Exploring PTSD Symptoms, Barriers and Facilitators to Mindfulness-based Stress Reduction for Justice-Involved Black/African American Female Adolescents and Parents/Caregivers

点击翻译按钮获取中文摘要

PROJECT SUMMARY/ABSTRACT High rates of trauma and post-traumatic stress disorder (PTSD) associated with delinquency (and recidivism) persist for justice-involved individuals. This enduring problem denotes a significant gap in our treatment approach. PTSD, the primary outcome of the proposed study about healing informed mindfulness-based stress reduction (MBSR), combines stress-inflammation/cortisol reactivity, recidivism, personal agency, racial identity, and parent-child relationships (secondary outcomes), which contribute to the overall health equity and well-being of justice-involved Black/African American female adolescents (JI BAFAs). The proposed study will investigate the barriers and facilitators to the MBSR intervention with JI BAFAs and their P/Cs. MBSR has been successfully implemented as a treatment for PTSD and is a promising new approach for healing to reduce health disparities among both JI BAFAs and their P/Cs. We will use a healing-informed MBSR approach based on an intersectional trauma-responsive (ITR) framework: Intersectionality theory, Healing Centered Engagement (HCE), and Theoretical Domains Framework (TDF). HCE is based on healing justice, a strengths-based framework to re- center culture and improve and nurture well-being that involves transforming institutions and relationships that cause harm to collectively heal and foster hope. TDF comprises 7 stages to assess implementation problems and supports intervention design as a solution to the theory-practice gap as it helps identify theoretically driven targets for interventions based on content-specific information about the behavior targeted to change, i.e., PTSD symptoms. For this study, we expect to enroll (35 JI BAFAs and P/C dyads) in Franklin County, OH. This two- phase study follows a multimodal mixed methods design, comprising two phases. Phase I includes collecting qualitative interview data about their past barriers to treatment and interventions and use this information as well as self-report survey results to culturally adapt until we reach saturation. Participants will complete study assessments with psychosocial and biological (biomarker) data (n = 10 JI BAFAs-P/Cs dyads) (Aim 1). Phase II consists of conducting a nonrandomized pilot test of the adapted intervention adapted healing intervention to assess the feasibility of recruitment, acceptability, and preliminary effects of the adapted intervention on the study outcomes. Dyads will complete assessments, and psychosocial and biological data at baseline, immediately after the final intervention session (~ 3 months post baseline) and again 6-months post-baseline. Clinically meaningful improvements in PTSD symptoms (primary outcome) and stress/cortisol reactivity, recidivism, agency, racial identity, parent-child relationships (secondary outcomes) will be examined. (n = 25 JI BAFAs-P/Cs dyads) (Aim 2). We will also promote healing of the dyads’ relationship dynamic via the intervention to create a corrective outcome for P/Cs and JI BAFAs, including the use of safety procedures (Exploratory Aim). We will hold two separate focus groups with 6 dyads who completed the MBSR intervention to elicit feedback on the initial qualitative findings. The study findings will be integrated based on the two types of data.