Enduring Happiness and Continued Self-Enhancement (ENHANCE) 2.0

Study Overview
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Brief Summary
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The study is designed to compare the efficacy of two programs intended to improve happiness and well-being among healthy, community adults between the ages of 25 and 75 years. Participants will complete either an in-person program (ENHANCE) or a mindfulness-based stress reduction (MBSR) self-help program over 3-months. The ENHANCE program will include 12-weekly sessions based on researched principles of happiness. Alternatively, the MBSR self-help guide will teach ways to replace stress-promoting habits. Participants will be asked to complete a series of measures at three points of the study: at the start of the study, the end of the study, and 3-months following the study.

Detailed Description
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In 2011, the United Nations defined happiness as a fundamental human goal and invited Member States to pursue measures that enhance the happiness of their citizens. The majority of people across the globe agree that happiness is an important goal. In accordance with this global goal to be happy, the psychological literature abounds with interventions to combat problems that may prevent people from being happy-from obesity to depression and physical pain. However, happiness is not simply the absence of problems. Yet, interventions to help people attain and maintain higher levels of happiness are rare. Accordingly, in a previous study, the investigators designed and evaluated the efficacy of a theoretically-grounded, evidence-based randomized controlled trial for enhancing happiness and well-being. In the present study, it is the goal to assess the efficacy of modifications made to the original program, and compare the program to a self-help comparison group. All participants in the study will complete weekly questionnaires, as well as the same battery of online assessments at baseline, the end of the study, and 3-months following the study. The investigators will be examining if changes seen from baseline to the end of the interventions are maintained through a maintenance intervention in both arms for 3 months following the primary intervention. It is expect that participants actively completing the in-person ENHANCE program will report greater increase in their overall levels of happiness/well-being at the end of the 12-week program compared to participants in the MBSR self-help group. It is predicted that there will be a downstream effect on happiness for all participants' mental and physical health, cognitive function, social relationships, and other positive outcomes, but that this effect will be greater for participants in the active in-person ENHANCE group. The insights gained from this research could be used in future intervention research towards promoting health, achievement, citizenship, and better relationships.

Official Title
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Enduring Happiness and Continued Self-Enhancement (ENHANCE) 2.0: A Well-Being Program

Conditions
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Well-being

Intervention / Treatment
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* Behavioral: ENHANCE group
* Behavioral: MBSR group


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: All participants in the study will include males and females between the ages of 25 and 75 years. Participants of all racial and ethnic backgrounds will be eligible to participate. Participants of all religious and spiritual orientations will be eligible to participate. Exclusion Criteria: Participants will be screened for major psychological disorders, such as anxiety and depression using the Patient Health Questionnaire-9 (PHQ-9. Participants who are screened with a major mental illness (such as severe depression as determined by a cut-off score of 15 or greater on the PHQ-9) will be advised that this study is not designed as a treatment for mental illness (including severe depression), and will be given a list of the appropriate mental health services offered in their community (e.g., Kelowna Mental Health and Substance Use Services).

Ages Eligible for Study
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Minimum Age: 25 Years
Maximum Age: 75 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: Other
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: ENHANCE group<br>The ENHANCE group is comprised of 12 weekly session to be completed in-person and delivered by trained group facilitators. | Behavioral: ENHANCE group<br>* The ENHANCE program includes an initial 3-month treatment of 12 weekly sessions (including an introductory session, a final session, and 10 content sessions) followed by a 3-month maintenance phase intervention with bi-weekly sessions. Over the course of the program, participants will learn about 10 evidenced-based principles of happiness and how these principles can be applied effectively in their lives. At the final session, participants will receive feedback outlining the happiness principles and activities that fit them best, and will then be asked to work on creating a plan for integrating those principles into their daily lives.<br>|
| Active Comparator: MBSR group<br>The MBSR group will complete a self-help workbook entitled, A Mindfulness-Based Stress Reduction Workbook over a 12 week period. | Behavioral: MBSR group<br>* The MBSR program is based on the self-help workbook entitled, A Mindfulness-Based Stress Reduction Workbook. This workbook is authored by Drs. Bob Stahl and Elisha Goldstein - who are both certified MBSR trainers. The workbook is written to help everyday people learn how to replace stress-promoting habits with mindfully-based ones to improve overall well-being. The workbook begins by providing a thorough introduction to the basic tenets of mindfulness, and improving well-being through the use of mindfulness-based skills. The workbook outlines, in detail, several skills-based exercises for practicing mindfulness across different aspects of a person's life. The MBSR group will be provided with a recommended weekly schedule for the initial 3-month treatment and a list of additional resources to be completed over the 3-month maintenance phase.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change from Baseline Satisfaction With Life | Satisfaction With Life Scale | Baseline, 3, 6 months | 
| Change from Baseline in Positive Affect | Scale of Positive and Negative Experience: SPANE | Baseline, 3, 6 months | 
| Change from Baseline in Negative Affect | Scale of Positive and Negative Experience: SPANE | Baseline, 3, 6 months | 
| Change from Baseline in Meaning in Life | Meaning in Life Questionnaire | Baseline, 3, 6 months | 
| Change from Baseline in Thriving | Comprehensive Inventory of Thriving | Baseline, 3, 6 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change from Baseline in Physical Activity | Step count captured from Fitbits | Baseline, 3, 6 months | 
| Change from Baseline in Perceived Social Support | The Social Provisions Scale | Baseline, 3, 6 months | 
| Change from Baseline in Relationship Satisfaction | The Revised Dyadic Adjustment Scale | Baseline, 3, 6 months | 
| Change from Baseline to attention, concentration, reaction time, memory, processing speed, executive functioning and decision-making | Automated Neuropsychological Assessment Metrics (ANAM) | Baseline, 3, 6 months | 
| Change from Baseline in Implicit Theories of Well-Being |  | Baseline, 3, 6 months | 
| Change from baseline to Empathy | The Toronto Empathy Questionnaire | Baseline, 3, 6 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Well-being, Comparative Clinical Trial, Positive Psychology Intervention, Mindfulness Based Stress Reduction (MBSR), Group Therapy, Happiness, Bibliotherapy