Optimizing a mindful intervention for urban minority youth via stress physiology

通过压力生理学优化对城市少数民族青年的正念干预

基本信息

批准号：
9765164
负责人：
DIANA H FISHBEIN
金额：
$ 50.71万
依托单位：
PENNSYLVANIA STATE UNIVERSITY, THE
依托单位国家：
美国
项目类别：
财政年份：
2018
资助国家：
美国
起止时间：
2018-08-17 至 2023-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9765164
关键词：
Adolescence Adolescent Adult Affect Affective Affective Symptoms Arousal Baltimore Behavior Behavioral Biofeedback Brain Characteristics Cities Clinical Communities Data Development Disadvantaged Disease Economics Emotional Exhibits Foundations Future Galvanic Skin Response Goals High School Student Household Intervention Investigation Knowledge Laboratories Life Low income Measurable Measures Mediating Mediation Mediator of activation protein Meditation Mind-Body Intervention Minority Modeling Mood Disorders Neighborhoods Neuronal Plasticity Nonprofit Organizations Outcome Participant Pathway interactions Pattern Personal Satisfaction Phase Physiological Physiology Population Population Group Poverty Pre-Post Tests Process Psychophysiology Randomized Randomized Controlled Trials Recording of previous events Recovery Reporting Research Risk Role Sampling Schools Services Stress Students Subgroup Syndrome System Target Populations Trauma Traumatic Stress Disorders Work Youth active control acute stress age group attentional control base biological adaptation to stress body system clinically relevant coping cost demographics design emotion regulation experience externalizing behavior follow-up functional outcomes heart rate variability high school improved inner city innovation insight interest intervention effect maltreatment mindfulness mindfulness intervention neuroimaging neurophysiology novel post intervention preservation programs recruit response sex stress management stress reactivity stress symptom teacher trauma exposure trauma symptom vulnerable adolescent

项目摘要

PROJECT SUMMARY The proposed R61/R33 phased study aims to elucidate the physiological stress mechanisms underlying effects of a mindfulness program designed to target youth at risk for externalizing, affective and traumatic stress disorders by virtue of significant environmental disadvantage. Adolescents for each phase will be recruited from schools serving high poverty neighborhoods in Baltimore City where adversity and experiences of trauma and maltreatment are common. The intervention is currently being implemented in a few Baltimore City schools and other settings by the Holistic Life Foundation, Inc. (HLF), a non-profit organization with a lengthy track record of providing mindfulness-based programming (breath work and meditation) to impoverished youth. Both empirical and anecdotal reports of significant change in emotion regulation have been reported with this intervention, yet similar to most mindfulness programs, mechanisms of effects have not yet been delineated, particularly in disadvantaged youth. Our primary mechanism of interest is stress physiology, as measured by heart rate variability (HRV) and skin conductance response (SCR) during acute stress, a central component of emotion regulation and implicated in relevant clinical syndromes (e.g., externalizing behaviors, affective disorders).To identify the characteristics of youth that predict intervention response (moderation) and the stress-related pathways through which positive outcomes are achieved (mediation), we propose to conduct two RCTs with the ultimate goal to maximally improve externalizing behaviors and affective and traumatic disorders in at-risk youth. In the R61, we will intensively measure mechanistic effects of the mindfulness program to establish its effects in a conceptually appropriate population. Students in 4 Baltimore City High Schools will be randomized to treatment and active control conditions (N=160 students) and assessed at baseline, post-intervention and follow-up. Stress physiological profiles that improve in response to intervention will be identified. In the R33, we will conduct a larger RCT (8 schools, N=240) with assignment either to the mindfulness program or the mindfulness program plus an enhancement—HRV biofeedback—shown to independently exert effects on stress responses. Comparisons will be made between conditions and then a mediation model will be applied to the intervention condition exhibiting maximal effects to determine whether positive change in stress physiology explains improvements in outcomes. This sequence of studies will characterize participants who are maximally impacted by mindfulness and will differentiate between treatment conditions, leading to more efficient and effective targeting and scaling. In so doing, this research will break new ground in the rapidly growing field of youth mindfulness-based interventions by identifying key physiological mechanisms of effect for common mindfulness practices.

项目摘要拟议的R61/R33分阶段研究旨在阐明物理压力机制正念计划的影响，旨在针对面临外在，情感和创伤的风险的青年由于巨大的环境灾难而受到压力障碍。每个阶段的青少年将是从学校在巴尔的摩市提供高贫困社区的学校招募，在那里广告和经验创伤和虐待很常见。目前正在巴尔的摩进行干预整体生活基金会（HLF）的城市学校和其他环境，一个非营利组织，提供基于正念的编程（呼吸工作和冥想）的冗长记录贫穷的青年。情绪监管发生重大变化的经验和轶事报告都据报道了这种干预措施，但与大多数正念计划相似，效果机制尚未但被描述了，特别是在处境不利的青年中。我们感兴趣的主要机制是由心率变异性（HRV）和急性压力期间皮肤电导反应（SCR），情绪调节的核心和在相关的临床综合征（例如外在行为，情感障碍）中实施预测干预反应（适度）和应力相关途径的青年特征通过实现积极结果（调解），我们提议进行两个最终的RCT 目标是提高高危青年的外在行为以及情感和创伤性疾病的目标。在 R61，我们将深入衡量正念计划的机械效应，以在从概念上适当的人群。巴尔的摩市4所高中的学生将被随机接受治疗和主动控制条件（n = 160名学生），并在基线，干预后和随访时进行评估。将确定响应干预措施改善的压力物理特征。在R33中，我们将进行更大的RCT（8所学校，n = 240），并分配正念计划或正念程序加上增强功能 - HRV Biofeffack-展示，以独立执行对压力反应。条件将进行比较，然后将调解模型应用于干预条件表现出最大的影响，以确定压力生理的正变化是否积极变化解释结果的改进。这一系列研究将表征最多的参与者受正念的影响，并将区分治疗条件，从而提高效率和有效的定位和缩放。这样，这项研究将在快速增长的领域中打破新的基础通过确定共同的关键生理机制，基于青年正念的干预措施正念练习。