RESUMEN
Background: Comparative analyses of alternative interventions within the same trial enable acceptability and fidelity of each to be investigated more critically. In addition, whereas so far studies have focused on efficacy evaluations, more understanding is needed on motivational factors influencing the uptake of mental health-promoting practices rather than solely their effects. Purpose: This study investigates whether the motivational responses to a mindfulness intervention are different from a relaxation intervention. We compare social cognitions outlined by the reasoned action approach and their roles in practice uptake, self-reported reasons for non-practice, and experienced benefits. Methods: In a cluster-randomized trial (ISRCTN18642659; N = 3134), 12-15-year-old participants were given a 9-week intervention and followed up to 52 weeks. Main statistical analyses included t-tests, mixed ANOVAs, path models, and chi-square tests. Results: Social cognitions in the mindfulness arm were slightly more positive immediately post-intervention, but recipients mostly responded similarly to the two interventions in the longer term. While attitudes, norms, intention, and self-efficacy were relatively high post-intervention, most of them slightly decreased by 26 weeks. Main reasons for non-practice in both arms included not finding the exercises helpful, no felt need, boringness of exercises and forgetting. The most common benefits experienced by practicing respondents were stress management and concentration ability. Better sleep was a more frequently reported benefit in the relaxation arm, but no other major differences emerged. Conclusion: This study offers an example of comparing motivational responses to experimental and active control arm interventions, a potentially helpful approach in improving intervention adherence.
RESUMEN
RATIONALE: Clustering techniques have been used within intervention studies to locate any distinct subgroups among intervention participants. One way in which they have not yet been utilized, but for which there is potential benefit, is in finding different motivational and behavioral response types to a newly introduced behavior. OBJECTIVE: This study aimed to use latent profile analyses (the same as latent class analyses except with continuous indicator variables) to identify 1) types, or classes, in terms of social cognitive responses to a mindfulness intervention, using The Reasoned Action Approach constructs, and 2) longitudinal/change trajectory classes of the target behavior (i.e., mindfulness practice). METHODS: The data derived from a school-based mindfulness intervention (N = 1646) among 12-15 year-olds, conducted in southern Finland from 2014 to 2016. We explored associations between the identified classes and with gender, linguocultural group, and mental health and practice outcomes. RESULTS: Analyses indicated a solution of five latent classes for both social cognition post-intervention-Uncertain but Positive (40.2%), Acceptable but No (18.8%), Indifferent (16.8), Inclined (15.5%), Disinclined (8.6%)-and practice trajectories-Stable Low (52.1%), Decreased from Seldom (25.8%), Decreased from Sometimes (10.7%), Increased from Zero (6.8%), Increased from Seldom (4.6%). The strongest differentiating theoretical construct among the social cognitive classes was a descriptive norm. The classes were characterized by some associations between each other (e.g., "Acceptable but No" and "Stable Low") and with linguocultural groups (e.g., "Inclined" and small language minorities) and mental health (e.g., "Disinclined" and externalization and depressive symptoms), but no specific associations were found by gender. CONCLUSIONS: This study shows how more person-centered analyses can be utilized in process evaluations, which predominantly only make use of variable-centered analyses. This knowledge could suggest ways to tailor universal interventions for subgroups with different receipt profiles and thereby improve intervention acceptability and engagement.