Creating and Optimizing Mindfulness Measures to Enhance and Normalize Clinical Evaluation

The investigators will use Patient Reported Outcomes Measurement Information System (PROMIS®)
methodologies to construct improved self-report mindfulness-related measures. They will also
use PROMIS-based PROsetta Stone® instrument linking methods to equate scores and create
cross-walks between new mindfulness measures and existing ones. The research team has
extensive experience in patient reported outcomes (PRO) development through PROMIS and
related PRO development initiatives, including mind-body measures (Chicago and Pittsburgh),
PROsetta Stone linking methodologies (Chicago), and mindfulness research (Pittsburgh and
Chicago).

PROMIS methodologies involve a systematic and iterative approach to person-centered
measurement and are the gold standard. Following PROMIS methods, newly created mindfulness
measures will be informed by: 1) the existing literature, and 2) stakeholders such as
mindfulness researchers, Buddhist and MBI teachers, and new and experienced meditators.
COMMENCE analyses will also reflect PROMIS, producing concise, precise, clinically relevant
measures that can be administered as Computerized Adaptive Tests (CATs) or fixed-length short
forms. PROsetta Stone methods will enable a crosswalk between the new mindfulness measures
and legacy instruments that assess similar constructs. All of this will have a major impact
on mindfulness research through increasing measurement precision and comparability across and
between studies: past, present, and future. The project will also address the response shift
challenge. New mindfulness measures and crosswalk linking will be produced through the
following three SPECIFIC AIMS:

SPECIFIC AIM I. Development of New Mindfulness Item Banks. Activities include: 1) a review of
the mindfulness measurement literature; 2) an online survey of mindfulness researchers to
identify domains and measurement considerations for item bank development; 3) focus groups
with new and experienced meditators, and individual interviews with mindfulness meditation
practitioners, including Buddhist teachers, to elaborate on concepts such as response shift;
4) item refinement; 6) translatability review; and 7) cognitive interviews to assess item
clarity.

SPECIFIC AIM II. Calibration of New Mindfulness Item Banks and Score Linking with Legacy
Measures. Calibration activities will include: 1) testing new mindfulness item banks in a
large online general population sample (n=4200) and a sample of mindfulness teachers and
students (n=500); 2) evaluation of dimensionality and other assumptions prior to Item
Response Theory (IRT) analysis; 3) IRT analyses; and 4) creation of CATs and fixed length
short forms. A battery of legacy measures will also be administrated alongside new
mindfulness banks. Using PROsetta Stone procedures, the investigators will test mindfulness
banks and legacy measures in a new large online sample (n=3000) to link measures on a common
measurement metric and create cross-walk scoring tables to facilitate interpretation.

SPECIFIC AIM III. Validation of New Mindfulness Short Forms in Ongoing Mindfulness Courses.
To evaluate different forms of validity (e.g., construct, criterion), responsiveness to
change over time, and estimation of minimally important differences, the investigators will
administer new mindfulness short forms and legacy measures to 250 mindfulness students at
baseline, 8-weeks, and 16 weeks in multiple, on-going 8-week Mindfulness-Based Stress
Reduction (MBSR) courses and similar MBI programs at Pittsburgh and Chicago sites, as well as
at member sites from the Academic Consortium for Integrative Medicine and Health and the
BraveNet Practice-Based Research Network. In addition to legacy measures, a subset of the
sample will complete the meditation breath awareness score, an experiential measure of
focused attention.

Inclusion Criteria:

- Must be at least 18 years of age

- Must be able to speak and understand English

- Must be participating in an ongoing mindfulness-based intervention taking place in
practice-based research network collaborating sites (e.g., Bravenet, Academic
Consortium for Integrative Medicine and Health) as well as local networks at
Pittsburgh and Chicago sites

Exclusion Criteria: