Stress Free UC Study

Am I eligible for the Stress Free UC +Health Study?

UCSF employees with access to a computer or smartphone, aged 18 years or older, and English-speaking may be eligible to participate in the Stress Free UCSF Health Study. Because we are interested in whether stress reduction and mindful eating can improve health, we are only recruiting participants with a body mass index of 25 or higher.

Find out if you're eligible by clicking this link and taking the eligibility screener.

How much time will my participation take?

Every participant will have the following time commitments:

• Two in-person assessments: 60 minutes + 30 minutes (90 minutes total)
• Daily diary completion for two (non-adjacent) weeks: <10 minutes per day for 7 days (x2) (140 minutes total)
• Four surveys: two 20-minute and five 5-minute surveys (60 minutes total)

• Meditation Group:
  • 10 minutes of meditation daily for 8 weeks
  • 1-Year Follow-Up Questionnaire (5 minutes)
• Meditation + Healthy Eating Group:
  • 10 minutes of meditation daily for 8 weeks
  • Counseling session (20 minutes)
  • Three booster phone calls (15 minutes total)
  • Optional audio guides (1-5 minutes each)
  • 1-Year Follow-Up Questionnaire (5 minutes)
• Healthy Eating Group:
  • Counseling session (20 minutes)
  • Three booster phone calls (15 minutes total)
  • Optional audio guides (1-5 minutes each)
• Waitlist Group: no extra time commitments in addition to those listed above

Does it cost to participate in this study?

No costs are associated with your participation in this study.

Will I be paid to participate in this study?

You will not be paid for your participation in this study. However, you will receive a free 1-year subscription to Headspace, which has a market value of $155. You will also receive a free Fitbit Alta HR, with a market value of $129.95. Lastly, you will be entered into a drawing to win a paid trip to Napa Valley, a $1000 value.

What will I do in the Stress Free UC +Health Study?

If you are eligible and choose to join, expect the following procedures:

1. Phone call to schedule your in-person assessment
2. In-person assessment #1 (60 min)
3. Baseline questionnaire
4. Nightly and morni ng diaries #1: complete a 5-min survey in the morning and at night for 7 consecutive days (wear your Fitbit this week)
5. Randomization: learn which group you are assigned to
6. Week 4: Midway Questionnaire (5 min)
7. Week 7: Nightly and morning diaries #2: complete a 5-min survey in the morning and at night for 7 consecutive days (wear your Fitbit this week)
8. Week 8: In-person assessment #2 (30 min) and 8-Week Follow-Up Questionnaire (30 min)
9. 4-Month Follow-Up Questionnaire
10. 1-Year Follow-Up Questionnaire (Meditation Groups only)

Additional responsibilities will depend on what group you are assigned to. See below for descriptions of the four possible groups.

• Meditation Group: If you’re in this group, you will be asked to use HeadspaceTM for 10 minutes a day for 8 weeks, starting with the "Basics" pack and then moving on to the "Letting Go of Stress" pack.
• Meditation + Healthy Eating Group: If you’re in this group, you will be asked to use HeadspaceTM for 10 minutes each day for 8 weeks. You will also participate in a brief healthy eating program for 8 weeks, which entails the following:
  • One 20-minute in-person counseling session with a health educator to develop specific healthy eating goals
  • 3 phone calls to check-in on progress towards healthy eating goals
  • Text messages 3x per week to provide help towards reaching healthy eating goals
  • Optional audio exercises to utilize before mealtimes or other high craving times during the 8-week period. These are provided as tools and include one aimed at increasing mindfulness and another to help curve specific food cravings. A brief, two-item survey will be completed before and after each audio use.
• Healthy Eating Group: If you're in this group, you will participate in a brief healthy eating program for 8 weeks, which entails the following:
  • One 20-minute in-person counseling session with a health educator to develop specific healthy eating goals
  • 3 phone calls to check-in on progress towards healthy eating goals
  • Text messages 3x per week to provide help towards reaching healthy eating goals
  • Optional audio exercises to utilize before mealtimes or other high craving times during the 8-week period. These are provided as tools and include one aimed at increasing mindfulness and another to help curve specific food cravings. A brief, two-item survey will be completed before and after each audio use.
• Waitlist Group: No additional responsibilities than those listed above. Maintain your daily life and receive Headspace at the end of 4 months.

Can I change the condition I am assigned to?

No, you may not change the condition you are assigned to, as this is computer-generated and completely random. Before you participate in the study, it is important that you make sure you are okay with being a part of any and all four conditions: Meditation, Meditation + Healthy Eating, Healthy Eating, and Waitlist. Keep in mind that all participants will eventually receive a free 1-year subscription to Headspace, regardless of condition!

Do I have to answer ALL of the questions in the survey?

We would like you to answer all survey questions because it helps us get the best data possible, allowing us to determine for whom the intervention works best and why. If certain questions make you very uncomfortable, we ask that you pause the survey and return back to it after a certain period away (you have one week to finish the survey after starting it). If, upon returning, you still cannot answer the question(s), then you may omit it.

What if I want to end my participation in the study?

It is essential that you carefully weigh your decision before joining this study. In consenting to participate, you have made a commitment both to yourself and to the scientific quality of the research. In these trials, it is very important that we minimize the amount of people who drop out of the study and avoid the possibility that our research finds that meditation is more or less effective than it truly may be.

If participants ask to end their role in the study after being assigned to a group, we ask that you consider answering the follow-up questionnaires, whether you continue with the other study procedures or not. However, if you do choose to end all study contact, we will refrain from any further communication.

While we will honor your right to drop out of the study at any time, we appreciate your considering your decision and the scientific integrity of the study. No matter what decision you make, there will be no penalty to you in any way.

Are my answers saved if I exit and then return to the survey?

We suggest that you complete all surveys in one sitting, but if you happen to exit out, you may return to your survey where you left off. As long as you return on the same device (your computer or smartphone), your answers will be saved.

What is the difference between the Stress Free UC Study and the Stress Free UC +Health Study?

The Stress Free UC +Health Study is a smaller component of the larger Stress Free UCSF Study focusing on health outcomes and behaviors, including sleep, physical activity, and diet. Participants in the +Health Study will have the same responsibilities as those in the larger Stress Free UCSF Study, including 3-4 questionnaires and the possibility of daily meditation with Headspace. Additional responsibilities include the following:

• Two in-person assessments, where body measurements, such as height and weight, and physiological measures like blood pressure will be collected. Participants will also undergo a fingerprick so researchers can assess blood-based health markers.
• Completion of a morning and nightly diary for 7 consecutive days at the beginning and end of the 8-week period (participants will also be asked to wear their Fitbit during these two weeks)
• 50% of participants will participate in a healthy eating program, involving one 20-minute counseling session performed at the participant's place of work and three 5-minute booster phone calls throughout the 8-week period

• A free Fitbit Alta HR fitness watch, received at the beginning of the 8-week period
• The opportunity to learn more about your health and ways to improve your stress
• The chance to participate in a healthy eating program and achieve your healthy eating goals

What is the meditation experience with Headspace like?

The Headspace “Basics" pack is designed as an introduction to mindfulness meditation and can be used as an opportunity for you to get familiar with the Headspace teaching style. It presents the concept of mindfulness and encourages you to pay attention to your breathing and notice patterns of mind-wandering and thoughts.

The “Letting go of Stress" pack is more specialized, and combines visualization and body scanning to help users learn to accept their emotions and pay close attention to the present moment. The more lessons you complete, meditations become less and less guided and allow for more freedom in the meditation style.

Practicing mindfulness is like any skill, and takes time to develop, so we suggest that you stick with it and find the time and practice that works best for you.

Curious about what else the Headspace team is up to? See our study and similar research projects featured in the Wall Street Journal here!

When should I meditate?

The benefit of a digitally-based mindfulness program is that you can do it from practically anywhere! As long as you can find a relatively quiet location where you will be undisturbed for 10 minutes, you can meditate at any time. We encourage you to try out different locations and times of day to figure out where you can get the most out of your meditation practice.

How often do I have to meditate? What if I skip a day or two?

We recommend that you try your very best to use Headspace every day. Of course, we understand that life happens, and if you don’t get around to meditating for a day, that’s ok! We will reach out to you once a week to remind you to meditate over text and email. If you don’t meditate for 2 weeks, we will give you a call to check in.

How do I find the time to meditate?

As a hardworking UC employee, you are likely busy most of the day. While it is always a bit difficult to change your routine, the benefit of this intervention is that it only takes up less than 1% of your entire day. You may find that this short amount of time can shift how you experience the rest of your day. Forming a habit may be tricky in the beginning, but the more you practice, the easier it likely will be to find the time.

Why am I not seeing any improvements?

Learning to meditate takes time, and like any other skill, it takes practice. Try to be patient with yourself and avoid seeking perfection, because everybody is different in their meditation style. If you come into the practice with high expectations, it may be harder to become satisfied in your practice. Instead, try taking it one day at a time and most importantly, avoid judgement and practice self-kindness.

For more tips, watch this short video:

What do I do when I encounter distractions during meditation?

You may notice distractions and experience some frustration during your meditation practice, especially when you are first beginning the journey. That is ok! Feel the frustration, watch it pass and come back to the breath. If the distraction continues, rather than fighting with it and struggling to come back to the breath, give the disturbance your full attention, whether it’s a sound, smell, sensation or whatever else. By making it your new point of focus, you make use of it and it ceases to become a disturbance. You may well still experience some frustration, but allow that to happen, see it clearly, look into it and understand from where that frustration arises. This way, we are able to bring everything into our meditation practice.

Can I still meditate offline, if I don't have internet connection?

Yes, you can still use Headspace without any internet connection! Using the mobile app, follow the steps below: 1. Tap Discover on the bottom of the screen 2. Tap the pack you want to listen to offline, and tap "+ ADD TO MY PACKS" 3. Tap your first name at the bottom right corner then select the ‘Settings’ icon at the top 4. Toggle the switch to green to begin download on your current packs 5. Visit the "Discover" or "Home" screens to play your downloaded sessions

Why do you want permission to use my personal health information for research?

We ask for access to your medical and employment records so we can better understand how meditation might be related to employee health (for example, the number of sick days you take or visits to the doctor).

Giving us permission will not affect your employment at UCSF, nor will it affect the health care you receive. All information that you provide will be de-identified, that is none of your records will be associated with your name.

Giving us permission is optional. You may still participate in the study if you choose not to give us access to your medical or employment records. If you agree to alowing us access to this information, you may change your mind at any time by emailing the study staff at StressFreeUC@ucsf.edu.

Do I need to allow access to my employment and/or medical records?

Giving us access to your employment and/or medical records is optional. You may still participate in this study if you choose not to. If you do agree to letting us access this information but change your mind later, you may withdraw permission at any time by emailing the study staff at StressFreeUC@ucsf.edu.

What if I seek health care outside of the university?

We will only look at health information from those who receive health care from UCSF.

What kind of health data do you look at?

We are interested in examining health care participants receive, such as medications prescribed, illnesses diagnosed, and the number of times participants go to the doctor.

What do the daily diaries involve?

The "daily diaries" consist of two 5-minute surveys to be completed daily, one in the morning and one at night, for seven consecutive days. This will occur at two time points - once after your first in-person assessment and then again at Week 7 (or seven weeks after randomization).

Do I have to complete ALL of the diaries?

We ask that you try your best to complete the diaries on a daily basis. Because your first week of daily diaries will begin the night after your first in-person assessment, we ask that you keep in mind your availability to complete the daily diaries when scheduling your in-person visit. (Again, they should take no more than 5 minutes each.) However, if something urgent comes up and you must skip a questionnaire or two, we understand.

Do I have to complete ALL of the daily diary questions?

We would like you to answer all of the questions, and we encourage participants to engage with each survey as much as possible. This will help us get more reliable data. However, if certain questions make you very uncomfortable, you may skip them.

How will I be reminded to complete the morning and nightly diary?

Is the Fitbit waterproof?

Your Fitbit Alta is water-resistant and can be worn in the shower (and bodies of water up to 50 meters). Feel free to take yours swimming! However, when you are done, make sure to rinse and dry your Fibit thoroughly to avoid any skin irritation.

How does the Fitbit work?

Your Fitbit will automatically capture real-time fitness data, such as steps walked and climbed, heart rate, and sleep quality.

What am I expected to do with the Fitbit?

We ask that you wear your Fitbit as much as possible for the two weeklong periods that coincide with your daily diaries. You are responsible for keeping your Fitbit charged and for syncing it every day during this period.

Can I ever take the Fitbit off?

During the two weeklong periods (following your first in-person visit and your seventh week of participation), we ask that you try your best to wear the Fitbit at all times, especially while you are sleeping and active. When you charge the watch, you may remove it. However, if possible, please charge your Fitbit during times of inactivity. Examples include while sitting at your desk, while showering, and on your commute.

How long does the Fitbit take to charge?

The Fitbit Alta battery life is approximately 5 days. If completely dead, the Fitbit Alta can take up to 1 to 2 hours to charge. We, therefore, recommend charging it for 10-15 minutes each day.

When should I charge my Fitbit?

You are asked to wear your Fitbit while sleeping every night during the two weeklong periods, so you will need to find a time to charge it when you are not sleeping and, ideally, inactive. We recommend the following as good times to charge: while showering, on your commute, sitting at your desk, or watching TV. For more ideas, contact the study team.

Will the Fitbit irritate my skin?

If you have eczema, allergies or asthma, you may be more likely to experience a skin irritation or allergy from a wearable device. Please contact the study team with any related concerns.

How do I sync my Fitbit?

To manually sync your Fitbit with your smartphone:

1. Open the Fitbit app on your phone and find the dashboard
2. Touch the picture of your device at the top of the screen and pull down
   ( Windows 10 users: pull up from the bottom of the screen)

1. Pair your device with your smartphone via Bluetooth
2. Turn on All-Day sync in Settings --> ...

When should I sync my Fitbit?

You should sync your Fitbit daily for the two weeklong periods (following your first in-person visit and then again during your seventh week of participation). (do they need to make sure to sync at the end of the week?)

How do I pair my device with my smartphone or computer?

Please review our Fitbit orientation slides here. You may also refer to the handout received during your first in-person visit.

How long will the in-person visits take?

The first assessment will take about one hour to ensure you are properly oriented to the study and study procedures. The second assessment will be about 30 minutes.

What happens at the visits?

You will read over applicable forms, participate in body and physiological measurements, and be oriented to the study procedures. During the first visit only, you will read and sign the consent form if you choose to participate. You will also have the option to sign the PHI form, giving us access to your health records. During the first visit only, you will be given verbal and written instructions regarding completion of the daily diaries and proper care of your Fitbit, including charging and syncing instructions. During both visits, the following data will be collected:

• Body measurements like height, weight, and waist-to-hip ratio
• Physiological measures like blood pressure
• Blood measures from a finger prick

How should I prepare for the visits?

We ask that you wear loose-fitting clothing to your visits and fast for 8 hours beforehand.

Where will the visits take place?

The visits will take place at Langley Porter Psychiatric Hospital, located at the UCSF Parnasssus campus at the following address: Langley Porter (LPPI) 401 Parnassus Ave. San Francisco, CA 94143 Include suite, floor, etc., and attach map

Will I be reimbursed for transportation to the visits?

If participants choose to drive to the UCSF Parnassus Campus, we will cover parking costs for up to 1 hour ($4). No other transportation costs will be covered or reimbursed. We recommend that participants utilize UCSF's free shuttle service. Click here for shuttle routes between campuses, or use the UCSF Mobile App for trip planning and real-time shuttle information.

What if I cannot get to a visit?

If something comes up, and you can no longer make it to the visit, we understand and ask that you let us know prior to the visit so we can re-schedule. You may call us at 415-502-4857 or email us at StressFreeUC@ucsf.edu.

What is mindful eating?

Mindful eating is the practice of experiencing eating and food in a way that helps us pay attention to our bodies and experiences of hunger, fullness, cravings, and mood. Research has shown that mindful eating practices can decrease our tendency to eat in response to stress and emotions.

What will happen during the counseling session?

The in-person counseling session will be conducted by a trained coordinator and will include:

1. An overview of the program and how it might help you make healthy changes to your nutrition

2. Information regarding eating behaviors that can contribute to too much weight gain over time and other health risk factors

3. A discussion of eating behaviors and personal goals related to improving nutrition

4. An introduction on how to practice mindful eating and manage cravings

What are the audio exercises, and when should I listen to them?

If you are in the Healthy Eating program, you have access to two audio exercises to use whenever you are experiencing cravings or stress around eating (just enter your UCSF email). As part of the Healthy Eating program, we require that you listen to an audio at least 1x per week to gain the most benefit. The first audio exercise involves eating mindfully and should be used any time you feel you would like to increase your mindfulness during eating (e.g., before eating a snack). The second audio exercise addresses cravings for sugar and should be used any time you are experiencing sugar cravings (e.g., after a meal or on the way home from work). For both exercises, you should first complete the 5-minute introduction module. After you have completed the training modules, then you should move on to the shorter practices.

When should I practice mindful eating?

There is no set guideline for how often to practice mindful eating. However, we strongly recommend that you practice these skills at least 1x per week to gain the most benefit. We will provide text message prompts during times you have identified as being high-stress periods for overeating or experiencing food cravings as a helpful reminder to practice mindfulness activities or food craving management. You may also respond to these messages (or text 415-502-4857) at times you feel you could use extra support.