Abstract
INTRODUCTION: Adults with congenital heart disease (ACHD) often experience elevated health anxiety. The SMART-3RP is an eight-week, mind-body group resiliency intervention with evidence to reduce health anxiety in other medical populations. The aims of this waitlist-controlled, randomized pilot feasibility trial were to explore (1) feasibility and acceptability of videoconference-delivered SMART-3RP, (2) feasibility and acceptability of remote blood pressure monitoring, and (3) changes in health anxiety, mindfulness, and resiliency. METHODS: Participants (N = 12 adults with CHD; Mean age = 41.2 years, SD = 13.8, 100% white, and 75% female) were 1:1 randomized into a pilot from July 2020 to September 2020. Participants completed surveys at baseline, three-month, and six-month follow-up; recorded their blood pressure via a digital health platform four times per week for eight weeks post-randomization (n = 32 total recordings); and completed individual exit interviews. RESULTS: 91% (29/32) of patients screened were eligible; of those, 41% (12/29) enrolled. 83% were retained at three-month follow-up (10/12) and 90% of those (9/10) were retained at six months. Average adherence to blood pressure monitoring was 70% (22/32 recordings completed; SD = 31.9). Effect sizes from baseline to three months suggested greater improvement in the immediate group compared to the waitlist group for health anxiety (Cohen's r = -.59), mindfulness (r = -0.44), and resiliency (r = -0.49). Exit interviews revealed positive experiences with the intervention, benefits of mindfulness skills for coping with anxiety, and suggestions for improvement including further targeting ACHD-specific needs. CONCLUSIONS: These findings support the feasibility of conducting a randomized controlled efficacy trial of SMART-3RP for ACHD, and the acceptability and potential utility of SMART-3RP for emotional health in ACHD.