EMBRACE Study: Outcomes of a Randomized, Mindfulness-Based Intervention for Adults with Congenital Heart Disease.
Vicki A Freedenberg, Rachel Steury, Robert Podolsky, Anitha S John
Pediatric cardiology July 2, 2025 DOI: 10.1007/s00246-025-03933-2
Summary
Even with congenital heart disease, improving mental health is achievable. A study explored if a virtual mindfulness-based behavioral intervention could enhance coping and resilience. Participants showed significant positive changes: over 60% experienced reduced anxiety, and nearly half saw less depression, as measured by the HADS scale. Resilience and mindfulness also notably improved. This virtual intervention effectively supports mental health for adults managing chronic conditions, fostering better coping skills.
Abstract
Adults with congenital heart disease (ACHD) have high rates of anxiety and depression. Strategies to manage the stress of having a chronic disease, improve coping skills and resilience can reduce these rates. To examine the effectiveness of an ACHD-specific, real-time virtual mindfulness-based behavioral intervention (MBBI) on mental health and resilience. A randomized wait-list control study was conducted, testing a virtual MBBI for 90 min once weekly × 6 weeks compared to standard of care (SOC) control. Primary outcomes of anxiety and depression were assessed through the Hospital and Anxiety and Depression Scale (HADS-A/HADS-D), while secondary outcomes of resilience and mindfulness were assessed through the Brief Resilience Scale (BRS) and Cognitive and Affective Mindfulness Scale-Revised (CAMS-R), respectively. Outcomes were assessed pre-post-intervention and 3-month post-intervention. Forty-one participants were recruited. Thirty-one participants (average age = 39.7 + 12.6 years, 64.5% female) completed the study, attending an average of 5 sessions. While the randomization groups did not show differences in changes in any outcomes, participants did show meaningful improvements after the EMBRACE intervention in anxiety [60.9% with decreased HADS-A (95% CI 43.8-76.8%)]; depression [48.4% with decreased HADS-D (95% CI 31.6-65.5%)]; resilience [43.6% with increased BRS score (95% CI 26.9-61.0%)]; and mindfulness [69.4% with increased CAMS-R-score (95% CI 52.3-84.0%)] scores. Satisfaction surveys revealed that 97% found the program effective. Major qualitative themes included community connections, focus on self-care and self-management. The EMBRACE study demonstrates the effectiveness of a virtual intervention to improve mental health, resilience, and coping skills. Further study is needed to evaluate the long-term benefits and sustainability for ACHD patients.