{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T12:31:31Z","timestamp":1789129891301,"version":"build-2803163510"},"reference-count":30,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T00:00:00Z","timestamp":1788739200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T00:00:00Z","timestamp":1788739200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100007366","name":"Fondazione Italiana Sclerosi Multipla","doi-asserted-by":"publisher","award":["2016\/B\/3"],"award-info":[{"award-number":["2016\/B\/3"]}],"id":[{"id":"10.13039\/100007366","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Mult Scler"],"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>People with multiple sclerosis (PwMS) often experience reduced resilience, the ability to adapt to stressors using internal and external resources. Resilience and Activities for every DaY (READY) is an Acceptance and Commitment Therapy\u2013based group resilience intervention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To assess the effectiveness of READY versus group relaxation in PwMS with low resilience (Connor-Davidson Resilience Scale 25 [CD-RISC] score\u2009&lt;\u200983).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Cluster-randomized controlled trial across seven Italian centers with assessments at baseline, immediately post-intervention, and after 3 and 6 months. The primary outcome was CD-RISC at 3 months. Secondary outcomes include mood, psychological flexibility, well-being, and health-related quality of life (HRQoL).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Of 226 PwMS randomized to 24 groups, 197 were analyzed; 188 completed the trial. At 3 months, CD-RISC improved in both arms (+2.53 READY;\u2009+0.43 relaxation; between-arm difference\u2009+2.10, 95% CI \u22121.06 to\u2009+5.26;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.193); READY showed greater improvement than relaxation in Anxiety (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.016), Well-being (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.022), Psychological Flexibility (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.033), and generic HRQoL (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.001). At 6 months, differences increased to include depression (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.039). Longitudinal models showed significant within-group improvements in READY across resilience, mood, HRQoL, well-being, and flexibility outcomes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>READY was not superior for the primary endpoint but was superior for most secondary outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration:<\/jats:title>\n                    <jats:p>\n                      ISRCTN67194859 (ISRCTN Registry;\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.isrctn.com\">https:\/\/www.isrctn.com<\/jats:ext-link>\n                      )\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/13524585261464886","type":"journal-article","created":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T04:20:11Z","timestamp":1788841211000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["A group resilience training program for people with multiple sclerosis: A cluster-randomized controlled trial (multi-READY for MS)"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7496-6727","authenticated-orcid":false,"given":"Ambra Mara","family":"Giovannetti","sequence":"first","affiliation":[{"name":"Unit of Neuroepidemiology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy; School of Psychology, Faculty of Health, Medicine and Behavioural Sciences, The University of Queensland, Brisbane, QLD, Australia; Multiple Sclerosis Centre, Unit of Neuroimmunology and Neuromuscular Diseases, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8653-4593","authenticated-orcid":false,"given":"Kenneth Ian","family":"Pakenham","sequence":"additional","affiliation":[{"name":"School of Psychology, Faculty of Health, Medicine and Behavioural Sciences, The University of Queensland, Brisbane, QLD, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7960-5947","authenticated-orcid":false,"given":"Massimiliano","family":"Copetti","sequence":"additional","affiliation":[{"name":"Unit of Biostatistics, Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2026-3572","authenticated-orcid":false,"given":"Giampaolo","family":"Brichetto","sequence":"additional","affiliation":[{"name":"AISM Rehabilitation Service of Genoa, Italian Multiple Sclerosis Society, Genova, Italy; NeuroBRITE Research Center, Italian Multiple Sclerosis Society Foundation, Genova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2645-7477","authenticated-orcid":false,"given":"Massimiliano","family":"Di Filippo","sequence":"additional","affiliation":[{"name":"Clinica Neurologica, Dipartimento di Medicina e Chirurgia, Universit\u00e0 degli Studi di Perugia, Perugia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-9716-8696","authenticated-orcid":false,"given":"Maria Esmeralda","family":"Quartuccio","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, San Camillo Forlanini Hospital, Roma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-8791-2000","authenticated-orcid":false,"given":"Monica","family":"Grobberio","sequence":"additional","affiliation":[{"name":"Laboratorio di neuropsicologia, UOSD psicologia clinica e UOC neurologia, ASST Lariana, Como, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-7213-2815","authenticated-orcid":false,"given":"Mary","family":"Micheli","sequence":"additional","affiliation":[{"name":"Dipartimento Riabilitazione, ASLUmbria2, Foligno, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2580-3646","authenticated-orcid":false,"given":"Eleonora","family":"Tavazzi","sequence":"additional","affiliation":[{"name":"General Neurology, IRCCS Mondino, Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Confalonieri","sequence":"additional","affiliation":[{"name":"Multiple Sclerosis Centre, Unit of Neuroimmunology and Neuromuscular Diseases, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Di Sabatino","sequence":"additional","affiliation":[{"name":"Clinica Neurologica, Dipartimento di Medicina e Chirurgia, Universit\u00e0 degli Studi di Perugia, Perugia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0891-4558","authenticated-orcid":false,"given":"Giovambattista","family":"Presti","sequence":"additional","affiliation":[{"name":"Kore University Behavioral Lab, Faculty of Human and Social Sciences, Universit\u00e0 degli Studi di Enna \u201cKore,\u201d Enna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-4434-9076","authenticated-orcid":false,"given":"Simone","family":"Napolitano","sequence":"additional","affiliation":[{"name":"\u201cQui e Ora\u201d\u2014Centro per la promozione del benessere psicologico, Catanzaro, 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