Meditation and Exercise for Prevention of Acute Respiratory Infection
Background: Preliminary evidence suggests that meditation and exercise may work through interacting psychological and physiological pathways to influence the immune system and reduce infectious respiratory disease.
Methods: In this study, women and men aged 50 and older will be randomized to: 1) an 8-week behavioral training program in mindfulness meditation, 2) an intensity, duration and location-matched 8-week exercise training program, or 3) a waiting list control group. Sample size will be N=150 enrolled, with N=50 in each group. The main patient-oriented outcome will be severity-adjusted total days of acute respiratory infection (ARI) illness, as self-reported on the Wisconsin Upper Respiratory Symptom Survey (WURSS-24), a validated questionnaire outcome measure. Nucleic acid based viral identification will verify all symptomatic infections, and the cytokine IL-8 and nasal neutrophil from nasal wash will serve as biomarkers of illness severity. Biomarkers of immune function will include antibody response to influenza immunization (serum IgG, mucosal IgA) and cytokines IFN-? and IL-10 from cultured ex vivo lymphocytes. Questionnaire measures assessing perceived stress, positive and negative emotion, optimism, and anxiety will be analyzed as potential mediators of immunomodulation and illness prevention.
Timeframe / logistics: This will be a 2-year project, with 2 cohorts conducted during a single cold season. The first cohort of N=60 will be randomized and begin interventions in September 2009. The second cohort of N=90 will be randomized and begin interventions in January 2010. Tri-valent influenza vaccination will occur on week 6 of behavioral interventions in both cohorts. Blood for antibody titer and ex vivo cytokine assay will be drawn at baseline, at the end of the 8-week session, and once again 3 months later. Nasal swab for IgA will be done at the same times. Participants will be followed with telephone contact every 2 weeks, with monthly questionnaire instruments, and with daily self-assessments during ARI illness episodes.
Analysis: ANOVA-based models will assess effects of meditation and exercise on immune markers and ARI illness. Psychological measures will be assessed as potential mediators of effects of meditation and exercise on ARI illness. Generalized estimating equations, random-effects pattern-mixture models, and hierarchical linear models will be used to assess longitudinal effects, interactions, and covariate mediation.
Barrett, B., Hayney, M.S., Muller, D., Rakel, D., Ward, A., Obasi, O.N., … Coe, C.L. (2012). Meditation or Exercise for Preventing Acute Respiratory Infection: A Randomized Controlled Trial. Annals of Family Medicine, 10(4), 337-346.
View publication via DOI: DOI:10.1370/afm.1376
Husted, C. & Barrett, B. (2010). Therapeutics and safety profile section in monograph: Echinacea angustifolia root: Standards of analysis, quality control and therapeutics. American Herbal Pharmacopoeia and Therapeutic Compendium. A.H.P., Scotts Valley, CA.
Rakel, D.P., Hoeft, T.J., Barrett, B., Chewning, B.A., Craig, B.M., & Niu, M. (2009). Practitioner empathy and the duration of the common cold. Family Medicine, 41(7), 494-50.
Barrett, B., Brown, R.L., Mundt, M.P., Thomas, G.R., Barlow, S.K., Highstrom, A.D., & Bahrainian, M. (2009). Validation of a short form Wisconsin Upper Respiratory Symptom Survey (WURSS-21). Health and Quality of Life Outcomes, 7, 76.
View publication via DOI: DOI:10.1186/1477-7525-7-76
Rakel, D.P., Hoeft, T.J., Barrett, B.P., Chewning, B.A., Craig, B.M., & Niu, M. (2009). Practitioner empathy and the duration of the common cold. Family Medicine, 41(7), 494-501.
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Barrett, B., Mundt, M., & Brown, R. (2008). Comparison of anchor-based and distributional approaches in estimating important difference in common cold. Quality of Life Research, 17(1), 75-85.
View publication via DOI: DOI:10.1007/s11136-007-9277-2
Barrett, B., Harahan, B., Brown, D., Zhang, Z., & Brown, R. (2007). Sufficiently important difference for common cold: Severity reduction. Annals of Family Medicine, 5(4), 216-223.
View publication via DOI: DOI:10.1370/afm.698
Barrett, B., Endrizzi, S., Andreoli, P., Barlow, S., & Zhang, Z. (2007). Clinical significance of common cold treatment: Professionals' opinions. Wisconsin Medical Journal, 106(8), 473-480.
Barrett, B., Rakel, D., Chewning, B., Marchand, L., Rabago, D., Brown, R., Scheder, J., Schmidt, R., Gern, J. E., Bone, K., Thomas, G., & Barlow, S. (2007). Rationale and methods for a trial assessing placebo, echinacea and doctor patient interaction in common cold. Explore: The Journal of Science and Healing, 3(6), 561-572.
View publication via DOI: DOI:10.1016/j.explore.2007.08.001
Linde, K., Barrett, B., Wölkart, K., Bauer, R., & Melchart, D. (2006). Echinacea for preventing and treating the common cold. Cochrane Collaboration Systematic Review.
View publication via DOI: DOI:10.1002/14651858.CD000530.pub2
Barrett, B., Muller, D., Rakel, D., Rabago, D., Marchand, L., & Scheder, J. (2006). Placebo, meaning and health. Perspectives in Biology and Medicine, 49(2), 178-198.
View publication via DOI: DOI:10.1353/pbm.2006.0019
Barrett, B., Brown, R., Voland, R., Maberry, R., & Turner, R. (2006). Relations among questionnaire and laboratory measures of rhinovirus infection. European Respiratory Journal, 28(2), 358-362.
View publication via DOI: DOI:10.1183/09031936.06.00002606
Barrett, B., Brown, D., Mundt, M. P., & Brown, R. L. (2005). Sufficiently important difference: Expanding the framework of clinical significance. Medical Decision Making, 25(2), 1-11.
View publication via DOI: DOI:10.1177/0272989X05276863
Barrett, B., Marchand, L., Scheder, J., Appelbaum, D., Plane, M. B., Blustein, J., Maberry, R., & Capperino, C. (2004). What complementary and alternative medicine practitioners say about health and health care. Annals of Family Medicine, 2(3), 253-259.
View publication via DOI: DOI:10.1370/afm.81
Barrett, B. (2003). Medicinal properties of echinacea: A critical review. Phytomedicine, 10(1), 66-86.
View publication via DOI: DOI:10.1078/094471103321648692
Barrett, B. (2003). Echinacea: A safety review. HerbalGram: Journal of the American Botanical Council, 57, 36-39.
Barrett, B., Marchand, L., Scheder, J., Plane, M. B., Maberry, R., Appelbaum, D., Rakel, D., & Rabago, D. (2003). Themes of holism, empowerment, access and legitimacy define complementary, alternative and integrative medicine in relation to conventional biomedicine. Journal of Alternative and Complementary Medicine, 9(5), 937-47.
View publication via DOI: DOI:10.1089/107555303771952271
Barrett, B., Locken, K., Maberry, R., Brown, R.L., Bobula, A., & D’Alessio, D. (2002). Treatment of the common cold with unrefined echinacea: A randomized double-blind, placebo-controlled trial. Annals of Internal Medicine, 137(12), 939-946.
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