Adapting a mindfulness-based stress reduction intervention for emotion regulation and impulsivity in homeless young adults: a pilot project

采用基于正念的减压干预措施来调节无家可归的年轻人的情绪和冲动：试点项目

• 批准号: 10477381
• 负责人: Diane M. Santa Maria
• 金额: $ 23.67万
• 依托单位: UNIVERSITY OF TEXAS HLTH SCI CTR HOUSTON
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-21 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10477381
• 关键词: Address; Adherence; Adolescent; Adolescent Risk Behavior; Affect; Age; Area; Attention; Benchmarking; Cause of Death; Clinical Trials; Collaborations; Data; Decision Making; Development; Dose; Elements; Emotional; Ensure; Focus Groups; Follow-Up Studies; Future; Goals; Health; Health Promotion; Homeless Youth; Homelessness; Housing; Impulsivity; Individual; Informal Social Control; Intervention; Interview; Knowledge; Life; Life Experience; Link; Literature; Mental Health; Methods; Mind-Body Intervention; Morbidity - disease rate; Multiple Partners; National Center for Complementary and Integrative Health; Outcome; Outcome Assessment; Outcome Measure; Overdose; Personal Satisfaction; Pharmaceutical Preparations; Phased Innovation Awards; Pilot Projects; Plant Roots; Population; Population Programs; Prevalence; Prevention Research; Provider; Public Health; Randomized; Randomized Controlled Trials; Recording of previous events; Reduce health disparities; Regulation; Research; Research Priority; Risk; Risk Behaviors; Sample Size; Sampling; Secure; Shelter facility; Stress; Stressful Event; Suicide; Testing; Time; Trauma; Unsafe Sex; Youth; acceptability and feasibility; attentional control; cognitive interview; comorbid depression; condoms; coping; emotion regulation; executive function; experience; feasibility testing; follow-up; high risk; housing instability; improved; informant; innovation; mindfulness; mindfulness intervention; mindfulness-based stress reduction; mortality; physical conditioning; point of care; prevent; programs; psychologic; randomized trial; recruit; resilience; retention rate; service providers; sex; sexual risk behavior; skills; stress management; substance use; symptom management; working group; young adult

Mindfulness-based interventions (MBIs) enhance self-observation and self-regulation and build skills to increase non-judgmental attention and emotional reappraisal. While found to be effective in many youth populations, to date, very few rigorous trials testing these methods have been conducted among YEH and none of the tested interventions have been tailored specifically for YEH in a trauma-informed way that is optimized for delivery in a shelter setting. To implement a rigorous randomized controlled trial (RCT), we must first determine the feasibility of conducting an attention control randomized trial and optimize outcome measures, as well as recruitment and retention strategies. Building on the promising results of our pilot study, the goal of this R34 is to further tailor an MBI .b (pronounced dot-b) and conduct a feasibility pilot at a homeless youth shelter in Houston, TX. Data from this study will lay the groundwork for rigorous intervention testing in a real-world sheltered sample of YEH. Our strong partnerships with shelters will ensure that the intervention is modified in a trauma-informed way in collaboration with point-of-care service providers to approximate broad dissemination. A trauma-informed approach has three elements 1. realizing the prevalence of trauma, 2. recognizing how trauma affects all individuals involved, and (3) putting this knowledge into practice. MBIs may address the root causes of risk behaviors in YEH by targeting stress and emotion regulation using mindfulness strategies 2 to decrease stress, improve emotion regulation, impulsivity, and increase executive function. We will use a participatory action approach to develop, beta test, and conduct an attention control randomized pilot study. The specific aims for this R34 exploratory clinical trial of a mind and body intervention are to: 1. Tailor .b and finalize the attention control condition using focus group discussions (n=56), key informant interviews (n=12), and iterative beta-testing with the Homeless Youth Working Group (HYWG; n=10); 2. Optimize RCT outcome measures using cognitive interviews with the HYWG (n=10); 3. Conduct an attention control randomized trial of the final tailored MBI with 60 YEH 18-24 years old recruited from a shelter to test real-world feasibility and acceptability (Evaluate recruitment, randomization, and follow-up strategies; adherence to intervention dose; retention benchmarks; and acceptability among YEH, and evaluate the preliminary assessment of outcome measures and outcome effects. Data from this R34 will inform the development of a Phased Innovation Award to Optimize Mind and Body Interventions by finalizing the intervention, optimizing the recruitment and retention strategies, informing the final sample size for a larger randomized trial, and finalizing the outcome measures needed.

基于正念的干预措施（MBI）增强自我观察和自我调节，并培养以下技能： 增加非评判性的注意力和情感重新评估。虽然发现对许多年轻人有效 迄今为止，在 YEH 和 所测试的干预措施均未以创伤知情的方式专门为 YEH 量身定制，即 优化了在庇护所环境中的交付。为了实施严格的随机对照试验（RCT），我们必须 首先确定进行注意力控制随机试验的可行性并优化结果 措施以及招聘和保留策略。 基于我们试点研究的有希望的结果，R34 的目标是进一步定制 MBI .b （发音为 dot-b），并在德克萨斯州休斯顿的无家可归青年收容所进行可行性试点。数据来自于此 研究将为在现实世界的受保护 YEH 样本中进行严格的干预测试奠定基础。我们的 与庇护所的强有力的伙伴关系将确保以创伤知情的方式修改干预措施 与现场护理服务提供商合作以实现广泛传播。创伤知情者 方法包含三个要素 1. 认识到创伤的普遍性，2. 认识到创伤如何影响所有人 相关个人，以及 (3) 将这些知识付诸实践。 MBI 可以解决风险的根本原因 通过使用正念策略 2 针对压力和情绪调节来减少 YEH 中的行为 压力，改善情绪调节，冲动，增强执行功能。我们将采用参与式 开发、β 测试和进行注意力控制随机试点研究的行动方法。 这项 R34 身心干预探索性临床试验的具体目标是： 1. 定制 .b 和 通过焦点小组讨论（n=56）、关键知情人访谈（n=12）最终确定注意力控制条件， 与无家可归青年工作组（HYWG；n=10）进行迭代 beta 测试； 2. 优化RCT结果 使用 HYWG 认知访谈进行测量（n=10）； 3. 进行注意力控制随机试验 最终定制的 MBI，从庇护所招募了 60 名 18-24 岁的 YEH，以测试现实世界的可行性 可接受性（评估招募、随机化和随访策略；遵守干预剂量； 保留基准；和 YEH 的可接受性，并评估结果的初步评估 措施和结果影响。 R34 的数据将为阶段性创新奖的制定提供信息 通过完成干预、优化招募和保留来优化身心干预 策略，告知更大随机试验的最终样本量，并最终确定结果指标 需要。

项目成果

Adapting an evidence-based mindfulness-based intervention for sheltered youth experiencing homelessness.

• DOI: 10.1186/s12906-023-04203-5
• 发表时间: 2023-10-17
• 期刊: BMC COMPLEMENTARY MEDICINE AND THERAPIES
• 影响因子: 3.9
• 作者: Santa Maria, Diane;Cuccaro, Paula;Bender, Kimberly;Sibinga, Erica;Guerrero, Natalie;Keshwani, Najiba;Jones, Jennifer;Fine, Micki
• 通讯作者: Fine, Micki