Predictors of Out-of-Class Mindfulness Practice Adherence During and After a Mindfulness-Based Intervention.

OBJECTIVE: Out-of-class mindfulness meditation practice is a health behavior that is considered to be a crucial ingredient in mindfulness-based interventions (MBIs), yet participant adherence to practice recommendations is often inconsistent. Furthermore, MBIs may enhance factors that lead to greater adherence to medical regimens in other contexts. This study examined baseline factors previously found to relate to adherence to medical regimen, MBI-related changes in these baseline factors, and treatment-related factors as predictors of meditation adherence in an 8-week MBI. METHODS: Baseline traits (personality, depressive symptoms, and executive function) were entered into regression models (n = 96) to predict intervention and postintervention out-of-class meditation adherence. Trait changes and treatment-related factors were entered into models to predict postintervention meditation adherence. RESULTS: Baseline conscientiousness (ß = 0.33, p = .002), openness (ß = 0.23, p = .019), and depressive symptoms (ß = 0.19, p = .042) predicted intervention meditation adherence, whereas conscientiousness (ß = 0.21, p = .044) and depressive symptoms (ß = 0.22, p = .020) predicted postintervention meditation adherence. Although all trait variables except for agreeableness changed significantly pre-to-post intervention, these changes did not predict postintervention meditation adherence. Retreat attendance (ß = 0.38, p = .029) and instructor/group-related therapeutic factors collectively predicted postintervention meditation adherence (R2 = 0.21, p = .019). CONCLUSIONS: The identified baseline trait factors could be used to increase adherence in these interventions as a method of increasing their effectiveness. An emphasis on the MBI retreat and social factors during the intervention may be important for participant out-of-class practice postintervention.Trial Registration:ClinicalTrials.govNCT01831362.

Mindfulness and Cardiovascular Disease Risk: State of the Evidence, Plausible Mechanisms, and Theoretical Framework.

The purpose of this review is to provide (1) a synopsis on relations of mindfulness with cardiovascular disease (CVD) and major CVD risk factors, and (2) an initial consensus-based overview of mechanisms and theoretical framework by which mindfulness might influence CVD. Initial evidence, often of limited methodological quality, suggests possible impacts of mindfulness on CVD risk factors including physical activity, smoking, diet, obesity, blood pressure, and diabetes regulation. Plausible mechanisms include (1) improved attention control (e.g., ability to hold attention on experiences related to CVD risk, such as smoking, diet, physical activity, and medication adherence), (2) emotion regulation (e.g., improved stress response, self-efficacy, and skills to manage craving for cigarettes, palatable foods, and sedentary activities), and (3) self-awareness (e.g., self-referential processing and awareness of physical sensations due to CVD risk factors). Understanding mechanisms and theoretical framework should improve etiologic knowledge, providing customized mindfulness intervention targets that could enable greater mindfulness intervention efficacy.