Effectiveness of Mindfulness-Based Stress Reduction in a Self-Selecting and Self-Paying Community Setting

“Self-determination Theory (SDT), a psychological theory on motivation, proposes that persistent high-quality motivation of behavior requires identified personal endorsement of doing the behavior (Ryan and Deci 2000).”

“The randomized DPS efficacy trial had shown statistically significant differences in these outcomes between the intervention and the control group (Tuomilehto et al. 2001).”

“Furthermore, Cohen’s d were calculated according to the formula: (M post – M pre) / ((sd post + sd pre)/2) (Lakens 2013), for our study groups and for the intervention groups in the three reference RCTs.”

“…have further shown effects in terms of functional alterations in brain regions involved in how we respond to negative and/or stressful events (Davidson et al. 2003; Farb et al. 2013), changes in associated somatic measures including immune function (Davidson et al. 2003; Rosenkranz et al.…”

“Long-term stress is an increasing public health problem and is associated with impaired psychological and physical functioning (Chandola et al. 2006; Horri et al. 2010; Kelly and Ismail 2015; Pallesen et al. 2016; Rosengren et al. 2004; Stansfeld et al. 2002).”

“health care practitioner and others were self-referred) reported that perceived stress decreased significantly, self-reported mindfulness, increased significantly (Carmody and Baer 2008).”

“A pragmatic randomized trial is also an appropriate solution for testing effectiveness (Zwarenstein et al. 2008).”

“Furthermore, in a systematic review of studies evaluating MBSR in non-clinical populations, moderate effects in both pre-post analyses (Hedge’s g 0.55) and in between-group analyses (Hedge’s g 0.53) were found (Khoury et al. 2015).”

“A central effect of this Bcortisol resistance^ is the triggering of inflammation (normally downregulated by cortisol), which is a critical early step in a multitude of symptoms and diseases (Cohen et al. 2012).”

“A SCL-5 score >2 has been found to predict the presence of a mental illness, as assessed independently by psychiatrists (Strand et al. 2003).”

“With long-term stress, there is a risk of poor health behavior, which further contributes to reduced health (Ng and Jeffery 2003; Rod et al. 2009; Stults-Kolehmainen and Sinha 2014).”

“Long-term stress is an increasing public health problem and is associated with impaired psychological and physical functioning (Chandola et al. 2006; Horri et al. 2010; Kelly and Ismail 2015; Pallesen et al. 2016; Rosengren et al. 2004; Stansfeld et al. 2002).”

“Stages 1–5 also encompass basic science on mechanisms of change or the validation of mechanisms of change at the different stages (Onken et al. 2014).”

“With long-term stress, there is a risk of poor health behavior, which further contributes to reduced health (Ng and Jeffery 2003; Rod et al. 2009; Stults-Kolehmainen and Sinha 2014).”

“There is general consensus that the RCT is the gold-standard design for efficacy testing (Bonell et al. 2012; Zwarenstein et al. 2008).”

“This change in the signaling power of cortisol also affects glucose metabolism and may lead to overweight and diabetes (Joseph and Golden 2016).”

“…effects in terms of functional alterations in brain regions involved in how we respond to negative and/or stressful events (Davidson et al. 2003; Farb et al. 2013), changes in associated somatic measures including immune function (Davidson et al. 2003; Rosenkranz et al. 2013) and blood pressure…”

“Although we did not track participants’ home practice, this may be an important avenue for future work (Parsons et al. 2017).”

“In the review by de Vibe, we identified two relevant reference RCTs (de Vibe andMoum 2006; Nyklicek and Kuijpers 2008), which included participants with perceived stress, and which had used the Symptom Check List (SCL)-5 (Tambs and Moum 1993) and the Perceived Stress Scale (PSS) (Cohen et al.”

“…we identified two relevant reference RCTs (de Vibe andMoum 2006; Nyklicek and Kuijpers 2008), which included participants with perceived stress, and which had used the Symptom Check List (SCL)-5 (Tambs and Moum 1993) and the Perceived Stress Scale (PSS) (Cohen et al. 1983), as outcome measures.”

“…review (Khoury et al. 2015) published after the review of reviews (Gotink et al. 2015), we identified a relevant reference RCT (Robins et al. 2012) that also included participants with perceived stress and had used Five Facet Mindfulness Questionnaire (FFMQ) (Gu et al. 2016) as an outcome measure.”

“Proponents of SDT also suggest that high-quality motivation, also termed autonomous motivation, can be encouraged by mindfulness (Weinstein and Ryan 2011).”

“In a review (Khoury et al. 2015) published after the review of reviews (Gotink et al. 2015), we identified a relevant reference RCT (Robins et al. 2012) that also included participants with perceived stress and had used Five Facet Mindfulness Questionnaire (FFMQ) (Gu et al. 2016) as an outcome…”

“…in brain regions involved in how we respond to negative and/or stressful events (Davidson et al. 2003; Farb et al. 2013), changes in associated somatic measures including immune function (Davidson et al. 2003; Rosenkranz et al. 2013) and blood pressure (Hughes et al. 2013; Nyklicek et al. 2013).”

“Most studies on the effect of MBSR have been carried out as pilot studies or efficacy trials in research settings, for example with the researcher as the only intervention provider (stages 1 and 2 research) (Dimidjian and Segal 2015).”

“To our knowledge, this study design has only been used in diabetes prevention implementation research (Absetz et al. 2007).”

“Long-term stress is an increasing public health problem and is associated with impaired psychological and physical functioning (Chandola et al. 2006; Horri et al. 2010; Kelly and Ismail 2015; Pallesen et al. 2016; Rosengren et al. 2004; Stansfeld et al. 2002).”

“Long-term stress is an increasing public health problem and is associated with impaired psychological and physical functioning (Chandola et al. 2006; Horri et al. 2010; Kelly and Ismail 2015; Pallesen et al. 2016; Rosengren et al. 2004; Stansfeld et al. 2002).”

“The PSS has been widely used in studies of stress reduction in MBSR (de Vibe et al. 2012; Gotink et al. 2015).”

“With long-term stress, there is a risk of poor health behavior, which further contributes to reduced health (Ng and Jeffery 2003; Rod et al. 2009; Stults-Kolehmainen and Sinha 2014).”

“In the field of diabetes prevention research, an effectiveness study named BThe GOAL Implementation trial^ investigated whether results from RCTs that had shown efficacy, for example results from the randomized BDiabetes Prevention Study^ (DPS) could be replicated in routine health care (Absetz et al. 2007).”

“We pre-defined a cut-point of ≥18 because a recent Danish population-based study has shown that this cut-point is associated with an increased mortality risk compared to a perceived stress level of below 7 (Prior et al. 2016).”

“…in brain regions involved in how we respond to negative and/or stressful events (Davidson et al. 2003; Farb et al. 2013), changes in associated somatic measures including immune function (Davidson et al. 2003; Rosenkranz et al. 2013) and blood pressure (Hughes et al. 2013; Nyklicek et al. 2013).”

“Another study also recruited study participants from a self-paid, community-based MBSR program and showed statistically significant pre-post improvement in mental health, as measured by the Short-Form Health Survey, Mental Component Score (Greeson et al. 2011).”

“…in brain regions involved in how we respond to negative and/or stressful events (Davidson et al. 2003; Farb et al. 2013), changes in associated somatic measures including immune function (Davidson et al. 2003; Rosenkranz et al. 2013) and blood pressure (Hughes et al. 2013; Nyklicek et al. 2013).”

“Long-term stress is an increasing public health problem and is associated with impaired psychological and physical functioning (Chandola et al. 2006; Horri et al. 2010; Kelly and Ismail 2015; Pallesen et al. 2016; Rosengren et al. 2004; Stansfeld et al. 2002).”

“During long-term on-going stress, in contrast, the stress response causes wear and tear on the body, as restitution is put on hold (Mc Ewen and Norton Lasley 2002; Pallesen et al. 2016).”

“The sample selected is typical of the age range and gender breakdown of those who attend courses at this centre.(23) Five teachers participated (1 male, 4 female, median age1⁄4 50), all affiliated with the Danish Center for Mindfulness.”

“Poor questionnaire completion rates have been reported in similar self-paying participant samples [33].”

“Fourth, fi nancial barriers, such as self-paying participation fees, are often not covered by insurance or national healthcare systems [26].”

“Juul et al. (2018), drawing on data from 132 of 227 participants (58.1”

“Although some studies have reported promising outcomes, integration into mainstream healthcare is lacking – not due to lack of efficacy, but rather structural and organizational barriers [24, 25, 28–31].”

“It should also be noted, however, that self-selected participation may favor individuals and groups with socioeconomic advantages, especially if financial incentives are absent (Juul et al., 2018).”

“This non-judgmental acceptance of the present moment helps individuals cope more effectively with stress and manage their emotional states (Arslan, 2018; Juul et al., 2018; Penque, 2019).”