Online Mindfulness-based Program for Parents of Children With Autism

Study Overview
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Brief Summary
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The goal of the project is to investigate the effects of online 8-week MBSR intervention on diverse parents to support their children with ASD. The investigators will conduct a randomized waitlist-controlled trial with a sample size 22 parents. This study utilizes psychological, behavioral and psychophysiological measures with parents of children with ASD ages 6-12. The first aim is to determine if parents of children with autism from diverse populations are willing participate in and complete an online MBSR program and if online delivery is as effective as in-person program. The battery of parental-report psychological assessments to measure resilience, parental sleep and stress as well as children's behaviors will be administered before and after the treatment. The second aim is to investigate the effects of a virtual MBSR intervention on cardiovascular and sympathetic nervous activity measured by continuous EDA and EKG. Participants will participate in a validated laboratory stress protocol consisting of mental arithmetic and speech tasks before and after the MBSR intervention.

Detailed Description
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After the participants eligibility are confirmed, their signatures will be obtained on the consent form. Three data collection phases are included in this protocol: baseline, post 3 months and post 6 months. All tests are identical in which phase. Each test includes a survey packet and the lab experiment. The surveys packet includes: the Connor-Davidson Resilience Scale, Mindfulness Attention Awareness Scale, Parenting Stress Index - 4th edition Short Form, Pittsburgh Sleep Quality Index, Adult Sensory Processing Scale, Strength and Difficulties Questionnaire, and WHO Quality of Life-BREF. For the lab experiment, EKG and EDA data will be collected through lab protocol, which include a 5-min baseline recording followed by Trier Social Stress Test (speaking, math test) and then another 5-min rest period. After that, a pre-recorded 15-min mindfulness practice will be played for the participants to practice. After completing the baseline test, participants will be randomly grouped into the MBSR group or the waitlist controlled group. The online MBSR program is a 8-week group-based, intervention, which will be delivered by a UMASS trained MBSR instructor.

Official Title
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Use of a Telehealth Approach to Build Resilience in Parents of Children With Autism Through Mindfulness Practice

Conditions
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Mindfulness, Psychophysiologic Reaction, Behavior, Health

Intervention / Treatment
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* Behavioral: Online Mindfulness Based Stress Reduction


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: have a child aged 6-12 years old that has been diagnosed by a psychiatrist or a psychologist with autism spectrum disorder English speaking parents do not receive any form of psychological or behavioral treatment at the time of referral parents have never participated in a MBSR workshop prior to the enrollment parents do not have previous meditation experience parents do not have a severe mental illness (self-assessed), parents agree to participate in the 8-week MBSR intervention Exclusion Criteria: parents who currently receive psychotherapy or take medications for health issues

Ages Eligible for Study
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Minimum Age: 21 Years
Maximum Age: 64 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: Treatment
Allocation: Randomized
Intervention Model: Sequential Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Online MBSR 1<br>received modified online 8-week group-based MBSR intervention delivered by a UMASS trained MBSR instructor | Behavioral: Online Mindfulness Based Stress Reduction<br>* Based on the UMASS curriculum developed by Dr. Jon Kabat-Zinn, it is an 8-week mindfulness stress reduction program. It is a skill-based psychoeducational program that meets 2 hours for 8 weeks to discuss stress, cognition and health. The weekly intervention includes didactic presentations, class dialogue and inquiry, formal (e.g., body scan, walking meditation) and informal (e.g., awareness of pleasant and unpleasant events, interpersonal communications, etc.) mindfulness practice.<br>* Other names: MBSR;|
| Active Comparator: Waitlist control<br>On a waiting list to receive the identical intervention as the treatment group after the active treatment group completes. | Behavioral: Online Mindfulness Based Stress Reduction<br>* Based on the UMASS curriculum developed by Dr. Jon Kabat-Zinn, it is an 8-week mindfulness stress reduction program. It is a skill-based psychoeducational program that meets 2 hours for 8 weeks to discuss stress, cognition and health. The weekly intervention includes didactic presentations, class dialogue and inquiry, formal (e.g., body scan, walking meditation) and informal (e.g., awareness of pleasant and unpleasant events, interpersonal communications, etc.) mindfulness practice.<br>* Other names: MBSR;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in Connor-Davidson Resilience Scale from baseline to midpoint | This standardized assessment is comprised of 25 items, which measures 7 aspects of resilience including: hardiness, coping, adaptability, self-efficacy, meaningfulness/purpose, optimism, and regulation of emotion and cognition. Each item is rated on a 5-point Likert scale. The total score ranges from zero to 100. Higher score indicate greater resilience. It has been shown to have the sensitivity to detect the treatment effects. | from baseline to midpoint (approximately 3 months from baseline) | 
| Change in Connor-Davidson Resilience Scale from baseline to exit evaluation | This standardized assessment is comprised of 25 items, which measures 7 aspects of resilience including: hardiness, coping, adaptability, self-efficacy, meaningfulness/purpose, optimism, and regulation of emotion and cognition. Each item is rated on a 5-point Likert scale. The total score ranges from zero to 100. Higher score indicate greater resilience. It has been shown to have the sensitivity to detect the treatment effects. | from baseline to exit evaluation (approximately 6 months from baseline) | 
| Change in Connor-Davidson Resilience Scale from midpoint to exit evaluation | This standardized assessment is comprised of 25 items, which measures 7 aspects of resilience including: hardiness, coping, adaptability, self-efficacy, meaningfulness/purpose, optimism, and regulation of emotion and cognition. Each item is rated on a 5-point Likert scale. The total score ranges from zero to 100. Higher score indicate greater resilience. It has been shown to have the sensitivity to detect the treatment effects. | from midpoint to exit evaluation (approximately 3 months from baseline to 6 months from baseline) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Mindfulness Attention Awareness Scale | This 15-item standardized assessment evaluates awareness of or attention to the present moment in daily life. Each item is rated on a 6-point Likert scale. The total score ranges from 15 to 90 and higher scores indicate a greater mindfulness state. Each It has moderate to strong correlations with other measures of mindfulness and has been used with families with children with ASD . | from baseline to midpoint (approximately 3 months from baseline) | 
| Mindfulness Attention Awareness Scale | This 15-item standardized assessment evaluates awareness of or attention to the present moment in daily life. Each item is rated on a 6-point Likert scale. The total score ranges from 15 to 90 and higher scores indicate a greater mindfulness state. Each It has moderate to strong correlations with other measures of mindfulness and has been used with families with children with ASD . | from baseline to exit evaluation (approximately 6 months from baseline) | 
| Mindfulness Attention Awareness Scale | This 15-item standardized assessment evaluates awareness of or attention to the present moment in daily life. Each item is rated on a 6-point Likert scale. The total score ranges from 15 to 90 and higher scores indicate a greater mindfulness state. Each It has moderate to strong correlations with other measures of mindfulness and has been used with families with children with ASD . | from midpoint to exit evaluation (approximately 3 months from baseline to 6 months from baseline) | 
| Parenting Stress Index - 4th edition Short Form | This index has 36 items assessing parenting-related stress that includes a Total Stress scale along with three subscales: Parental Distress, Parent-Child Dysfunctional Interaction and Difficult Child. Each item is rated on the agreement from 1= strongly agree to 5=strongly disagree. The higher scores indicate a greater perceived stress. | from baseline to midpoint (approximately 3 months from baseline) | 
| Parenting Stress Index - 4th edition Short Form | This index has 36 items assessing parenting-related stress that includes a Total Stress scale along with three subscales: Parental Distress, Parent-Child Dysfunctional Interaction and Difficult Child. Each item is rated on the agreement from 1= strongly agree to 5=strongly disagree. The higher scores indicate a greater perceived stress. | from baseline to exit evaluation (approximately 6 months from baseline) | 
| Parenting Stress Index - 4th edition Short Form | This index has 36 items assessing parenting-related stress that includes a Total Stress scale along with three subscales: Parental Distress, Parent-Child Dysfunctional Interaction and Difficult Child. Each item is rated on the agreement from 1= strongly agree to 5=strongly disagree. The higher scores indicate a greater perceived stress. | from midpoint to exit evaluation (approximately 3 months from baseline to 6 months from baseline) | 
| Pittsburgh Sleep Quality Index (Buysse et al., 1989) | This 19-item questionnaire measures sleep quality and quantity based on 7 components: subjective sleep quality, sleep latency, sleep duration, sleep disturbance, use of sleep medication, and daytime dysfunction and global score. The score ranges from 0 to 21 and the higher scores indicate more sleep problems | from baseline to midpoint (approximately 3 months from baseline) | 
| Pittsburgh Sleep Quality Index (Buysse et al., 1989) | This 19-item questionnaire measures sleep quality and quantity based on 7 components: subjective sleep quality, sleep latency, sleep duration, sleep disturbance, use of sleep medication, and daytime dysfunction and global score. The score ranges from 0 to 21 and the higher scores indicate more sleep problems | from baseline to exit evaluation (approximately 6 months from baseline) | 
| Pittsburgh Sleep Quality Index (Buysse et al., 1989) | This 19-item questionnaire measures sleep quality and quantity based on 7 components: subjective sleep quality, sleep latency, sleep duration, sleep disturbance, use of sleep medication, and daytime dysfunction and global score. The score ranges from 0 to 21 and the higher scores indicate more sleep problems | from midpoint to exit evaluation (approximately 3 months from baseline to 6 months from baseline) | 
| World Health Organization Quality of Life- BREF | This 26-item standardized questionnaire assess quality of life. It is composed of 4 domains: physical health, psychological health, social relationships, and environmental. facets. Each item is rated on a 5-point response scale and the scores are transformed linearly to a 0-100 scale. The higher score indicates higher quality of life. | from baseline to midpoint (approximately 3 months from baseline) | 
| World Health Organization Quality of Life- BREF | This 26-item standardized questionnaire assess quality of life. It is composed of 4 domains: physical health, psychological health, social relationships, and environmental. facets. Each item is rated on a 5-point response scale and the scores are transformed linearly to a 0-100 scale. The higher score indicates higher quality of life. | from baseline to exit evaluation (approximately 6 months from baseline) | 
| World Health Organization Quality of Life- BREF | This 26-item standardized questionnaire assess quality of life. It is composed of 4 domains: physical health, psychological health, social relationships, and environmental. facets. Each item is rated on a 5-point response scale and the scores are transformed linearly to a 0-100 scale. The higher score indicates higher quality of life. | from midpoint to exit evaluation (approximately 3 months from baseline to 6 months from baseline) | 
| Electrodermal activity (EDA) | EDA is also known as skin conductance. Two electrodes are attached to the palm to record skin conductance level that measures sweat gland activity with a sampling rate of 1000 Hz through a lab protocol. The unit of EDA is denoted as uS or microsiemens. | from baseline to midpoint (approximately 3 months from baseline) | 
| Electrodermal activity (EDA) | EDA is also known as skin conductance. Two electrodes are attached to the palm to record skin conductance level that measures sweat gland activity with a sampling rate of 1000 Hz through a lab protocol. The unit of EDA is denoted as uS or microsiemens. | from baseline to exit evaluation (approximately 6 months from baseline) | 
| Electrodermal activity (EDA) | EDA is also known as skin conductance. Two electrodes are attached to the palm to record skin conductance level that measures sweat gland activity with a sampling rate of 1000 Hz through a lab protocol. The unit of EDA is denoted as uS or microsiemens. | from midpoint to exit evaluation (approximately 3 months from baseline to 6 months from baseline) | 
| heart rate | continuous data recording of electrocardiogram through a lab protocol. The recording data will be processed to generate analytical data showing average heart rate per 5 minutes. | from baseline to midpoint (approximately 3 months from baseline) | 
| heart rate | continuous data recording of electrocardiogram through a lab protocol. The recording data will be processed to generate analytical data showing average heart rate per 5 minutes. | from baseline to exit evaluation (approximately 6 months from baseline) | 
| heart rate | continuous data recording of electrocardiogram through a lab protocol. The recording data will be processed to generate analytical data showing average heart rate per 5 minutes. | from midpoint to exit evaluation (approximately 3 months from baseline to 6 months from baseline) |