A Web-Based Mind-Body Intervention (Mindful Steps) for Promoting Walking in Chronic Cardiopulmonary Disease: Insights From a Qualitative Study

Author: Kristen M Kraemer1,2, Karen Kilgore3, Daniel Litrownik1,4, Brianna Jean-Laurent3, Peter M Wayne4, Caroline R Richardson5, Marilyn L Moy2,6, Gloria Y Yeh1,4
1 Division of General Medicine, Beth Israel Deaconess Medical Center, Boston, MA, United States.
2 Harvard Medical School, Boston, MA, United States.
3 University of Florida, Gainesville, FL, United States.
4 Osher Center for Integrative Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, United States.
5 Warren Alpert Medical School, Brown University, Providence, RI, United States.
6 Veterans Administration Boston Healthcare System, Boston, MA, United States.
Conference/Journal: Glob Adv Integr Med Health
Date published: 2023 Dec 2
Other: Volume ID: 12 , Pages: 27536130231212169 , Special Notes: doi: 10.1177/27536130231212169. , Word Count: 329

Given the deleterious effects of physical inactivity in persons with chronic obstructive pulmonary disease (COPD) and/or heart failure (HF), interventions that promote long-term daily physical activity are needed. Mindful Steps, designed to promote walking behaviors in COPD and HF, is a multicomponent intervention that integrates mind-body content with other self-regulatory components. The aim of the current qualitative study was to characterize participants' experiences with Mindful Steps and understand the perceived influence of the intervention on walking and health.

In the context of a pilot randomized controlled feasibility trial comparing the year-long Mindful Steps program to usual care among individuals with COPD and HF, semi-structured qualitative interviews were administered at 6- and 12-months. Interviews were audio recorded and transcribed. The constant comparative method was used to code transcripts, identify categories, and develop interrelated themes.

Nineteen participants (63% female; Mage = 70.2 years, SD = 6.95) who were randomized to the intervention group completed the 6-month interview and 17 completed the 12-month interview. The pedometer with feedback, live group classes, and mind-body videos were described as the most helpful intervention components. Participants learned several strategies that helped their walking (e.g., breathing regulation and awareness, body awareness, mind-body techniques, pacing), described walking as enjoyable, and identified internal reasons for walking (e.g., to feel good). They also reported several physical and mental health benefits of the intervention. Some participants reported limited influence of the intervention on walking or health. Many participants continued to use the strategies they learned in the first half of the intervention at 12-months.

The mind-body content of Mindful Steps appeared to positively influence walking behaviors. Participants' experiences with the intervention helped to identify areas for future intervention refinement. Future quantitative work is needed to corroborate these qualitative findings and assess the efficacy of the intervention on long-term physical activity engagement.

Trial registration:
This trial is registered in Clinical Trials.gov, ID number NCT01551953.

Keywords: chronic obstructive pulmonary disease; heart failure; mind-body; physical activity; self-regulation.

PMID: 38050584 PMCID: PMC10693791 DOI: 10.1177/27536130231212169