The travel destination, Bad Tatzmannsdorf, is a small resort town (1,300 inhabitants) in a rural part of eastern Austria with a spa treatment center, two rehabilitation centers, and several hotels encircling a large park. Spa therapy is a common form of treatment in Austria incorporating treatments such as massages, baths, mud packs, exercise treatment, and health counseling administered during a 3-week stay at a resort.[31] The aim is to improve health especially in regard to chronic musculoskeletal pain and cardiovascular

risk factors. The costs for spa therapy including the stay at the health resort are covered by public health insurance. Individuals participating in this study lived in a hotel. A daily selleck chemicals llc BP value was calculated as mean of the morning and evening BP readings after imputing missing values in both readings using linear interpolation. On average, 2.3% of the morning BP measurements and 11.1% of the evening BP measurements were missing. The correlation between morning and evening baseline BP was r = 0.84/0.69 (systolic/diastolic). High correlations between morning and evening BP measures (r = 0.90/0.88)

previously have been reported in literature.[32] The late afternoon measures were excluded due to frequent missing values, large differences in recording time and the potential of being affected to a greater extent by daily chores and work. The correlation of baseline home BP measurements and clinical BP assessment made on the first day of the study is r = 0.72/0.62, thus documenting an acceptable unless validity of the home

BP measurement. The quality of sleep and mood were recorded in a CX-5461 molecular weight diary on 7-point Likert scales. The phrasing was “last night, I slept very poorly/very well” and “today I am in very bad/in very good mood.” On average, 1.6% of the sleep or mood measures were missing. These again were imputed using linear interpolation. This format of single item measures was used on grounds of acceptability for participants, as the diary had to be filled out on a daily basis over 9 weeks. Single item self-report measures are used for the assessment of different aspects of health and well-being and are generally considered to have good reliability.[33, 34] The correlation of baseline quality of sleep and the average number of nocturnal awakenings reported at the onset of the study was r = 0.52, thus indicating some cross-validity of the used sleep scale. The correlations of baseline mood with the scales “negative mood” of a well-known standardized German quality of life questionnaire[35] as well as with “burnout,” a well-known standardized measure of general well-being,[36, 37] was r = −0.43 and r = −0.56, respectively, indicating an acceptable validity for assessing general well-being. As a reference value for every-day home-based life, a baseline value (BL) was calculated as average of the 3-week period prior to the temporary change of residence.