Participant adherence in web-based mindfulness interventions for chronic pain: a comprehensive review and case study
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Citation
Abstract
OBJECTIVE: Chronic pain is a public health issue that afflicts a substantial number of individuals in society. Web-based interventions can be a great modality as they allow for flexibility. With the rise in web-based mind-body programs, feasibility has been the primary focus and program adherence is largely understudied. There are multiple barriers and facilities to engagement across the socioecological model. This thesis highlights patient adherence protocols and implementation of proposed protocols to improve adherence to web-based programs aimed at attenuating chronic pain. A case study is included to assess barriers and methods of engagement to a web-based mind-body program aimed to attenuate non traumatic upper extremity pain.
METHODS: Databases searched include PubMed, Web of Science, Embase and other sources such as Google Scholar. Articles were chosen that displayed mindfulness interventions including, body scans, mindfulness-based cognitive therapy, guided meditation and guided imagery. Adults aged 18 and older were included in this framework. All interventions spanned the course of at least 2 weeks. Engagement and adherence strategies applied at both facilitator and program levels were examined.
RESULTS: This comprehensive review and the provided case study delve into popular engagement strategies used by web-based mindfulness interventions. The engagement strategy found to have been employed most frequently is the use of reminder messages. Other engagement strategies include website and app feature interaction, homework activities, journaling, group discussions and gamification of educational content. Findings suggested little difference in adherence and the type of engagement strategy employed by the programs.
DISCUSSION: Current research lacks a standardized method of adherence measurement. The variability in length of programs, surveys, exit interviews and participant follow-up periods creates a lack of generalizability of participant outcomes. A standardized framework to measurement and an increase in population variability is needed to accurately assess engagement strategies and their effect on adherence to these holistic treatment programs.
Description
2025