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

项目摘要 这个指导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过渡，重点是使用社区参与的方法， 制定和传播社区参与的正念干预措施，以促进弱势群体的健康 少数民族人口。人际暴力在黑人/非裔美国人（AA; 44%），西班牙裔/拉丁裔/a/x（34%）和非西班牙裔/拉丁裔/a/x白色女性（37%），以及 与IV和其他属性相关的污名化（例如，种族/民族、体重）。暴力和耻辱都驱使 “下游”不良行为和身体健康。污名后遗症-预期因污名而产生的痛苦 (fear的）耻辱，内化的耻辱-独立地促进羞耻和影响失调，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，但文化上敏感的跨诊断方法，以减少幸存者的痛苦， 种族人口稀少。我们建议利用社区参与的研究， 医学计划，将适应性正念自我Compensation（MSC）培训与创伤知情瑜伽相结合 (TIY)改善耻辱后遗症和减少民族-种族多样性幸存者的痛苦：整合TIY和 MSC（I-YMSC）。MSC针对与耻辱相关的问题（影响失调，羞耻），并改善 长期的，但可以暂时增加短期的困扰。TIY减少了短期的痛苦， 生理自主调节。布劳恩博士的项目评估数据表明， 解决文化因素和交叉污名，并将这种方法与TIY相结合是非常必要的 并有可能改善不同种族的IV幸存者所经历的健康不平等。此外，本发明还 培训社区瑜伽教练幸存者教I-YMSC代表了一个额外的参与水平， 这在正念研究中是不寻常的。在这个K23提案中，黑色/AA， 西班牙裔/拉丁裔/a/x和白色幸存者将在所有项目阶段中平等代表（各占33%）， 结果考虑了参与者之间和每个亚组内的结果。具体目标包括：（1）（1.1）发展I- YMSC利用社区参与的研究与妇女四幸存者利益攸关方伙伴，（1.2）预试点 在一个开放的试点试验中进行干预，以进一步完善干预措施，（1.3）培养一名社区参与的教师 培训，和（2）（2.1）进行双臂测试的行为干预相比，健康教育 控制以评估I-YMSC干预的可行性和可接受性;（2.2）试点教师培训。 这项补助金中的基本实践学习和指导培训将支持Braun博士建立她的 研究计划作为一个独立的调查员在社区参与的身心研究工作， 弱势群体和少数群体，包括暴力行为的妇女幸存者。调查结果也可能具有适用性 促进健康的弹性和恢复在其他边缘化的人口谁经历卫生不公平。

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.