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

基于正念的干预(MBIS)增强自我观察和自我调节，并培养技能以 增加非评判的关注和情绪化的重新评估。虽然被发现在许多年轻人中有效 到目前为止，测试这些方法的严格试验很少在Yeh和 没有一个测试的干预措施是专门为叶诗文量身定做的，也就是说， 针对避难所环境中的运送进行了优化。为了实施严格的随机对照试验，我们必须 首先确定进行注意力对照随机试验的可行性并优化结果 这些措施，以及招聘和留用战略。 在我们试点研究成果的基础上，这款R34的目标是进一步定制MBI。 (发音为.-b)，并在德克萨斯州休斯顿的一家无家可归青年收容所进行可行性试点。来自于此的数据 这项研究将为在现实世界中庇护的叶氏样本进行严格的干预测试奠定基础。我们的 与庇护所的牢固伙伴关系将确保在#年以创伤知情的方式修改干预措施 与护理点服务提供者合作，以近似广泛传播。创伤--通晓 方法有三个要素1.认识到创伤的流行，2.认识到创伤是如何影响所有人的 个人参与，以及(3)将这一知识付诸实践。MBIS可能会解决风险的根本原因 YEH中的行为通过定向压力和情绪调节使用正念策略2来减少 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 制定行动方法，进行Beta测试，并进行注意力控制随机先导研究。 这项R34精神和身体干预的探索性临床试验的具体目标是：1.量身定做.B.和 使用焦点小组讨论(n=56)、主要告密者访谈(n=12)、 与无家可归青年工作组(HYWG；n=10)进行迭代Beta测试；2.优化随机对照试验结果 使用与HYWG的认知访谈进行测量(n=10)；3.进行注意控制随机试验 最终的定制MBI是从收容所招募的60名18-24岁的年轻人，以测试现实世界的可行性和 可接受性(评估招募、随机化和随访策略；坚持干预剂量； 保留基准；YE的可接受性，并评估结果的初步评估 措施和结果影响。来自R34的数据将为阶段性创新奖的制定提供信息 通过最终完成干预，优化招募和保留，来优化心理和身体干预 策略，通知更大的随机试验的最终样本量，并最终确定结果衡量标准 需要的。

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.