Effects of Mindfulness Training on Emotional Care Strategies

Study Overview
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Brief Summary
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Teachers in Hong Kong are susceptible to professional stress and its associated psychosomatic illnesses. To enhance teachers' well-being, mindfulness training is conducted in local schools. The present study is a randomized controlled trial to investigate 1) the effects of mindfulness training on teachers' well-being (i.e. general health, positive affect, stress, negative affect); 2) whether decentering strategy (vs. cognitive reappraisal strategy) is nurtured by mindfulness practice; and 3) whether decentering instead of cognitive reappraisal is the mediator that explains the impact of mindfulness on well-being. Participants will be randomized to either intervention (8-week .b Foundations course) or waiting-list control condition.

Detailed Description
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All the participants will complete an online survey before (baseline), after (post-intervention), and two-months (follow-up) after the intervention. A subset of participants (N = 30) will complete an electroencephalography (EEG) experiment. Prior to the experiment, participants will complete an online questionnaire writing down eight recent autobiographical situations: four reflecting a neutral experience, two reflecting events that triggered anxiety, and two reflecting events that triggered sadness. After writing about each situation, participants will be asked to identify five keywords that are both unique and tightly linked to each situation. During the experiment, participants will be reminded of the autobiographical situations in the computerized task. Participants will be asked to view the keywords (i.e. control condition); step back and view the keywords like an impartial observer, allowing whatever thoughts or emotions arise to come and go (i.e. decentering condition); and think about the keywords from different perspective to minimize negative emotions (i.e. reappraisal condition). EEG will be recorded while participants complete the task. Participants will receive $200 Hong Kong dollars each time as a remuneration for the time to participate in the experiment.

Official Title
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Effects of Mindfulness Training on Emotional Care Strategies

Conditions
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Mental Health Issue

Intervention / Treatment
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* Behavioral: 8-week mindfulness program


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Aged 18 years old or above Working in local schools or education institutions Willing to participate in mindfulness training voluntarily Exclusion Criteria: Have history of neurological or psychiatric disorder, brain injury, birth complications, or significant sensory impairment Currently under medications that are known to affect the brain (e.g. anti-depressants, epileptica, tranquilizer, sleep medication, psychotropics, ritalin, concerta, etc.) Experiencing severe or unstable mental health condition currently Completed 8-week mindfulness training previously Unwilling to go by random assignment

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Intervention group<br>8-week mindfulness program | Behavioral: 8-week mindfulness program<br>* The .b Foundations course is an 8-week mindfulness program developed by Mindfulness in Schools Project (MiSP) for school teachers and personnel. It includes a taster session and 8 weekly sessions. Each session lasts for 1.5 hours with a specific theme (e.g. Lesson 1 waking up from autopilot). Formal and informal mindfulness practices (e.g. mindful eating, body scan, mindful walking, habit releaser etc.), psychoeducation, cognitive exercises, inquiry, and home practice are involved.<br>|
| No Intervention: Wait-list control<br>Participants in wait-list control group will receive the same intervention, two months after experimental group completed the intervention. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in General Health | General Health Questionnaire (GHQ), 12 items, 5-point Likert scale ranging from 1 (never) to 5 (always) | Baseline, Immediately after intervention, Two-months after intervention | 
| Change in Stress | Perceived Stress Scale (PSS), 10 items, 5-point Likert scale ranging from 1 (never) to 5 (always) | Baseline, Immediately after intervention, Two-months after intervention | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in Positive affect | Positive and Negative Affect Schedule (PANAS), 4 items, 5-point Likert scale ranging from 1 (never) to 5 (always) | Baseline, Immediately after intervention, Two-months after intervention | 
| Change in Negative affect | Positive and Negative Affect Schedule (PANAS), 4 items, 5-point Likert scale ranging from 1 (never) to 5 (always) | Baseline, Immediately after intervention, Two-months after intervention | 
| Change in Decentering | Non Reactivity Subscale of Chinese Five Facet Mindfulness Questionnaire (FFMQ-C), 4 items, 5-point Likert scale ranging from 1 (never) to 5 (always) | Baseline, Immediately after intervention, Two-months after intervention | 
| Change in Reappraisal | Reappraisal subscale of Emotion Regulation Questionnaire (ERQ), 6 items, 5-point Likert scale ranging from 1 (never) to 5 (always) | Baseline, Immediately after intervention, Two-months after intervention | 
| Change in Mindfulness | Cognitive and Affective Mindfulness Scale-Revised (CAMS-R), 12 items, 5-point Likert scale ranging from 1 (never) to 5 (always) | Baseline, Immediately after intervention, Two-months after intervention | 
| Change in Late positive potential (LPP) | A measure of emotional reactivity in EEG experiment; the amplitude of event-related potential (ERP) time-locked to the presentation of emotional stimulus (-200ms to 6000ms). | Baseline, Immediately after intervention | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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mindfulness, teacher mental health, emotional care, decentering, cognitive reappraisal, mindfulness-based intervention for teachers