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Pro G, Horton H, Tody B, Gu M, Washington T, Williams A, Gorvine MM, Johnson O, Lovelady N, Jackson T, Ray A, Montgomery B, Zaller N. National and state-level trends in the availability of mental health treatment services tailored to individuals ordered to treatment by a court: United States, 2016, 2018, and 2020. Soc Psychiatry Psychiatr Epidemiol 2024:10.1007/s00127-023-02589-8. [PMID: 38193943 DOI: 10.1007/s00127-023-02589-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 10/30/2023] [Indexed: 01/10/2024]
Abstract
PURPOSE We sought to identify trends and characteristics associated with the availability of tailored mental health services for individuals involved in the criminal justice system and ordered to treatment by a court, nationally in the US and by state. METHODS We used National Mental Health Services Survey to identify outpatient mental health treatment facilities in the US (2016 n = 4744; 2018 n = 4626; 2020 n = 4869). We used clustered multiple logistic regression to identify changes over time as well as facility- and state-level factors associated with the availability of specialty court-ordered services. RESULTS Slightly more than half of the outpatient mental health treatment facilities offered specialized services for individuals ordered to treatment by a court, with wide variation between states. Nationally, there was a significant increase in the odds of offering court-ordered treatment in 2020 compared to 2016 (aOR = 1.16, 95% CI = 1.06-1.27, p < 0.01). Notable associations included offering integrated substance use treatment (versus none, aOR = 2.95, 95% CI = 2.70-3.22, p < 0.0001) and offering trauma therapy (versus none, aOR = 2.05, 95% CI = 1.85-2.27, p < 0.0001). CONCLUSION The availability of mental health services for individuals ordered to treatment by a court is growing nationally but several states are lagging behind. Court ordered treatment is a promising strategy to improve health and reduce reliance on the carceral system as a healthcare provider. At the same time, we express caution around disparities within behavioral health courts and advocate for equity in access to incarceration alternatives.
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Affiliation(s)
- George Pro
- Southern Public Health and Criminal Justice Research Center, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA.
| | - Heather Horton
- Southern Public Health and Criminal Justice Research Center, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Brooklyn Tody
- Southern Public Health and Criminal Justice Research Center, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Mofan Gu
- Southern Public Health and Criminal Justice Research Center, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Taylor Washington
- Southern Public Health and Criminal Justice Research Center, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Ashley Williams
- Southern Public Health and Criminal Justice Research Center, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Margaret M Gorvine
- Southern Public Health and Criminal Justice Research Center, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - O'Dell Johnson
- Southern Public Health and Criminal Justice Research Center, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Nakita Lovelady
- Southern Public Health and Criminal Justice Research Center, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Timikia Jackson
- Southern Public Health and Criminal Justice Research Center, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Azizi Ray
- Southern Public Health and Criminal Justice Research Center, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
- College of Pharmacy, University of New Mexico Health Sciences Center, Albuquerque, New Mexico, USA
| | - Brooke Montgomery
- Southern Public Health and Criminal Justice Research Center, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Nick Zaller
- Southern Public Health and Criminal Justice Research Center, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
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Swindle T, Baloh J, Landes SJ, Lovelady NN, Vincenzo JL, Hamilton AB, Zielinski MJ, Teeter BS, Gorvine MM, Curran GM. Evidence-Based Quality Improvement (EBQI) in the pre-implementation phase: key steps and activities. Front Health Serv 2023; 3:1155693. [PMID: 37292120 PMCID: PMC10244502 DOI: 10.3389/frhs.2023.1155693] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 05/04/2023] [Indexed: 06/10/2023]
Abstract
Background Evidence-Based Quality Improvement (EBQI) involves researchers and local partners working collaboratively to support the uptake of an evidence-based intervention (EBI). To date, EBQI has not been consistently included in community-engaged dissemination and implementation literature. The purpose of this paper is to illustrate the steps, activities, and outputs of EBQI in the pre-implementation phase. Methods The research team applied comparative case study methods to describe key steps, activities, and outputs of EBQI across seven projects. Our approach included: (1) specification of research questions, (2) selection of cases, (3) construction of a case codebook, (4) coding of cases using the codebook, and (5) comparison of cases. Results The cases selected included five distinct settings (e.g., correction facilities, community pharmacies), seven EBIs (e.g., nutrition promotion curriculum, cognitive processing therapy) and five unique lead authors. Case examples include both community-embedded and clinically-oriented projects. Key steps in the EBQI process included: (1) forming a local team of partners and experts, (2) prioritizing implementation determinants based on existing literature/data, (3) selecting strategies and/or adaptations in the context of key determinants, (4) specifying selected strategies/adaptations, and (5) refining strategies/adaptations. Examples of activities are included to illustrate how each step was achieved. Outputs included prioritized determinants, EBI adaptations, and implementation strategies. Conclusions A primary contribution of our comparative case study is the delineation of various steps and activities of EBQI, which may contribute to the replicability of the EBQI process across other implementation research projects.
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Affiliation(s)
- Taren Swindle
- Department of Family and Preventive Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, United States
- Center for Implementation Research, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Jure Baloh
- Center for Implementation Research, University of Arkansas for Medical Sciences, Little Rock, AR, United States
- Department of Health Policy and Management, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Sara J. Landes
- Center for Implementation Research, University of Arkansas for Medical Sciences, Little Rock, AR, United States
- Behavioral Health Quality Enhancement Research Initiative (QUERI), Central Arkansas Veterans Healthcare System, Little Rock, AR, United States
- Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Nakita N. Lovelady
- Department of Health Behavior and Health Education, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Jennifer L. Vincenzo
- Department of Physical Therapy, University of Arkansas for Medical Sciences, Fayetteville, AR, United States
| | - Alison B. Hamilton
- Center for the Study of Healthcare Innovation, Implementation, & Policy; VA Greater Los Angeles Healthcare System, Los Angeles, CA, United States
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, United States
| | - Melissa J. Zielinski
- Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR, United States
- Department of Psychological Science, University of Arkansas, Fayetteville, AR, United States
| | - Benjamin S. Teeter
- Center for Implementation Research, University of Arkansas for Medical Sciences, Little Rock, AR, United States
- Department of Pharmacy Practice, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Margaret M. Gorvine
- Department of Health Behavior and Health Education, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Geoffrey M. Curran
- Center for Implementation Research, University of Arkansas for Medical Sciences, Little Rock, AR, United States
- Department of Pharmacy Practice, University of Arkansas for Medical Sciences, Little Rock, AR, United States
- Central Arkansas Veterans Healthcare System, Little Rock, AR, United States
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Zaller ND, Staton M, Gorvine MM, Tillson M, Glenn J, Pro G, Oser C, Ramaswamy M. Proposed development of the Criminal Justice Translation and Clinical Science (CJ-TRACS) network. J Clin Transl Sci 2023; 7:e189. [PMID: 37745927 PMCID: PMC10514680 DOI: 10.1017/cts.2023.531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 03/29/2023] [Accepted: 04/06/2023] [Indexed: 09/26/2023] Open
Affiliation(s)
- Nickolas D. Zaller
- Southern Public Health and Criminal Justice Research Center, University of Arkansas for Medical Sciences Fay W. Boozman College of Public Health, Little Rock, AR, USA
| | - Michele Staton
- Department of Behavioral Science, College of Medicine, University of Kentucky, Lexington, KY, USA
| | - Margaret M. Gorvine
- Southern Public Health and Criminal Justice Research Center, University of Arkansas for Medical Sciences Fay W. Boozman College of Public Health, Little Rock, AR, USA
| | - Martha Tillson
- Department of Behavioral Science, College of Medicine, University of Kentucky, Lexington, KY, USA
| | - Jason Glenn
- Department of Population Health, School of Medicine, Kansas University, Kansas City, KS, USA
| | - George Pro
- Southern Public Health and Criminal Justice Research Center, University of Arkansas for Medical Sciences Fay W. Boozman College of Public Health, Little Rock, AR, USA
| | - Carrie Oser
- Department of Sociology, College of Arts and Sciences, University of Kentucky, Lexington, KY, USA
| | - Megha Ramaswamy
- Department of Population Health, School of Medicine, Kansas University, Kansas City, KS, USA
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Zaller ND, Gorvine MM, Ross J, Mitchell SG, Taxman FS, Farabee D. Providing substance use disorder treatment in correctional settings: knowledge gaps and proposed research priorities-overview and commentary. Addict Sci Clin Pract 2022; 17:69. [PMID: 36482490 PMCID: PMC9733039 DOI: 10.1186/s13722-022-00351-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 11/18/2022] [Indexed: 12/13/2022] Open
Abstract
This manuscript is the product of the authors' discussions, literature overview, and consultation with experts in the field, and identifies important gaps in the evidence base for substance use disorder (SUD) treatment effectiveness within criminal justice (CJ) settings. Lacking from the extant literature are longitudinal investigations of treatment related outcomes during and after incarceration. Such studies could provide rich contextual data about treatment delivery and effectiveness across the CJ continuum, and would provide important insight into individual characteristics (e.g., motivation, treatment modality preferences, treatment completion rates, etc.) as well as institutional and environmental factors (e.g., appropriate staffing, space limitations for individual treatment sessions, distribution of medications, etc.). We also identified the importance of reproducibility within CJ research, and the unfortunate reality of too many single studies conducted in single (or relatively few) correctional facilities. Some of this has been because the studies designed to produce that evidence are not prioritized for funding, which has continually placed researchers in a position where we cannot make firm conclusions or recommendations based on available evidence. The importance of replicating the foundational studies in this field cannot be overstated. We hope this article spurs other researchers to join in the healthy process of questioning the existing state of the CJ-based SUD treatment research, what should be re-examined, and how we can lay a stronger foundation for the future.
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Affiliation(s)
- Nickolas D Zaller
- University of Arkansas for Medical Sciences, College of Public Health, Little Rock, AR, USA.
| | - Margaret M Gorvine
- University of Arkansas for Medical Sciences, College of Public Health, Little Rock, AR, USA
| | - Jon Ross
- TASC, Inc. (Treatment Alternatives for Safe Communities), Chicago, IL, USA
| | | | - Faye S Taxman
- George Mason University, Schar School of Policy and Government, Fairfax, VA, USA
| | - David Farabee
- New York University, School of Medicine, New York, NY, USA
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McKay M, Gorvine MM, Zaller N, Singh V, Goree J. Federal and Statewide Coverage for Opioid-Sparing Chronic Pain Treatments. Pain Physician 2022; 25:E1457-E1466. [PMID: 36608017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND With increased hospitalizations and deaths related to opioid use disorder, there is an impetus for federal and private insurance companies to provide coverage for integrative treatments that address pain. The Centers for Disease Control and Prevention (CDC) and the current literature recommend that nonpharmacological and nonopioid treatments must be considered for chronic pain management. The continued examination of potential coverage and cost-effectiveness for opioid-sparing alternatives with proven efficacy is critical for physicians who treat chronic pain. STUDY DESIGN Qualitative analysis of coverage policies for 10 alternative chronic back pain therapies was completed using the most up-to-date publicly available information from federal and state databases until September 2021. OBJECTIVES To determine coverage for opioid-sparing treatments for chronic back pain across federal and state healthcare systems. METHODS We selected the alternative therapies from the National Institute of Health's National Center for Complementary and Integrative Health (NCCIH) (www.nccih.nih.gov). We then collected and analyzed coverage policies for federal and state healthcare plans, including Medicare, Veterans Health Administration (VHA), Indian Health Services (IHS), and Medicaid, by accessing federal databases and state policy databases via the department of health and human services (HHS). RESULTS The 2 most commonly covered nonpharmacologic therapies for chronic back pain are physical therapy and cognitive behavioral therapy. Other more novel therapies have a heterogenous distribution among federal and state healthcare coverage. Assessment of regional differences determined that the median number of treatments in the Northeast and Midwest was 3, while in the South and West, it was 2. LIMITATIONS Several provider manuals included varying degrees of information regarding their services. Some states included all pertinent information, such as the definition of treatment, the exact number of service visits allowed annually, and whether prior authorization was necessary. Many manuals provided less information than this. Each state's Medicaid document contained inherent variability, especially with respect to when they were updated or published. Some states had updated information available for 2021, while the most updated policies for other states included documents that were last updated in 2008. CONCLUSIONS Integrative treatments for chronic back pain are currently available, yet coverage varies widely depending on the patient's Medicare or Medicaid status. Different states cover different therapies, which may lead to unequal healthcare outcomes for patients with chronic pain.
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Affiliation(s)
- Monroe McKay
- University of Arkansas for Medical Sciences, College of Medicine, Little Rock, AR
| | - Margaret M Gorvine
- University of Arkansas for Medical Sciences, Fay W. Boozman College of Public Health, Little Rock, AR
| | - Nickolas Zaller
- University of Arkansas for Medical Sciences, Fay W. Boozman College of Public Health, Little Rock, AR
| | - Vinita Singh
- Department of Anesthesiology, Emory University, Atlanta, GA
| | - Johnathan Goree
- Department of Anesthesiology, University of Arkansas for Medical Sciences, Little Rock, AR
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Marshall SA, Barham C, Neher T, Zielinski MJ, Brinkley-Rubinstein L, Gorvine MM, Zaller N. Acceptability of a Community Health Worker Program to Link High-Risk People in Jail to HIV Pre-Exposure Prophylaxis. J Health Care Poor Underserved 2022; 33:149-166. [DOI: 10.1353/hpu.2022.0012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Gorvine MM, Haynes TF, Marshall SA, Clark CJ, Lovelady NN, Zaller ND. A Qualitative Exploration of Women's Lives and Resilience in Substance Use Disorder Recovery. Integr Med (Encinitas) 2021; 20:20-29. [PMID: 34377097 PMCID: PMC8325504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
OBJECTIVE This study sought to explore constructs of the Whole Health resilience model to identify potential intervention and local research opportunities as a precursor to intervention development, as well as to describe women's resilience in Substance Use Disorder (SUD) recovery including current strengths, coping, self-care, needs and priorities in the context of their everyday lives. METHODS Qualitative data were collected from December 2018 to January 2020 in the Mid-South United States. In-depth interviews of 17 women age 25 to 65 years in SUD recovery for 2 weeks or longer were conducted in 9 different settings including a Medication Assisted Treatment (MAT) hospital setting, a MAT pilot program in a community corrections setting, an incarceration re-entry residential program, community-based peer support organizations (eg, Narcotics Anonymous, Alcoholics Anonymous), a residential SUD treatment facility and a yoga teachers' online group. These data were analyzed with a hybrid approach (inductive and deductive coding). RESULTS The major themes that emerged from the analysis included social support, individual-level cognitive and spiritual strategies; self-care; stressors, priorities, needs, and self-care barriers and trauma. In this context, women needed a wide range of support including treatment of severe physical injuries, professional psychological support, help with restoring relationships, SUD treatment and recovery services, job training and coaching, health insurance advice, transportation, intimate partner violence (IPV) counseling and housing. Peer-support groups and faith communities were instrumental in many (but not all) of these women's lives in recovery-a gap was identified for women who did not have social support from these groups. CONCLUSION These data highlight the need for developing interventions for women in SUD recovery that take a holistic view of resilience life areas, as well as integrate professional services, family support, community support and approach care as wrap-around support that includes integration of social services to meet women's basic needs.
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Gorvine MM, Haynes TF, Marshall SA, Clark CJ, Lovelady NN, Zaller ND. An Exploratory Study of the Acceptability and Feasibility of Yoga Among Women in Substance Use Disorder Recovery. J Altern Complement Med 2020; 27:273-281. [PMID: 33373528 DOI: 10.1089/acm.2020.0351] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Objectives: This qualitative study explored the acceptability and feasibility of yoga among women in substance use disorder (SUD) recovery. Design: Seventeen women in SUD recovery for 2 weeks or longer were recruited from nine sites in the mid-South, including a Medication-Assisted Treatment clinic in a hospital setting, prison re-entry housing, community-based peer support organizations (e.g., Alcoholics Anonymous [AA], Narcotics Anonymous [NA]), a residential SUD treatment facility, a yoga teachers' online group, and through referrals. The median age of participants was 41.5, with ages ranging from 25 to 65. We used an interpretive description approach to explore both the perceptions of women without yoga experience and the experiences of women with yoga experience to collect formative data for intervention development and implementation. The interviews were recorded and transcribed verbatim. A hybrid analysis (i.e., inductive and deductive coding) was applied to the data. Results: Women's narratives included a high prevalence of trauma exposure. Overall, women in this sample were interested in either beginning or continuing yoga. Barriers to participation included perceived lack of self-efficacy of yoga, weight, and physical injuries. Additional environmental barriers included balancing care of self with caring for others, including partners, children, and NA/AA sponsees; as well as prioritizing finances, housing, employment, and transportation. Conclusion: High prevalence of trauma exposure among women in SUD recovery necessitates careful consideration of co-occurring psychiatric disorders such as post-traumatic stress disorder, anxiety and depression and the necessary professional psychological support, as well as serious physical injuries that require modification in yoga āsana classes. As transportation and balancing care needs were salient in these data, rural SUD populations could be served with telehealth interventions that provide SUD recovery support with integrative health practices such as adjunctive yoga interventions.
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Affiliation(s)
- Margaret M Gorvine
- Department of Health Behavior and Health Education, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Tiffany F Haynes
- Department of Health Behavior and Health Education, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - S Alexandra Marshall
- Department of Health Behavior and Health Education, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Cari J Clark
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Nakita N Lovelady
- Department of Health Behavior and Health Education, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Nickolas D Zaller
- Department of Health Behavior and Health Education, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, USA
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Gorvine MM, Zaller ND, Hudson HK, Demers D, Kennedy LA. A naturalistic study of yoga, meditation, self-perceived stress, self-compassion, and mindfulness in college students. Health Psychol Behav Med 2019; 7:385-395. [PMID: 34040857 PMCID: PMC8114396 DOI: 10.1080/21642850.2019.1688154] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Objective: This study compared the effects of yoga and mindfulness meditation on self-compassion, mindfulness, and perceived stress in college students; and explored mind–body mechanisms and predictors of stress reduction. Participants: Student participants (N = 92) were enrolled in either yoga or mindfulness meditation classes at a college in the southern United States from August through May of 2015–2016. Methods: Students participated in 50-minute classes twice a week for 10 weeks, completing self-report questionnaires during the 1st and 10th week. Results: Multiple-linear regression analysis found change in self-compassion was the strongest predictor of stress reduction. Conclusions: Increasing self-compassion may increase the efficacy of mind–body interventions. Research into mind–body mechanisms is needed to identify intervention components that most improve student well-being.
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Affiliation(s)
- Margaret M Gorvine
- Department of Health Behavior and Health Education, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Nickolas D Zaller
- Department of Health Behavior and Health Education, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Heather K Hudson
- Department of Health Sciences, University of Central Arkansas, Conway, AR, USA
| | - Denise Demers
- Department of Health Sciences, University of Central Arkansas, Conway, AR, USA
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