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: 10062212
• 负责人: Diane M. Santa Maria
• 金额: $ 25.2万
• 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 2023-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10062212
• 关键词: Address; Adherence; Adolescent; Adolescent Risk Behavior; Affect; Age; Alcohol or Other Drugs use; 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; 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; Regulation; Research; Research Priority; Risk; Risk Behaviors; Sample Size; Sampling; Secure; Shelter facility; Stress; Stressful Event; Suicide; Testing; Time; Trauma; Unsafe Sex; Youth; attentional control; cognitive interview; comorbid depression; condoms; coping; effective intervention; emotion regulation; executive function; experience; follow-up; health disparity; 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; 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（MBIs）增强自我观察和自我调节，并培养技能， 增加非判断性注意力和情感重新评价。虽然发现对许多年轻人有效， 人口，迄今为止，很少有严格的试验测试这些方法已经在YEH和 没有一个测试的干预措施是专门为YEH量身定制的， 最适合在庇护所环境中分娩。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，以及招聘和保留战略。 基于我们的试点研究的良好结果，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。数据从该 这项研究将奠定基础，严格的干预测试在一个真实世界的庇护样本的YEH。我们 与庇护所建立强有力的伙伴关系，将确保以了解创伤的方式修改干预措施， 与护理点服务提供者合作，以接近广泛传播。一个受过创伤的人 方法有三个要素1.认识到创伤的普遍性，2.认识到创伤如何影响所有 个人参与，（3）把这些知识付诸实践。MBIs可以解决风险的根本原因 通过针对压力和情绪调节，使用正念策略2来减少YEH中的行为 压力，改善情绪调节，冲动，并增加执行功能。我们将使用参与式 行动的方法来开发，beta测试，并进行注意力控制随机试点研究。 这项R34探索性身心干预临床试验的具体目标是：1。裁缝。B和 使用焦点小组讨论（n=56），关键线人访谈（n=12）， 与无家可归青年工作组（HYWG; n=10）进行迭代beta测试; 2.优化RCT结局 使用与HYWG的认知访谈进行测量（n=10）; 3.进行注意力控制随机试验， 最终定制的MBI与60 YEH 18-24岁从庇护所招募，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;干预剂量的依从性; 保留基准;和YEH之间的可接受性，并评估结果的初步评估 措施和结果的影响。来自R34的数据将为分阶段创新奖的制定提供信息 通过最终确定干预措施，优化招募和保留， 策略，为更大的随机试验提供最终样本量，并最终确定结局指标 needed.