Optimizing a Daily Mindfulness Intervention to Reduce Stress from Discrimination among Sexual and Gender Minorities of Color "REDUCE”

Emerging adult (EA) sexual and gender minorities (SGM), especially SGM of color, experience a disproportionate burden of mental health disparities as compared to their older SGM and non-SGM counterparts. Moreover, emerging research shows that EA SGM of color who possess multiple, intersecting minority identities (e.g., racial/ethnic minority SGM) are at greater risk for poor mental health outcomes as compared to their White EA SGM counterparts due to experiences with intersectional discrimination. Recent research has shown that mindfulness interventions may be a relevant method through which to reduce the impact of stress among SGM of color and increase well-being. However, there are a myriad of mindfulness interventions and components of these interventions. Thus, it is unknown which components of mindfulness-based interventions are the most effective at reducing stress and promoting well-being. Thus, this study utilizes the innovative daily diary multiphase optimization strategy (MOST) which employs an 8-component factorial experiment to determine the most effective, efficient, and immediately scalable combination of the mindfulness intervention components of awareness, purpose, connection, and positive reappraisal.

STUDY DESIGN

  • REDUCE used a daily diary multiphase optimization strategy (MOST; Collins, 2018) to examine: (a) the feasibility and acceptability of an app-based mindfulness intervention among young SGM and (b) to examine the preliminary results regarding the effectiveness of different combinations of of mindfulness meditations.

  • Participants were randomly assigned to one of eight experimental conditions based on the combination(s) of awareness, connection, and purpose.

  • Mindfulness activities were completed via the Healthy Minds Program (HMP) smartphone app (Center for Healthy Minds, University of Wisconsin)

  • Our specific optimization objective was to identify a multi-component intervention that was effective in reducing stress from discrimination and improving well-being among SGM of color in the smallest amount of time possible.

QUALITATIVE

  • Individual interviews were conducted with each participant using a guide designed to gather information on: (1) feasibility and acceptability, (2) potential barriers, and (3) app usability. Research Assistants recorded detailed notes on participants' responses.

  • The notes were analyzed using a directed content analysis approach (Hsieh & Shannon, 2005). Prespecified themes included feasibility, acceptability, and barriers, with subthemes from participants' responses.

QUANTITATIVE

  • Participants completed baseline and follow-up assessments of perceived stress (using the Perceived Stress Scale [PSS]; Cohen et al., 1983) and life satisfaction (using the Satisfaction with Life Scale [SLS]; Diener et al., 1985).

  • The study first analyzed socio-demographic data and rates of loss-to-follow-up. Usability was evaluated through descriptive statistics, including average days of app use and practice duration for each condition.

  • Preliminary results were examined using factorial linear modeling with effect coding, focusing on the percentage changes in PSS and SLS scores from baseline to follow-up.

STUDY BACKGROUND

  • Young sexual and gender minorities (SGM)  of color experience poor mental health due to minority stress (e.g., discrimination).

  • Mindfulness meditation has shown to be effective in reducing stress among young SGM.

  • Mindfulness refers to “moment-to-moment, non-judgmental awareness” of one’s thoughts, feelings, and sensations in a non-judgmental manner (Kabat-Zinn, 2015).

  • Smartphone-based mindfulness apps may be a relevant method through which to promote mental health and well-being among young SGM.