Culturally Responsive Stress Reduction: A Mobile Mindfulness Application toSupport Health Promotion for African Americans

摘要 建议的干预，文化责任减压：移动正念应用于 支持非裔美国人健康促进(CRSR)，旨在鼓励使用正念来 缓解非洲裔美国人面临的与压力相关的不成比例的健康差距。当前 正念方法在吸引这一人群方面一直不成功。这项提议旨在弥合这一点。 通过开发mHealth(移动健康)正念应用程序(“app”)，专门为 非裔美国人社区的文化价值观。 正念包括冥想练习，培养对当前的有目的和不加评判的注意 思想、情感和身体上的感觉。正念已经被广泛应用于 干预措施，包括接受和承诺疗法(ACT)。CRSR应用程序将在ACT停用 并将把移动技术的便利性与量身定做的内容相结合，让用户从 潜在有害的文化规定的应对压力的活动(例如，自力更生、情绪压抑) 基于正念的适应性压力应对活动与特定的文化价值观保持一致。这一整合 内容，有理论和经验证据支持，有效的教学交付，跨学科 开发团队和现代通信技术将产生有效的mHealth干预。 CRSR应用程序的功能包括引导冥想，将用户连接到当前时刻和地点 通过以灵性、口述、自我赋权和韧性为基础的文化一致性练习来保持冷静； 个性化通知，提示用户反映和参与应用程序；定期在 重要性正念作为一种加强对身心健康的控制的方式；以及用户- 自定义提醒。 第一阶段包括开发CRSR应用程序的可测试原型，名为Minemful You。原型机 为参与者提供练习正念的功能，并用于测试概念验证，即 CRSR应用程序的可行性和社会接受性。用户体验到的压力显著减少， 提高自我效能感。他们还报告说，更多地使用正念行为和改善自我 监管。第二阶段将迭代地建立在原型的基础上，以开发最终产品并通过 完全有效的随机对照试验。最终产品将由一个本地移动应用程序组成 安卓和苹果iOS。 申请者特里福亚组建了一支知识渊博、经验丰富的研究科学家团队， 内容和技术开发人员，以及评估专家，以充分实现该项目。该公司 在开发和销售技术辅助的公共卫生干预措施方面有既定的记录。

ABSTRACT The proposed intervention, Culturally Responsible Stress Reduction: A Mobile Mindfulness Application to Support Health Promotion for African Americans (CRSR), is designed to encourage the use of mindfulness to mitigate the disproportionate amount of stress-related health disparities facing African Americans. Current mindfulness approaches have been unsuccessful in engaging this population. This proposal aims to bridge this disparity by developing an mHealth (mobile health) mindfulness application (“app”) tailored specifically to the cultural values of the African American community. Mindfulness involves meditative practices that cultivate purposeful and nonjudgmental attention to current thoughts, emotions, and physical sensations in the body. Mindfulness has been incorporated into widely-used interventions, including Acceptance and Commitment Therapy (ACT). The CRSR app will be grounded in ACT and will integrate the convenience of mobile technology with tailored content to allow users to shift from potentially harmful culturally prescribed stress-coping activities (e.g., self-reliance, emotional suppression) to adaptive mindfulness-based stress-coping activities aligned with culturally specific values. This integration of content, backed by theory and empirical evidence, effective instructional delivery, an interdisciplinary development team, and modern communication technology will produce an effective mHealth intervention. The CRSR app features include guided meditations to connect the user to the present moment and a place of calm through culturally aligned exercises grounded in spirituality, orality, self-empowerment, and resilience; personalized notifications prompting users to reflect and engage with the app; periodic email messages on the importance mindfulness as a way increase control over physical and psychological health; and user- customized reminders. Phase I included developing a testable prototype of the CRSR app, called Mindful You. The prototype provided functionality for participants to practice mindfulness and was used to test proof of concept, i.e., the feasibility and social acceptability of the CRSR app. Users experienced significantly decreased stress and increased self-efficacy. They also reported increased use of mindfulness behaviors and improved self- regulation. Phase II will iteratively build on the prototype to develop the final product and test its efficacy with a fully-powered randomized controlled trial. The final product will consist of a native mobile application on Android and Apple iOS. The applicant, Trifoia, has assembled a knowledgeable and experienced team of research scientists, content and technology developers, and evaluation specialists to adequately realize this project. The company has an established track record of developing and marketing technology-assisted public health interventions.