Feasibility and acceptability of a faith-based mind-body intervention among African American adults

Mind-body therapy for cardiometabolic risk in U.S. middle-aged Black adults: a scoping review

Background

In the U.S., Black adults do not achieve the same life expectancy as their White counterparts, and this is attributable in large part to the development of cardiovascular disease (CVD). Mind-body therapy (MBT) interventions demonstrate improvements in cardiometabolic risk (CMR) factors that promote CVD, with increased feasibility and acceptability in the general population. Less known is the feasibility, acceptability, and evidence of reduction in CMR factors in the U.S. Black population with MBT.

Purpose

This study aimed to synthesize the current state of research regarding MBT on CMR factors in middle-aged U.S. Black adults and identify gaps in the literature. Research Question 1: What types of studies have been conducted (study design, theoretical framework, and cultural relevance)? and Research Question 2: What is the feasibility and acceptability and effectiveness of MBT in Black adults for CMR reduction?

Methods

Following PRISMA-ScR guidelines, a review of three databases was conducted. Our inclusion criteria were articles that (1) describe empirical research; (2) assessed a MBT intervention in middle-aged (35-64) adults with a minimum of 60% Black adult participants for CMR reduction; and (3) written in English. Independent reviewers selected articles for inclusion and data extraction, with a third reviewer providing consensus.

Results

Fourteen articles met the eligibility criteria (n = 14). Characteristics included randomized controlled trials (8, 57.1%); single-arm (3, 21.0%); mixed methods (3, 21.0%); sample size (17-375); mean age range 43-64; female (6, 42.8%); theoretical framework (4, 28.6%); culturally adapted (7, 50.0%); and studies demonstrating feasibility and/or acceptability (7, 50.0%). Of the seven articles assessing CMR physiologic factors, five studies observed significant improvement. For the 11 studies assessing CMR psychological factors, 6 studies had statistically significant results and 3 studies identified trends toward positive statistical outcomes.

Implication

A growing body of literature across research stages demonstrating acceptability, and feasibility, and evidence of effectiveness for selected outcomes of MBT in middle-aged Black adults with CMR factors shows promise. Future research recommendations include greater recruitment of Black men for MBT studies, larger sample sizes, and utilizing culturally adapted interventions for engaging Black adults in MBT for reduced CMR factors.

Perceptions of mindfulness practices as a support for individuals managing caregiving responsibilities and chronic disease: A qualitative study

OBJECTIVES

Explore the lived experience of individuals managing and/or caregiving for someone with a chronic disease and their perceptions of developing a mindfulness program for stress reduction.

METHODS

Sixteen participants with chronic disease and/or caregivers participated. Participants completed eligibility screening, demographic questionnaires, and semi-structured interviews (30-60 min each) online or by phone. Interviews (n = 16) were audio recorded, transcribed, and analyzed using thematic analysis and NVivo® 12. Survey data were analyzed using SPSS® 28.

RESULTS

Four themes emerged: (a) Chronic disease management and stress-perspectives on life's stressors; (b) Stress reduction techniques/perceptions of mindfulness-knowledge and implementation of stress reduction practices and familiarity with mindfulness; (c) Mindfulness program acceptability, barriers, and facilitators-interest, barriers, and facilitators to attending; (d) Mindfulness program structure-logistics to increase access and appeal to diverse audiences.

DISCUSSION

Mindfulness has the potential for addressing the complexities of stress associated with disease management. Targeting mindfulness programs for populations with chronic disease management and caregiving responsibilities should include: Consideration of group formats with participation limited to this population, structuring programs to overcome barriers (i.e., culturally appropriate location), and equipping members of the community being served as instructors to ensure culturally relevant instruction.

Perceptions of Health Among Black Women in Emerging Adulthood: Alignment With a Health at Every Size Perspective

OBJECTIVE

To explore the health perceptions of Black women in emerging adulthood and the degree to which perceptions align with core Health at Every Size (HAES) principles.

DESIGN

Semistructured interviews with Black women in emerging adulthood. Data were collected between June and July 2018 as part of a larger, mixed-methods study.

SETTING

Southern California.

PARTICIPANTS

Forty-one Black women aged 18-24 years were recruited via a combination of convenience and respondent-drive sampling.

PHENOMENON OF INTEREST

Health perceptions of young Black women and alignment with core HAES principles.

ANALYSIS

Data were analyzed using principles of inductive thematic analysis. Following analysis, data were further interpreted within the HAES framework.

RESULTS

Participants' insights resulted in 3 main themes: (1) health is multidimensional, (2) good health means taking care of yourself, and (3) systemic and environmental disparities affect Black women's health. These themes reflect 3 HAES principles of health enhancement, weight inclusivity, and eating for well-being.

CONCLUSIONS AND IMPLICATIONS

Findings provide preliminary support for aligning HAES principles and perceptions and health for Black women in emerging adulthood. Prioritizing holistic well-being, attention to individualized health needs and access to needed information and resources in efforts to improve health outcomes among members of this demographic may be promising.

The impact of yoga on components of energy balance in adults with overweight or obesity: A systematic review

Background

Yoga may reduce body weight in individuals with overweight or obesity, but whether this occurs through decreased energy intake (EI) or increased energy expenditure (EE)/physical activity (PA) is unclear.

Methods

A systematic search of PubMed, Web of Science, Embase, and PsychINFO was conducted from inception until April 26, 2021. Eligible studies included randomized controlled trials or single-arm pre-post studies with any type and duration of yoga intervention in adults with overweight or obesity. Studies with measures related to EI , EE, or PA were eligible. The review initially identified 1,373 articles.

Results

Of the 10 included studies, one used indirect calorimeter measures of resting EE, while nine used self-reported measures of EI and PA. Of the seven studies measuring parameters related to EI, only one found greater decreases in EI relative to the control group, although three other investigations reported trends toward improved dietary intake. Of the eight studies measuring PA, two reported greater increases in resting EE or PA in the yoga group relative to the control group. Two reported significant within-group increases in PA from pre-post intervention, and four studies reported a trend for increased PA with no p-values reported.

Conclusions

Limited evidence suggests yoga may reduce EI and increase PA in adults with overweight or obesity. Additional studies that investigate the effects of yoga interventions on energy balance parameters using objective techniques are warranted.

A faith-based mind-body intervention to improve psychosocial well-being among rural adults

Churches are well positioned to promote better mental health outcomes in underserved populations, including rural adults. Mind-body (MB) practices improve psychological well-being yet are not widely adopted among faith-based groups due to conflicting religious or practice beliefs. Thus, "Harmony & Health" (HH) was developed as a culturally adapted MB intervention to improve psychosocial health in urban churchgoers and was adapted and implemented in a rural church. The purpose of this study was to explore the feasibility, acceptability, and efficacy of HH to reduce psychosocial distress in rural churchgoers. HH capitalized on an existing church partnership to recruit overweight or obese (body mass index [BMI] ≥25.0 kg/m2) and insufficiently active adults (≥18 years old). Eligible adults participated in an 8 week MB intervention and completed self-reported measures of perceived stress, depressive symptoms, anxiety, and positive and negative affect at baseline and postintervention. Participants (mean [M] age = 49.1 ± 14.0 years) were mostly women (84.8%), non-Hispanic white (47.8%) or African American (45.7%), high socioeconomic status (65.2% completed ≥bachelor degree and 37.2% reported an annual household income ≥$80,000), and obese (M BMI = 32.6 ± 5.8 kg/m2). Participants reported lower perceived stress (t = -2.399, p = .022), fewer depressive symptoms (t = -3.547, p = .001), and lower negative affect (t = -2.440, p = .020) at postintervention. Findings suggest that HH was feasible, acceptable, and effective at reducing psychosocial distress in rural churchgoers in the short-term. HH reflects an innovative approach to intertwining spirituality and MB practices to improve physical and psychological health in rural adults, and findings lend to our understanding of community-based approaches to improve mental health outcomes in underserved populations.

Fostering spirituality and psychosocial health through mind-body practices in underserved populations

Background

This study examined changes in spirituality and psychosocial outcomes among African American and rural adults participating in a culturally-adapted mind-body intervention.

Methods

African American (n = 22) and rural (n = 38) adults in Harmony & Health attended mind-body sessions twice a week for eight weeks and completed questionnaires on spirituality and psychosocial distress at baseline and post-intervention. Linear regression and repeated measures analyses were used to examine associations between intervention attendance and spirituality.

Results

Attendance was significantly associated with increased spirituality (β=0.168, p = 013). Repeated measures analyses revealed a significant three-way interaction between attendance, spirituality, and study site (F(9,31)=2.891, p = 013). Urban African American participants who attended ≥75% of sessions reported greater increases in spirituality.

Conclusion

Findings suggest that mind-body practices may foster spirituality in urban African American adults. Additional adaptations are needed to strengthen spirituality in rural residents and to improve psychosocial health and wellbeing in this underserved population.