1
|
Obeng-Nyarko CN, Ralston PA, Wickrama KKAS, Lemacks JL, Ilich JZ. Health for Hearts United Longitudinal Trial: Improving Perceived Stress and Allostatic Load Outcomes of Mid-Life and Older African American Women. HEALTH EDUCATION & BEHAVIOR 2024:10901981241263027. [PMID: 39051464 DOI: 10.1177/10901981241263027] [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: 07/27/2024]
Abstract
Cardiovascular disease (CVD) continues to be the leading cause of death in the United States, with African Americans experiencing higher age-adjusted mortality compared to Whites. African American women in particular carry a high CVD burden due to more exposure to adverse personal and socioenvironmental challenges. Church-based interventions can improve health behaviors and health status of African Americans, yet few have addressed stress-related health. The purpose of this study was to determine the effectiveness of the 18-month Health for Hearts United intervention in relation to stress-related outcomes (perceived stress, allostatic load) of mid-life and older African American women (≥45 years of age; n = 152 overall sample, n = 65 clinical subsample). The results of the repeated measures analysis of variance (ANOVA) analyses showed overall significant decreases in perceived stress and allostatic load for both treatment and comparison groups over the measurement occasions (baseline and 18 months) with educational level remaining as a significant correlate over time. There was no significant interaction between treatment and time, yet there were trends in improvements for the treatment group compared to the comparison group. The findings demonstrate the potential of church-based interventions in reducing both self-reported stress and allostatic load in African American women, and highlight the need for further investigation of educational level and other possible factors influencing stress management in these settings.
Collapse
|
2
|
Yuan GF, Qiao S, Li X, Zhou Y, Shen Z. Psychological Mechanisms of Internalized HIV Stigma Affect Sleep Impairment among People Living with HIV in China: A follow-up Study. AIDS Behav 2024; 28:439-449. [PMID: 38048016 DOI: 10.1007/s10461-023-04236-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2023] [Indexed: 12/05/2023]
Abstract
Prior studies have demonstrated that HIV-related stigma (e.g., internalized HIV stigma) is detrimental to the physical and mental health (e.g., sleep impairment and depressive symptoms) of people living with HIV (PLWH). However, follow-up data are limited regarding the longitudinal relationships between internalized HIV stigma, future orientation, self-esteem, depressive symptoms, and sleep impairment. The present study attempted to examine a mediation model involving these variables among Chinese PLWH. A two-wave follow-up design (6 months intervals) was employed in a final sample of 1,140 Chinese PLWH (Mage = 41.63, SD = 9.29, age range: 21-67 years; 64.6% men). Participants completed Internalized HIV Stigma Scale, Optimism About the Future Scale, Rosenberg Self-Esteem Scale, Center of Epidemiological Studies Depression Scale, and an adapted version of Pittsburgh Sleep Quality Index. Results revealed that internalized HIV stigma at baseline had a significant direct relationship with sleep impairment over time, and a significant indirect relationship with increased sleep impairment over time via future orientation and depressive symptoms. Furthermore, the linkage between internalized HIV stigma and sleep impairment was serially mediated via self-esteem and depressive symptoms. This study highlights the deleterious effects of internalized HIV stigma on the physical and psychological health of PLWH. The findings suggest that interventions targeting internalized HIV stigma and related factors such as future orientation, self-esteem, and depressive symptoms may facilitate improvements in sleep quality and overall well-being among PLWH.
Collapse
Affiliation(s)
- Guangzhe Frank Yuan
- School of Education Science, Leshan Normal University, Leshan, Sichuan, China.
- Department of Health Promotion Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.
- South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.
| | - Shan Qiao
- Department of Health Promotion Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
- South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Xiaoming Li
- Department of Health Promotion Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
- South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Yuejiao Zhou
- Guangxi Center for Disease Control and Prevention, Nanning, Guangxi, China
| | - Zhiyong Shen
- Guangxi Center for Disease Control and Prevention, Nanning, Guangxi, China
| |
Collapse
|
3
|
Juarez-Reyes M, Martinez E, Xiao L, Goldman Rosas L. A Randomized Controlled Trial of a Culturally Adapted, Community-Based, Remotely Delivered Mindfulness Program for Latinx Patients With Breast Cancer is Acceptable and Feasible While Reducing Anxiety. GLOBAL ADVANCES IN INTEGRATIVE MEDICINE AND HEALTH 2024; 13:27536130241274240. [PMID: 39157776 PMCID: PMC11329901 DOI: 10.1177/27536130241274240] [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: 12/21/2023] [Revised: 07/05/2024] [Accepted: 07/29/2024] [Indexed: 08/20/2024]
Abstract
Background/Objective Few Spanish mindfulness interventions have been evaluated in Latinx patients with cancer. We culturally adapted a mindfulness intervention for Spanish speaking Latinx patients. The objective was to measure feasibility and acceptability as primary outcomes, with changes in anxiety, depression, and sleep as secondary outcomes. Method Spanish-speaking Latinx patients with breast cancer (n = 31) were randomized, between April 2021 and May 2022 to either intervention or wait-list control groups. The mindfulness intervention consisted of 6-weekly 1.5-hour sessions remotely delivered by a novice facilitator. Cultural adaptations included language, metaphor, goal, concept, trauma informed, and acknowledgement of spirituality. Feasibility was benchmarked as 75% of participants attending their first session, 75% of participants completing 4 of 6 sessions, and scoring ≥ 4 on a 5-point Likert feasability scale measuring ability to implement changes after 6-weeks. Acceptability was measured as scoring ≥ 4 on a 5-point Likert scale measuring usefulness and relevance of the mindfulness intervention for each session. An intention-to-treat, linear mixed model with repeated measures analysis examined changes in anxiety, depression, and sleep at week 6 and 18 (3 months post intervention). Results All three feasibility benchmarks were met with 75% of first session attendance, 96% of participants completing 4 of 6 sessions, and 94% scoring ≥ 4, on the feasibility scale (Mean (SD) = 4.3 (0.6)). Acceptability scores for both usefulness and relevance questions were ≥ 4 across all 6 sessions. Anxiety was significantly reduced at 3 months (-3.6 (CI -6.9, -0.2), P = .04), but is of unclear clinical significance given the small change. Depression scores declined, but not significantly, and there were no changes in sleep. Conclusion This culturally adapted, remotely delivered mindfulness intervention using a novice facilitator was acceptable and feasible and demonstrated associated reductions in anxiety amongst Spanish speaking Latinx patients with breast cancer. Trial Registration ClinicalTrials.gov ID# NCT04834154.
Collapse
Affiliation(s)
- Maria Juarez-Reyes
- Division of Primary Care and Population Health, Department of Medicine, Stanford University, Portola Valley, CA, USA
| | - Erica Martinez
- Program in Medical Education for the Latino Community (PRIME-LC), School of Medicine, University of California, Irvine, CA, USA
| | - Lan Xiao
- Department of Epidemiology and Population Health, Stanford University, Palo Alto, CA, USA
| | - Lisa Goldman Rosas
- Department of Epidemiology and Population Health, Stanford University, Palo Alto, CA, USA
| |
Collapse
|
4
|
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.
Collapse
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
| |
Collapse
|
5
|
Liu C, Yuan GF, Li X, Fung HW, Wong MYC, Zhao J, Feng X. Associations among internalized and perceived stigma, state mindfulness, self-efficacy, and depression symptoms among men who have sex with men in China: A serial mediation model. Arch Psychiatr Nurs 2023; 45:81-88. [PMID: 37544707 DOI: 10.1016/j.apnu.2023.06.001] [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: 11/17/2022] [Revised: 03/23/2023] [Accepted: 06/01/2023] [Indexed: 08/08/2023]
Abstract
Previous research has demonstrated that stigma is strongly related to depressive symptoms among men who have sex with men (MSM). However, data are limited regarding the associations between stigma, state mindfulness, self-efficacy, and depression symptoms. The current study aimed to analyze state mindfulness and self-efficacy as possible mediators between internalized and perceived stigma and depression symptoms. A sample of 2610 Chinese MSM (Mage = 23.99, SD = 6.09, age range: 18-68 years) was recruited from an online survey platform and completed the HIV and Homosexuality Related Stigma Scale, Patient Health Questionnaire-9, the short version of Five Facet Mindfulness Questionnaire, and the Chinese General Self-Efficacy Scale. Results indicated that state mindfulness significantly mediated the linkage between internalized and perceived stigma and depressive symptoms, and self-efficacy significantly mediated the relation between state mindfulness and depression symptoms. Furthermore, internalized and perceived stigma were associated with depression symptoms through a serial mediation of state mindfulness and self-efficacy. This study highlights that state mindfulness and self-efficacy might play important roles in the psychological response of MSM to stigmatization and psychopathology symptoms.
Collapse
Affiliation(s)
- Caimeng Liu
- College of Teacher Education, Institute of Education Science, Leshan Normal University, Leshan, China
| | - Guangzhe Frank Yuan
- Department of Health Promotion Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA; South Carolina SmartState Center for Healthcare Quality, University of South Carolina, Columbia, SC, USA.
| | - Xiaoming Li
- Department of Health Promotion Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA; South Carolina SmartState Center for Healthcare Quality, University of South Carolina, Columbia, SC, USA
| | - Hong Wang Fung
- Department of Social Work, Faculty of Social Sciences, The Hong Kong Baptist University, Kowloon Tong, Hong Kong
| | - Ming Yu Claudia Wong
- Department of Health and Physical Education, The Education University of Hong Kong, Hong Kong
| | - Jingjing Zhao
- Department of Psychology, Beijing Forestry University, Beijing, China
| | - Xueyou Feng
- Center for Mental Health Education and Counseling, Guangzhou College of Commerce, Guangzhou, China
| |
Collapse
|
6
|
Powers A, Lathan EC, Dixon HD, Mekawi Y, Hinrichs R, Carter S, Bradley B, Kaslow NJ. Primary care-based mindfulness intervention for posttraumatic stress disorder and depression symptoms among Black adults: A pilot feasibility and acceptability randomized controlled trial. PSYCHOLOGICAL TRAUMA : THEORY, RESEARCH, PRACTICE AND POLICY 2023; 15:858-867. [PMID: 36265048 PMCID: PMC10227868 DOI: 10.1037/tra0001390] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/21/2024]
Abstract
OBJECTIVE There is support for the use of mindfulness-based approaches with trauma-exposed adults. However, limited data are available on feasibility and acceptability of group-based mindfulness interventions in urban medical clinics serving primarily Black adults with low socioeconomic resources, where rates of trauma exposure are high. The present randomized pilot study evaluated the feasibility and acceptability of an 8-week adapted mindfulness-based cognitive therapy (MBCT) group for trauma-exposed Black adults who screened positive for posttraumatic stress disorder (PTSD) and depression in an urban primary care clinic setting. METHOD Participants were randomized to waitlist control (WLC) or MBCT. Feasibility and acceptability were assessed through examination of retention rates, measures of group satisfaction and treatment barriers, and qualitative interview. Forty-two Black adults (85% women) were consented; of those, 34 (81%) completed preassessment and randomization. RESULTS Feasibility of study design was shown, with > 75% (n = 26) of randomized participants completing the study through postassessment. Twenty-four individuals (70.5%) completed through 1-month follow-up. Results showed high levels of group acceptability across quantitative and qualitative measures. Perceived barriers to psychological treatment were high, with an average of > 6 barriers present. CONCLUSIONS The findings indicate feasibility and acceptability of MBCT group interventions in urban primary care settings with trauma-exposed patients with significant psychopathology. However, substantial barriers to treatment engagement were endorsed and to improve numbers for successful engagement in the intervention, continued efforts to reduce treatment barriers and increase access to mindfulness-based interventions in underresourced communities are needed. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
Collapse
Affiliation(s)
- Abigail Powers
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta GA
| | - Emma C. Lathan
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta GA
| | - H. Drew Dixon
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta GA
| | - Yara Mekawi
- Department of Psychological and Brain Sciences, University of Louisville, Louisville, KY
| | - Rebecca Hinrichs
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta GA
| | - Sierra Carter
- Department of Psychology, Georgia State University, Atlanta, GA
| | - Bekh Bradley
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta GA
| | - Nadine J. Kaslow
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta GA
| |
Collapse
|
7
|
Burnett-Zeigler I, Zhou E, Martinez JH, Zumpf K, Lartey L, Moskowitz JT, Wisner KL, McDade T, Brown CH, Gollan J, Ciolino JD, Schauer JM, Petito LC. Comparative effectiveness of a mindfulness-based intervention (M-Body) on depressive symptoms: study protocol of a randomized controlled trial in a Federally Qualified Health Center (FQHC). Trials 2023; 24:115. [PMID: 36803835 PMCID: PMC9936464 DOI: 10.1186/s13063-022-07012-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 12/14/2022] [Indexed: 02/19/2023] Open
Abstract
BACKGROUND Mindfulness-based interventions have been shown to improve psychological outcomes including stress, anxiety, and depression in general population studies. However, effectiveness has not been sufficiently examined in racially and ethnically diverse community-based settings. We will evaluate the effectiveness and implementation of a mindfulness-based intervention on depressive symptoms among predominantly Black women at a Federally Qualified Health Center in a metropolitan city. METHODS In this 2-armed, stratified, individually randomized group-treated controlled trial, 274 English-speaking participants with depressive symptoms ages 18-65 years old will be randomly assigned to (1) eight weekly, 90-min group sessions of a mindfulness-based intervention (M-Body), or (2) enhanced usual care. Exclusion criteria include suicidal ideation in 30 days prior to enrollment and regular (>4x/week) meditation practice. Study metrics will be assessed at baseline and 2, 4, and 6 months after baseline, through clinical interviews, self-report surveys, and stress biomarker data including blood pressure, heart rate, and stress related biomarkers. The primary study outcome is depressive symptom score after 6 months. DISCUSSION If M-Body is found to be an effective intervention for adults with depressive symptoms, this accessible, scalable treatment will widely increase access to mental health treatment in underserved, racial/ethnic minority communities. TRIAL REGISTRATION ClinicalTrials.gov NCT03620721. Registered on 8 August 2018.
Collapse
Affiliation(s)
- Inger Burnett-Zeigler
- Asher Center, Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, 676 N St. Clair St, Chicago, IL 60611 USA
| | - Elayne Zhou
- Asher Center, Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, 676 N St. Clair St, Chicago, IL 60611 USA
| | - Jennifer H. Martinez
- Asher Center, Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, 676 N St. Clair St, Chicago, IL 60611 USA
| | - Katelyn Zumpf
- Division of Biostatistics, Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL USA
| | - Lynette Lartey
- Asher Center, Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, 676 N St. Clair St, Chicago, IL 60611 USA
| | - Judith T. Moskowitz
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL USA
| | - Katherine L. Wisner
- Asher Center, Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, 676 N St. Clair St, Chicago, IL 60611 USA
| | - Thomas McDade
- Department of Anthropology, Weinberg College of Arts and Sciences, Northwestern University, Chicago, IL USA
| | - C. Hendricks Brown
- Asher Center, Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, 676 N St. Clair St, Chicago, IL 60611 USA
| | - Jacqueline Gollan
- Asher Center, Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, 676 N St. Clair St, Chicago, IL 60611 USA
| | - Jody D. Ciolino
- Division of Biostatistics, Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL USA
| | - Jacob M. Schauer
- Division of Biostatistics, Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL USA
| | - Lucia C. Petito
- Division of Biostatistics, Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL USA
| |
Collapse
|
8
|
Waldron EM, Miller ES, Wee V, Statton A, Moskowitz JT, Burnett‐Zeigler I. Stress, coping and the acceptability of mindfulness skills among pregnant and parenting women living with HIV in the United States: A focus group study. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e6255-e6266. [PMID: 36214377 PMCID: PMC10092748 DOI: 10.1111/hsc.14063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 08/25/2022] [Accepted: 09/12/2022] [Indexed: 06/16/2023]
Abstract
Pregnant and parenting women living with HIV (WLWH) face high levels of psychological stress and mental illness but lack tailored and acceptable psychosocial treatments. The research team sought to inform the adaptation of a mindfulness intervention for pregnant and parenting WLWH through focus groups exploring psychosocial treatment needs and mindfulness intervention preferences. The research team conducted focus groups with pregnant and parenting WLWH (n = 16) and case managers (n = 6) recruited from a community-based enhanced case management program. The research team utilised an iterative inductive approach to coding of the transcripts from these focus groups. Five themes emerged: stressors, signs of stress, coping, lack of access and acceptability of care, and motivation and trust in care engagement. These focus groups revealed a desire for a group intervention that could decrease isolation while protecting against involuntary disclosure of HIV status. Participants expressed openness to mindfulness skills for coping with stress. The focus group participants' preference for a non-stigmatising group intervention supports the potential of a mindfulness-based group intervention to reduce stress and improve the mental health of pregnant and parenting women living with HIV.
Collapse
Affiliation(s)
- Elizabeth M. Waldron
- Department of Psychiatry and Behavioral SciencesNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
- Present address:
Department of PsychiatryMassachusetts General HospitalBostonMassachusettsUSA
| | - Emily S. Miller
- Department of Psychiatry and Behavioral SciencesNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
- Department of Obstetrics and Gynecology, Division of Maternal Fetal MedicineNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
| | - Victoria Wee
- Department of Psychiatry and Behavioral SciencesNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
| | | | - Judith T. Moskowitz
- Department of Medical Social SciencesNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
| | - Inger Burnett‐Zeigler
- Department of Psychiatry and Behavioral SciencesNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
| |
Collapse
|
9
|
Braden BB, Pagni BA, Monahan L, Walsh MJM, Dixon MV, Delaney S, Ballard L, Ware JE. Quality of life in adults with autism spectrum disorder: influence of age, sex, and a controlled, randomized mindfulness-based stress reduction pilot intervention. Qual Life Res 2022; 31:1427-1440. [PMID: 34655389 PMCID: PMC9012783 DOI: 10.1007/s11136-021-03013-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/01/2021] [Indexed: 12/14/2022]
Abstract
PURPOSE Adults with autism spectrum disorder (ASD) consistently report worse functional health and well-being, compared to neurotypical (NT) peers. In a series of studies, we aimed to elucidated the effects of sex, age, and their interaction on health-related quality of life (HRQoL) and evaluated the effectiveness of mindfulness-based stress reduction (MBSR) for improving health-, disability-, and autism-related QoL, with possible sex and age outcome moderators, in adults with ASD. METHODS Study 1 used the 36-Item Short Form Survey to compare mental and physical HRQoL composite scores in adults with ASD (n = 67) and matched NT adults (n = 66). Study 2 was a randomized pilot evaluation of the effect of MBSR, compared to an active control intervention with social support and relaxation education (support/education; n = 56), on the World Health Organization QoL BREF, Disability, and Autism-Specific scales in adults with ASD. RESULTS In Study 1, we replicated findings that mental HRQoL is worse in both men and women with ASD, compared to NT counterparts, but physical HRQoL is only worse in women with ASD. We present novel findings that older age is associated with better mental HRQoL in women with ASD only. In Study 2, MBSR improved disability-related QoL in adults with ASD over and above the support/education intervention, but both interventions improved mental HRQoL. Lastly, both interventions were more effective for HRQoL improvements in women with ASD. CONCLUSION Findings encourage precision medicine approaches tailored to age and sex groups for best HRQoL outcomes in adults with ASD. CLINICALTRIALS gov Identifier: NCT04017793.
Collapse
Affiliation(s)
- B Blair Braden
- College of Health Solutions, Arizona State University, Tempe, AZ, USA.
| | - Broc A Pagni
- College of Health Solutions, Arizona State University, Tempe, AZ, USA
| | - Leanna Monahan
- College of Health Solutions, Arizona State University, Tempe, AZ, USA
| | - Melissa J M Walsh
- College of Health Solutions, Arizona State University, Tempe, AZ, USA
| | - Maria V Dixon
- College of Health Solutions, Arizona State University, Tempe, AZ, USA
| | - Shanna Delaney
- College of Health Solutions, Arizona State University, Tempe, AZ, USA
| | - Lisa Ballard
- College of Health Solutions, Arizona State University, Tempe, AZ, USA
| | - John E Ware
- College of Health Solutions, Arizona State University, Tempe, AZ, USA
- Department of Medicine, Tufts Medical Center, Boston, MA, USA
| |
Collapse
|
10
|
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
| |
Collapse
|
11
|
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.
Collapse
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
| |
Collapse
|
12
|
Aubry C, Rider A, Russell S, Moyer S, Kinser PA. "I'm Not the Only One With Depression": Women's Perceptions of In-Person Group Formats of Depressive Symptom Interventions. J Perinat Neonatal Nurs 2021; 35:37-45. [PMID: 33528186 PMCID: PMC7863574 DOI: 10.1097/jpn.0000000000000530] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
A standard format for depression management has long been the in-person group-based intervention, yet recent calls for scalable interventions have increased interest in individual online formats. However, the perspectives and preferences of women are largely missing in the literature. This secondary qualitative data analysis using a phenomenological method of inquiry explored the lived experiences of pregnant and nonpregnant women with depressive symptoms (N = 44) who participated in 2 studies involving group-based face-to-face mindful physical activity interventions for depressive symptom self-management. Four main themes emerged regarding the group format: shared experiences enhanced the feeling of safety and impact of the group interventions; group instructors played a key role in fostering a safe environment; participants wished for more group interactions; and participants preferred a synchronous group-based intervention over a technology-based or asynchronous alternative for depressive symptom management. The findings from this study suggest that women with depression enjoy synchronous group-based interventions and find them to be beneficial for the shared experiences with other women and the safe environment created by group instructors. Future research should include study designs that consider these factors in the context of hybrid or fully online intervention formats for depression management.
Collapse
Affiliation(s)
- Christine Aubry
- Virginia Commonwealth University School of Nursing Richmond, VA
| | - Amy Rider
- Virginia Commonwealth University School of Nursing Richmond, VA
| | - Sasha Russell
- Virginia Commonwealth University School of Nursing Richmond, VA
| | - Sara Moyer
- Virginia Commonwealth University School of Nursing Richmond, VA
| | | |
Collapse
|
13
|
Biggers A, Spears CA, Sanders K, Ong J, Sharp LK, Gerber BS. Promoting Mindfulness in African American Communities. Mindfulness (N Y) 2020; 11:2274-2282. [PMID: 33584869 DOI: 10.1007/s12671-020-01480-w] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
African Americans report higher rates of chronic stress compared to non-Hispanic Whites. Consequently, chronic stress contributes to disproportionately higher rates of poor health outcomes among African Americans. Mindfulness meditation is a well-established and studied strategy to reduce stress and potentially improve health outcomes. However, the practice of mindfulness meditation is largely underutilized in African American communities despite its potential health benefits. In this commentary, we will discuss the relevance of mindfulness interventions, limited research available, reasons for low representation, and cultural adaptations for mindfulness meditation in African American communities. We also provide additional strategies to guide future mindfulness research that target African Americans.
Collapse
Affiliation(s)
- Alana Biggers
- University of Illinois at Chicago College of Medicine, 1747 West Roosevelt Road Chicago, IL 60608
| | | | - Kimberly Sanders
- Hunter Holmes Mcguire Veterans Hospital, 1201 Broad Rock Blvd Richmond, VA 23249
| | - Jason Ong
- Northwestern University Feinberg School of Medicine, 710 N Lake Shore Drive Suite 1004
| | - Lisa K Sharp
- University of Illinois at Chicago College of Pharmacy, 833 South Wood St, Chicago, IL, 60612
| | - Ben S Gerber
- University of Illinois at Chicago College of Medicine, 1747 West Roosevelt Road Chicago, IL 60608
| |
Collapse
|