-management intervention to help alleviate symptoms of mood disorder. |
Abstract
Background: Following stroke, rates of mood disorder are and remain high at five years (anxiety 34.4%; depression 23%). Structured mindfulness-based stress reduction (MBSR) courses are effective in a range of health conditions, but stroke survivors find adherence challenging. We aimed to adapt a standard MBSR course specifically for people affected by stroke.
Methods: We recruited stroke survivors and family members with symptoms of anxiety and/or depression to take part in a co-development study comprising two rounds of MBSR 'taster' sessions, followed by focus groups in which views were sought on the practices sampled. Data were collected in October 2017 and May 2018 and were analysed using framework analysis, informed adaptations to mindfulness materials and delivery.
Results: Twenty-eight stroke survivors and seven family members participated. Nineteen (76%) stroke survivors had anxiety; 15 (60%) had depression. Five (71.4%) family members reported anxiety; n = 4 (57.1%) depression. Thirty participants attended the first round of taster sessions and focus groups; twenty (66%) the second and three (10%) were unable to attend either round. Framework analysis informed adaptations to course delivery, practices, and materials, ultimately resulting in a stroke-specific MBSR course, HEADS: UP (Helping Ease Anxiety and Depression after Stroke).
Conclusions: HEADS: UP may provide a feasible, appropriate, and meaningful self-management intervention to help alleviate symptoms of mood disorder.
Comparable studies
Other qualitative studies on anxiety, most cited first.
Citations in the library
Cited by 2
- Mechanisms of sustained mindfulness practice in stroke survivors: A critical realist secondary analysis of the HEADS: UP intervention. Complementary Therapies in Clinical Practice December 23, 2025
- A Pilot Randomized Controlled Trial Testing the Feasibility and Acceptability of Helping Ease Anxiety and Depression after Stroke (HEADS: UP): An Online Mindfulness-Based Intervention for Stroke Survivors Mindfulness July 1, 2025
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