Currently submitted to: JMIR Research Protocols
Date Submitted: Nov 11, 2026
Open Peer Review Period: Nov 12, 2026 - Jan 7, 2027
(currently open for review)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Remote Delivery of a Stress-Recovery Intervention for Myocardial Infarction Survivors Younger Than 55 Years With Cardiac Distress (BRIM-55): Rationale and Protocol for a Single-Arm Feasibility Study
ABSTRACT
Background:
Myocardial infarction (MI) among adults younger than 55 years is an important public health challenge. Compared with older patients, younger MI survivors experience greater psychological distress and face specific challenges related to working life, family responsibilities, and adaptation to life after MI. Cardiac distress has emerged as a clinically important patient-reported outcome encompassing the emotional, cognitive, behavioral, and social burden of heart disease, yet few psychological interventions have been developed for younger people with MI. The stress-recovery intervention Behavioral Recovery Intervention for General Health and Thriving (BRIGHT), developed for prolonged stress related to everyday stressors, has been adapted for remote delivery to younger people with MI who experience cardiac distress (MI-BRIGHT). Recruitment, adherence, and retention are recognized challenges in trials of remote psychological interventions.
Objective:
This study aims to evaluate the feasibility and acceptability of MI-BRIGHT and of the planned trial procedures, using prespecified progression criteria, before a full-scale randomized controlled trial.
Methods:
This is a prospective, single-arm feasibility study aiming to enroll approximately 30 people who had an MI before the age of 55 years within the previous 12 months and who report cardiac distress. Participants are identified through the Swedish quality registry SWEDEHEART and recruited nationwide via a digital mailbox. MI-BRIGHT comprises 6 steps described in a printed workbook, supported by 6 online sessions with a personal supervisor and digital educational videos, delivered over 13 weeks. Feasibility outcomes are recruitment, acceptability, adherence, retention, adverse events, program credibility, and program satisfaction. Exploratory outcomes include cardiac distress, recovery experiences, health-related quality of life, depression, anxiety, work ability, and health care use.
Results:
The study is funded by the Swedish Research Council (grant 2023-02220) and was approved by the Swedish Ethical Review Authority (2025-07157-01). Recruitment began on August 28, 2026, and was completed on October 9, 2026, by which time 30 participants had provided informed consent. Data collection is expected to be completed in 2027, and the results are expected to be published in 2027.
Conclusions:
This feasibility study will provide evidence on the practicality and acceptability of MI-BRIGHT for younger MI survivors with cardiac distress and on recruitment, intervention delivery, adherence, and outcome assessment. The findings will inform refinement of the intervention and study procedures and determine whether progression to a fully powered randomized controlled trial is warranted. Clinical Trial: ClinicalTrials.gov NCT07706816; https://clinicaltrials.gov/study/NCT07706816
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