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This randomized waitlist-controlled trial tests the efficacy of the Stress Management and Resiliency Training Relaxation Response Resiliency Program (SMART-3RP), a mind-body intervention, to enhance resilience and flourishing among residents in continuing care retirement communities. The investigators hypothesize that participants in the SMART-3RP group will report greater increases in resilience and flourishing relative to participants in the control group.
This randomized control trial tests the efficacy of the Stress Management and Resiliency Training Relaxation Response Resiliency Program (SMART-3RP) to improve resilience and flourishing among older adults residing in continuing care retirement communities relative to a wait-list control group. At enrollment, participants will be randomly assigned to the intervention group or the control group using computer generated 1:1 blocked randomization stratified by community site. The intervention group will receive the SMART-3RP program immediately upon enrollment; the wait-list control group will be invited to receive the SMART-3RP program after the final survey time point. An estimate of 360 participants will be recruited from up to nine geographically diverse Erickson Senior Living communities.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| SMART-3RP Group Intervention | Experimental | Residents will participate in 9 structured weekly group sessions which incorporates stress management and relaxation training upon enrollment. |
|
| Waitlist Control Group Intervention | Active Comparator | Residents will participate in 9 structured weekly group sessions which incorporates stress management and relaxation training after the final survey time point. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| SMART-3RP Group Intervention | Behavioral | Nine 1.5 hour group sessions focusing on developing:
Participants receive a copy of the SMART-3RP session manual and audio recorded guided meditations for independent relaxation practice. Participants are encouraged to practice eliciting the relaxation response daily throughout the study, using the audio recordings or other mind body techniques. Participants will use a practice log to track their practice. |
| Measure | Description | Time Frame |
|---|---|---|
| Resilience: Current Experiences Scale (CES) | We will investigate longitudinal differences in resilience between study groups (CES score range 0-115), with higher scores indicating greater resilience. | Up to 12 weeks |
| Flourishing: Flourishing Measure (FM) | We will investigate longitudinal differences in flourishing between study groups (FM score range 0-10), with higher scores indicating greater flourishing. | Up to 12 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Psychological distress: Patient Health Questionnaire 4 (PHQ4) | We will investigate longitudinal differences in psychological distress between study groups (PHQ4 score range 0-12), with higher scores indicating greater distress. | Up to 12 weeks |
| Social isolation: Patient-Reported Outcomes Measurement Information System - Social Isolation (PROMIS-SI) |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Lara Traeger, PhD | Massachusetts General Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Massachusetts General Hospital | Boston | Massachusetts | 02114 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 8379800 | Background | McEwen BS, Stellar E. Stress and the individual. Mechanisms leading to disease. Arch Intern Med. 1993 Sep 27;153(18):2093-101. | |
| Background | UN Dept of Economic and Social Affairs, Population Division. Population ageing and development: ten years after Madrid. Population Facts. 2012;No. 2012/4. | ||
| 23352048 |
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| ID | Term |
|---|---|
| D013315 | Stress, Psychological |
| ID | Term |
|---|---|
| D001526 | Behavioral Symptoms |
| D001519 | Behavior |
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|
We will investigate longitudinal differences in social isolation between study groups (PROMIS-SI score range 4-20), with higher scores indicating greater isolation. |
| Up to 12 weeks |
| Physical symptoms: Condensed Memorial Symptom Assessment Scale (CMSAS) | We will investigate longitudinal differences in physical symptom burden between study groups (CMSAS score range 0-48, with higher scores indicating greater symptom burden. | Up to 12 weeks |
| Coping self-efficacy: Measure of Current Status - Part A (MOCS-A) | We will investigate longitudinal differences in coping self-efficacy between study groups (MOCS-A score range 0-52), with higher scores indicating greater self-efficacy. | Up to 12 weeks |
| Community well-being: Community Well Being Survey (CWB) | We will investigate longitudinal differences in community well-being between study groups (CWB range 0-10), with higher scores indicating greater community well-being. | Up to 12 weeks |
| Positive affect: Positive and Negative Affect Schedule - Positive Subscale (PANAS-POS) | We will investigate longitudinal differences in positive affect between study groups (PANAS-POS range 10-50), with higher scores indicating greater positive affect. | Up to 12 weeks |
| Background |
| Park ER, Traeger L, Vranceanu AM, Scult M, Lerner JA, Benson H, Denninger J, Fricchione GL. The development of a patient-centered program based on the relaxation response: the Relaxation Response Resiliency Program (3RP). Psychosomatics. 2013 Mar-Apr;54(2):165-74. doi: 10.1016/j.psym.2012.09.001. Epub 2013 Jan 22. |
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