•  
  •  
 

Abstract

Mindfulness has many potential benefits to physical and mental health but requires many hours of practice to attain the strongest benefits. Mindfulness interventions delivered within the context of primary care settings are often brief, so independent practice beyond the training context is important. Motivational factors are important predictors of sustained practice and different types of motivational factors are associated with different likelihood of sustained practice. The Personal Health Inventory (PHI) is a publicly available personal health planning tool that assesses motivational factors related to self-care behaviors like mindfulness. Our objective was to understand how the PHI can support patient engagement in a mindfulness training delivered in primary care. Three research questions guided the overall approach to (1) identify pre-class motivational factors for mindfulness, (2) explore how motivation relates to class attendance and mindfulness outcomes, and (3) understand mindfulness trainees’ post-class goals, particularly for sustained practice. For the second research question, we specifically hypothesized that factors aligning with motivational theory indicating higher motivation would predict higher class attendance and better mindfulness outcomes. We conducted an exploratory sequential merging mixed-methods secondary analysis of data from a randomized clinical trial of a brief mindfulness training in primary care. Data were collected in parallel, but analyzed sequentially with a primary qualitative matrix analysis first, followed by a targeted retrospective observational between-group pre-post quantitative design using groups identified from the qualitative analysis. PHIs were administered to 28 Veterans with PTSD before and after brief mindfulness classes. Outcome measures were collected via self-report and include the Five Factor Mindfulness Questionnaire (FFMQ-15). Data was collected between January 2019-July 2020. We used matrix analysis as the primary qualitative analysis of open-ended PHI responses and one-way ANOVAs for quantitative analysis of hypotheses. A joint display integrated open-ended and numeric pre-treatment PHI responses and yielded a three-step interpretation approach classifying mindfulness motivation. High motivation was associated with higher post-treatment mindfulness than low-moderate motivation, F(1,26)=3.857, p=0.049, based on a one-way analysis of variance. Motivation did not significantly predict class attendance. Qualitative analysis of post-mindfulness training goals reported on PHIs indicated that most trainees had goals that would benefit from referrals or ongoing treatment (e.g., goals to improve mental health or sleep). Less than half of mindfulness trainees described goals on their post-class PHIs to continue practicing mindfulness. The results of our joint display analysis process provide a concrete way to clinically interpret the PHI to support independent practice and therefore maximum benefits from mindfulness classes. Further, these results suggest that primary care-based mindfulness trainers may consider helping mindfulness trainees identify initial motivation for mindfulness and set post-training practice goals may maximize benefits from primary care mindfulness trainings.

Download

Share

COinS