Adapting an evidence-based mindfulness-based intervention for sheltered youth experiencing homelessness.
Adapting an evidence-based mindfulness-based intervention for sheltered youth experiencing homelessness.
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DOI：
10.1186/s12906-023-04203-5
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发表时间：
2023-10-17
影响因子：
3.9
通讯作者：
Fine, Micki
中科院分区：
文献类型：
--
作者：
Santa Maria, Diane;Cuccaro, Paula;Bender, Kimberly;Sibinga, Erica;Guerrero, Natalie;Keshwani, Najiba;Jones, Jennifer;Fine, Micki
关键词：
青年经历无家可归（YEH）面临的挑战，影响他们的身体，心理和社会福祉，情绪调节和应对。正念可以减轻压力，提高弹性，情绪调节和执行功能。基于正念的干预（MBI）教导正念的实践，以培养当下的注意力而不加判断，并加强自我观察和自我调节，从而提高对思想和情绪的认识，改善人际关系。其中一种干预措施，.B，已被证明可以降低青年人的压力。虽然在庇护青年中进行的一项关于.B的试点研究发现，这种干预措施是可行的，但确定需要进行修改，以提高其相关性和可获得性，并纳入一种了解创伤的方法。我们使用ADAPT-ITT（评估，决策，管理，生产，专题专家，整合，培训人员和测试）框架来适应.B正念干预生活在紧急避难所的YEH。九个焦点小组讨论（n = 56），关键的线人访谈（n = 8），并与五个青年工作组会议（n = 10）的beta测试确定需要修改。对课程和提供方式进行了调整，以接近在收容所停留的平均时间;整合创伤知情护理方法;增加种族、民族、年龄、性取向和性别认同图像的多样性;并增加视听部分的相关性。青年和照顾青年的保健和社会服务提供者普遍喜欢课程的核心概念和介绍。使用ADAPT-ITT框架，进行了微小但重要的变更，以增加干预的相关性、可接受性和可行性。下一步是进行一项随机注意力控制试点研究，以评估可行性和可接受性。
Youth experiencing homelessness (YEH) face challenges that impact their physical, mental, and social wellbeing, emotion regulation, and coping. Mindfulness reduces stress and improves resilience, emotion regulation, and executive functioning. Mindfulness-based interventions (MBI) teach the practice of mindfulness to foster present-moment attention without judgement and enhance self-observation and self-regulation, resulting in greater awareness of thoughts and emotions and improved interpersonal relationships. One such intervention, .b, has been shown to lower stress among youth. While a pilot study of .b among sheltered youth found the intervention to be feasible, the need for modifications was identified to improve its relevance, accessibility, and incorporate a trauma-informed approach. We used the ADAPT-ITT (Assessment, Decisions, Administration, Production, Topical experts, Integration, Training staff, and Testing) framework to adapt the .b mindfulness intervention to YEH living in an emergency shelter. Nine focus group discussions (n = 56), key informant interviews (n = 8), and beta testing with five youth working group sessions (n = 10) identified needed modifications. Adaptations to the curriculum and delivery modality were made to approximate the average length of stay in the shelter; integrate trauma-informed care approaches; increase diversity of images by race, ethnicity, age, sexual orientation, and gender identity; and increase the relevance of the audio-visual components. Youth and the health and social services providers who care for youth generally liked the core concepts and presentation of the curriculum. Using the ADAPT-ITT framework, minor, yet important, changes were made to increase the relevance, acceptability, and feasibility of the intervention. Next steps are to conduct a randomized attention control pilot study to assess feasibility and acceptability.
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