EMBRACE Study: Outcomes of a Randomized, Mindfulness-Based Intervention for Adults with Congenital Heart Disease

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.