Mindfulness-based Personalized Health Planning for Reducing Risk Factors of Heart Disease and Diabetes (AWARENESS)

• Insulin Resistance [ Time Frame: screening, post-intervention (6 months) ] [ Designated as safety issue: No ]
  Changes from baseline insulin resistance at 6-months. Insulin resistance will be assessed using the homeostasis model of assessment for insulin resistance. This model uses fasting levels of insulin and glucose to determine insulin resistance.
  
  

• Stress responses [ Time Frame: Baseline, post-intervention (6 months) ] [ Designated as safety issue: No ]
  Changes in baseline stress responses to an anger induction procedure at 6-months. Measures of stress responses include measures of heart rate, blood pressure, stress hormones, metabolism, inflammation, emotions, and mindful qualities.
  
  

There is a need for new preventive strategies to help combat the rising prevalence of type 2 diabetes (T2D) and coronary heart disease (CHD). This need is particularly critical for individuals who already show impaired fasting glucose (IFG), a condition in which the fasting blood sugar level is 100 to 125 milligrams per deciliter (mg/dL), and psychological distress as indexed by greater severity of depressive symptoms, anger, and anger-related emotions, because they are at increased risk for developing disease. With few exceptions, current interventions are 'one-size fits all' and pay little or no attention to patients' individual goals, resources, and barriers in making positive behavior changes. This novel study adopts a 'patient-centered' strategy for decreasing risk for T2D and CHD and specifically a mindfulness-based personalized health planning (MB-PHP) as the primary intervention. MB-PHP incorporates four primary strategies: (1) individual risk quantification of T2D and cardiovascular disease (CVD) based on fasting blood sugar and a psychological risk profile; (2) group-based education on risk factors for CVD and T2D; (3) development of a personalized health plan (PHP); and (4) support in PHP implementation and patient engagement through integrative health partnering. To further support the goals of the PHP, mindfulness meditation will be used in the group setting to promote greater awareness of the unity of mind and body and specifically how unconscious thoughts, feelings, and behaviors can undermine emotional and physical health. The MB-PHP will stress personalized, predictive, and preventive risk management while fostering meaningful subject engagement with the goal of reducing risk factors for T2D and CVD.