scholarly journals The Selah Study Protocol of Three Interventions to Manage Stress among Clergy: A Preference-based Randomized Waitlist-control Trial

Author(s):  
Logan C Tice ◽  
David E. Eagle ◽  
Joshua A. Rash ◽  
Jessie S. Larkins ◽  
Sofia M. Labrecque ◽  
...  

Abstract Introduction: Like many helping professionals in emotional labor occupations, clergy experience high rates of mental and physical comorbidities. Regular stress management practices may reduce stress-related symptoms and morbidity, but more research is needed into what practices can be reliably included in busy lifestyles, and practiced at a high enough level to meaningfully reduce stress symptoms. Methods and analysis: The overall design is a preference-based randomized waitlist-control trial. United Methodist clergy in North Carolina will be eligible to participate. The intervention and waitlist-control groups will be recruited by email. The interventions offered are specifically targeted to clergy preference and include: Mindfulness-Based Stress Reduction, Daily Examen and stress inoculation training. Surveys will be conducted at 0, 12 and 24 weeks with heart rate data collected at 0 and 12 weeks. The primary outcomes for this study are self-reported symptoms of stress and heart rate at week 12 for each intervention compared to waitlist control; the secondary outcome is symptoms of anxiety comparing each intervention vs waitlist control. Ethics and dissemination: Ethical approval was obtained from the Duke University Campus IRB (2019-0238). Results will be made available to researchers, funders, and members of the clergy community.ClinicalTrials.gov trial registration number: NCT04625777.

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Logan C. Tice ◽  
David E. Eagle ◽  
Joshua A. Rash ◽  
Jessie S. Larkins ◽  
Sofia M. Labrecque ◽  
...  

Abstract Introduction Like many helping professionals in emotional labor occupations, clergy experience high rates of mental and physical comorbidities. Regular stress management practices may reduce stress-related symptoms and morbidity, but more research is needed into what practices can be reliably included in busy lifestyles and practiced at a high enough level to meaningfully reduce stress symptoms. Methods and analysis The overall design is a preference-based randomized waitlist control trial. United Methodist clergy in North Carolina will be eligible to participate. The intervention and waitlist control groups will be recruited by email. The interventions offered are specifically targeted to clergy preference and include mindfulness-based stress reduction, Daily Examen, and stress inoculation training. Surveys will be conducted at 0, 12, and 24 weeks with heart rate data collected at 0 and 12 weeks. The primary outcomes for this study are self-reported symptoms of stress and heart rate at week 12 for each intervention compared to waitlist control; the secondary outcome is symptoms of anxiety comparing each intervention vs waitlist control. Ethics and dissemination Ethical approval was obtained from the Duke University Campus IRB (2019-0238). The results will be made available to researchers, funders, and members of the clergy community. Strengths and limitations of this study While evidence-based stress reduction practices such as mindfulness-based stress reduction (MBSR) exist, a wider variety of practices should be tested to appeal to different individuals. Clergy in particular may prefer, and consequently enact, spiritual practices like the Daily Examen, and individuals such as clergy who spend most of their time thinking and feeling may prefer experiential-based practices like stress inoculation training. If efficacious, the Daily Examen and stress inoculation training practices have high feasibility in that they require few minutes per day. This study is limited by the inclusion of Christian clergy of only one denomination. Trial registration ClinicalTrials.gov NCT04625777. November 12, 2020.


BMJ Open ◽  
2018 ◽  
Vol 8 (9) ◽  
pp. e023097 ◽  
Author(s):  
Amy R Mulick ◽  
Victoria Allen ◽  
Hywel C Williams ◽  
Douglas J C Grindlay ◽  
Neil Pearce ◽  
...  

IntroductionAtopic dermatitis is a complex disease with differing clinical presentations. Many attempts have been made to identify uniform subtypes, or phenotypes, of atopic dermatitis in order to identify different aetiologies, improve diagnosis, estimate more accurate clinical prognoses, inform treatment andmanagement or predict treatment efficacy andeffectiveness. However, no consensus yet exists on exactly what defines these phenotypes or how many there are and whether they are genuine or statistical artefacts. This review aims to identify previously reported phenotypes of atopic dermatitis, the features used to define them and any characteristics or clinical outcomes significantly associated with them.Methods and analysisWe will search Ovid Embase, Ovid MEDLINE and Web of Science from inception to the latest available date at the time of the search for studies attempting to classify atopic dermatitis in humans using any cross-sectional or longitudinal epidemiological or interventional design. Primary outcomes are atopic dermatitis phenotypes, features used to define them and characteristics associated with them in subsequent analyses. A secondary outcome is the methodological approach used to derive them. Two reviewers will independently screen titles and abstracts for inclusion, extract data and assess study quality. We will present the results of this review descriptively and with frequencies where possible.Ethics and disseminationEthical approval is not required for this study as it is a systematic review. We will report results from this systematic review in a peer-reviewed journal. The main value of this study will be to inform further research.PROSPERO registration numberCRD42018087500


2021 ◽  
Author(s):  
Rae Jean Proeschold-Bell ◽  
David E. Eagle ◽  
Logan C. Tice ◽  
Jia Yao ◽  
Joshua A. Rash ◽  
...  

Abstract Background The job-demand-control-support model indicates that clergy are at high risk for chronic stress and adverse health outcomes. Methods A non-randomized participant preference design with a control group was used to evaluate the feasibility, acceptability, and range of outcome effect sizes for four potentially stress-reducing interventions: stress inoculation training, mindfulness-based stress reduction (MBSR), the Daily Examen, and Centering Prayer. All United Methodist clergy in North Carolina were eligible and recruited via email to attend their preferred intervention: in-person workshops of one (Daily Examen, Centering Prayer) or two days (stress inoculation training) at retreat centers, or eight weekly online 90-minute sessions (MBSR). Surveys at 0, 3, and 12 weeks assessed symptoms of stress, anxiety, and perceived stress reactivity. Heart rate variability was assessed at baseline and 12 weeks using data from 24h ambulatory heart rate monitoring. A patched-up control group was recruited after recruitment commenced. A subset of participants completed in-depth interviews and reported skill practice using daily text messages. Standardized mean differences with 95% and 75% confidence intervals were calculated for each intervention relative to control to determine the range of effect sizes likely to be observed in a definitive trial. Results 78 clergy participated in an intervention and 7 provided data as a control group. The daily percentage of participants engaging in stress management practices ranged from 47% (MBSR) to 69% (Examen). Every participant interviewed (n=23) reported that learning content was acceptable and they would recommend their intervention to others. Small-to-large effect sizes on measures of stress and anxiety were observed for Daily Examen, stress inoculation, and MBSR relative to control. Little evidence for change in HRV was observed between intervention and control, with the most favorable effects observed for MBSR. Results were mixed for Centering Prayer. Conclusions All four interventions were feasible and acceptable, with the best trends in outcomes for MBSR, although other interventions were promising. Participants welcomed daily text messages reminding them to engage in practice and wore ambulatory heart rate monitoring devices without incident. Three-week survey data did not contribute to study findings. Trial registration: ClinicalTrials.gov trial registration number: NCT04625777, November 12, 2020 (retrospectively registered).


2020 ◽  
pp. 1-9 ◽  
Author(s):  
Matthew J. Hirshberg ◽  
Simon B. Goldberg ◽  
Melissa Rosenkranz ◽  
Richard J. Davidson

Abstract Background Mindfulness meditation has become a common method for reducing stress, stress-related psychopathology and some physical symptoms. As mindfulness programs become ubiquitous, concerns have been raised about their unknown potential for harm. We estimate multiple indices of harm following Mindfulness-Based Stress Reduction (MBSR) on two primary outcomes: global psychological and physical symptoms. In secondary analyses, we estimate multiple indices of harm on anxiety and depressive symptoms, discomfort in interpersonal relations, paranoid ideation and psychoticism. Methods Intent-to-treat analyses with multiple imputations for missing data were used on pre- and post-test data from a large, observational dataset (n = 2155) of community health clinic MBSR classes and from MBSR (n = 156) and waitlist control (n = 118) participants from three randomized controlled trials conducted contemporaneous to community classes in the same city by the same health clinic MBSR teachers. We estimate the change in symptoms, proportion of participants with increased symptoms, proportion of participants reporting greater than a 35% increase in symptoms, and for global psychological symptoms, clinically significant harm. Results We find no evidence that MBSR leads to higher rates of harm relative to waitlist control on any primary or secondary outcome. On many indices of harm across multiple outcomes, community MBSR was significantly preventative of harm. Conclusions Engagement in MBSR is not predictive of increased rates of harm relative to no treatment. Rather, MBSR may be protective against multiple indices of harm. Research characterizing the relatively small proportion of MBSR participants that experience harm remains important.


2020 ◽  
Author(s):  
Matthew James Hirshberg ◽  
Simon Goldberg ◽  
Melissa A. Rosenkranz ◽  
Richard J Davidson

Background: Mindfulness meditation has become a common method for reducing stress, stress-related psychopathology and some physical symptoms. As mindfulness programs become ubiquitous, concerns have been raised about their unknown potential for harm. We estimate multiple indices of harm following Mindfulness-based Stress Reduction (MBSR) on two primary outcomes: global psychological and physical symptoms. In secondary analyses we estimate multiple indices of harm on anxiety and depressive symptoms, discomfort in interpersonal relations, paranoid ideation and psychoticism. Methods: Intent-to-treat analyses with multiple imputation for missing data were used on pre- and post-test data from a large, observational dataset (n = 2155) of community health clinic MBSR classes and from MBSR (n = 156) and waitlist control (n = 118) participants from three randomized controlled trials conducted contemporaneous to community classes in the same city by the same health clinic MBSR teachers. We estimate change in symptoms, proportion of participants with increased symptoms, proportion of participants reporting greater than a 35% increase in symptoms, and for global psychological symptoms, clinically significant harm. Results: We find no evidence that MBSR leads to higher rates of harm relative to waitlist control on any primary or secondary outcome. On many indices of harm across multiple outcomes, community MBSR was significantly preventative of harm.Conclusions: Engagement in MBSR is not predictive of increased rates of harm relative to no treatment. Rather, MBSR may be protective against multiple indices of harm. Research characterizing the relatively small proportion of MBSR participants that experience harm remains important.


2019 ◽  
Vol 11 (8) ◽  
pp. 842-850 ◽  
Author(s):  
Sarah Jackson ◽  
Matthew R. Baity ◽  
Kailyn Bobb ◽  
Diane Swick ◽  
Jeannette Giorgio

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