Minding GOALS: An Internet-Assisted Mind-Body-Behavior Program for Blood Pressure Control
Condition: Hypertension
MeSH terms: Hypertension
Study type: Interventional

Summary: 
      This pilot study will evaluate the feasibility of adding an online mind-body-behavior program
      to an existing behavioral self-management support platform that has been modified to promote
      achievement of blood pressure goals.
    

Detailed description: 
      Efficacious hypertension therapies are well-documented, yet 40% of treated patients do not
      meet the blood pressure goals set by the Joint National Committee. This gap between
      scientific evidence and clinical outcomes in part reflects low patient adherence to lifestyle
      recommendations (e.g., physical activity, weight and diet), as well as medication
      non-adherence. Accordingly, growing attention is focused on the need to provide patients with
      effective self-management support tools. In addition to finding ways to help patients adhere
      to currently prescribed hypertension care, it is useful to consider the range of treatment
      options that are offered. Evidence-based reviews have identified stress reduction as an
      effective tool for reducing blood pressure, yet such approaches are typically not implemented
      in practice. This omission represents a chance to improve the quality of hypertension care by
      adding stress management self-management tools. Furthermore, since patients have demonstrated
      a clear interest in mindfulness, the incorporation of a holistic mind-body intervention is an
      innovative approach to inherently patient-centered care. Increasing data supports the use of
      mindfulness for treating health concerns. Its holistic nature may be particularly well-suited
      to developing and maintaining healthy lifestyles, since lifestyle impacts diverse aspects of
      physical and psychological health. Yet the potential for mindfulness in health
      self-management has not been realized.

      Limited but promising data demonstrate the effectiveness of web-based counseling for behavior
      modification to improve common chronic disease risk factors. It is an ideal solution to
      provider time constraints and a potential solution to patient non-adherence to lifestyle
      recommendations. Health information technology provides a way to make self-management support
      affordable, convenient and feasible. The investigators have developed a convenient behavioral
      self-management support platform, "Goal-oriented Online Access to Lifestyle Support" (GOALS)
      for primary care patients, which has promoted weight loss and improved blood pressure control
      among primary care patients with weight-related cardiovascular risk factors. To maximize the
      ability of patients to achieve blood pressure goals, the investigators propose to add an
      online mind-body-behavior program to GOALS: "Minding GOALS." The investigators will evaluate
      the feasibility of using this program for self-management support, in coordination with
      primary care, in a group of 76 patients with uncontrolled hypertension. In preparation for a
      randomized clinical trial comparing the online tool to online traditional self-management
      support, the investigators will assess implementation and determine 1) the availability of
      eligible and willing subjects using the proposed recruitment methods, 2) the feasibility of
      delivering the proposed interventions in the population of interest, and 3) the viability of
      the proposed measurement protocols.
    

Intervention name(s): GOALS; Minding GOALS
Intervention type(s): Behavioral; Behavioral
Intervention description(s): 16 weeks of online support to improve blood pressure using traditional behavioral lifestyle approaches and medication adherence support.; 16 weeks of online support to improve blood pressure using traditional behavioral lifestyle approaches and medication adherence support, coupled with a mind-body-behavior program to further enhance improvements in blood pressure.
Other intervention name(s): Stress reduction
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: high blood pressure, systolic, diastolic; complementary therapies, meditation