Examining Performance, Maintenance, and Mental Health Benefits of Mindfulness-based Practices: Applying the Transtheoretical Model (TTM) of Behavior Change Public

Abstract

Mindfulness meditation, especially Mindfulness-Based Stress Reduction (MBSR), has become an increasingly researched means of helping people cope with stress (Kabat-Zinn, 1990). At present, however, it is unclear what influences one's likelihood of maintaining a routine mindfulness practice, and its associated benefits to overall mental health and well-being.

This study used the Transtheoretical Model (TTM) to examine long-term maintenance of mindfulness meditation. A sample of 132 adults with previous MBSR training completed a self-administered, online survey. TTM's constructs of cognitive and behavioral processes of change, decisional balance, and self-efficacy were examined for their influence on maintenance of a regular mindfulness practice. The study also applied TTM to explore how maintenance of mindfulness practice was related to overall mental health and well-being. Differences in the TTM constructs between maintainers versus non-maintainers were assessed via t-tests and multiple logistic regression. The association between readiness to maintain a mindfulness practice and mental health was assessed via a chi-square test.

Consistent with theory, behavioral processes were more important than experiential processes for maintaining mindfulness practice (O'Conner, Carbonari, & DiClemente, 1996; Prochaska, Redding, & Evers, 2008). In a fully controlled model, helping relationships and stimulus control were the only two significant behavioral processes that were positively associated with maintenance. Self-liberation and counter-conditioning were not associated with maintenance, and use of reinforcement management was significantly negatively associated with maintenance. High levels of self-efficacy were also found to increase the odds of maintaining mindfulness practice. Regarding mental health, maintainers were significantly more likely to have flourishing mental health than non-maintainers, who had more frequent moderate or languishing mental health.

This study demonstrated that constructs of the TTM are associated with maintaining a mindfulness meditation practice and that a significant and positive association exists between maintaining mindfulness practice and mental health. Based on these results, constructs of the TTM can aid in facilitating an ongoing mindfulness practice, which can be a means to attaining positive mental health. The results of this study can inspire new and unique ideas for promoting, and increasing, long-term maintenance of mindfulness-based mediation techniques. This can increase overall mental health in our community, as a result.

Table of Contents

Table of Contents

Ch. I: Introduction 1

Research Questions/Hypotheses 3

Ch. II: Review of the Literature 5

Conceptualizing Mental Health Versus Mental Illness 6

Research Evidence for the Use of Mindfulness-Based Practices 8

The Construct of Mindfulness 10

Mindfulness-based Stress Reduction (MBSR) 12

Applying Principles of the Transtheoretical Model (TTM) 13

Ch. III: Methods 18

A. Study Participants 18

Target population 18

Inclusion/Exclusion Criteria 18

Sampling Technique 19

Response Rate 19

B. Procedures 19

Research Design 19

IRB Requirement 21

Recruitment Strategy 21

Recruitment Methods 21

Recruitment Materials 22

Study Procedures for Participants 22

Response Burden 23

Human Subjects Protection 23

Data Collection Procedures 25

Data Safety Monitoring 25

Setting 26

C. Measures 26

General Scope of Topic Areas 26

Sample Demographics 27

Previous Formal MBSR Training 27

Current Mindfulness Meditation Practices 27

Stage of Readiness to Maintain Regular Mindfulness Meditation Practices 29

Processes of Change 30

Other TTM Constructs 32

Overall Mental Health 33

D. Data Analysis Plan 36

Plans for Data Management and Statistical Analysis 36

Research Question 1 36

Research Question 2 36

Research Question 3 37

Rationale for Proposed Number of Subjects 38

Ch. IV: Results 40

A. Study Population Basic Demographics 40

B. Descriptive Statistics for Current Mindfulness Practices of the Sample 41

C. Descriptive Statistics of Key Study Variables of Interest 42

Stage of Readiness to Maintain Regular Mindfulness Meditation Practices 42

Processes of Change and Other TTM Constructs 42

Overall Mental Health 43

D. Results for Research Question 2 43

E. Results for Research Question 3 49

Ch. V: Discussion 50

Findings and Conclusions 50

Strengths and Limitations 54

Implications for Future Research 58

Implications for Intervention 59

References 62

Appendix A 75

Appendix B 76

Appendix C 78

Appendix D 86

Appendix E 87

Appendix F 88

Appendix G 89

About this Master's Thesis

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School	Rollins School of Public Health
Department	Behavioral Sciences and Health Education
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health Health Sciences, Mental Health
Mot-clé	Processes of Change MBSR Transtheoretical Model Mindfulness Mental Health
Committee Chair / Thesis Advisor	Thompson, Nancy J, Emory University
Committee Members	Zesiger, Heather, Emory University
Partnering Agencies	Does not apply (no collaborating organization)

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