Background

Mindfulness-based programs hold promise for improving cardiovascular health (e.g. physical activity, diet, blood pressure). However, despite theoretical frameworks proposed, no studies have reported qualitative findings on how study participants themselves believe mindfulness-based programs improved their cardiovascular health. With an emphasis on in-depth, open-ended investigation, qualitative methods are well suited to explore the mechanisms underlying health outcomes. The objective of this qualitative study was to explore the mechanisms through which the mindfulness-based program, Mindfulness-Based Blood Pressure Reduction (MB-BP), may influence cardiovascular health.

Methods

This qualitative study was conducted as part of a Stage 1 single arm trial with one-year follow-up. The MB-BP curriculum was adapted from Mindfulness-Based Stress Reduction to direct participants’ mindfulness skills towards modifiable determinants of blood pressure. Four focus group discussions were conducted (N = 19 participants), and seven additional participants were selected for in-depth interviews. Data analysis was conducted using the standard approach of thematic analysis. Following double-coding of audio-recorded transcripts, four members of the study team engaged in an iterative process of data analysis and interpretation.

Results

Participants identified self-awareness, attention control, and emotion regulation as key mechanisms that led to improvements in cardiovascular health. Within these broader themes, many participants detailed a process beginning with increased self-awareness to sustain attention and regulate emotions. Many also explained that the specific relationship between self-awareness and emotion regulation enabled them to respond more skillfully to stressors. In a secondary sub-theme, participants suggested that higher self-awareness helped them engage in positive health behaviors (e.g. healthier dietary choices).

Conclusion

Qualitative analyses suggest that MB-BP mindfulness practices allowed participants to engage more effectively in self-regulation skills and behaviors lowering cardiovascular disease risk, which supports recent theory. Results are consistent with quantitative mechanistic findings showing emotion regulation, perceived stress, interoceptive awareness, and attention control are influenced by MB-BP.

中文翻译：

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正念与心血管健康：基于正念的血压降低（MB-BP）研究中机制的定性发现。

背景

以正念为基础的计划有望改善心血管健康（例如，体育锻炼，饮食，血压）。然而，尽管提出了理论框架，但尚无研究报道定性研究结果，表明研究参与者自己如何相信以正念为基础的计划可以改善他们的心血管健康。定性方法强调深入，开放性调查，非常适合探索健康结果的潜在机制。这项定性研究的目的是探讨以正念为基础的血压降低（MB-BP）可能影响心血管健康的机制。

方法

这项定性研究是在为期一年的随访的1期单臂试验的一部分中进行的。MB-BP课程改编自基于正念的减压，以指导参与者的正念技能转向可改变的血压决定因素。进行了四次焦点小组讨论（N = 19名参与者），并选择了另外七名参与者进行深入采访。使用主题分析的标准方法进行数据分析。在对录音笔录进行双重编码之后，研究小组的四名成员进行了数据分析和解释的迭代过程。

结果

参与者认为自我意识，注意力控制和情绪调节是导致心血管健康改善的关键机制。在这些更广泛的主题中，许多参与者详细介绍了一个过程，该过程从增强自我意识开始，以保​​持注意力和调节情绪。许多人还解释说，自我意识与情绪调节之间的特定关系使他们能够更熟练地应对压力。在第二个子主题中，参与者建议更高的自我意识有助于他们进行积极的健康行为（例如，更健康的饮食选择）。

结论

定性分析表明，MB-BP正念练习可以使参与者更有效地参与自我调节技能和行为，从而降低心血管疾病的风险，这支持了最新的理论。结果与定量机制结果一致，表明MB-BP影响情绪调节，感知压力，感知觉知觉和注意力控制。