Adapting Mindfulness to Engage Latinos and Improve Mental Health in Primary Care: a Pilot Study
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Latinos comprise a sizeable and growing population that experiences unmet health needs and health inequities. Mindfulness-based interventions may be a cost-effective way to address mental health problems in primary care. We sought to adapt a mindfulness-based intervention to better serve and improve the mental health of Latinos in the primary care setting.
The authors employed a unique set of adaptations to increase retention and engagement of Latinos in a mindfulness-based stress reduction (MBSR) intervention. These adaptations included (1) group motivational interviewing, (2) problem-solving barriers to retention, (3) a testimonial by a prior Latino MBSR participant, and (4) modifications to increase perceived applicability of MBSR for Latinos. Thirty Latino participants were recruited for an 8-week mindfulness intervention adapted (MBSR-A) specifically for Latino populations.
Twenty-six out of thirty (87%) participants completed at least five of the eight sessions, which was significantly greater than in previous studies targeting Latino participants (60–66%). Of those who completed and provided pre- and post-data, there were decreases in anxiety and depression, and increases in measures of general mental health and physical health.
The adaptations utilized in this pilot study may increase retention and engagement of Latinos in mindfulness-based interventions and may be a cost-effective way to reduce mental health problems in this growing population.
KeywordsLatino Hispanic Mindfulness Primary care Anxiety Depression
The authors wish to thank Beth Roth for her inspiring pioneering work in this area, First Choice Community Healthcare, and all the participants who gave their time and effort to be involved in this study.
JAO: created MBSR-A adaptations, selected measures, recruited participants, facilitated MBSR-A groups, analyzed data, wrote and revised the manuscript, and oversaw first submission. BWS: provided critical mentorship and feedback through all processes, assisted JAO in writing Results, Introduction, and Discussion sections. BMS: assisted in the recruitment and running of the MBSR-A groups, writing the Method section, and editing. KE: did an initial update of the manuscript, handled all aspect of the revise and resubmit process: literature review, editing, and all analyses.
Compliance with Ethical Standards
Conflict of Interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the University of New Mexico Institutional Review Board and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
- Andres-Hyman, R. C., Ortiz, J. A., Anez, L. M., Paris, M., & Davidson, L. (2006). Culture and clinical practice: recommendations for working and Puerto Ricans and other Latinas(os) in the United States. Professional Psychology: Research and Practice, 37(6), 694–701.Google Scholar
- Barrera, M., & Castro, F. G. (2006). A heuristic framework for the cultural adaptation of interventions. Clinical Psychology: Science and Practice, 13(4), 311–316.Google Scholar
- Chapman, D. P., Perry, G. S., & Strine, T. W. (2004). The vital link between chronic disease and depressive disorders. Preventing Chronic Disease, 2(1).Google Scholar
- Cohen, J. (1998). Statistical power analysis for the behavioral sciences (2nd ed.). Hillsdale: Lawrence Erlbaum Associates, Inc..Google Scholar
- Corringan, P. (2004). How stigma interferes with mental health care. American Psychologist, 59(7), 614–625.Google Scholar
- Durden, T. E., & Hummer, R. A. (2006). Access to healthcare among working-aged Hispanic adults in the United States. Social Science Quarterly, 87(5), 1319–1343.Google Scholar
- Falicov, C. J. (1998). Latino families in therapy: a guide to multicultural practice. New York: Guilford Press.Google Scholar
- Franzini, P. L., Ribble, M. J. C., & Keddie, M. A. M. (2011). Understanding the Hispanic paradox. Ethnic Disparities, 11(3), 496–518.Google Scholar
- Goldberg, J., Hayes, W., & Huntley, J. (2004). Understanding health disparities. Columbus, Ohio: Health Policy Institute of Ohio.Google Scholar
- Kabat-Zinn, J. (1987). Six-month hospital visit cost reductions in medical patients following self-regulatory training. Paper presentation presented at the Society of Behavioral Medicine, Washington, DC.Google Scholar
- Kabat-Zinn, J. (1990). Full catastrophe living: using the wisdom of your body and mind to face stress, pain, and illness. New York: Delta.Google Scholar
- Kabat-Zinn, J. (1994). Mindfulness-based inner-city community stress reduction clinic. Worchester: University of Massachusetts Medical Center.Google Scholar
- Kouyoumdjian, H., Zamboanga, B. L., & Hansen, D. J. (2003). Barriers to community mental health services for Latinos: treatment considerations. Clinical Psychology: Science and Practice, 10(4), 394–422.Google Scholar
- Lochman, J. E., & Curry, J. F. (1986). Effects of social problem-solving training and self-instruction training with aggressive boys. Journal of Clinical Child Psychology, 15(2), 159–164.Google Scholar
- Markides, K. S., & Eschbach, K. (2011). Hispanic paradox in adult mortality in the United States. In International Handbooks of Population, International Handbook of Adult Mortality (pp. 227–240).Google Scholar
- Marmot, M. G., Wilkinson, R. G., & Brunner, E. (2006). Social determinants of health. New York: Oxford University Press.Google Scholar
- Meadow, M. J., & Culligan, K. (2007). Christian insight meditation: following in the footsteps of John of the Cross. Boston: Wisdom Publications.Google Scholar
- Miller, W. R., & Rollnick, S. (2012). Motivational interviewing: helping people change (3rd ed.). New York: Guilford Press.Google Scholar
- Peek, M. K., Cutchin, M. P., Salinas, J. J., Sheffield, K. M., Eschbach, K., Stowe, R. P., & Goodwin, J. S. (2010). Allostatic load among non-Hispanic Whites, non-Hispanic Blacks, and people of Mexican origin: effects of ethnicity, nativity, and acculturation. American Journal of Public Health, 100(5), 940–946.PubMedPubMedCentralGoogle Scholar
- Radloff, L. S. (1977). The CES-D Scale: a self-report depression scale for research in the general population. Applied Psychological Measurement, 1(3), 385–401.Google Scholar
- Roth, B. (1997). Mindfulness-based stress reduction in the inner city. Advances, 13(4), 50–58.Google Scholar
- Roth, B., & Stanley, T. (2002). Mindfulness-based stress reduction and healthcare utilization in the inner city: preliminary findings. Alternative Therapies in Health & Medicine, 8(1), 60–66.Google Scholar
- U.S. Department of Health and Human Services. (2001). Mental health: culture, race, and ethnicity. A supplement to mental health: a report of the Surgeon General. Rockville: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services.Google Scholar