Friday, August 14, 2015

Scaling Mindfulness to Population Health and Tobacco Addiction: The Science Behind the Art

Think about it....
Years ago, the young Population Health Blog was a part of a nurse-led tobacco cessation program.  Hundreds of patients later, we reported the one-year quit rate of over 30%. That seminal research catalyzed the creation of other nurse-based programs in asthma, diabetes and heart failure. The PHB and colleagues didn't know it at the time, but it was the start of an almost 20 year journey in population health that continues to pay dividends today.

The art and science of population health continues to evolve, however.  That's why the PHB is always happy to hear from the leadership of outfits like Craving to Quit.  And this is something different.

As readers may know, "apps" are becoming an important part of the population health landscape, but what the PHB didn't know is that an app could be combined with the science of "mindfulness."

Mindfulness?  Conscious intention was a part of the PHB's martial arts training, but it didn't know that there was a science to it and that could be applied to health care.

Mindfulness can be defined as being attentive to and aware of what is taking place in the present. By consciously stepping back and being aware of the status of your well being, the accompanying cognitive insight enables the "user" to better cope and manage the wide array of emotional states. That can include enhancing a state of wellness or, conversely, combating depression, anxiety, addictions and cravings  The PHB didn't know this, but it's been a subject of intense basic neuroscience as well as clinical real-world research (here and here) for years.  And if you're wondering if there is a Buddhist pedigree in all of this, you're right.

Enter Craving to Quit.

It's seeking to scale one-on-one mindfulness to populations using an app that can be used to combat tobacco addiction.  Users can prompt attentive mindfulness to manage nicotine-withdrawal related cravings.  Add in feedback, access to a community of like-minded users, live expert addiction coaching, plus a library of video-based instructional resources and - boom! - an academic backwater of "mindfulness" turns into a robust population-based intervention.

And credit to the leadership at CtoQ for committing the resources to precisely measure their outcomes for the scrutiny of peer review.  They're conducting an Institutional Review Board - approved randomized clinical trial to further document the impact of mindfulness. As the PHB has written here, without a disciplined approach to documenting outcomes, population health service providers are putting themselves and the industry at significant risk.

Being mindful of an attitude of plenty, this is good news for the art and science of population health.
No wonder it caught CNN's attention. It's worth paying attention to.
Their success is our success.

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