Integrative Yoga and Mindful Self-Compassion to Reduce Distress in Women Survivors of Interpersonal Violence

综合瑜伽和正念自我同情减少人际暴力女性幸存者的痛苦

• 批准号: 10429628
• 负责人: Tosca Braun
• 金额: $ 17.69万
• 依托单位: BUTLER HOSPITAL (PROVIDENCE, RI)
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-06-01 至 2027-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10429628
• 关键词: Acute; Address; Affect; African American; Black race; Breathing; Chronic stress; Clinical; Clinical Research; Clinical Trials; Communities; Compassion; Complement; Complementary Medicine; Cultural Sensitivity; Data; Development; Disease; Distress; Ensure; Ethnic Origin; Focus Groups; Fostering; Fright; Funding; Future; Grant; Health; Health Promotion; Health education; Hispanic; Interpersonal Violence; Intervention; Interview; K-Series Research Career Programs; Knowledge; Latina; Latino; Learning; Manuals; Meditation; Mental Health; Mental disorders; Mentors; Methods; Mind-Body Method; Minority Groups; National Center for Complementary and Integrative Health; Not Hispanic or Latino; Outcome; Participant; Phase; Physiological; Population; Posture; Program Evaluation; Public Health; Race; Randomized; Regulation; Relaxation; Reporting; Research; Research Personnel; Resources; Risk; Risk Behaviors; Safety; Scientist; Series; Shame; Stigmatization; Subgroup; Survivors; Target Populations; Teacher Professional Development; Therapeutic Effect; Training; Training Programs; Trauma; Trust; United States National Institutes of Health; Variant; Violence; Vulnerable Populations; Weight; Woman; Work; Yoga; acceptability and feasibility; base; behavior test; behavioral health; body-mind; community engaged research; community setting; comparison intervention; design; efficacy trial; experience; hands-on learning; health equity; health equity promotion; health inequalities; improved; innovation; instructor; internalized stigma; intersectionality; intervention effect; marginalized population; mindfulness; mindfulness intervention; novel; physical conditioning; pilot trial; prevent; primary outcome; programs; racial and ethnic; racial diversity; resilience; response; restoration; revictimization; secondary outcome; skills; social stigma; stress disorder; teacher

PROJECT ABSTRACT The overall objective of this Mentored Research Scientist Career Development Award is to support Dr. Tosca Braun’s transition to an independent investigator with a focus on using community-engaged approaches to develop and disseminate community-engaged mindfulness-based interventions to advance health in vulnerable and minority populations. Interpersonal violence is commonly experienced among Black/African American (AA; 44%), Hispanic/Latino/a/x (34%), and non-Hispanic/Latino/a/x White women (37%) in the US, as well as stigmatization related to IV and other attributes (e.g., race/ethnicity, weight). Violence and stigma both drive “downstream” poor behavioral and physical health. Stigma sequelae – distress in response to stigma, anticipated (fear of) stigma, internalized stigma – independently foster shame and affect dysregulation, thus magnifying distress and consequent health impacts. These interpersonal violence (IV) sequelae can be alleviated by reducing distress, yet culturally sensitive transdiagnostic approaches to reduce survivor distress across ethno- racial populations are rare. We propose to use community-engaged research to develop a complementary medicine program that integrates adapted Mindful Self-Compassion (MSC) training with Trauma-Informed Yoga (TIY) to improve stigma sequelae and reduce distress in ethno-racially diverse survivors: Integrated TIY and MSC (I-YMSC). MSC targets stigma-related problems (affect dysregulation, shame) and improves distress in the long-term, yet can temporarily increase short-term distress. TIY reduces short-term distress and promotes physiological-autonomic regulation. Dr. Braun’s program evaluation data suggests adapting MSC to explicitly address cultural factors and intersectional stigma and integrating this approach with TIY is strongly warranted and has potential to ameliorate health inequities experienced by ethno-racially diverse IV survivors. Further, training community yoga instructor survivors to teach I-YMSC represents an additional level of engagement with our stigmatized target population that is unusual in mindfulness research. In this K23 proposal, Black/AA, Hispanic/Latino/a/x, and White survivors will be equally represented across all project phases (33% each), with results considered both across participants and within each subgroup. Specific aims include: (1) (1.1) develop I- YMSC using community-engaged research with women IV survivor stakeholder partners, (1.2) pre-pilot the intervention in an open pilot trial to further refine the intervention, (1.3) develop a community-engaged teacher training, and (2) (2.1) conduct a 2-armed test of the behavioral intervention compared to a health education control to assess the feasibility and acceptability of the I-YMSC intervention, and (2.2) pilot the teacher training. The essential hands-on learning and mentored training in this grant will support Dr. Braun in establishing her program of research as an independent investigator in community-engaged mind-body research working with vulnerable and minority populations, including women survivors of violence. Findings may also have applicability to promoting health resiliency and restoration in other marginalized populations who experience health inequities.

项目摘要 该导师研究科学家职业发展奖的总体目标是支持托斯卡博士 布劳恩向独立调查员的转变，重点是使用社区参与的方法 制定和传播社区参与的基于正念的干预措施，以促进弱势群体的健康 和少数民族人口。人际暴力在黑人/非裔美国人 (AA； 美国的西班牙裔/拉丁裔/a/x 裔 (34%) 和非西班牙裔/拉丁裔/a/x 白人女性 (37%) 与 IV 和其他属性（例如种族/民族、体重）相关的污名化。暴力和耻辱共同驱动 “下游”行为和身体健康状况不佳。耻辱后遗症——预期对耻辱反应的痛苦 （害怕）耻辱，内在的耻辱——独立地培养羞耻感并影响失调，从而放大 痛苦和随之而来的健康影响。这些人际暴力（IV）后遗症可以通过以下方式缓解： 减少痛苦，但具有文化敏感性的跨诊断方法可以减少跨种族的幸存者痛苦 种族人口很少。我们建议利用社区参与的研究来开发补充性的 将正念自我同情 (MSC) 训练与创伤知情瑜伽相结合的医学计划 (TIY) 改善耻辱后遗症并减少不同种族幸存者的痛苦：综合 TIY 和 MSC（I-YMSC）。 MSC 针对耻辱相关问题（影响失调、羞耻）并改善痛苦 从长远来看，但可能会暂时增加短期困扰。 TIY 减少短期困扰并促进 生理自主调节。 Braun 博士的项目评估数据建议使 MSC 明确适应 解决文化因素和交叉耻辱并将这种方法与 TIY 相结合是非常有必要的 并有可能改善不同种族的静脉注射幸存者所经历的健康不平等。更远， 培训社区瑜伽教练幸存者来教授 I-YMSC 代表了更高层次的参与 我们被污名化的目标人群在正念研究中是不寻常的。在这个K23提案中，Black/AA， 西班牙裔/拉丁裔/a/x 裔和白人幸存者在所有项目阶段的比例将相同（各 33%），其中 结果同时考虑了参与者之间和每个小组内的结果。具体目标包括： (1) (1.1) 开发 I- YMSC 与女性 IV 幸存者利益相关者合作伙伴一起进行社区参与研究，(1.2) 进行预试点 进行公开试点试验以进一步完善干预措施，(1.3) 培养社区教师 培训，以及 (2) (2.1) 对行为干预与健康教育进行比较进行 2 组测试 控制评估 I-YMSC 干预的可行性和可接受性，以及 (2.2) 试点教师培训。 这笔赠款中必要的实践学习和指导培训将支持布劳恩博士建立她的 作为社区参与身心研究的独立调查员的研究计划 弱势群体和少数群体，包括暴力行为的女性幸存者。研究结果可能也有适用性 促进其他经历健康不平等的边缘人群的健康弹性和恢复。