Feasibility of a Virtual Mindfulness-Based Intervention Modified with Accessibility Features for College Students with Chronic Health Conditions and Disabilities PDF Download

Author: Lauren Hope Conder
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Languages : en
Pages : 0

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Book Description
There have been few published studies examining mindfulness-based interventions (MBIs) with college students with health conditions and no published studies examining MBIs in college students with disabilities. Additionally, there is a gap in the literature examining the feasibility of virtual MBIs for this population, and there are no studies examining the feasibility of adding accessibility features (e.g., closed captioning, image descriptions, chair yoga) to virtual MBIs. Koru mindfulness is an MBI that has been feasible with recruitment/enrollment, attrition, intervention processes, and acceptability of the intervention and significantly decreased symptoms of depression, anxiety, perceived stress, and sleep problems for emerging adults and college students when implemented in-person (Greeson et al., 2014, Weis et al., 2021). In an RCT of the Koru MBI delivered virtually during the Fall 2020 semester, researchers found that compared to a waitlist control group, Koru increased mindfulness and physical activity, and decreased anxiety, stress, worry, rumination, and other mood difficulties (Mirabito & Verhaeghen, 2022). Virtually administered versions of Kour had no significant differences in depression or sleep difficulties, which differs from the in-person Koru studies (Mirabito & Verhaeghen, 2022; Smit & Stavrulaki, 2021). In this way, more studies examining the feasibility of virtual Koru interventions are needed. The current study modified the Koru mindfulness intervention to include accessibility features for college students with mental and physical conditions/disabilities for virtual implementation of the intervention based on the ORBIT model of behavioral treatment (Powell et al, 2021). Based on the refinement phase of the ORBIT model, the aim of this study was to examine the feasibility of a virtual format of the Koru mindfulness intervention refined for college students with mental and physical disabilities by integrating accessibility features. Specific elements of feasibility examined in this study: recruitment and enrollment, participant adherence to the intervention, attrition, intervention processes, and participant acceptability of the intervention. With regard to recruitment and enrollment, the recruitment duration, group formation was not sufficient to meet the minimum group size of four participants, recruitment methods were not sufficient to reach the target sample size, and there were barriers to recruitment and enrollment that need to be addressed. The findings indicate corrective actions are needed to increase recruitment and enrollment to reach the target sample size needed for a clinical trial, increase adherence to the intervention, more adequately assess attrition in assessment completion, and further modify study protocol and intervention elements based on suggestions provided by participants. There are a variety of corrective actions needed to address these areas. For recruitment and enrollment, corrective actions include increasing recruitment duration, increasing the number of groups offered and varying days/times they are offered and possibly exploring asynchronous options, continuing to involve disability support services to aid in recruitment, recruiting from more than one university, making the eligibility survey shorter and moving some questions from the eligibility survey into the pre-survey, eliminating the confirmation step, and allowing individuals to participate as long as they commit to attending at least three out of four group sessions. Corrective actions for adherence include allowing participants who missed a session to attend a different group that week or attend a makeup session with others who also missed a session could increase connection with others during mindfulness practices. Recommendations related to attrition include increasing flexibility by eliminating the confirmation step and including a gift card for the completion of the pre-survey. Recommendations with regard to intervention processes include reviewing how the Koru app differs from the current study (e.g. no accessibility features, includes practices that are not mentioned in the current study, and does not include some current study features like chair yoga), potentially eliminating the Koru app and using accessible study materials instead, having cameras on at the beginning of each session to ensure privacy and confirm that there are no others in the room with the participant. After these changes are made, randomized controlled trials with larger samples from multiple universities may be implemented to determine efficacy using phase three of the ORBIT model of behavioral treatments (Powell et al., 2021). During future interventions, quantitative measures will be used not only to examine assessment protocols and attrition, but also to look for symptom change over time. Additionally, during future interventions, it is likely that COVID-19 will no longer be considered a pandemic, but rather an endemic. This could influence the feasibility of certain study processes. Because of this continuing to examine qualitative feedback via Koru evaluations and focus groups will be helpful, as well as continuing to examine participant acceptability and feedback on virtual and accessibility features.