Efficacy of mindfulness and goal setting interventions for increasing resilience and reducing smoking in lower socio-economic groups: randomised controlled trial protocol.
Study Goal
The researchers aimed to test the efficacy of mindfulness-based interventions, delivered online and consolidated with peer support, in promoting smoking cessation and resilience among low SES smokers.
Results Summary
The study compares mindfulness-integrated cognitive behavioral therapy, mindfulness training, and goal-setting interventions, but specific results regarding Mindfulness's effects are not yet provided in the abstract.
Population
Adult smokers in Australia with an average weekly household income less than $457AUD or receiving welfare benefits.
Effective Dosage
Not specified
Duration
6 months of group-based interventions followed by 6 months of peer support.
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
mindfulness-integrated cognitive behavioural therapy | decrease | self-reported 14-day period prevalence of smoking abstinence | adult smokers in Australia with low weekly household income or receiving welfare benefits | - | test the efficacy of | #1 |
mindfulness training | decrease | self-reported 14-day period prevalence of smoking abstinence | adult smokers in Australia with low weekly household income or receiving welfare benefits | - | test the efficacy of | #2 |
setting realistic goals | decrease | self-reported 14-day period prevalence of smoking abstinence | adult smokers in Australia with low weekly household income or receiving welfare benefits | - | test the efficacy of | #3 |
mindfulness-integrated cognitive behavioural therapy | increase | internal resilience | adult smokers in Australia with low weekly household income or receiving welfare benefits | - | test the efficacy of | #4 |
mindfulness training | increase | internal resilience | adult smokers in Australia with low weekly household income or receiving welfare benefits | - | test the efficacy of | #5 |
setting realistic goals | increase | internal resilience | adult smokers in Australia with low weekly household income or receiving welfare benefits | - | test the efficacy of | #6 |
mindfulness-integrated cognitive behavioural therapy | increase | external resilience | adult smokers in Australia with low weekly household income or receiving welfare benefits | - | test the efficacy of | #7 |
mindfulness training | increase | external resilience | adult smokers in Australia with low weekly household income or receiving welfare benefits | - | test the efficacy of | #8 |
setting realistic goals | increase | external resilience | adult smokers in Australia with low weekly household income or receiving welfare benefits | - | test the efficacy of | #9 |
mindfulness-integrated cognitive behavioural therapy | increase | quality adjusted life years | adult smokers in Australia with low weekly household income or receiving welfare benefits | - | test the efficacy of | #10 |
mindfulness training | increase | quality adjusted life years | adult smokers in Australia with low weekly household income or receiving welfare benefits | - | test the efficacy of | #11 |
setting realistic goals | increase | quality adjusted life years | adult smokers in Australia with low weekly household income or receiving welfare benefits | - | test the efficacy of | #12 |
mindfulness-integrated cognitive behavioural therapy | increase | self-efficacy for smoking abstinence | adult smokers in Australia with low weekly household income or receiving welfare benefits | - | test the efficacy of | #13 |
mindfulness training | increase | self-efficacy for smoking abstinence | adult smokers in Australia with low weekly household income or receiving welfare benefits | - | test the efficacy of | #14 |
setting realistic goals | increase | self-efficacy for smoking abstinence | adult smokers in Australia with low weekly household income or receiving welfare benefits | - | test the efficacy of | #15 |
mindfulness-integrated cognitive behavioural therapy | increase | motivation to quit smoking | adult smokers in Australia with low weekly household income or receiving welfare benefits | - | test the efficacy of | #16 |
mindfulness training | increase | motivation to quit smoking | adult smokers in Australia with low weekly household income or receiving welfare benefits | - | test the efficacy of | #17 |
setting realistic goals | increase | motivation to quit smoking | adult smokers in Australia with low weekly household income or receiving welfare benefits | - | test the efficacy of | #18 |
mindfulness-integrated cognitive behavioural therapy | decrease | nicotine dependence | adult smokers in Australia with low weekly household income or receiving welfare benefits | - | test the efficacy of | #19 |
mindfulness training | decrease | nicotine dependence | adult smokers in Australia with low weekly household income or receiving welfare benefits | - | test the efficacy of | #20 |
setting realistic goals | decrease | nicotine dependence | adult smokers in Australia with low weekly household income or receiving welfare benefits | - | test the efficacy of | #21 |
mindfulness-integrated cognitive behavioural therapy | increase | equanimity | adult smokers in Australia with low weekly household income or receiving welfare benefits | - | test the efficacy of | #22 |
mindfulness training | increase | equanimity | adult smokers in Australia with low weekly household income or receiving welfare benefits | - | test the efficacy of | #23 |
setting realistic goals | increase | equanimity | adult smokers in Australia with low weekly household income or receiving welfare benefits | - | test the efficacy of | #24 |
mindfulness-integrated cognitive behavioural therapy | decrease | stress | adult smokers in Australia with low weekly household income or receiving welfare benefits | - | test the efficacy of | #25 |
mindfulness training | decrease | stress | adult smokers in Australia with low weekly household income or receiving welfare benefits | - | test the efficacy of | #26 |
setting realistic goals | decrease | stress | adult smokers in Australia with low weekly household income or receiving welfare benefits | - | test the efficacy of | #27 |
mindfulness-integrated cognitive behavioural therapy | increase | goal assessment/attainment | adult smokers in Australia with low weekly household income or receiving welfare benefits | - | test the efficacy of | #28 |
mindfulness training | increase | goal assessment/attainment | adult smokers in Australia with low weekly household income or receiving welfare benefits | - | test the efficacy of | #29 |
setting realistic goals | increase | goal assessment/attainment | adult smokers in Australia with low weekly household income or receiving welfare benefits | - | test the efficacy of | #30 |
BACKGROUND: Smoking and resulting health problems disproportionately impact low socioeconomic status (SES) individuals. Building resilience presents an approach to 'closing the gap'. Mindfulness-based interventions and setting realistic goals are preferred in low socioeconomic communities. We aim to test if these interventions, delivered online and consolidated with peer support offered via ex-smokers, are successful in promoting smoking cessation and resilience. Our conceptualisation of resilience encompasses the inner capacity/skills and external resources (e.g., social support) which smokers utilise to bounce back from adversity. We include a process evaluation of barriers/facilitators to interventions and cost-effectiveness analysis (from health system perspective). METHODS: We plan a four-arm parallel 12-month RCT with a 6-month follow-up to test the efficacy of three group-based interventions each followed by peer support. Arm 1: mindfulness-integrated cognitive behavioural therapy; Arm 2: mindfulness training; Arm 3: setting realistic goals; Arm 4: active control group directed to quit services. All interventions will be administered online. Participants are adult smokers in Australia (N = 812) who have an average weekly household income less than $457AUD or receive welfare benefits. Group-based interventions will occur over 6 months, followed by 6 months of forum-based peer support. PRIMARY OUTCOME: self-reported 14-day period prevalence of smoking abstinence at 6 months, with remote biochemical verification of saliva cotinine (< 30 ng/mL). Secondary outcomes include: internal resilience (Connor-Davidson Resilience Scale-25); external resilience (ENRICHD social support tool); quality adjusted life years (EQ-5D-5L); self-efficacy for smoking abstinence (Smoking-Abstinence Self-Efficacy Questionnaire); motivation to quit smoking (Biener and Abrams Contemplation Ladder); nicotine dependence (Fagerstrom Test for Nicotine Dependency); equanimity (Equanimity Scale-16); stress (Perceived Stress Scale-10); goal assessment/attainment (Problems and Goals Assessment Scale). DISCUSSION: This study is the first to compare resilience interventions for low SES smokers which have been identified by them as acceptable. Our various repeated measures and process evaluation will facilitate exploration of mechanisms of impact. We intervene within the novel framework of the Psychosocial Model of Resilience, applying a promising paradigm to address a critical and inequitable public health problem. Trial registration Australian New Zealand Clinical Trials Registry ID: ACTRN12621000445875, registered 19 April 2021 ( https://anzctr.org.au/Trial/Registration/TrialReview.aspx?id=381007&isReview=true ). The Universal Trial Number is U1111-1261-8951.