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

项目摘要 这个导师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来 发展和传播社区参与的以正念为基础的干预措施，促进弱势群体的健康 和少数族裔人口。人际暴力在黑人/非裔美国人(AA； 44%)，西班牙裔/拉丁裔/a/x(34%)，非西班牙裔/拉丁裔/a/x白人女性(37%)，以及 与IV和其他属性(如种族/族裔、体重)有关的污名化。暴力和耻辱都在驱使 “下游”行为和身体健康状况不佳。耻辱后遗症--对耻辱的反应痛苦，预期 (害怕)耻辱，内在化的耻辱--独立地滋生羞耻并影响调节失调，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，但文化敏感的跨诊断方法，以减少跨种族的幸存者痛苦- 种族人口很少。我们建议使用社区参与的研究来开发一个互补的 将调整后的正念自我同情(MSC)训练与创伤信息瑜伽相结合的医学计划 (Tiy)改善耻辱后遗症，减少种族多元化幸存者的痛苦：整合Tiy和Tiy MSC(i-YMSC)。MSC针对与耻辱相关的问题(影响调节失调、羞耻)并改善 长期的，却可以暂时增加短期的苦恼。TIY减少短期痛苦并促进 生理-自主调节。布劳恩博士的项目评估数据表明，让MSC明确地 应对文化因素和跨部门污名，并将这一方法与Tiy相结合是非常有必要的 并有可能改善种族多样化的IV幸存者所经历的健康不平等。此外， 培训社区瑜伽教练幸存者教授I-YMSC代表着与 我们被污名化的目标人群，这在正念研究中是不寻常的。在这份K23提案中，布莱克/AA 西班牙裔/拉丁裔/a/x和白人幸存者将在所有项目阶段(每个阶段33%)平等分配， 结果既考虑了参与者之间的结果，也考虑了每个小组内的结果。具体目标包括：(1)(1.1)发展i- 基督教青年会与妇女IV幸存者利益攸关方合作伙伴进行社区参与研究，(1.2)试行前 在开放式试点试验中进行干预以进一步完善干预措施，(1.3)培养社区参与型教师 培训，以及(2)(2.1)与健康教育相比，进行行为干预的双臂测试 控制评估I-YMSC干预措施的可行性和可接受性，以及(2.2)试点教师培训。 这笔赠款中的基本实践学习和指导培训将支持布劳恩博士建立她的 作为社区参与的心身研究的独立调查员的研究计划 弱势群体和少数群体，包括暴力的女性幸存者。这些发现也可能具有适用性 在经历健康不平等的其他边缘化人口中促进健康复原力和恢复。

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.