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Martin ZT, Fields ND, Erving CL, Udaipuria S, Moore RH, Blevins KM, Murden RJ, Booker B, Culler L, Swanson S, Goodson J, Barinas-Mitchell E, Quyyumi AA, Vaccarino V, Lewis TT. Central Hemodynamics in African American Women: Examining the Role of Superwoman Schema Endorsement. J Am Heart Assoc 2024; 13:e033587. [PMID: 39149994 DOI: 10.1161/jaha.123.033587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Accepted: 04/19/2024] [Indexed: 08/17/2024]
Abstract
BACKGROUND African American women bear a disproportionate burden of cardiovascular diseases, potentially due to altered central hemodynamics. Racism and sexism often lead to African American women taking on numerous caretaking roles and overall increases their use of the Strong Black Woman (ie, Superwoman) mindset, which may have negative health consequences. We hypothesized that endorsing the Superwoman role and its Obligation to Help Others dimension would be associated with a deleterious central hemodynamics profile in African American women. METHODS AND RESULTS Using cross-sectional data, we examined central systolic blood pressure (mm Hg; n=408), augmentation index (percentage, adjusted for height and heart rate; n=408), and pulse wave velocity (m/s; n=368) in African American women aged 30 to 46 years. The Giscombe Superwoman Schema (SWS) questionnaire assessed endorsement of Overall SWS (range, 0-105) and SWS-Obligation to Help Others (range, 0-3). Multiple linear regression modeled associations between Overall SWS (10-unit increments) and SWS-Obligation to Help Others (1-unit increments) and central hemodynamics while adjusting for pertinent sociodemographic, clinical, and psychosocial factors. In fully adjusted models, central systolic blood pressure was significantly associated with Overall SWS (β=0.83 [95% CI, 0.19-1.47]) and SWS-Obligation to Help Others (β=2.03 [95% CI, 0.39-3.67]). Augmentation index was associated with Overall SWS (β=0.66 [95% CI, 0.02-1.30]) and SWS-Obligation to Help Others (β=2.21 [95% CI, 0.58-3.84]). Significant associations were not observed between pulse wave velocity and SWS. CONCLUSIONS Greater endorsement of the Superwoman role and prioritizing caregiving over self-care were associated with higher central systolic blood pressure and augmentation index, which may contribute to adverse cardiovascular health among African American women.
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Affiliation(s)
- Zachary T Martin
- Department of Epidemiology, Rollins School of Public Health Emory University Atlanta GA USA
| | - Nicole D Fields
- Department of Epidemiology, Rollins School of Public Health Emory University Atlanta GA USA
- Hubert Department of Global Health, Rollins School of Public Health Emory University Atlanta GA USA
| | - Christy L Erving
- Department of Sociology, College of Liberal Arts The University of Texas at Austin Austin TX USA
| | - Shivika Udaipuria
- Department of Epidemiology, Rollins School of Public Health Emory University Atlanta GA USA
| | - Reneé H Moore
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health Drexel University Philadelphia PA USA
| | - Kennedy M Blevins
- Department of Psychological Science, School of Social Ecology University of California, Irvine Irvine CA USA
| | - Raphiel J Murden
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health Emory University Atlanta GA USA
| | - Bianca Booker
- Department of Epidemiology, Rollins School of Public Health Emory University Atlanta GA USA
| | - LaKeia Culler
- Department of Epidemiology, Rollins School of Public Health Emory University Atlanta GA USA
| | - Seegar Swanson
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health Emory University Atlanta GA USA
| | - Jaylah Goodson
- Department of Epidemiology, Rollins School of Public Health Emory University Atlanta GA USA
| | - Emma Barinas-Mitchell
- Department of Epidemiology, School of Public Health University of Pittsburgh Pittsburgh PA USA
| | - Arshed A Quyyumi
- Department of Medicine, School of Medicine Emory University Atlanta GA USA
| | - Viola Vaccarino
- Department of Epidemiology, Rollins School of Public Health Emory University Atlanta GA USA
- Department of Medicine, School of Medicine Emory University Atlanta GA USA
| | - Tené T Lewis
- Department of Epidemiology, Rollins School of Public Health Emory University Atlanta GA USA
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Shafer J, Harr E, Roth I, Williams S, Gaylord S, Faurot K. Telephone-based mindfulness intervention positively impacts family communication and stress within rural, African American dementia caregiving teams. Aging Ment Health 2024:1-7. [PMID: 39172043 DOI: 10.1080/13607863.2024.2392726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Accepted: 08/09/2024] [Indexed: 08/23/2024]
Abstract
OBJECTIVES The objective of this paper is to explore how telephone-delivered mindfulness training impacts family conflict and communication within the informal dementia caregiving team, including primary caregivers, their care partner, and the care recipient. METHOD Primary caregivers and their care partners participated in an eight-week telephone-delivered mindfulness-based intervention (MBI). This study used mixed methods and a pre-post design to evaluate the intervention's effect on family satisfaction, perceived support, and family conflict. RESULTS Both family satisfaction and perceived informational support increased significantly, and qualitative analysis revealed four key themes illustrating how the mindfulness intervention served to positively impact family conflict and communication among participating caregivers. CONCLUSION This study provides preliminary evidence for the beneficial effects of an MBI on family functioning among rural African American caregivers of people with Alzheimer's disease and related dementias.
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Affiliation(s)
- J Shafer
- Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA
| | - E Harr
- Department of Physical Medicine and Rehabilitation, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA
| | - I Roth
- Department of Physical Medicine and Rehabilitation, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA
| | - S Williams
- Department of Physical Medicine and Rehabilitation, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA
| | - S Gaylord
- Department of Physical Medicine and Rehabilitation, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA
| | - K Faurot
- Department of Physical Medicine and Rehabilitation, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA
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Xu Y, Hall WJ, Scott M, Gao Y, Chiang PC, Williams DY, Srivastava A, Ramon ME, Englert AR. Strategies for Coping with Minority Stress among Queer Young Adults: Usage Frequency, Associations with Demographics, and Mental Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:1052. [PMID: 39200662 PMCID: PMC11354887 DOI: 10.3390/ijerph21081052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2024] [Revised: 07/25/2024] [Accepted: 08/07/2024] [Indexed: 09/02/2024]
Abstract
Queer young adults report significantly higher levels of anxiety and depression than their heterosexual counterparts, which is linked to sexual minority stress. Therefore, it is important to understand the coping strategies employed by this population to navigate minority stress and how coping strategies may impact mental health outcomes. Drawing from a U.S. national diverse sample of 387 queer young adults (ages 18-39 years), we analyzed descriptive results of 11 behavioral strategies to cope with minority stress and used ordered logistic and linear regression to examine the following objectives: the frequency of the use of each coping strategy, and the associations between each strategy and demographic characteristics as well as depression and anxiety. Results revealed that avoidance and talking with friends were the most frequently utilized coping strategies, while prayer/religious activities and counseling/psychotherapy/support groups were infrequently used. We examined utilization preferences of coping strategies across demographic factors (e.g., assigned sex at birth and sexual orientation). The use of counseling/psychotherapy/support group was positively associated with mental health symptoms, while exercise and mindfulness/mediation were associated with lower mental health symptoms. Our findings provide insights for mental health researchers and professionals in selecting appropriate coping strategies for queer young adults in prevention and intervention efforts.
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Affiliation(s)
- Yinuo Xu
- School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; (W.J.H.); (M.S.); (P.-C.C.); (D.Y.W.); (A.S.); (M.E.R.); (A.R.E.)
- School of Education, University of North Carolina at Chapel Hill, Chapel Hill, NC 27514, USA;
| | - William J. Hall
- School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; (W.J.H.); (M.S.); (P.-C.C.); (D.Y.W.); (A.S.); (M.E.R.); (A.R.E.)
| | - McRae Scott
- School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; (W.J.H.); (M.S.); (P.-C.C.); (D.Y.W.); (A.S.); (M.E.R.); (A.R.E.)
| | - Yutong Gao
- School of Education, University of North Carolina at Chapel Hill, Chapel Hill, NC 27514, USA;
| | - Pin-Chen Chiang
- School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; (W.J.H.); (M.S.); (P.-C.C.); (D.Y.W.); (A.S.); (M.E.R.); (A.R.E.)
| | - Denise Yookong Williams
- School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; (W.J.H.); (M.S.); (P.-C.C.); (D.Y.W.); (A.S.); (M.E.R.); (A.R.E.)
| | - Ankur Srivastava
- School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; (W.J.H.); (M.S.); (P.-C.C.); (D.Y.W.); (A.S.); (M.E.R.); (A.R.E.)
| | - Magdelene E. Ramon
- School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; (W.J.H.); (M.S.); (P.-C.C.); (D.Y.W.); (A.S.); (M.E.R.); (A.R.E.)
| | - Adam R. Englert
- School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; (W.J.H.); (M.S.); (P.-C.C.); (D.Y.W.); (A.S.); (M.E.R.); (A.R.E.)
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Watson-Singleton NN, Pennefather J. Using a Randomized Clinical Trial to Test the Efficacy of a Culturally Responsive Mobile Health Application in African Americans. Behav Ther 2024; 55:813-824. [PMID: 38937052 DOI: 10.1016/j.beth.2023.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Revised: 11/19/2023] [Accepted: 12/12/2023] [Indexed: 06/29/2024]
Abstract
Mindfulness is a promising health promotion strategy for African Americans, and it is imperative that culturally responsive mindfulness approaches be accessible to this population. One way to address this need is to develop and test if culturally responsive mobile health (mhealth) applications are efficacious in reducing stress-related outcomes in this population. With this goal in mind, we employed a repeated-measures randomized control trial (RCT) across a 12-week intervention period to evaluate if participants in the intervention group outperformed a wait-list control group in reductions in stress, depressive symptoms, anxiety, emotional regulation difficulties as well as in increases in self-compassion, resilience, and mindfulness attitudes and behaviors. Our sample included 170 Black/African American participants who were randomly assigned to either the intervention condition (n = 84) or the wait-list control group (n = 86). Participants in the intervention condition reported more self-compassion, used more mindfulness, and had greater self-efficacy using mindfulness; yet, no other differences were evident. Participants expressed high levels of satisfaction with the app and gave it a positive rating for its relevance to their lives. These findings support the efficacy of a culturally responsive mindfulness mHealth app to enhance self-compassion and increase the use of health-promoting behaviors, like mindfulness, among African Americans. Implications for future research are discussed.
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Michaud M, Evans M, Mendez R, Zapanta J, Trochez A, Mehta KM, Márquez-Magaña L, Parangan-Smith A. Investigating the Impacts of a Modified Mindfulness Practice on Minoritized College Students' Chronic Stress. INTEGRATIVE MEDICINE REPORTS 2024; 3:102-110. [PMID: 39211561 PMCID: PMC11353227 DOI: 10.1089/imr.2024.0009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/02/2024] [Indexed: 09/04/2024]
Abstract
Context Students of color in the United States experience elevated stress across the entire spectrum of education, spanning from early stages of K-12 to the more advanced stages of postgraduate studies. This sustained state of chronic stress decreases learning and curtails opportunities, especially in science, technology, engineering, and math (ST EM) fields, where stress levels are considered exceptionally high. Mindfulness-based practices such as MBSR have a proven effective for stress reduction in college students. However, to date, mindfulness practices have yet to be designed to support the unique needs of minoritized students with intersectional identities (e.g., poor, English as second language learners, and sexual/gender minorities) that are stigmatized in ST EM. Objectives This article describes the development of an online, eight-week modified mindfulness practice (MMP) for minoritized students adapted from traditional MBSR. The MMP was purposely designed to be culturally inclusive and anti-racist, with the goal to reduce stress in undergraduate students of color in ST EM. Methods In this pilot study, we assessed the impact of MMP using both biological and perceived stress measures. Specifically, cortisol was measured from donated biospecimen hair samples, the Perceived Stress Scale measured perceived stress, and key informant interviews were conducted to understand student stressors and coping strategies before and after the intervention. Results While the observed decrease biological and perceived stress before and after the intervention was not statistically significant due to the small sample size of this pilot study, we see a dramatic positive change in student coping strategies. Conclusion This study highlights the importance of providing minoritized students with options for stress reduction that are relevant and accessible.
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Affiliation(s)
- Midley Michaud
- Department of Biology, San Francisco State University, San Francisco, CA, USA
- SF BUILD, San Francisco State University, San Francisco, CA, USA
| | - Maiya Evans
- Department of Holistic Health, College of Health and Social Sciences, San Francisco State University, San Francisco, CA, USA
| | - Rebecca Mendez
- Department of Biology, San Francisco State University, San Francisco, CA, USA
| | - Jalena Zapanta
- Department of Biology, San Francisco State University, San Francisco, CA, USA
| | - Anthony Trochez
- Department of Education, University of California Los Angeles, Occidental College, Los Angeles, CA, USA
| | - Kala M. Mehta
- SF BUILD, San Francisco State University, San Francisco, CA, USA
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Leticia Márquez-Magaña
- Department of Biology, San Francisco State University, San Francisco, CA, USA
- SF BUILD, San Francisco State University, San Francisco, CA, USA
| | - Audrey Parangan-Smith
- Department of Biology, San Francisco State University, San Francisco, CA, USA
- SF BUILD, San Francisco State University, San Francisco, CA, USA
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Davis AM, Burks-Abbott G, Merecias O, Swenor BK. Autism interventions designed or adapted for the Black/African American population: A systematic review. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024:13623613241259910. [PMID: 38910297 DOI: 10.1177/13623613241259910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/25/2024]
Abstract
LAY ABSTRACT Black/African American people in the United States who have a diagnosis of autism often experience service-related disparities, including not having the same access to high-quality autism and related care (e.g. behavioral interventions), and are less likely to have sustained treatment engagement across their lifespan. While interventions to support autistic people are typically designed to be universal, there is concern that these interventions not being tailored to the Black/African American population could reduce the overall impact due to a lack of responsiveness to the needs of the Black children or families who receive the intervention. The current systematic review summarized research on interventions developed for the Black autism community, including Black children with autism and their caregivers. After a comprehensive, systematic search, eight peer-reviewed publications were identified that met the study's inclusion criteria. The majority of the interventions were tailored to Black caregivers of children with autism. Autism researchers demonstrate different strategies for engaging Black caregivers in culturally responsive ways; however, more research into these interventions is needed in order to assess their effectiveness. In addition, there are still limited interventions adapted to be culturally responsive to Black/African American autistic people. The Cultural Adaptation Checklist framework is a novel approach with promise to become the standard for adapting interventions to meet the needs of culturally diverse groups. Cultural responsiveness is an important facet in the development of interventions that produce optimal outcomes for the range of diversity in the United States and is an important step to achieving equitable autism research practices.
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Woods-Giscombe CL, Gaylord S, Bradford A, Vines S, Eason K, Smith R, Addo-Mensah D, Lackey C, Dsouza V, Sheffield-Abdullah K, Day T, Green-Scott K, Chilcoat A, Peace-Coard A, Chalmers L, Evenson KR, Samuel-Hodge C, Lewis TT, Crandell J, Corbie G, Faurot K. Protocol of the HARMONY study: A culturally relevant, randomized-controlled, stress management intervention to reduce cardiometabolic risk in African American women. Contemp Clin Trials 2024; 146:107604. [PMID: 38866096 DOI: 10.1016/j.cct.2024.107604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 05/16/2024] [Accepted: 06/09/2024] [Indexed: 06/14/2024]
Abstract
BACKGROUND African American Women (AAW) are at high risk for stress-related cardiometabolic (CM) conditions including obesity, heart disease, and diabetes. Prior interventions lack attention to culturally-nuanced stress phenomena (Superwoman Schema [SWS], contextualized stress, and network stress), which are positively and significantly associated with unhealthy eating and sedentary behavior. PURPOSE The HARMONY Study is designed to test a culturally tailored mindfulness-based stress management intervention to address SWS, contextualized stress, and network stress as potential barriers to adherence to healthy exercise and eating goals. The study will help AAW build on their strengths to promote cardiometabolic health by enhancing positive reappraisal, self-regulation, and self-efficacy as protective factors against chronic stress-inducing biobehavioral morbidity and mortality risk. METHODS This two-arm, randomized-controlled trial will test the effects of two group-based, online interventions. HARMONY 1 includes culturally-tailored exercise and nutrition education. HARMONY 2 includes mindfulness-based stress reduction, exercise, and nutrition education. We aim to recruit 200 AAW ≥ 18 years old with CM risk. RESULTS Primary outcomes (actigraphy and carotenoid levels) and secondary outcomes (body composition, inflammatory markers, glucose metabolism, and stress) are being collected at baseline and 4-, 8-, and 12-months post-intervention. Intent-to-treat, data analytic approaches will be used to test group differences for the primary outcomes. DISCUSSION This study is the first to address culturally-nuanced stress phenomena in AAW (SWS, network stress, and contextualized stress) using culturally-tailored stress management, exercise, and nutrition educational approaches to reduce biobehavioral CM risk among AAW. Quantitative and qualitative results will inform the development of scalable and sustainable CM risk-reduction programming for AAW. TRIAL REGISTRATION The Multiple PIs registered the clinical trial (Identifier: NCT04705779) and reporting of summary results in ClinicalTrials.gov in accordance with the NIH Policy on the Dissemination of NIH-Funded Clinical Trial Information, within the required timelines.
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Affiliation(s)
- Cheryl L Woods-Giscombe
- School of Nursing, The University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America.
| | - Susan Gaylord
- Program for Integrated Medicine, School of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Andrew Bradford
- School of Nursing, The University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Sierra Vines
- School of Nursing, The University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Kelly Eason
- Physical Medicine Rehab, School of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Raven Smith
- School of Nursing, The University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Dorothy Addo-Mensah
- School of Nursing, The University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Charity Lackey
- School of Nursing, The University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Vinisha Dsouza
- School of Nursing, The University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Karen Sheffield-Abdullah
- School of Nursing, The University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Tomeka Day
- School of Nursing, The University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Kerri Green-Scott
- School of Nursing, The University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Aisha Chilcoat
- Physical Medicine Rehab, School of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Angela Peace-Coard
- School of Nursing, The University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - LaTonia Chalmers
- School of Nursing, The University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Kelly R Evenson
- Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Carmen Samuel-Hodge
- Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Tene T Lewis
- Rollins School of Public Health, Emory University, Atlanta, GA, United States of America
| | - Jamie Crandell
- School of Nursing, The University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Giselle Corbie
- Department of Social Medicine, School of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Keturah Faurot
- Physical Medicine Rehab, School of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
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Frank HE, Albanese A, Sun S, Saadeh F, Johnson BT, Elwy AR, Loucks EB. Mindfulness-Based Stress Reduction Health Insurance Coverage: If, How, and When? An Integrated Knowledge Translation (iKT) Delphi Key Informant Analysis. Mindfulness (N Y) 2024; 15:1220-1233. [PMID: 38817538 PMCID: PMC11133142 DOI: 10.1007/s12671-024-02366-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/24/2024] [Indexed: 06/01/2024]
Abstract
Objectives Hundreds of trials have evaluated Mindfulness-Based Stress Reduction (MBSR), but in the United States, it is generally not covered by health insurance. Consequently, the aims were to identify the following: (1) key questions to make decisions about if, how, and when MBSR should be covered by health insurance; (2a) barriers and (2b) facilitators to understand and resolve for MBSR to be covered by health insurance; and (3) highest priority evidence needed to inform health insurance coverage decisions. Methods Key informants (n = 26) included health insurers, healthcare administrators, policymakers, clinicians, MBSR instructors, and MBSR students. An initial pool of items related to the study aims was generated through qualitative interviews. Through the Delphi process, participants rated, discussed, and re-rated each item's relevance. Items were required to reach a consensus of ≥ 80% agreement to be retained for final inclusion. Results Of the original 149 items, 42 (28.2%) met the ≥ 80% agreement criterion and were retained for final inclusion. The most highly rated items informing whether MBSR should be covered by health insurance included research demonstrating that MBSR works and that it is not harmful. The most highly rated barriers to coverage were that MBSR is not a medical treatment and patient barriers to attendance. Highly rated facilitators included the potential of MBSR to address common mental health and psychosomatic problems. Finally, understanding what conditions are effectively treated with MBSR and the impact of MBSR on stress were rated as the highest priority evidence needed to inform health insurance coverage decisions. Conclusions Findings highlight priorities for future research and policy efforts to advance health insurance coverage of MBSR in the United States. Supplementary Information The online version contains supplementary material available at 10.1007/s12671-024-02366-x.
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Affiliation(s)
- Hannah E. Frank
- Department of Psychiatry and Human Behavior, The Warren Alpert Medical School, Brown University, Providence, RI USA
| | - Ariana Albanese
- Department of Psychiatry and Human Behavior, The Warren Alpert Medical School, Brown University, Providence, RI USA
| | - Shufang Sun
- Department of Behavioral and Social Sciences, School of Public Health, Brown University, Providence, RI USA
- Mindfulness Center, Brown University, Providence, RI USA
| | - Frances Saadeh
- Mindfulness Center, Brown University, Providence, RI USA
- School of Professional Studies, Brown University, Providence, RI USA
| | - Blair T. Johnson
- Department of Psychological Sciences, University of Connecticut, Storrs, CT USA
| | - A. Rani Elwy
- Department of Psychiatry and Human Behavior, The Warren Alpert Medical School, Brown University, Providence, RI USA
- Center for Healthcare Organization and Implementation Research, VA Bedford Healthcare System, Bedford, MA USA
| | - Eric B. Loucks
- Mindfulness Center, Brown University, Providence, RI USA
- Department of Epidemiology, School of Public Health, Brown University, Providence, RI 02910 USA
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Rice HM, Collins CC, Singh M, Cherney E, Hercbergs D. The Impact of Covid-19 on Community Perinatal Doula Support Services for Black Women. Matern Child Health J 2024; 28:858-864. [PMID: 38349424 DOI: 10.1007/s10995-023-03858-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/11/2023] [Indexed: 04/09/2024]
Abstract
OBJECTIVES To better understand the experiences of Black pregnant women during COVID-19, we examined Black pregnant clients' and doulas' experiences with perinatal support services amid COVID-19's social distancing protocols. METHODS We used qualitative description, employing a social constructionist framework to interview 12 perinatal support doulas and 29 Black women who were pregnant or gave birth during the pandemic about their experiences during the pandemic, when social distancing was required. RESULTS Three key themes were identified: (1) Clients experienced increased social isolation; (2) Doulas' exclusion from medical visits limited women's access to support and advocacy; (3) Doula support as a sisterhood helped clients mitigate effects of COVID isolation. CONCLUSIONS FOR PRACTICE Doulas should be considered essential support persons for Black pregnant women and should not be excluded from the birthing team. Support through technology is acceptable for some clients but less desirable for others and restricted doula's ability to build rapport and be hands on with their clients.
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Affiliation(s)
- Heather M Rice
- School of Nursing, Cleveland State University, Cleveland, OH 44115, USA.
| | - Cyleste C Collins
- School of Social Work, Cleveland State University, Cleveland, OH 44115, USA
| | - Monica Singh
- School of Social Work, Cleveland State University, Cleveland, OH 44115, USA
| | - Emily Cherney
- School of Social Work, Cleveland State University, Cleveland, OH 44115, USA
| | - Dana Hercbergs
- School of Social Work, Cleveland State University, Cleveland, OH 44115, USA
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Telles R, Whitney BM, Froelich S, Lutgendorf SK. Mindfulness-based psychosocial interventions and psychological wellbeing in cancer survivorship: a meta-analysis. Health Psychol Rev 2024:1-27. [PMID: 38561221 DOI: 10.1080/17437199.2024.2336014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 03/22/2024] [Indexed: 04/04/2024]
Abstract
PURPOSE Among cancer survivors, mindfulness-based interventions appear promising in decreasing distress for cancer patients, but little attention has been paid to the ultimate mindfulness goal of increasing psychological wellbeing. This meta-analysis aims to summarise and synthesise available evidence concerning the effectiveness of MBIs on positive psychological outcomes reflecting key aspects of psychological wellbeing in heterogeneous cancer patients. METHODS A literature search of mindfulness-based randomised clinical trials in cancer survivors was conducted across six electronic databases. Two reviewers independently screened studies and extracted data. Meta-analyses were conducted using R; standardised mean difference (SMD) was used to determine intervention effect. Moderators examined included therapeutic orientation, control group type, treatment modality, treatment target, heterogeneous vs. homogeneous cancer type, and facet of wellbeing. RESULTS Thirty-one studies were included (N = 2651). Those who received mindfulness-based interventions reported significantly higher eudaimonic, hedonic, and social wellbeing than respondents in control groups (SMD = 0.599). Interventions were equally effective across therapeutic orientation, control group type, treatment modality and treatment target. There were trend level differences favouring homogeneous cancer diagnosis groups over heterogeneous diagnosis groups. CONCLUSION MBIs provide an effective treatment for increasing psychological wellbeing in cancer survivors. This finding has important implications for clinical practice.
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Affiliation(s)
- Rachel Telles
- Department of Psychological & Brain Sciences, University of Iowa, Iowa City, IA, USA
| | - Brendan M Whitney
- Department of Psychological & Brain Sciences, University of Iowa, Iowa City, IA, USA
| | - Sarah Froelich
- Department of Psychological & Brain Sciences, University of Iowa, Iowa City, IA, USA
| | - Susan K Lutgendorf
- Department of Psychological & Brain Sciences, University of Iowa, Iowa City, IA, USA
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Iowa, Iowa City, IA, USA
- Holden Comprehensive Cancer Center, University of Iowa, Iowa City, IA, USA
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11
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Garfield L, Watson-Singleton NN, Mathews HL, Witek Janusek L. Protocol for a pilot study assessing a virtual mindfulness intervention for postpartum African American women. BRAIN BEHAVIOR AND IMMUNITY INTEGRATIVE 2024; 6:100060. [PMID: 39036323 PMCID: PMC11258811 DOI: 10.1016/j.bbii.2024.100060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 07/23/2024]
Abstract
Elevated perinatal depressive symptoms are more common among disadvantaged African American women, and they are almost four times as likely to have postpartum posttraumatic stress compared to white women. For new mothers, depressive symptoms and posttraumatic stress can lead to negative parenting, poor mother-infant bonding, and delayed infant development. For African American women, a culturally adapted mindfulness-based intervention offers great potential as an acceptable approach to reduce psycho-behavioral symptoms and improve mother-infant interactions (i.e., bonding). Additionally, it is critical that mindfulness interventions consider time constraints of new mothers, provide accessible intervention delivery, address parenting, and consider the challenges of caring for an infant. Given these considerations, we describe a pilot research protocol in which we evaluate a culturally adapted mindfulness program: Mindfulness for African Americans Postpartum (MAAP). The intervention is based upon Kabat-Zinn's Mindfulness Based Stress Reduction program, but is adapted to include culturally relevant concepts of spirituality, inter-dependence, self-empowerment, and storytelling, which are salient to African American culture. To accommodate the needs of new mothers, a certified mindfulness interventionist delivers each session virtually using Zoom. The investigation uses a randomized controlled design in which African American women within 12 months of giving birth are randomized either to the MAAP intervention or to an Education Program. The primary aim is to determine the extent to which the MAAP intervention decreases maternal psycho-behavioral symptoms (perceived stress, depressive symptoms, anxiety, poor sleep, posttraumatic stress, and fatigue) and improves mother-infant bonding. A secondary aim is to explore the effects of MAAP on proinflammatory cytokines and oxytocin. Culturally adapted mindfulness interventions delivered virtually will make mindfulness more accessible and meaningful to populations, like African American new mothers, who are at higher risk for postpartum mood disorders and poor infant outcomes.
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Affiliation(s)
- Lindsey Garfield
- Marcella Niehoff School of Nursing, 2160 S. First Ave, Maywood, IL 60153, United States
| | - Natalie N. Watson-Singleton
- Spelman College, Department of Psychology, 350 Spelman Lane, Box 1657 Giles Hall 317, Atlanta, GA 30314, United States
| | - Herbert L. Mathews
- Stritch School of Medicine, Department of Microbiology and Immunology, Loyola University Chicago, United States
| | - Linda Witek Janusek
- Marcella Niehoff School of Nursing, Loyola University Chicago, United States
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12
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Pham TV, Kincade M, Vranceanu AM. Culturally Adapting Mind-Body Interventions for Black Individuals with Chronic Pain: Arguments and Recommendations Towards a Task-Sharing Approach. Adv Mind Body Med 2024; 37:12-19. [PMID: 38466049 PMCID: PMC11168092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
Abstract
Compared to non-Hispanic White individuals, non-Hispanic Black Individuals report worse chronic pain from a variety of medical issues. Among the options for non-pharmacological pain treatment, mind-body interventions (MBI) are a promising modality to help Black individuals manage their chronic pain effectively. MBIs such as mindfulness meditation improve chronic pain and chronic pain-related outcomes by shifting the individual's perception of pain away from stress-related cognitive appraisals, emotional reactions, and behaviors. MBIs may also address disparities in chronic pain outcomes between Black and White individuals because of their contextual overlap with (1) centering and contemplative prayer, (2) racial empowerment, and (3) social support. Despite this overlap, the demand for MBIs among Black individuals has generally been low due to lingering access and acceptability barriers. To reduce these barriers for Black individuals with chronic pain, we must adopt a community-engaged approach and culturally adapt MBIs for the specific historic, environmental, financial, and psychosocial needs of Black individuals. Example adaptations include increasing Black representation among MBI instructors, reducing geographical access barriers, accommodating the financial and personal realities of Black adults, and explicitly allowing relevant attitudes, practices, and terms.
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Affiliation(s)
- Tony V Pham
- Department of Psychiatry, Massachusetts General Hospital
| | - Michael Kincade
- Center for Alzheimer's Research and Treatment, Massachusetts Alzheimer's Disease Research Center
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13
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West NT, Harmon BE, Rawlett KE, Short SJ, Spanier AJ, Mathews S, Kimble K, McGehee C, Ratliff ML, Puett RC. Perceptions of mindfulness practices as a support for individuals managing caregiving responsibilities and chronic disease: A qualitative study. Chronic Illn 2024; 20:159-172. [PMID: 37077138 DOI: 10.1177/17423953231170401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/21/2023]
Abstract
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.
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Affiliation(s)
- Nathan T West
- Institute of Social and Economic Research, University of Alaska Anchorage, Anchorage, AK, USA
| | - Brook E Harmon
- Department of Nutrition and Health Care Management, Beaver College of Health Sciences, Appalachian State University, Boone, NC, USA
| | - Kristen E Rawlett
- Department of Family and Community Health, School of Nursing, University of Maryland, Baltimore, MD, USA
| | - Sarah J Short
- Department of Educational Psychology, University of Wisconsin, Madison, WI, USA
- Center for Healthy Minds, University of Wisconsin, Madison, WI, USA
| | - Adam J Spanier
- Department of Pediatrics, Division of General Pediatrics, School of Medicine, University of Maryland, Baltimore, MD, USA
| | - Shifali Mathews
- Maryland Institute for Applied Environmental Health, School of Public Health, University of Maryland, College Park, MD, USA
| | | | - Chad McGehee
- Center for Healthy Minds, University of Wisconsin, Madison, WI, USA
- Department of Athletics, University of Wisconsin, Madison, WI, USA
| | - Macy L Ratliff
- Center for Healthy Minds, University of Wisconsin, Madison, WI, USA
| | - Robin C Puett
- Maryland Institute for Applied Environmental Health, School of Public Health, University of Maryland, College Park, MD, USA
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14
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Haidar A, Kalantzis M, Nallajerla M, Vela A, Adler SR, Burnett-Zeigler I. A Qualitative Examination of Perceptions of Mindfulness Among Arab, Middle Eastern, and North African Americans: Implications for Cultural Adaptation of Mindfulness-Based Interventions. GLOBAL ADVANCES IN INTEGRATIVE MEDICINE AND HEALTH 2024; 13:27536130241247074. [PMID: 38655072 PMCID: PMC11036918 DOI: 10.1177/27536130241247074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Revised: 03/22/2024] [Accepted: 03/27/2024] [Indexed: 04/26/2024]
Abstract
Background Mindfulness-based interventions (MBIs) are well-positioned to address health disparities among racial-ethnic minority communities, given their focus on stress reduction and potential for greater accessibility and acceptability than conventional mental health treatments. Yet, there are currently no peer-reviewed studies of MBIs in an Arab, Middle Eastern, or North African (MENA) American sample. Addressing this gap in the literature is critical for advancing integrative health equity, given the high burden of stress and high prevalence of stress-related health conditions among Arab/MENA Americans. Objective The present study sought to explore perceptions of mindfulness among Arab/MENA Americans and identify potential cultural adaptations to MBIs for this population. Methods 4 focus groups were conducted with 26 Arab/MENA American adults who had participated in an introductory mindfulness workshop. Participants were asked about their experience learning mindfulness skills, the usefulness of mindfulness for problems they face, the alignment of mindfulness with their cultural values and practices, and suggestions for adapting mindfulness programs. Qualitative coding of focus group session transcriptions was conducted to identify themes in the data. Conclusion The participants in this study described experiencing high levels of stress and identified micro- and macro-level stressors related to their Arab/MENA American identity, including discrimination, exclusion, historical and intergenerational trauma, and protracted sociopolitical crises in their heritage countries. They viewed mindfulness as a potentially useful approach to coping with stress. At the same time, participants identified aspects of mindfulness that could be adjusted to better align with their cultural values and experiences. Potential adaptations to MBIs for Arab/MENA Americans were identified based on suggestions from participants and issues they raised while discussing cultural strengths, stressors they face, and perceived barriers and facilitators to engaging in mindfulness practice.
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Affiliation(s)
- Andrea Haidar
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Maria Kalantzis
- Department of Psychology, Bowling Green State University, Bowling Green, OH, USA
| | - Meghana Nallajerla
- USC Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - Alyssa Vela
- Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Shelley R. Adler
- UCSF Osher Center for Integrative Health, University of California San Francisco, San Francisco, CA, USA
| | - Inger Burnett-Zeigler
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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Dejene A, Carter Z, Woo E, Sun S, Loucks EB, Proulx J. The Evolution of Mindfulness-Based Stress Reduction Teacher Training Programs for People Who Serve Historically Underrepresented Racial and Ethnic Groups. GLOBAL ADVANCES IN INTEGRATIVE MEDICINE AND HEALTH 2024; 13:27536130241244744. [PMID: 38623412 PMCID: PMC11017240 DOI: 10.1177/27536130241244744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 03/11/2024] [Accepted: 03/13/2024] [Indexed: 04/17/2024]
Abstract
Background There is a lack of mindfulness instructors from underserved/underrepresented communities who have completed systematic mindfulness teacher-training programs to meet the growing demand for culturally responsive mindfulness training in those communities. Objectives To investigate strategies for increasing the representation of Mindfulness-Based Stress Reduction (MBSR) teachers who serve historically underrepresented racial and ethnic groups. Methods Conducted through 4 one-hour Zoom focus groups (n = 54; women = 74%), this study queried individuals with experience serving underrepresented racial and ethnic communities, and had mindfulness experience, on how to increase participation from underrepresented communities in mindfulness. Thematic analysis of transcripts of participant responses involved double-coding by three team members, supporting rigorous evaluation of the data. All respondents who expressed interest in participating enrolled (no dropout from study enrollment to participation in focus groups). Results The study identified four key themes that illuminate challenges and essential adaptations for MBSR teacher training aimed at individuals serving historically underrepresented racial and ethnic groups. These themes include: (1) Cost and time commitment; (2) Trauma sensitivity; (3) Cultural Awareness; and (4) Diversity in teachers. Conclusion Participants provided actionable recommendations poised to facilitate the expansion of MBSR into more diverse communities, emphasizing optimal benefits and effective communication of inherent healing strengths within these communities. The findings underscore the compelling interest among leaders in marginalized communities to extend the reach of MBSR through culturally responsive approaches. This involves guiding pertinent adjustments and encouraging greater involvement of underserved communities in MBSR teacher training programs.
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Affiliation(s)
- Abraham Dejene
- Department of Behavioral and Social Science, Brown University, Providence, RI, USA
| | - Zoie Carter
- Department of Behavioral and Social Science, Brown University, Providence, RI, USA
| | - Erin Woo
- Department of Behavioral and Social Science, Brown University, Providence, RI, USA
| | - Shufang Sun
- Department of Behavioral and Social Science, Brown University, Providence, RI, USA
| | - Eric B. Loucks
- Department of Behavioral and Social Science, Brown University, Providence, RI, USA
| | - Jeffrey Proulx
- Department of Behavioral and Social Science, Brown University, Providence, RI, USA
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16
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de Fátima Fernandes MN, Ciol MA, Camargo Júnior EB, Guidorizzi Zanetti AC, Gherardi-Donato ECDS. Validation of the Brazilian Version of the Langer Mindfulness Scale. J Nurs Meas 2023; 31:569-579. [PMID: 37553159 DOI: 10.1891/jnm-2021-0096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/10/2023]
Abstract
Background and Purpose: The Langer Mindfulness Scale (LMS) is distinguished from other mindfulness scales by its dimensions, which are closely related to the awareness and experience of novelty, and by being a scale derived from a cognitive perspective of information processing. There are no mindfulness instruments of this type available in Brazil. Therefore, this study aimed to carry out a translation and cultural adaptation of the LMS into Brazilian Portuguese and to validate and assess the internal consistency and convergent construct validity of the translated instrument. Methods: The study had two distinct stages: (a) translation and cultural adaptation of the LMS into Brazilian Portuguese and (b) validation of the adapted instrument using a sample of 543 participants. Results: The Brazilian version of the LMS demonstrated acceptable internal consistency, with confirmatory factor analysis supporting the original four-factor model. Correlations between LMS, and the Five Facets of Mindfulness Questionnaire and the Mindfulness Attention Awareness Scale were statistically significant and in the expected directions. Conclusions: Our findings suggest that the Brazilian version of LMS, with its four dimensions, presents acceptable psychometric properties and seems to be a reliable and valid instrument for assessing the state of mindfulness in a Brazilian cultural context.
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Affiliation(s)
| | - Marcia A Ciol
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA
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17
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Jones G, Castro-Ramirez F, McGuire T, Al-Suwaidi M, Herrmann F. A Digital Music-Based Mindfulness Intervention ("healing attempt") for Race-Based Anxiety in Black Americans. J Med Internet Res 2023; 25:e51320. [PMID: 37824179 PMCID: PMC10603556 DOI: 10.2196/51320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 09/26/2023] [Accepted: 09/29/2023] [Indexed: 10/13/2023] Open
Abstract
This study replicates and extends findings that "healing attempt"-a brief digital music-based mindfulness intervention-represents a feasible and potentially effective intervention for race-based anxiety in the Black community.
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Affiliation(s)
- Grant Jones
- Department of Psychology, Harvard University, Cambridge, MA, United States
| | | | - Taylor McGuire
- Department of Psychology, Harvard University, Cambridge, MA, United States
| | - Maha Al-Suwaidi
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, United States
| | - Felipe Herrmann
- Department of Psychology, Harvard University, Cambridge, MA, United States
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18
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Jones G, Herrmann F, Nock MK. A Digital Music-Based Mindfulness Intervention for Black Americans With Elevated Race-Based Anxiety: A Multiple-Baseline Pilot Study. JMIR Form Res 2023; 7:e49284. [PMID: 37585252 PMCID: PMC10468709 DOI: 10.2196/49284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 06/26/2023] [Accepted: 07/19/2023] [Indexed: 08/17/2023] Open
Abstract
BACKGROUND Race-based anxiety is a substantial health issue for the Black community. Although mindfulness interventions have demonstrated efficacy for alleviating anxiety, three central barriers prevent Black Americans from accessing existing mindfulness treatments: high costs, excessive time commitments, and limited cultural relevance. There is a need for novel mindfulness interventions for the Black community that can overcome these barriers. OBJECTIVE The goal of this web-based study was to examine the preliminary efficacy, feasibility, and acceptability of a novel digital music-based mindfulness intervention for middle-to-low-income Black Americans with elevated race-based anxiety. METHODS This study used a nonconcurrent multiple-baseline design (n=5). The intervention featured contributions from Lama Rod Owens (a world-renowned meditation teacher and LA Times best-selling author) and Terry Edmonds (the former chief speechwriter for President Bill Clinton). We examined the effect of the intervention on state anxiety and assessed its feasibility and acceptability using quantitative and qualitative measures. RESULTS Results revealed that administration of the intervention led to significant decreases in state anxiety (Tau-U range -0.75 to -0.38; P values<.001). Virtually all feasibility and acceptability metrics were high (ie, the average likelihood of recommending the intervention was 98 out of 100). CONCLUSIONS This study offers preliminary evidence that a digital music-based mindfulness intervention can decrease race-based anxiety in Black Americans. Future research is needed to replicate these results, test whether the intervention can elicit lasting changes in anxiety, assess mechanisms of change, and explore the efficacy of the intervention in real-world contexts.
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Affiliation(s)
- Grant Jones
- Harvard University, Cambridge, MA, United States
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19
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Pham TV, Doorley J, Kenney M, Joo JH, Shallcross AJ, Kincade M, Jackson J, Vranceanu AM. Addressing chronic pain disparities between Black and White people: a narrative review of socio-ecological determinants. Pain Manag 2023; 13:473-496. [PMID: 37650756 PMCID: PMC10621777 DOI: 10.2217/pmt-2023-0032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 08/10/2023] [Indexed: 09/01/2023] Open
Abstract
A 2019 review article modified the socio-ecological model to contextualize pain disparities among different ethnoracial groups; however, the broad scope of this 2019 review necessitates deeper socio-ecological inspection of pain within each ethnoracial group. In this narrative review, we expanded upon this 2019 article by adopting inclusion criteria that would capture a more nuanced spectrum of socio-ecological findings on chronic pain within the Black community. Our search yielded a large, rich body of literature composed of 174 articles that shed further socio-ecological light on how chronic pain within the Black community is influenced by implicit bias among providers, psychological and physical comorbidities, experiences of societal and institutional racism and biomedical distrust, and the interplay among these factors. Moving forward, research and public-policy development must carefully take into account these socio-ecological factors before scaling up pre-existing solutions with questionable benefit for the chronic pain needs of Black individuals.
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Affiliation(s)
- Tony V Pham
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA 02114, USA
| | - James Doorley
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Martha Kenney
- Department of Anesthesiology, Duke University Medical Centre, Durham, NC 27710, USA
| | - Jin Hui Joo
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Amanda J Shallcross
- Wellness & Preventative Medicine, Cleveland Clinic, Cleveland, OH 44195, USA
| | - Michael Kincade
- Center for Alzheimer's Research & Treatment, Massachusetts Alzheimer's Disease Research Centre, Boston, MA 02129, USA
| | - Jonathan Jackson
- Department of Neurology, Harvard Medical School, Boston, MA 02115, USA
| | - Ana-Maria Vranceanu
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA 02114, USA
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20
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Emezue C, Karnik NS, Reeder B, Schoeny M, Layfield R, Zarling A, Julion W. A Technology-Enhanced Intervention for Violence and Substance Use Prevention Among Young Black Men: Protocol for Adaptation and Pilot Testing. JMIR Res Protoc 2023; 12:e43842. [PMID: 37126388 PMCID: PMC10186193 DOI: 10.2196/43842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 01/30/2023] [Accepted: 01/31/2023] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Black boys and men from disinvested communities are disproportionately survivors and perpetrators of youth violence. Those presenting to emergency departments with firearm-related injuries also report recent substance use. However, young Black men face several critical individual and systemic barriers to accessing trauma-focused prevention programs. These barriers contribute to service avoidance, the exacerbation of violence recidivism, substance use relapse, and a revolving-door approach to prevention. In addition, young Black men are known to be digital natives. Therefore, technology-enhanced interventions offer a pragmatic and promising opportunity to mitigate these barriers, provide vital life skills for self-led behavior change, and boost service engagement with vital community resources. OBJECTIVE The study aims to systematically adapt and pilot-test Boosting Violence-Related Outcomes Using Technology for Empowerment, Risk Reduction, and Life Skills Preparation in Youth Based on Acceptance and Commitment Therapy (BrotherlyACT), a culturally congruent, trauma-focused digital psychoeducational and service-engagement tool tailored to young Black men aged 15-24 years. BrotherlyACT will incorporate microlearning modules, interactive safety planning tools for risk assessment, goal-setting, mindfulness practice, and a service-engagement conversational agent or chatbot to connect young Black men to relevant services. METHODS The development of BrotherlyACT will occur in 3 phases. In phase 1, we will qualitatively investigate barriers and facilitators influencing young Black men's willingness to use violence and substance use prevention services with 15-30 young Black men (aged 15-24 years) who report perpetrating violence and substance use in the past year and 10 service providers (aged >18 years; any gender; including health care providers, street outreach workers, social workers, violence interrupters, community advocates, and school staff). Both groups will be recruited from community and pediatric emergency settings. In phase 2, a steering group of topic experts (n=3-5) and a youth and community advisory board comprising young Black men (n=8-12) and service providers (n=5-10) will be involved in participatory design, alpha testing, and beta testing sessions to develop, refine, and adapt BrotherlyACT based on an existing skills-based program (Achieving Change Through Values-Based Behavior). We will use user-centered design principles and the Assessment, Decision, Administration, Production, Topical, Experts, Integration, Training, and Testing framework to guide this adaptation process (phase 2). In phase 3, a total of 60 young Black men will pilot-test the adapted BrotherlyACT over 10 weeks in a single-group, pretest-posttest design to determine its feasibility and implementation outcomes. RESULTS Phase 1 data collection began in September 2021. Phases 2 and 3 are scheduled to start in June 2023 and end in September 2024. CONCLUSIONS The development and testing of BrotherlyACT is a crucial first step in expanding an evidence-based psychoeducational and service-mediating intervention for young Black men involved in violence. This colocation of services shifts the current prevention strategy from telling them why to change to teaching them how. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/43842.
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Affiliation(s)
- Chuka Emezue
- Department of Women, Children and Family Nursing, Rush University College of Nursing, Chicago, IL, United States
| | - Niranjan S Karnik
- Department of Psychiatry, Institute for Juvenile Research, University of Illinois Chicago, Chicago, IL, United States
| | - Blaine Reeder
- Sinclair School of Nursing, University of Missouri-Columbia, Columbia, MO, United States
| | - Michael Schoeny
- Department of Community, Systems and Mental Health Nursing, Rush University College of Nursing, Chicago, IL, United States
| | - Rickey Layfield
- Urban Male Network, Vice President of Programming, Chicago, IL, United States
| | - Amie Zarling
- Department of Human Development and Family Studies, Iowa State University, Ames, IA, United States
| | - Wrenetha Julion
- Department of Women, Children and Family Nursing, Rush University College of Nursing, Chicago, IL, United States
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Beshai S, Desjarlais SM, Green B. Perspectives of Indigenous University Students in Canada on Mindfulness-Based Interventions and their Adaptation to Reduce Depression and Anxiety Symptoms. Mindfulness (N Y) 2023; 14:538-553. [PMID: 36845644 PMCID: PMC9942086 DOI: 10.1007/s12671-023-02087-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/31/2023] [Indexed: 02/23/2023]
Abstract
Objectives Indigenous university students experience high rates of anxiety and depression due primarily to the pernicious and persistent effects of colonialism, racism, and discrimination. Mindfulness-based interventions (MBIs) hold promise, but likely require adaptation to make them culturally relevant for Indigenous peoples. We sought to gather Indigenous students' perspectives on the consistency and adaptability of MBIs for Indigenous students experiencing symptoms of depression and anxiety. Method This three-part longitudinal investigation employed a qualitative design mixed with Indigenous research methods to elicit feedback from students (n = 14; M age = 28.92) on the acceptability of MBIs and ways to tailor MBIs to make them more consistent with Indigenous cultures and student lifestyles. We subsequently used this feedback to develop an outline for an adapted MBI that was then re-evaluated by the same participants for its cultural relevance and safety. Results Indigenous students emphasized the need for the adapted MBI to incorporate (a) traditional Indigenous practices; (b) Indigenous facilitators; (c) holistic conceptualizations of mental health that include spirituality; and (d) practices and methods that could improve flexibility and accessibility of the adapted intervention. Based on this feedback, we presented students with an outline of an adapted MBI tentatively titled Miyowâyâwin Mindful Wellbeing Program, which received favorable evaluations by students for cultural consistency and safety. Conclusions We confirmed the perceived acceptability and consistency of mindfulness and mindfulness programs with Indigenous cultures. The need for a flexible MBI that centers Indigenous elements and Indigenous facilitators was highlighted by Indigenous participants. This study paves the way for latter steps of the development and subsequent evaluation of the Miyowâyâwin Mindful Wellbeing Program. Preregistration This study is not preregistered.
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Affiliation(s)
- Shadi Beshai
- grid.57926.3f0000 0004 1936 9131Department of Psychology, University of Regina, 3737 Wascana Parkway, Regina, SK S4S0A2 Canada
| | - Sharon M. Desjarlais
- grid.57926.3f0000 0004 1936 9131Department of Psychology, University of Regina, 3737 Wascana Parkway, Regina, SK S4S0A2 Canada
| | - Brenda Green
- Indigenous Health, First Nations University, 1 First Nations Way, Regina, SK S4S 7K2 Canada
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22
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Comparative effectiveness and acceptability of psychotherapies for late-life depression: A systematic review and network meta-analysis. J Affect Disord 2023; 323:409-416. [PMID: 36470553 DOI: 10.1016/j.jad.2022.11.089] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 11/25/2022] [Accepted: 11/28/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND The purpose of this systematic review and network meta-analysis is to compare the effectiveness and acceptability of psychotherapies for late-life depression. METHODS We searched PubMed, Embase, PsycINFO, CINAHL, The Cochrane Library, China National Knowledge Infrastructure, WANFANG database, and Chinese Biomedicine literature (CBM) for randomized controlled trials (RCTs) from their respective inception dates to March 30, 2022. Comparative effectiveness and acceptability of these psychological interventions were evaluated by conducting standard pairwise meta-analyses and network meta-analyses. A battery of analyses and assessments, such as the risk of bias and certainty of the evidence were performed. RESULTS A total of 68 studies with 4550 participants on six psychotherapies compared with two control groups were included in the final analysis. Notably, there were no statistically significant differences between behavioral activation therapy, cognitive behavior therapy (CBT), cognitive therapy, life review therapy, mindfulness, and combined psychotherapy. Compared with the non-active control group, six psychological interventions were statistically effective in reducing depression symptoms (standardized mean differences (SMDs) range, -1.08 to -0.73). While, only CBT, life review therapy, mindfulness, and combined psychotherapy were more effective than the active control group (SMDs range, -0.85 to -0.74). Life review therapy was ranked as the best option according to effectiveness and acceptability, while behavioral activation therapy was the worst by acceptability. The certainty of the evidence was mostly rated as low to very low. CONCLUSIONS Despite the scarcity of high-quality evidence, all six psychotherapies were effective for late-life depression, and life review therapy seemed to be the best choice in terms of effectiveness and acceptability. The findings of our review could provide policymakers and service commissioners with evidence-based practice for making decisions among different psychotherapies.
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Pandya SP. Professional immigrants and high-functioning anxiety: assessing some interventions. HUMAN RESOURCE DEVELOPMENT INTERNATIONAL 2023. [DOI: 10.1080/13678868.2023.2170200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Affiliation(s)
- Samta P Pandya
- School of Social Work, Tata Institute of Social Sciences, Mumbai, Maharashtra, India
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Adkins-Jackson PB, Jackson Preston PA, Hairston T. 'The only way out': how self-care is conceptualized by Black women. ETHNICITY & HEALTH 2023; 28:29-45. [PMID: 35040742 DOI: 10.1080/13557858.2022.2027878] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Accepted: 01/06/2022] [Indexed: 05/24/2023]
Abstract
OBJECTIVE Discrimination in the lives of Black women often leads to maladaptive coping strategies that negatively influence health. Self-care encompasses practices that promote well-being; however, little is known about how Black women conceptualize and practice self-care. DESIGN This article reports qualitative findings from 10 semi-structured interviews conducted with 10 Black women subject-matter experts (SMEs) from throughout the US. There were eight individual interviews with SMEs who provided self-care services/content to other Black women and two group interviews with SME organizations that provided self-care and other wellness programs to Black women. This approach utilized both expert and personal lived experiences of SMEs. RESULTS Using the constant comparison analysis method, there was saturation with four concepts that describe the role of structural racism and sexism on the health outcomes of Black women, and the potential for self-care to mediate the negative relationship of these stressors on health. SME practices of self-care overlapped, comprising a 5-part theory of self-care. CONCLUSION Ultimately, self-care may help to combat the impact of structural influences on the health of Black women. Using self-care as a healthier approach to coping with stress can aid in the reduction of health disparities.
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Affiliation(s)
| | | | - Teah Hairston
- Be Love Holistic and Safe Black Space, Sacramento, CA, USA
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Jiwani Z, Tatar R, Dahl C, Wilson-Mendenhall CD, Hirshberg MJ, Davidson RJ, Goldberg SB. Examining Equity in Access and Utilization of a Freely Available Meditation App. NPJ MENTAL HEALTH RESEARCH 2023; 2:5. [PMID: 37159797 PMCID: PMC10164442 DOI: 10.1038/s44184-023-00025-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Digital interventions have the potential to alleviate mental health disparities for marginalized and minoritized communities. The current study examined whether disparities in access and utilization of meditation in the United States (US) were reduced for a freely available meditation app. We analyzed demographic and usage data from US-based users of the Healthy Minds Program (HMP; N = 66,482) between October 2019 and July 2022. College education was associated with a greater likelihood of accessing (65.0% of users vs. 32.9% of the US population) and continuing to utilize the app (β = .11-.17). Conversely, identifying as African American was associated lower likelihood of accessing (5.3% vs. 13.4% of US population) and continuing to utilize the app (β = -.02-.03). African Americans were more likely to access content from an African American meditation teacher, but this did not appear to increase utilization. Additional efforts are warranted to identify factors which might reduce disparities.
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Affiliation(s)
- Zishan Jiwani
- Department of Counseling Psychology, University of Wisconsin – Madison
- Center for Healthy Minds, University of Wisconsin – Madison
| | - Raquel Tatar
- Center for Healthy Minds, University of Wisconsin – Madison
- Healthy Minds Innovations
| | - Cortland Dahl
- Center for Healthy Minds, University of Wisconsin – Madison
- Healthy Minds Innovations
| | | | | | - Richard J. Davidson
- Center for Healthy Minds, University of Wisconsin – Madison
- Healthy Minds Innovations
| | - Simon B. Goldberg
- Department of Counseling Psychology, University of Wisconsin – Madison
- Center for Healthy Minds, University of Wisconsin – Madison
- Correspondence concerning this article should be addressed to Simon B. Goldberg, Department of Counseling Psychology, University of Wisconsin – Madison, 335 Education Building, 1000 Bascom Mall, Madison, WI, 53706.
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Sosa-Cordobés E, Ramos-Pichardo JD, Sánchez-Ramos JL, García-Padilla FM, Fernández-Martínez E, Garrido-Fernández A. How Effective Are Mindfulness-Based Interventions for Reducing Stress and Weight? A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:446. [PMID: 36612767 PMCID: PMC9819465 DOI: 10.3390/ijerph20010446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 12/17/2022] [Accepted: 12/22/2022] [Indexed: 06/17/2023]
Abstract
Stress contributes to the development and maintenance of obesity. Mindfulness-based therapies are being used to reduce stress and promote weight reduction and maintenance. This study aimed to determine the efficacy of mindfulness-based interventions for stress and weight reduction in the short, medium, and long term. Searches on PsycINFO, Medline, CINAHL, Scopus, WOS, and Science Direct were conducted until March 2021. Intervention studies with a sample of adults were included; these evaluated a mindfulness-based intervention and used stress and weight or body mass index as outcome variables. These criteria were met by 13 articles. A meta-analysis of 8 of the 13 articles was performed with a random-effects or fixed-effects model, depending on the level of heterogeneity between studies. Mindfulness-based interventions had a small effect on stress reduction over a 3-month period: effect size (standardized mean difference) = -0.29 (95% CI: -0.49, -0.10). However, no significant evidence was found for stress reduction from 3 months onwards, nor for weight or body mass index reduction in any period. Mindfulness-based interventions are effective in reducing stress in the short term, but not in the medium or long term, nor are they effective for weight or body mass index. More robust and longer study designs are needed to determine their effects.
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Gaylord S, Faurot KR, Shafer J, Harr E, Lathren C, Roth I, Giscombe K, Sheffield-Abdullah K, Williams S. Easing the burden of dementia caregiving: Protocol development for a telephone-delivered mindfulness intervention for rural, African American families. Contemp Clin Trials Commun 2022; 30:101031. [PMID: 36387990 PMCID: PMC9641173 DOI: 10.1016/j.conctc.2022.101031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 10/22/2022] [Accepted: 10/26/2022] [Indexed: 11/06/2022] Open
Abstract
Background There have been few interventions targeted for rural African American (AA) caregivers of persons with dementia despite their unique cultural, geographic, health-related and socio-economic needs, including relatively less access to-and willingness to engage with-formal supports and resources. One effective intervention, Mindfulness-based stress reduction (MBSR), has been found to be culturally acceptable in AA populations; however, no studies have assessed feasibility, acceptability and impact of an adapted mindfulness intervention targeting rural AA dementia caregivers. Aims The purpose of this study is to 1) determine the feasibility and acceptability of a telephone-delivered mindfulness training intervention in decreasing caregiver burden among rural, AA, informal caregiving teams of people with dementia; 2) to explore the effects of the training on caregiver burden and relevant secondary outcomes for both caregiving team members, including emotional regulation, tolerance of uncertainty, emotional and physical health, family conflict within the informal caregiving team, and self-efficacy; and 3) to explore comfort with and willingness to adopt technologies to access mindfulness practices and existing caregiving educational resources. Methods Our study utilizes a single-group, uncontrolled design to assess the feasibility and acceptability of telephone-delivered mindfulness training designed to alleviate burden for rural caregivers of AA individuals with moderate to severe dementia. A care partner-the person who provides additional help -is included in the intervention. The primary outcome is feasibility of the telephone-delivered mindfulness intervention as assessed by an 85% retention rate with completion of at least 6 of the intervention sessions. Pre- and post-participation interviews assess acceptability.
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Affiliation(s)
- Susan Gaylord
- Program on Integrative Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Keturah R. Faurot
- Program on Integrative Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jennifer Shafer
- Program on Integrative Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Corresponding author. Program on Integrative Medicine, Campus Box 7260, University of North Carolina, Chapel Hill, NC, 27599-7200, USA.
| | - Elondra Harr
- Program on Integrative Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Christine Lathren
- Program on Integrative Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Isabel Roth
- Program on Integrative Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Kessonga Giscombe
- Program on Integrative Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | - Sharon Williams
- Department of Speech and Hearing Sciences, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Jones HJ, Butsch Kovacic M, Lambert J, Almallah WR, Becker R, de las Fuentes L, Bakas T. A randomized feasibility trial of the Midlife Black Women's Stress and Wellness intervention (B-SWELL); a community participatory intervention to increase adoption of Life's Simple 7 healthy lifestyle behaviors. Transl Behav Med 2022; 12:1084-1095. [PMID: 36208220 PMCID: PMC9677463 DOI: 10.1093/tbm/ibac075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Black women have a disproportionately higher incidence of cardiovascular disease-related mortality than other groups, yet they are less likely to receive culturally proficient education and competent preventive care. PURPOSE The purpose of this study was to determine feasibility of the Midlife Black Women's Stress and Wellness intervention (B-SWELL); a culturally adapted, 8-week group intervention leveraging stress reduction and goal setting to increase awareness and adoption of Life's Simple 7 (LS7) healthy lifestyle behaviors. METHODS A randomized feasibility trial was conducted. Participants (N = 48, mean age = 55 years) were randomized to the B-SWELL or a group wellness (WE) intervention that lacked stress reduction and goal setting instruction. We hypothesized that B-SWELL participants would achieve a lower perceived stress, greater self-efficacy, improved LS7 scores, fewer symptoms (depression and unhealthy days), and greater perceived general health compared to WE participants. Survey data were collected at three timepoints: baseline, 8 weeks, and 12 weeks. RESULTS Both B-SWELL and WE groups had low attrition and navigated the online platform well. Further, both groups experienced lower perceived stress, improved LS7 scores, reduced depressive symptoms, and greater perceived general health from baseline to 8 weeks. Based on data trends, participants in the B-SWELL had more improvement in perceived stress, self-efficacy, and mental and physical unhealthy days compared to WE participants. CONCLUSION The B-SWELL is a feasible intervention for midlife Black women. Positive data trends were found for both B-SWELL and WE groups. Based on observations from the feasibility study, a larger outcomes-based study is planned.
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Affiliation(s)
- Holly J Jones
- Ohio State University College of Nursing Martha S. Pitzer Center for Women, Children, and Youth, 1577 Neil Avenue, Columbus, OH 43210, USA
| | - Melinda Butsch Kovacic
- University of Cincinnati College of Allied Health Sciences 3225 Eden Ave, Cincinnati, OH 45267, USA
- Cincinnati Children’s Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH 45229, USA
- University of Cincinnati College of Medicine, 3230 Eden Ave, Cincinnati, OH 45267, USA
| | - Joshua Lambert
- University of Cincinnati College of Nursing, 3110 Vine Street, Cincinnati, OH 45221, USA
| | - Wala’a R Almallah
- University of Cincinnati College of Nursing, 3110 Vine Street, Cincinnati, OH 45221, USA
| | - Richard Becker
- University of Cincinnati College of Medicine, 3230 Eden Ave, Cincinnati, OH 45267, USA
| | - Lisa de las Fuentes
- Washington University School of Medicine, 660 S Euclid Ave, St. Louis, MO 63110, USA
| | - Tamilyn Bakas
- University of Cincinnati College of Nursing, 3110 Vine Street, Cincinnati, OH 45221, USA
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G Bautista T, A Cash T, Meyerhoefer T, Pipe T. Equitable Mindfulness: The practice of mindfulness for all. JOURNAL OF COMMUNITY PSYCHOLOGY 2022; 50:3141-3155. [PMID: 35150593 PMCID: PMC9372226 DOI: 10.1002/jcop.22821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 01/30/2022] [Accepted: 02/02/2022] [Indexed: 06/14/2023]
Abstract
The benefits of mindfulness are well-documented; however, these benefits may not be evenly distributed across communities. Equitable Mindfulness aims to make these benefits accessible to a wider and more inclusive audience. The aim of this study was to investigate the applicability of Equitable Mindfulness and systemic barriers that prevent mindfulness programs from being equitably accessed across communities. Twenty-one participants were recruited for qualitative in-depth interviews during a 2-day mindfulness conference. The constant comparison method was used to iteratively identify and categorize themes that emerged within and across interviews. Five dominant themes emerged from the data as follows: inherent equitability, accessibility, inclusiveness, awareness and knowledge-sharing, and acknowledgement of multiple perspectives. Having an applicable and meaningful term to use when describing mindfulness as an inclusive and equitable practice can facilitate the exploration of a new area of research. There is a need for future initiatives aimed at making mindfulness trainings and programs more equitable and accessible to all, regardless of socioeconomic status, race/ethnicity, or abilities/disabilities.
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Affiliation(s)
- Tara G Bautista
- Yale Stress Center, Department of Psychiatry, School of Medicine, Yale University, New Haven, Connecticut, USA
| | - Tiara A Cash
- Department of Psychology, Simon Fraser University, British Columbia, Canada
| | | | - Teri Pipe
- Center for Mindfulness, Compassion and Resilience, Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona, USA
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West TN, Don BP, Fredrickson BL. Attachment insecurity moderates emotion responses to mindfulness and loving-kindness meditation in adults raised in low socioeconomic status households. Emotion 2022; 22:1101-1118. [PMID: 35201791 PMCID: PMC9399318 DOI: 10.1037/emo0001049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Research on attachment theory holds that insecure attachment influences people's daily social and emotional experiences. Mindfulness meditation and loving-kindness meditation have been associated with improvements in physical and mental well-being often through their influence on emotion experience and regulation. Yet, little research has examined how emotional well-being may be improved in insecurely attached individuals through meditation practice. We suspected that the emotion profiles of anxious and avoidant attachment may shift with meditation training, both across time and on a particular day. Improving emotional well-being may be especially consequential for those most at risk for negative health outcomes in late life. A diverse community sample of midlife adults raised in low-SES homes (N = 113; 55% white, 87.5% female) completed daily emotion reports for 10 weeks, during which they received 6 weeks of meditation training, randomized to either loving-kindness or mindfulness meditation practice. Results from growth curve analyses revealed that individuals with greater attachment anxiety and randomized to mindfulness meditation reported significant increases over time in positive emotions alongside decreases in negative emotions. Those high in attachment avoidance reported significant decreases in negative emotions in both meditation groups. On the daily level, within-person dose-response analyses revealed that individuals with greater attachment anxiety showed the most consistent dose-response relations between the duration of either meditation practice and same-day increases in positive emotions and decreases in negative emotions. These findings highlight how meditation interventions can shift emotion profiles of insecurely attached midlife adults who are at heightened risk for late life chronic illnesses. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Alvidrez JL, Barksdale CL. Perspectives From the National Institutes of Health on Multidimensional Mental Health Disparities Research: A Framework for Advancing the Field. Am J Psychiatry 2022; 179:417-421. [PMID: 35599536 DOI: 10.1176/appi.ajp.21100969] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Racial, ethnic, and other mental health disparities have been documented for several decades. However, progress in reducing or eliminating these disparities has been slow. In this review, the authors argue that understanding and addressing mental health disparities requires using a multidimensional lens that encompasses a wide array of social determinants of health at individual, interpersonal, organizational, community, and societal levels. However, much of the current research on mental health disparities, including research funded by the National Institutes of Health, is characterized by a narrower focus on a small number of determinants. The authors offer a research framework, adapted from the National Institute on Minority Health and Health Disparities Research Framework, that provides examples of determinants that may cause or sustain mental health disparities and that can serve as intervention targets to reduce those disparities. They also discuss different types of mental health disparities research to highlight the need for more research testing and implementing interventions that directly modify social determinants of health and promote mental health equity.
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Affiliation(s)
- Jennifer L Alvidrez
- Office of Disease Prevention, NIH, Bethesda, Md. (Alvidrez); Office for Disparities Research and Workforce Diversity, NIMH, Bethesda, Md. (Barksdale); National Institute on Minority Health and Health Disparities, NIH, Bethesda, Md. (Barksdale)
| | - Crystal L Barksdale
- Office of Disease Prevention, NIH, Bethesda, Md. (Alvidrez); Office for Disparities Research and Workforce Diversity, NIMH, Bethesda, Md. (Barksdale); National Institute on Minority Health and Health Disparities, NIH, Bethesda, Md. (Barksdale)
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West TN, Zhou J, Brantley MM, Kim SL, Brantley J, Salzberg S, Cole SW, Fredrickson BL. Effect of Mindfulness Versus Loving-kindness Training on Leukocyte Gene Expression in Midlife Adults Raised in Low-Socioeconomic Status Households. Mindfulness (N Y) 2022; 13:1185-1196. [PMID: 36278141 PMCID: PMC9585929 DOI: 10.1007/s12671-022-01857-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Objectives People raised in low socio-economic status (SES) households are at an increased risk for physical illness in adulthood. A shift in gene expression profiles in the immune system is one biological mechanism thought to account for elevated disease susceptibility, with a frequently-investigated profile being the conserved transcriptional response to adversity (CTRA), characterized by increased expression of proinflammatory genes and decreased expression of antiviral and antibody-related genes. Methods The present study investigated, in a sample of at-risk midlife adults (N = 88), whether those randomized to learn loving-kindness meditation (LKM) in a 6-week workshop, would show a reduction in CTRA gene expression, compared to those randomized to learn mindfulness meditation (MM). We assessed emotions daily and hypothesized positive emotions to account for the expected effect of LKM on gene expression. Results Results showed significant group differences from pre- to post-intervention, yet in the opposite direction as hypothesized: Participants randomized to the MM group showed significant declines in CTRA gene expression, whereas those in the LKM group showed significant increases in CTRA gene expression. Both groups showed increases over the 6 weeks in daily reports of positive emotions, b=.007, p <.001 alongside decreases in negative emotions b=-.005, p <.001. Thus, positive emotions were not pursued as a candidate mediator of observed group effects. Conclusion This study is the first to examine whether the biological impact of childhood low-SES can be reversed in mid-life through meditation interventions. Results suggest mindfulness meditation may be a viable option for improving health outcomes in this at-risk population. Trial Registration: ClinicalTrials.gov NCT02400593.
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Affiliation(s)
- Taylor N. West
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, CB #3270, Chapel Hill, NC, 27599, USA
| | - Jieni Zhou
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, CB #3270, Chapel Hill, NC, 27599, USA
| | | | - Sumi L. Kim
- Chaplain’s Office, Yale University, New Haven, CT, USA
| | - Jeffrey Brantley
- Duke Integrative Medicine, Duke University, Durham , NC, USA
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA
| | | | - Steve W. Cole
- Department of Medicine, Department of Psychiatry & Biobehavioral Sciences, University of California, Los Angeles, USA
| | - Barbara L. Fredrickson
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, CB #3270, Chapel Hill, NC, 27599, USA
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Sun S, Goldberg SB, Loucks EB, Brewer JA. Mindfulness-based interventions among people of color: A systematic review and meta-analysis. Psychother Res 2022; 32:277-290. [PMID: 34098859 PMCID: PMC8648858 DOI: 10.1080/10503307.2021.1937369] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 05/25/2021] [Indexed: 10/21/2022] Open
Abstract
Objective In the United States, people of color (POC) are disproportionately affected by various sources of stress and prevalent mental and physical health issues that may benefit from Mindfulness-based Interventions (MBIs). However, effects of MBIs for POC are unclear. This meta-analysis examines the efficacy of MBIs through randomized controlled trials (RCTs) that included predominately POC (≥75% of the sample). Method: Random effects models were used to synthesize effect sizes. A total of 24 RCT samples were analyzed. Results: Samples were on average 94.4% POC and predominantly from low-income backgrounds (total N = 2,156). At post-treatment, MBIs yielded small but statistically superior outcomes to active controls (Hedges' g = 0.11) and inactive controls (g = 0.26). Compared to active controls, MBIs' effects on well-being were smaller than their effects on other outcome types. Compared to inactive controls, MBIs that focused on non-clinical populations and had higher proportion of POC had larger effect sizes. Attrition rates of MBIs did not differ from other active conditions in outpatient settings. Conclusion: Findings provide modest, preliminary empirical support for MBIs among POC. We discuss main findings, limitations, and implications for future MBI research for health promotion among POC.
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Affiliation(s)
- Shufang Sun
- Department of Behavioral & Social Sciences, Brown University School of Public Health, Providence, RI, USA
- Mindfulness Center, Brown University, Providence, RI, USA
| | - Simon B. Goldberg
- Department of Counseling Psychology, University of Wisconsin-Madison, Madison, WI, USA
- Center for Healthy Minds, University of Wisconsin-Madison, Madison, WI, USA
| | - Eric B. Loucks
- Department of Behavioral & Social Sciences, Brown University School of Public Health, Providence, RI, USA
- Mindfulness Center, Brown University, Providence, RI, USA
| | - Judson A. Brewer
- Department of Behavioral & Social Sciences, Brown University School of Public Health, Providence, RI, USA
- Mindfulness Center, Brown University, Providence, RI, USA
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Burnett-Zeigler I, McLeod D. Diversifying Mindfulness: Reflections from Our Journeys Applying Mindfulness-Based Interventions in the Black Community. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2022; 28:110-113. [PMID: 35119290 PMCID: PMC8867099 DOI: 10.1089/jicm.2021.0440] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Inger Burnett-Zeigler
- Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.,Address correspondence to: Inger Burnett-Zeigler, PhD, Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, 676 N. St. Clair, Suite 1000, Chicago, IL 60611, USA
| | - Dennis McLeod
- Vanderbilt University Medical Center, Nashville, TN, USA
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Reangsing C, Lauderman C, Schneider JK. Effects of Mindfulness Meditation Intervention on Depressive Symptoms in Emerging Adults: A Systematic Review and Meta-Analysis. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2022; 28:6-24. [PMID: 35085023 DOI: 10.1089/jicm.2021.0036] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Introduction: Depression in emerging adults (20-29 years of age), a transition from adolescence to adulthood, is a mental health problem globally. Antidepressants and psychotherapy have limited effectiveness and might not be available worldwide. Alternative and complementary treatments, such as mindfulness meditation, are growing. Objective: We examined the effects of mindfulness interventions on depression in emerging adults and explored the moderating effects of participants, methods, and intervention characteristics. Design: Systematic review and meta-analysis. Subjects: Emerging adults. Interventions: Mindfulness meditation interventions versus control groups. Outcomes measures: depressive symptoms. Results: Forty-five studies resulted in 49 comparisons, including 3479 participants (23.0-2.7 years old); 1826 participants practiced mindfulness and 1653 served as controls. Overall, mindfulness interventions showed significant reduction in depression compared with controls (g = 0.44, 95% confidence interval: 0.33-0.55). Mindfulness interventions conducted in Asian countries had a greater decrease in depression (g = 0.69) than studies conducted in North America (g = 0.44) or Europe (g = 0.23). Mindfulness interventions showed greater reductions in depression in studies with higher proportion of females (Slope = 0.010, τ2 = 0.07, Qbetween = 7.10, p = 0.008). Mindfulness interventions conducted in emerging adults with depressive disorders reduced depression more (g = 1.12) than in emerging adults without (g = 0.40). Providing mindfulness intervention in a group setting had a greater reduction of depression (g = 0.54) than on an individual basis (g = 0.30). More minutes of unstructured mindfulness practice per session showed a greater reduction in depressive symptoms (Slope = 0.016, Qbetween = 1.34, p = 0.035). Using intention-to-treat analyses showed a lower ES (g = 0.14) than not using it (g = 0.55). Other quality indicators were not significant moderators. Primary researchers did not report the adverse effects of mindfulness interventions. Conclusion: Mindfulness interventions somewhat improved depression in emerging adults. Because primary researchers did not report the adverse effects, mindfulness interventions should be used with caution. Future researchers might study the adverse effects of mindfulness interventions as well as the long-term effects.
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Affiliation(s)
- Chuntana Reangsing
- School of Nursing, Mae Fah Luang University, Muang, Chiangrai province, Thailand
| | - Christina Lauderman
- Trudy Busch Valentine School of Nursing, Saint Louis University, St. Louis, MO, USA
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Cottrell-Daniels C, Jones DM, Bell SA, Bandlamudi M, Spears CA. Mindfulness and Mobile Health for Quitting Smoking: A Qualitative Study Among Predominantly African American Adults with Low Socioeconomic Status. AMERICAN JOURNAL OF QUALITATIVE RESEARCH 2022; 6:19-41. [PMID: 35392178 PMCID: PMC8985517 DOI: 10.29333/ajqr/11427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Low-income and African American adults experience severe tobacco-related health disparities. Mindfulness-based interventions show promise for promoting smoking cessation, but most mindfulness research has focused on higher income, Caucasian samples. "iQuit Mindfully" is a personalized, interactive text messaging program that teaches mindfulness for smoking cessation. This qualitative study sought feedback from predominantly low-income African American smokers, to improve the intervention for this priority population. After receiving 8 weekly group sessions of Mindfulness-Based Addiction Treatment for smoking cessation and between-session iQuit Mindfully text messages, participants (N=32) completed semi-structured interviews. Participants were adult cigarette smokers (90.6% African American, 62.6% annual income <$30,000, mean age 45.1 [±12.9]). Interviews inquired about participants' experiences with and suggestions for improving iQuit Mindfully, including message content, number, and timing. Interviews were audio-recorded, transcribed verbatim, and coded by a team of 5 coders in NVivo. The coding manual was developed based on response categories from the interview guide and themes emerging from the data. Themes were organized into a conceptual model of factors related to engagement with the mHealth program. Response categories included helpful aspects (e.g., themes of social support, mindfulness, personalization); unhelpful/disliked aspects (e.g., too many/repetitive messages); links between in-person sessions and texts; and suggestions (e.g., changes to number/timing and more personalization). Findings provide insight into participants' day-to-day experiences with iQuit Mindfully and suggest ways to improve mHealth programs among low-income and African American adults.
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Affiliation(s)
- Cherell Cottrell-Daniels
- Corresponding Author: Cherell Cottrell-Daniels, PhD, MPH, Moffitt Cancer Center. 4115 E. Fowler Ave., Tampa, FL 33617; Phone: 813.745.2149.
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Pandya SP. Enhancing high schoolers' creative thinking and complex problem‐solving abilities: Examining the effectiveness of spirituality. PSYCHOLOGY IN THE SCHOOLS 2021. [DOI: 10.1002/pits.22604] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Samta P. Pandya
- School of Social Work, Tata Institute of Social Sciences Mumbai Maharashtra India
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Lindsay EK. Mindfulness interventions for offsetting health risk following early life stress: Promising directions. Brain Behav Immun Health 2021; 17:100338. [PMID: 34589821 PMCID: PMC8474678 DOI: 10.1016/j.bbih.2021.100338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 08/19/2021] [Accepted: 08/24/2021] [Indexed: 11/29/2022] Open
Abstract
Early life stress (ELS), common to childhood maltreatment, socioeconomic disadvantage, and racial discrimination, is thought to create a proinflammatory phenotype that increases risk for poor health in adulthood. Systemic change is needed to address the root causes of ELS, but a substantial number of adults are already at increased health risk by virtue of ELS exposure. Interventions that target stress pathways have the potential to interrupt the trajectory from ELS to inflammatory disease risk in adulthood. Mindfulness-based interventions (MBIs), which train acceptance toward present-moment experience, have shown promise for reducing stress and improving a variety of stress-sensitive health outcomes. Although MBIs have primarily been conducted in more advantaged populations, evidence suggests that they may be uniquely effective for improving mental health and health-related quality of life among those with a history of ELS. Whether these effects extend to physical health remains unknown. To shed light on this question, I review evidence that MBIs influence inflammatory markers in at-risk samples, explore the promise of MBIs for improving stress-related health outcomes in diverse at-risk populations, and describe adaptations to MBIs that may increase their acceptability and efficacy in populations exposed to ELS. This prior work sets the stage for well-controlled RCTs to evaluate whether MBIs influence stress and inflammatory pathways among those exposed to ELS and for pragmatic and implementation trials focused on disseminating MBIs to reach these at-risk populations. Overall, the evidence assembled here shows the potential of MBIs for offsetting physical health risk related to ELS.
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Affiliation(s)
- Emily K Lindsay
- University of Pittsburgh, Department of Psychology 600 Old Engineering Hall, 3943 O'Hara Street, Pittsburgh, PA, 15213, USA
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Trombka M, Creedon TB, Demarzo M, Cuoco LT, Smith L, Oxnard AC, Rozembaque AT, Hirayama MS, Moreno NB, Comeau A, Gawande R, Griswold T, Cook BL, Rocha NS, Schuman-Olivier Z. Mindfulness Training for Primary Care for Portuguese-Speaking Immigrants: A Pilot Study. Front Psychiatry 2021; 12:664381. [PMID: 34566708 PMCID: PMC8458702 DOI: 10.3389/fpsyt.2021.664381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 08/04/2021] [Indexed: 11/24/2022] Open
Abstract
Background: Portuguese-speaking immigrants are a growing underserved population in the Unites States who experience high levels of psychological distress and increased vulnerability to mental health disorders such as depression and anxiety. Current evidence shows that mindfulness-based interventions (MBIs) are effective to promote physical and mental health among educated English speakers; nonetheless, the lack of diversity in the mindfulness literature is a considerable limitation. To our knowledge, the feasibility and acceptability of MBIs among Portuguese-speaking immigrants have not yet been investigated. Methods: This single-arm pilot study (N = 30) explored the feasibility, acceptability, and cultural aspects of Mindfulness Training for Primary Care (MTPC)-Portuguese among Portuguese-speaking immigrants in the Boston area. MTPC is an 8-week, primary care-adapted, referral-based, insurance-reimbursable, trauma-informed MBI that is fully integrated into a healthcare system. The study also examined intervention preliminary effectiveness on mental health outcomes (depression and anxiety symptoms) and self-regulation (emotional regulation, mindfulness, self-compassion, interoceptive awareness), and initiation of health behavior was explored. Results: Primary care providers referred 129 patients from 2018 to 2020. Main DSM-5 primary diagnoses were depression (76.3%) and anxiety disorders (6.7%). Participants (N = 30) attended a mean of 6.1 (SD 1.92) sessions and reported a mean of 213.7 (SD = 124.3) min of practice per week. All survey finishers would recommend the program to a friend, found the program helpful, and rated the overall program as "very good" or "excellent," and 93% would participate again, with satisfaction mean scores between 4.6 and 5 (Likert scale 0-5). Participants and group leaders provided feedback to refine MTPC-Portuguese culturally responsiveness regarding materials language, settings, time, food, and community building. Patients exhibited reductions in depression (d = 0.67; p < 0.001) and anxiety (d = 0.48; p = 0.011) symptoms, as well as enhanced emotional regulation (d = 0.45; p = 0.009), and among survey finishers, 50% initiated health behavior change through action plan initiation. Conclusion: This pilot study suggests that MTPC-Portuguese is feasible, acceptable, and culturally appropriate among Portuguese-speaking patients in the Boston area. Furthermore, the intervention might potentially decrease depression and anxiety symptoms, facilitate health behavior change, and improve emotional regulation. MTPC-Portuguese investigation with larger samples in controlled studies is warranted to support its dissemination and implementation in the healthcare system. Clinical Trial Registration: Identifier: NCT04268355.
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Affiliation(s)
- Marcelo Trombka
- Postgraduate Program in Psychiatry and Behavioral Sciences, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Department of Psychiatry–Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
- Innovations and Interventions for Quality of Life Research Group, Porto Alegre, Brazil
- Clinical Research Center–Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
- Cambridge Health Alliance, Center for Mindfulness and Compassion, Cambridge, MA, United States
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States
| | - Timothy B. Creedon
- Cambridge Health Alliance, Health Equity Research Lab, Cambridge, MA, United States
| | - Marcelo Demarzo
- Department of Preventive Medicine, Mente Aberta–Brazilian Center for Mindfulness and Health Promotion, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - Letícia T. Cuoco
- Cambridge Health Alliance, Center for Mindfulness and Compassion, Cambridge, MA, United States
| | - Lydia Smith
- Cambridge Health Alliance, Center for Mindfulness and Compassion, Cambridge, MA, United States
| | - Alexandra C. Oxnard
- Cambridge Health Alliance, Center for Mindfulness and Compassion, Cambridge, MA, United States
| | - Alana T. Rozembaque
- Cambridge Health Alliance, Center for Mindfulness and Compassion, Cambridge, MA, United States
| | - Marcio S. Hirayama
- Mente Aberta—Brazilian Center for Mindfulness and Health Promotion, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - Natalia B. Moreno
- Cambridge Health Alliance, Center for Mindfulness and Compassion, Cambridge, MA, United States
| | - Alexandra Comeau
- Cambridge Health Alliance, Center for Mindfulness and Compassion, Cambridge, MA, United States
| | - Richa Gawande
- Cambridge Health Alliance, Center for Mindfulness and Compassion, Cambridge, MA, United States
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States
| | - Todd Griswold
- Cambridge Health Alliance, Center for Mindfulness and Compassion, Cambridge, MA, United States
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States
| | - Benjamin L. Cook
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States
- Cambridge Health Alliance, Health Equity Research Lab, Cambridge, MA, United States
| | - Neusa S. Rocha
- Postgraduate Program in Psychiatry and Behavioral Sciences, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Department of Psychiatry–Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
- Innovations and Interventions for Quality of Life Research Group, Porto Alegre, Brazil
- Clinical Research Center–Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Zev Schuman-Olivier
- Cambridge Health Alliance, Center for Mindfulness and Compassion, Cambridge, MA, United States
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States
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Gingles D. Igniting Collective Freedom: An Integrative Behavioral Model of Acceptance and Commitment Toward Black Liberation. Behav Anal Pract 2021; 15:1050-1065. [PMID: 36605157 PMCID: PMC9744996 DOI: 10.1007/s40617-021-00584-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/24/2021] [Indexed: 01/09/2023] Open
Abstract
Racism continues to reveal disastrous effects on the Black community. There exists no behavior-analytic literature with a specific focus on ending Black psychological suffering due to continual acts of violence perpetrated against the community. I present a behavioral model to promote Black psychological liberation, infusing preestablished frameworks of Black psychology and cultural healing practices with acceptance and commitment therapy. The model addresses behaviors observed within systemic and internalized racism.
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Brooks JR, Madubata IJ, Jewell RD, Ortiz DA, Walker RL. Depression and Suicide Ideation: The Role of Self-Acceptance for Black Young Adults. JOURNAL OF BLACK PSYCHOLOGY 2021. [DOI: 10.1177/00957984211037440] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Suicide is a leading cause of death for Black young adults. Though depression is commonly linked to increased risk for suicide, empirical literature examining the depression–suicide association and intrinsic buffers for this association remains limited among Black young adults. This study sought to address this gap in the literature by examining the relationship between depression and suicide ideation among Black young adults. Importantly, this study assessed the moderating role of self-acceptance, an index of how content one is with oneself. Study participants included 123 Black young adults (63.5% female, Mage = 20.91 years, SD = 2.45 years) who completed measures evaluating symptoms of depression, suicide ideation, and psychological well-being. Multivariate regression analyses revealed that self-acceptance moderated the association between depressive symptomatology and suicide ideation ( β = −0.05, p < .01, 95% CI [-1.01, −0.11]), such that the depression–suicide ideation association was not significant for individuals who reported high levels of self-acceptance. These findings suggest that self-acceptance may be an important treatment target for interventions aimed specifically at reducing suicide vulnerability among Black young adults.
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Affiliation(s)
- Jasmin R. Brooks
- Department of Psychology, University of Houston, Houston, TX, USA
| | | | | | - David A. Ortiz
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Rheeda L. Walker
- Department of Psychology, University of Houston, Houston, TX, USA
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Reangsing C, Rittiwong T, Schneider JK. Effects of mindfulness meditation interventions on depression in older adults: A meta-analysis. Aging Ment Health 2021; 25:1181-1190. [PMID: 32666805 DOI: 10.1080/13607863.2020.1793901] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE We examined the effects of MMIs on depression in older adults and explored the moderating effects of participant, methods, and intervention characteristics. METHODS We systematically searched 15 databases through June 2019 without date restrictions using the following search terms: (mindful* OR meditat*) AND depress* AND (older adult* OR elder OR aging OR senior OR geriatric*). Inclusion criteria were primary studies evaluating MMIs with adults ≥65 years old with depression measured as an outcome, a control group, and written in English. Two researchers independently coded each study and compared for discrepancies and consulted a third researcher in cases of disagreement. We used random-effects model to compute effect sizes (ESs) using Hedges' g, a forest plot, and Q and I2 statistics as measures of heterogeneity; we also examined moderator analyses. RESULTS Nineteen studies included 1,076 participants (71.8 ± 5.2 years old). Overall, MMIs showed significantly improved depression (ES=.65, 95%CI 0.35, 0.94) compared to controls. With regards to moderators, Asians had a greater improvement in depression (1.28) than Europeans (.59) and North Americans (.32). Less than 5 weeks of MMIs showed greater improvement in depression (1.47) than longer periods (.55). MMIs with guided meditation reduced depression (.91) more than MMIs without (.42). Only one quality indicator, a priori power analysis, showed greater effects on depression (g = 1.0) than no power analysis (g=.35). CONCLUSION MMIs improved depressive symptoms in older adults. MMIs might be used as adjunctive or alternative to conventional treatment for depressed older adults.
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Affiliation(s)
- Chuntana Reangsing
- Trudy Busch Valentine School of Nursing, Saint Louis University, St Louis, MO, USA
| | - Tanapa Rittiwong
- Trudy Busch Valentine School of Nursing, Saint Louis University, St Louis, MO, USA
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Daubenmier J, Chao MT, Hartogensis W, Liu R, Moran PJ, Acree MC, Kristeller J, Epel ES, Hecht FM. Exploratory Analysis of Racial/Ethnic and Educational Differences in a Randomized Controlled Trial of a Mindfulness-Based Weight Loss Intervention. Psychosom Med 2021; 83:503-514. [PMID: 33214537 DOI: 10.1097/psy.0000000000000859] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE People of color and lower socioeconomic groups have higher obesity prevalence, lose less weight compared with Whites and higher socioeconomic groups, and are underrepresented in randomized controlled trials of mindfulness-based interventions. We examined whether mindfulness approaches reduce disparities in weight loss interventions. METHODS We analyzed data from a randomized controlled trial of 194 participants with obesity (41% participants of color, 36% without college degree) comparing a 5.5-month mindfulness-based weight loss intervention to an active-control with identical diet-exercise guidelines. We assessed attendance, 18-month attrition, and weight change at 6, 12, and 18 months by race/ethnicity and education level using linear mixed models, adjusting for baseline body mass index, age, and education or race/ethnicity, respectively. RESULTS Participants without versus with a college degree attended fewer sessions and had higher attrition across interventions. Participants of color attended fewer intervention sessions in the mindfulness compared with the control intervention. Overall, participants of color lost significantly less weight at 12 and 18 months compared with Whites. However, during the 6- to 18-month maintenance period, we found an interaction of intervention arm, race/ethnicity, and time (p = .035), indicating that participants of color compared with Whites regained more weight in the control (0.33 kg/mo; p = .005) but not mindfulness intervention (0.06 kg/mo; p = .62). Participants without a college degree had greater initial weight loss in the mindfulness compared to control intervention from 0 to 6 months (-0.46 kg/mo; p = .039). CONCLUSIONS Although disparities persist, mindfulness approaches may mitigate some racial/ethnic and socioeconomic differences in weight loss compared with conventional diet-exercise programs.Trial Registration: Clinicaltrials.gov registration: NCT00960414.
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Affiliation(s)
- Jennifer Daubenmier
- From the Institute of Holistic Health Studies (Daubenmier), San Francisco State University; Osher Center for Integrative Medicine (Chao, Hartogensis, Liu, Moran, Acree, Hecht), University of California, San Francisco, San Francisco, California; Department of Psychology (Kristeller), Indiana State University, Terre Haute, Indiana; and Department of Psychiatry (Epel), University of California, San Francisco, San Francisco, California
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Taylor S, Qiao S, Weissman S, Li X. Attitudes toward a mindfulness-based intervention from African American women living with HIV: A qualitative study. SAGE Open Med 2021; 9:20503121211025144. [PMID: 34188932 PMCID: PMC8212361 DOI: 10.1177/20503121211025144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 05/25/2021] [Indexed: 11/18/2022] Open
Abstract
Introduction: Mindfulness-based interventions train participants to pay attention to their
own emotions in the current moment without judging themselves. This study
aims to assess the attitudes toward a mindfulness-based stress reduction
intervention among African American women living with HIV. Methods: We collected qualitative data from three focus group discussions with 18
African American women living with HIV who were purposely recruited from the
Palmetto Health-USC Immunology Center in South Carolina, United States. The
participants discussed how they coped with stress, and then were given a
presentation on mindfulness-based stress reduction and a sample
mindfulness-based stress reduction mini workshop with follow-up discussion
about their thoughts and opinions on the information presented to them. Results: Participants said that mindfulness could be a useful technique and they were
interested in participating in a mindfulness-based stress reduction program.
Their main concerns included physical ability to perform some of the
mindfulness techniques (e.g. yoga) and logistic barriers, such as schedule
constraints. They also provided some suggestions to further tailor the
mindfulness-based stress reduction, such as modifying yoga, using familiar
terms, and combining both in-person and online components. These results
suggest that African American women living with HIV showed strong interest
in mindfulness-based stress reduction and a high level of willingness to
participate in mindfulness-based stress reduction, but the existing
mindfulness-based stress reduction program needs to be tailored to address
challenges and barriers these women may face for attendance and
completion. Conclusion: The next step is to further test the feasibility, acceptability, and efficacy
through a pilot study for African American women living with HIV to practice
a tailored mindfulness-based stress reduction for this group.
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Affiliation(s)
- Slone Taylor
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Shan Qiao
- Department of Health Promotion Education and Behavior, South Carolina SmartState Center for Healthcare Quality (CHQ), Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Sharon Weissman
- Department of Internal Medicine, School of Medicine, University of South Carolina, Columbia, SC, USA
| | - Xiaoming Li
- Department of Health Promotion Education and Behavior, South Carolina SmartState Center for Healthcare Quality (CHQ), Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
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Brooks JR, Lebeaut A, Zegel M, Walker RL, Vujanovic AA. Anxiety sensitivity and suicide risk: Mindfulness as a psychological buffer for Black adults. J Affect Disord 2021; 289:74-80. [PMID: 33945917 DOI: 10.1016/j.jad.2021.04.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 03/18/2021] [Accepted: 04/12/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Anxiety sensitivity (AS), defined as the fear of anxiety-related sensations, is associated with increased risk for suicide and related behavior. However, investigations of AS have centered on primarily non-Hispanic White men and women and with limited attention to clinically relevant underlying factors. METHODS The purpose of this preliminary study was to examine the indirect effect of AS on suicide ideation and elevated suicide risk through mindfulness in a sample of 307 Black adults (79.2% female; Mage = 22.4, SD = 5.6). Participants completed an online questionnaire battery that included measures of AS, mindfulness, suicide ideation, and elevated suicide risk. RESULTS After controlling for age and gender, results indicated that AS was directly and indirectly associated with suicide ideation and elevated suicide risk via lower levels of mindfulness. LIMITATIONS Limitations include using a cross-sectional methodological design and exclusive reliance on self-report measures. CONCLUSIONS These findings provide preliminary insight into novel risk and protective factors that influence suicide ideation and elevated suicide risk among Black Americans.
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Affiliation(s)
- Jasmin R Brooks
- Department of Psychology, University of Houston, Houston, TX
| | - Antoine Lebeaut
- Department of Psychology, University of Houston, Houston, TX
| | - Maya Zegel
- Department of Psychology, University of Houston, Houston, TX
| | - Rheeda L Walker
- Department of Psychology, University of Houston, Houston, TX
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Pandya SP. Geriatric Social Workers in Adult Day Care Facilities: Meditation, Worker Resilience, and Job Satisfaction. HEALTH & SOCIAL WORK 2021; 45:259-267. [PMID: 33447850 DOI: 10.1093/hsw/hlaa027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2019] [Revised: 05/25/2019] [Accepted: 02/07/2020] [Indexed: 06/12/2023]
Abstract
This article reports a wait list control design study on the influence of an online meditation training program for geriatric social workers (GSWs) in a range of adult day care facilities across eight Asian and African cities. Results indicated that the online program was effective in building resilience and promoting job satisfaction among the intervention group. The program was more effective for participants from Asian cities, women, Hindus, and Buddhists working in transitional day care facilities and regularly logging into the self-practice sessions. Self-practice was an important mediator determining the relationship between demographic predictors and outcomes. This synchronous and asynchronous online program can be used by GSWs with some modifications for participants from African cities; men; Muslims and Christians; and those working in active adult, palliative, and memory care facilities. Refinements may entail adding familiar spiritual ideologies, some activities for men involving greater verbalization of feelings and emotions linked to the work, and intensive exercises addressing specific challenges of workers in palliative and memory care facilities.
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Affiliation(s)
- Samta P Pandya
- associate professor, Tata Institute of Social Sciences, Mumbai, 400088 India
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Watson-Singleton NN, Pennefather J, Trusty T. Can a culturally-responsive Mobile health (mHealth) application reduce African Americans’ stress?: A pilot feasibility study. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-01534-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Pandya SP. Meditation program mitigates loneliness and promotes wellbeing, life satisfaction and contentment among retired older adults: a two-year follow-up study in four South Asian cities. Aging Ment Health 2021; 25:286-298. [PMID: 31755300 DOI: 10.1080/13607863.2019.1691143] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVES To examine the impact of a meditation program in mitigating loneliness and promoting wellbeing, life satisfaction and contentment among retired South Asian older adults. METHOD Intervention group older adults (IN2 =166) underwent weekly classes of the customized meditation program for 2 years as compared to the control group (CN2 =157) who underwent no intervention. Four scales were used to measure the outcomes: De Jong Gierveld Loneliness Scale (six-items), Warwick-Edinburgh Mental Wellbeing Scale, Satisfaction with Life Scale and Contentment with Life Assessment Scale. RESULTS There were significant mean differences in the post-test scores on loneliness, wellbeing, life satisfaction and contentment outcomes of the intervention group, with high observed effect sizes (Cohen's d range = 2.43-8.78, p≤.01). The intervention group older adults reported that they were less lonely and experienced greater wellbeing, life satisfaction and contentment post-test (ηp2 =.71-.78, p≤.01). Within the intervention cohort, post-test scores were higher for men, Hindus, middle class, married, living with spouse/children/kin, with acquired treatable lifestyle ailments, who attended 76-100 meditation lessons and regularly practiced at home. Results of the hierarchical regression models indicated that home practice was the strongest predictor explaining 17% (±.82%) variation in the outcomes. The structural equation models indicated that meditation lessons attended and home practice mediated the relationship between demographic variables and outcomes. CONCLUSION The customized meditation program is an effective loneliness-mitigating intervention for retired older adults. Identifying social cognition as a function of loneliness, this intervention addresses negative thoughts and feelings associated with a mental perception of loneliness.
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Affiliation(s)
- Samta P Pandya
- School of Social Work, Tata Institute of Social Sciences, Deonar, Mumbai, India
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Moadel-Robblee A, Camacho F, Milner GE, Kertzner A, Schlecht NF. Peer navigation-delivered loving kindness meditation: A pilot project. Complement Ther Med 2021; 57:102661. [PMID: 33418067 DOI: 10.1016/j.ctim.2021.102661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Revised: 12/29/2020] [Accepted: 12/31/2020] [Indexed: 10/22/2022] Open
Abstract
Peer navigators (PNs), including trained cancer survivor volunteers, can be an important resource to the cancer care team in reducing barriers to screening, treatment, and psychosocial care among underserved communities through their roles in outreach, education, advocacy, and peer support. As cancer centers face growing patient demand and evidence for integrating complementary therapies into conventional care, opportunities to envision new roles for PN arise. Based on psychosocial assessments conducted at an academic cancer center serving the low-income population of Bronx, NY, we found strong interest in both providing (44 %) and receiving (76 %) peer support, as well as in (76 %) mind-body practices (e.g., meditation). In research, these mind-body modalities and peer support have both been found to improve many aspects of physical and emotional outcomes in cancer patients, but none has looked at PNs as a potential resource for delivering such mind-body interventions. Towards this end, we conducted two pilot studies to train PN from an onsite peer navigation program called the BOLD Buddy Program, to deliver a well-defined, easy to learn, and culturally-aligned mind-body practice, i.e., Loving Kindness (LK) Meditation, to each other and to patients. Incorporating comparison to professional meditation instructors, our pilot work demonstrated that peer-lead LKM was associated with benefits to emotional well-being, relaxation, satisfaction, and perceived usability and that PNs were equally well-received in delivering LK as their professional counterparts. Evaluating 8 domains of feasibility using standardized measures, we were able to demonstrate that peer-lead LK was: in demand, acceptable, implementable, practical, adaptable, adoptable, expandable, and promising in efficacy.
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Affiliation(s)
- Alyson Moadel-Robblee
- Albert Einstein College of Medicine, Department of Epidemiology & Population Health, 1300 Morris Park Avenue, Bronx, NY 10461, United States; Albert Einstein Cancer Center, Montefiore Health System, Bronx, NY 10467, United States.
| | - Fernando Camacho
- Albert Einstein Cancer Center, Montefiore Health System, Bronx, NY 10467, United States
| | - Gabrielle E Milner
- Albert Einstein College of Medicine, Department of Epidemiology & Population Health, 1300 Morris Park Avenue, Bronx, NY 10461, United States
| | - Alexander Kertzner
- Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY, 10461, United States
| | - Nicolas F Schlecht
- Roswell Park Comprehensive Cancer Center, Department of Cancer Prevention & Control, Elm & Carlton Streets, Buffalo, NY, 14263, United States
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Abstract
Women's subjective childbirth experience is a risk factor for postpartum depression and childbirth-related posttraumatic stress symptoms. Subjective childbirth experience is influenced not only by characteristics of the childbirth itself but also by maternal characteristics. A maternal characteristic that may be associated with a more positive childbirth experience is trait mindfulness. The current study aimed to assess this association and to assess whether trait mindfulness during pregnancy had a moderating role in the possible association between non-spontaneous delivery and perception of childbirth. A subsample of 486 women, participating in a longitudinal prospective cohort study (Holistic Approach to Pregnancy and the first Postpartum Year study), completed the Three Facet Mindfulness Questionnaire-Short Form at 22 weeks of pregnancy. Women completed the Childbirth Perception Scale and the Edinburgh Postnatal Depression Scale between 7 and 21 days postpartum. The mindfulness facets acting with awareness and non-reacting were significantly associated with a more positive perception of childbirth, after adjusting for covariates. Moderation analyses showed a significant interaction between acting with awareness and non-spontaneous delivery and non-judging and non-spontaneous delivery. Non-spontaneous delivery was associated with a more negative perception of childbirth for low/medium scores of acting with awareness and non-judging, but not for high scores on these mindfulness facets. Trait mindfulness during pregnancy may enhance a positive perception of childbirth. Because this is among the first studies examining the association between maternal dispositional mindfulness and perception of childbirth, future research is needed to confirm the results of the current study.
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