Mindfulness-Based Mobile Health to Address Unhealthy Eating Among Middle-Aged Sexual Minority Women With Early Life Adversity: Mixed Methods Feasibility Trial.
Mindfulness-Based Mobile Health to Address Unhealthy Eating Among Middle-Aged Sexual Minority Women With Early Life Adversity: Mixed Methods Feasibility Trial.
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基于正念的移动健康，以解决患有早期生命逆境的中年性少数民族妇女中不健康的饮食：混合方法可行性试验。
DOI：
10.2196/46310
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发表时间：
2023-09-26
影响因子：
7.4
通讯作者：
Brewer, Judson
中科院分区：
文献类型：
--
作者：
Sun, Shufang;Nardi, William;Murphy, Matthew;Scott, Ty;Saadeh, Frances;Roy, Alexandra;Brewer, Judson
性少数群体女性（女同性恋、男同性恋、双性恋、泛性恋、酷儿和其他非异性恋女性）在健康研究中的代表性仍然相当不足，尽管与异性恋同龄人相比，她们患糖尿病和肥胖以及耻辱和心理困扰的风险更高。此外，性少数群体妇女中普遍存在早期生活逆境（ELA），这进一步增加了肥胖、心理困扰和心血管健康不良的风险。基于应用程序的正念干预可能有助于减轻ELA对健康的不利影响，减少对食物的渴望和不健康的饮食，解决与肥胖相关的风险。这项混合方法可行性试验旨在测试基于正念的移动的健康方法，用于患有ELA和超重或肥胖（BMI ≥25 kg/m2）的中年性少数女性（30-55岁），以改善健康结果。这项单组试验在社交媒体和各种女同性恋、男同性恋、双性恋、变性人和酷儿网络团体上做了广告。在基线，干预后（2个月）和4个月的随访中，参与者完成了对主要结果（通过邮寄量表的食物渴望，情绪化饮食和体重）和次要结果（抑郁，焦虑，正念和情绪失调）的评估。一个标准化的体重测量邮寄给参与者的体重报告。可行性和可接受性进行了评估后，通过调查和半结构式离职面谈的干预。我们筛选了442名个体，其中30名符合条件的性少数女性（平均年龄40.20岁，SD 7.15岁）来自美国各地区参加了这项研究。在基线时，86%（26/30）和80%（24/30）的参与者分别有抑郁和焦虑症状。在30名入组的参与者中，20名（66%）完成了所有干预模块，25名（83%）在2个月随访时保留，20名（66%）在4个月随访时保留。无不良反应报告。从基线到4个月随访，在食物渴望（Cohen d=1.64）和奖励性饮食（Cohen d=1.56）中发现了较大的影响，而在体重中发现了较小的影响（Cohen d=0.20;平均4.21 kg）。次要结局也有显著改善（抑郁，科恩d=0.98;焦虑，科恩d=0.50;正念，科恩d=0.49;情绪失调，科恩d=0.44;所有P<0.05）。父母言语和情感虐待水平较高的参与者对干预措施特别敏感。参与者报告说，该计划符合他们的目标和期望，易于使用，并促进饮食行为和心理健康的变化。参与的障碍包括需要不同的教师，个性化的支持和身体积极的语言。这项早期可行性试验为正念移动的健康方法提供了概念验证支持，以改善性少数女性的肥胖相关结局，并保证未来进行更大规模的随机对照试验。研究结果还表明，在解决性少数女性与体重相关的结果时，需要解决创伤和心理健康问题。
Sexual minority women (lesbian, gay, bisexual, pansexual, queer, and other nonheterosexual women) remain considerably underrepresented in health research despite being at a higher risk for diabetes and obesity as well as stigma and psychological distress than their heterosexual peers. In addition, early life adversity (ELA) is prevalent among sexual minority women, which further increases risks for obesity, psychological distress, and poor cardiovascular health. App-based mindfulness interventions are potentially promising for this group in mitigating the adverse health effects of ELA, reducing food craving and unhealthy eating, addressing the risks associated with obesity. This mixed methods feasibility trial aimed to test a mindfulness-based mobile health approach for middle-aged sexual minority women (aged 30-55 years) with ELA and overweight or obesity (BMI ≥25 kg/m2) to improve health outcomes. The single-arm trial was advertised on social media and various lesbian, gay, bisexual, transgender, and queer web-based groups. At baseline, after the intervention (2 months), and at the 4-month follow-up, participants completed assessments of primary outcomes (food craving, emotional eating, and weight via a mailed scale) and secondary outcomes (depression, anxiety, mindfulness, and emotion dysregulation). A standardized weight measure was mailed to participants for weight reporting. Feasibility and acceptability were assessed after the intervention via surveys and semistructured exit interviews. We screened 442 individuals, among which 30 eligible sexual minority women (mean age 40.20, SD 7.15 years) from various US regions were enrolled in the study. At baseline, 86% (26/30) and 80% (24/30) of participants had elevated depressive and anxiety symptoms, respectively. Among the 30 enrolled participants, 20 (66%) completed all intervention modules, 25 (83%) were retained at the 2-month follow-up, and 20 (66%) were retained at the 4-month follow-up. None reported adverse effects. From baseline to the 4-month follow-up, large effects were found in food craving (Cohen d=1.64) and reward-based eating (Cohen d=1.56), whereas small effects were found with weight (Cohen d=0.20; 4.21 kg on average). Significant improvements were also found in the secondary outcomes (depression, Cohen d=0.98; anxiety, Cohen d=0.50; mindfulness, Cohen d=0.49; and emotion dysregulation, Cohen d=0.44; all P<.05). Participants with higher levels of parental verbal and emotional abuse were particularly responsive to the intervention. Participants reported that the program aligned with their goals and expectations, was easy to use, and facilitated changes in eating behavior and mental health. Barriers to engagement included the need for diverse teachers, individualized support, and body positive language. This early phase feasibility trial provides proof-of-concept support for a mindfulness mobile health approach to improve obesity-related outcomes among sexual minority women and warrants a larger randomized controlled trial in the future. The findings also suggest the need to address trauma and psychological health when addressing weight-related outcomes among sexual minority women.
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儿童期性虐待，父母的身体虐待以及性少数群体和性非少数人的同伴受害的荟萃分析。
影响因子：
12.7
作者：
Friedman MS;Marshal MP;Guadamuz TE;Wei C;Wong CF;Saewyc E;Stall R
通讯作者：
Stall R
DOI：
10.1177/1745691620968771
发表时间：
2022-01
期刊：
Perspectives on psychological science : a journal of the Association for Psychological Science
影响因子：
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作者：
Goldberg SB;Riordan KM;Sun S;Davidson RJ
通讯作者：
Davidson RJ
影响因子：
25.8
作者：
Chen, Edith;Turiano, Nicholas A.;Miller, Gregory E.
通讯作者：
Miller, Gregory E.
影响因子：
1.9
作者：
Ingraham, Natalie;Harbatkin, Dawn;Minnis, Alexandra M.
通讯作者：
Minnis, Alexandra M.
影响因子：
4
作者：
Gale NK;Heath G;Cameron E;Rashid S;Redwood S
通讯作者：
Redwood S