{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T13:22:33Z","timestamp":1791897753379,"version":"4.3.4"},"reference-count":27,"publisher":"American Medical Association (AMA)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"Importance<\/jats:title>Neurofibromatoses (NF; NF1, NF2, and schwannomatosis) are hereditary tumor predisposition syndromes with a risk for poor quality of life (QOL) and no evidence-based treatments.<\/jats:p><\/jats:sec>Objective<\/jats:title>To compare a mind-body skills training program, the Relaxation Response Resiliency Program for NF (3RP-NF), with a health education program (Health Enhancement Program for NF; HEP-NF) for improvement of quality of life among adults with NF.<\/jats:p><\/jats:sec>Design, Setting, and Participants<\/jats:title>This single-blind, remote randomized clinical trial randomly assigned 228 English-speaking adults with NF from around the world on a 1:1 basis, stratified by NF type, between October 1, 2017, and January 31, 2021, with the last follow-up February 28, 2022.<\/jats:p><\/jats:sec>Interventions<\/jats:title>Eight 90-minute group virtual sessions of 3RP-NF or HEP-NF.<\/jats:p><\/jats:sec>Main Outcomes and Measures<\/jats:title>Outcomes were collected at baseline, after treatment, and at 6-month and 1-year follow-up. The primary outcomes were physical health and psychological domain scores of the World Health Organization Quality of Life Brief Version (WHOQOL-BREF). Secondary outcomes were the social relationships and environment domain scores of the WHOQOL-BREF. Scores are reported as transformed domain scores (range, 0-100, with higher scores indicating higher QOL). Analysis was performed on an intention-to-treat basis.<\/jats:p><\/jats:sec>Results<\/jats:title>Of 371 participants who underwent screening, 228 were randomized (mean [SD] age, 42.7 [14.5] years; 170 women [75%]), and 217 attended 6 or more of 8 sessions and provided posttest data. Participants in both programs improved from baseline to after treatment in primary outcomes of physical health QOL score (3RP-NF, 5.1; 95% CI, 3.2-7.0; P<\/jats:italic>\u2009&amp;lt;\u2009.001; HEP-NF, 6.4; 95% CI, 4.6-8.3; P<\/jats:italic>\u2009&amp;lt;\u2009.001) and psychological QOL score (3RP-NF, 8.5; 95% CI, 6.4-10.7; P<\/jats:italic>\u2009&amp;lt;\u2009.001; HEP-NF, 9.2; 95% CI, 7.1-11.2; P<\/jats:italic>\u2009&amp;lt;\u2009.001). Participants in the 3RP-NF group showed sustained improvements after treatment to 12 months; posttreatment improvements for the HEP-NF group diminished (between-group difference for physical health QOL score, 4.9; 95% CI, 2.1-7.7; P<\/jats:italic>\u2009=\u2009.001; effect size [ES]\u2009=\u20090.3; and psychological QOL score, 3.7; 95% CI, 0.2-7.6; P<\/jats:italic>\u2009=\u2009.06; ES\u2009=\u20090.2). Results were similar for secondary outcomes of social relationships and environmental QOL. There were significant between-group differences from baseline to 12 months in favor of the 3RP-NF for physical health QOL score (3.6; 95% CI, 0.5-6.6; P<\/jats:italic>\u2009=\u2009.02; ES\u2009=\u20090.2), social relationships QOL score (6.9; 95% CI, 1.2-12.7; P<\/jats:italic>\u2009=\u2009.02; ES\u2009=\u20090.3), and environmental QOL score (3.5; 95% CI, 0.4-6.5; P<\/jats:italic>\u2009=\u2009.02; ES\u2009=\u20090.2).<\/jats:p><\/jats:sec>Conclusions and Relevance<\/jats:title>In this randomized clinical trial of 3RP-NF vs HEP-NF, benefits from 3RP-NF and HEP-NF were comparable after treatment, but at 12 months from baseline, 3RP-NF was superior to HEP-NF on all primary and secondary outcomes. Results support the implementation of 3RP-NF in routine care.<\/jats:p><\/jats:sec>Trial Registration<\/jats:title>ClinicalTrials.gov Identifier: NCT03406208<\/jats:ext-link><\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2023.20599","type":"journal-article","created":{"date-parts":[[2023,6,28]],"date-time":"2023-06-28T15:34:25Z","timestamp":1687966465000},"page":"e2320599","source":"Crossref","is-referenced-by-count":18,"title":["Effect of Mind-Body Skills Training on Quality of Life for Geographically Diverse Adults With Neurofibromatosis"],"prefix":"10.1001","volume":"6","author":[{"given":"Ana-Maria","family":"Vranceanu","sequence":"first","affiliation":[{"name":"Center for Health Outcomes and Interdisciplinary Research, Department of Psychiatry, Massachusetts General Hospital, Boston"},{"name":"Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heena 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