An experimental study to inform adoption of mindfulness-based stress reduction in chronic low back pain.
Salene M W Jones, Karen J Sherman, Zoe Bermet, Lorella G Palazzo, Cara C Lewis
Implementation science communications August 6, 2022 DOI: 10.1186/s43058-022-00335-w (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Randomized online survey experiment (2 × 2 factorial) Peer reviewed |
|---|---|
| Sample size | 452 |
| Population | People with chronic low back pain |
| Topics | Meditation |
| Keywords | Low back pain Mediation |
| Key findings | Different descriptions of mindfulness training did not substantially increase intentions to try mindfulness training or practice at home (11 of 12 comparisons p > 0.05). Self-efficacy/control, norms, attitudes, feasibility, and acceptability were positively associated with adoption intentions, but no indirect effects from the experimental groups were significant. The authors propose that self-efficacy and acceptability may be key mediators and that mindfulness-based stress reduction may need tailoring to individual patients. |
Abstract
Chronic low back pain is a common and sometimes disabling condition, and mindfulness-based stress reduction is recommended as a first line of therapy. This study tested whether different descriptions of mindfulness training altered based on influential intervention characteristics increased adoption intentions. People with chronic low back pain (n = 452) were randomized to review one of four mindfulness training descriptions in an online survey using a 2 × 2 factorial design. The first factor was evidence strength and quality with relative advantage (ER). The second factor was adaptability, trialability, complexity, and design quality and packaging (AD). Each factor had two levels: a description of standardized mindfulness training that described each intervention characteristic and a patient-centered description emphasizing flexibility and patient testimonials. The primary outcomes were intentions to try mindfulness training and practice mindfulness at home. Using structural equation modeling with a bootstrapped distribution, we tested six mediators, three of which are Theory of Planned Behavior predictors of intention-self-efficacy, norms, and attitudes- and the other three are predictors of adoption-feasibility, appropriateness, and acceptability. Overall, the mindfulness training descriptions were not associated with an increase in intentions compared to the classic vignette (11/12 p's > 0.05). Most descriptions were unrelated to mediators except the classic ER with patient-centered AD was associated with higher self-efficacy/control and feasibility (p's ≤ 0.05; standardized effect range: 0.111-0.125). Self-efficacy/control (training standardized coefficient: 0.531, home: 0.686), norms (training: 0.303, home: 0.256), and attitudes (training: 0.316, home: 0.293) were all positively associated with intentions to adopt mindfulness training and home practice. Feasibility (training: 0.185; home: 0.293) and acceptability (training: 0.639; home: 0.554) were positively related to intentions to adopt mindfulness training. Appropriateness was related to intentions to adopt home practice (0.187) but not mindfulness training (0.100). None of the indirect effects from experimental group to intentions was significant (all p's > 0.05). Self-efficacy/control and acceptability may be key mediators for increasing patient adoption of mindfulness. Because experimental manipulation did not substantially change intentions to adopt mindfulness, the presentation and delivery of MBSR may need to be tailored to the individual patient's needs rather than a specific format for chronic low back pain.
Comparable studies
Other randomized controlled trials on meditation, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Alterations in Brain and Immune Function Produced by Mindfulness Meditation Healthy employees in a work environment | 2003 | Randomized controlled trial | n = 41 |
| Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Recovered recurrently depressed patients | 2000 | Randomized controlled trial | n = 145 |
| Open hearts build lives: Positive emotions, induced through loving-kindness meditation, build consequential personal resources. Working adults | 2008 | Randomized controlled trial | n = 139 |
| Short-term meditation training improves attention and self-regulation Undergraduate Chinese students | 2007 | Randomized controlled trial | n = 40 |
| Mindfulness-Based Cognitive Therapy for Depression: Replication and Exploration of Differential Relapse Prevention Effects. Recovered recurrently depressed patients | 2004 | Randomized controlled trial | n = 73 |
Citations in the library
Cited by 3
- Patients with Chronic Pain: Are Mindfulness Traits Protective Against Distress, Anxiety and Depression? Clinical neuropsychiatry October 1, 2023
- Mental Health and Quality of Life in Chronic Kidney Disease Patients with Mild-to-Moderate Depression: A Retrospective Cohort Study of Mindfulness-Based Stress Reduction Therapy. Actas Españolas de Psiquiatría April 1, 2024
- The Effect of Online Mindfulness-Based Stress Reduction Program on Sleep Quality in Mothers of Children with Autism Spectrum Disorder: A Randomized Clinical Trial. Iranian Journal of Nursing and Midwifery Research 2026
Cites 4
- Mindfulness-Based Stress Reduction for Treating Low Back Pain: A Systematic Review and Meta-analysis. Annals of Internal Medicine June 6, 2017
- A Mind-Body Program for Older Adults With Chronic Low Back Pain: A Randomized Clinical Trial. JAMA Internal Medicine March 1, 2016
- The design and methods of the aging successfully with pain study. Contemporary Clinical Trials November 15, 2011
- Effect of Mindfulness-Based Stress Reduction vs Cognitive Behavioral Therapy or Usual Care on Back Pain and Functional Limitations in Adults With Chronic Low Back Pain: A Randomized Clinical Trial. JAMA