MINDFULNESS-BASED INTERVENTION TO PROMOTE POSITIVE YOUTH DEVELOPMENT

• Sponsoring Institution: National Institute of Food and Agriculture
• Project Status: COMPLETE
• Funding Source: HATCH
• Reporting Frequency: Annual
• Accession No.: 0229967
• Project Start Date: Oct 1, 2012
• Project End Date: Sep 30, 2017
• Program Code: [(N/A)]- (N/A)

Recipient Organization
UNIV OF HAWAII
3190 MAILE WAY
HONOLULU,HI 96822

Performing Department
Family & Consumer Sciences

Non Technical Summary
Rationale: Adolescence can be a particularly vulnerable period, as evidenced in the increasing rates of delinquency, depression, and suicide, from early adolescence to young adulthood. In addition, not all ethnic group experience the same rates, with Native Hawaiians, Pacific Islanders, and multi-ethnics for instance experiencing disproportionately higher incarceration rates than whites or East Asian group (Umemoto, personal communication, April 1, 2012). Although many of the current prevention programs for violence, substance use, suicide do address common risks and promote protective factors, none have employed a contemplative theoretical framework. Surprisingly, these include programs that have been deemed promising or have included curriculum based on current concepts of what constitutes best practice. A contemplative framework considers maladaptive behavioral patterns as arising from destructive emotions and thoughts that are part of the default processing pattern (i.e., habitual processing networks). Mindfulness is one technique that can help bring insight and awareness to this processing pattern, and has also been shown in repeated clinical studies to strengthen the executive control processing system (i.e., decision-making, planning, and empathy), which in turn can effectively dampen and regulate the affective (e.g., insula, amygdala) and self-referential network (e.g., Farb et al., 2012; Sheline et al., 2010; Tang & Posner, 2009), both of which have been implicated in dysregulated mood, affect, and behavior. Mindfulness is a particularly innovative way to address mental health/delinquency issues including anger, aggression, and anxiety because it regards mental health as the ability to be fully present in an equilibrated way with moment to moment experiences. Youth who grow up in an unpredictable, violent, and abusive context may understandably have a much more difficult time staying in their experience. They may act out because they are trying to meet an un-recognized emotional need or respond to an emotional situation that they do not know how to be with. Mindfulness aims to shine light directly on the varied invisible states of awareness that are behind and beneath ordinary reactions that are most likely, feeling-based. As young people hone the capacity to directly experience their own internal needs and feelings with greater steadiness and clarity, they can separate these needs from actions. And here there lies the freedom. They are able to gain deeply personal insight into why they act the way they do, to begin to understand the origins of these behaviors and emotional and mental patterns in their own histories. They begin to become understandable to themselves. To date, the empirical evidence for mindfulness as an intervention strategy for mental, behavioral, and physical problems is growing, with more than 127 published studies to date (see Agency for Healthcare Research Quality report; Flook & Flaxman, 2010; Williams & Zylowska, 2009), including evidence from neuroscience, randomized clinical trials, and with unique populations.

Animal Health Component

(N/A)

Research Effort Categories

Basic

(N/A)

Applied

(N/A)

Developmental

(N/A)

Classification

Knowledge Area (KA)	Subject of Investigation (SOI)	Field of Science (FOS)	Percent
724	6099	3070	20%
802	6099	3070	20%
806	6099	3070	60%

Knowledge Area
724 - Healthy Lifestyle; 806 - Youth Development; 802 - Human Development and Family Well-Being;

Subject Of Investigation
6099 - People and communities, general/other;

Field Of Science
3070 - Psychology;

Keywords

mindfulness

positive youth development

prevention intervention

risk & resiliency

Goals / Objectives
The goal of this project is two-fold: 1) to assess and determine the feasibility of implementing a mindfulness-based youth intervention to various at-risk youth population in Hawaii including those involved in the juvenile justice system, those at risk for truancy and school disengagement, those at risk for stress, anxiety, depression, and suicide, military youth, as well as other groups at-risk for maladaptive outcomes; 2) to conduct a quasi-experimental or randomized trial study with at least 30 youth at each site to assess the mindfulness intervention's effectiveness in terms of reducing maladaptive outcomes (e.g., anxiety, aggression, delinquency) and increasing adaptive outcomes (e.g., empathy, social connections, well-being). Outputs of this proposed project include: 1) A mindfulness-based intervention curriculum that can be replicated and implemented in various at-risk Hawaiian communities (OYS/HYCF; afterschool programs; military youth community); 2) trained local mindfulness facilitators who will be able to continue and sustain the program; and 3) at least three manuscripts/ articles to be published in peer-reviewed journals (e.g., Journal of Adolescence & Research; Journal of Adolescent Health), and six presentations at professional national conferences (e.g., Society for Prevention Research; Society for Research in Adolescence) related to program development, implementation, and impact as part of dissemination activities.

Project Methods
Process Evaluation: PI will utilize a community-based participatory research (CBPR) approach to revise an existing evidence-based mindfulness curriculum to be culturally and developmentally appropriate for at-risk youth in Hawaii (at-risk for anxiety/depression; truancy/school disengagement; and delinquency). For instance, the current modules of the curriculum include: 1) Introduction to Mindfulness & Mindful Breathing; 2) Mindful Listening; 3) Mindfulness of Nature; 4) Mindfulness of the Body; 5) Mindfulness of Thoughts; 6) Mindfulness of Emotions; 7) Cultivating Compassion/Empathy; 8) Mindful Judgment & Forgiveness; and 9) Aligning with Vision. PI will work with partners to revise the modules, and to develop the appropriate metaphors and talk stories for the modules.PI will engage with partners/collaborators in a series of meetings to determine feasibility of implementing the mindfulness intervention. Discussions will involve sample selection; dosage including length, frequency, duration; and location where the intervention will take place. In line with CBPR, mindfulness facilitators will be recruited from the community and will be trained by seasoned mindfulness facilitators. Process measures will be develop to assess fidelity in implementation as well as key factors associated with effectiveness of the facilitators; acceptability by participants and participants uptake of the mindfulness practices; cultural appropriateness of the measures; and participants burden in completing the measures. Outcome Evaluation: For the educational intervention, the study will be guided by the common principles of a quasi-experimental or randomized control trial design. The study will test the hypotheses that youth randomized to participate in the mindfulness intervention will show greater reductions in maladaptive psychological (anxiety, depression, negative affect) or behavioral outcomes (truancy, delinquency, aggression) than the control group. PI will aim to obtain effect size estimates and potential trends and patterns as well as the most feasible but rigorous protocol possible that will inform definitive test of the intervention in the future (i.e., application for NIH RO1/R21 funding). The proposed measurement protocol uses a multi-trait, repeated measures assessment strategy that incorporates both quantitative and qualitative methodologies. Because reliance on use of self-report only is biased and potentially problematic, PI plans to collect data from multiple sources reflecting multiple perspectives including youth self-report (1st person), others' report (3rd person), biomarkers (cortisol, heart reactivity), objective measures (e.g., Flanker test task), and participant observations.

Progress 10/01/12 to 09/30/17

Outputs
Target Audience:Target audience that received the mindfulness-based training and curriculum continues to include: juvenile justice/court staff, youth correctional and detention officers, case managers, social workers, K-12 Hawaii public school teachers, mental health and substance use professionals, youth and family advocates and service providers. Target audience receiving the mindfulness-based youth development intervention includes youth and young adults (16-25 years old) residing in Hawaii, and attending UH Manoa. Changes/Problems: Nothing Reported What opportunities for training and professional development has the project provided?Opportunities for training and professional development centered on mindfulness and mindfulness-based youth development. How have the results been disseminated to communities of interest?For this reporting period, the results have been disseminated through 4 manuscripts (1 published, 3 currently under review), 1 book chapter (approved and targeted to be published in 2018), 1 national conference presentation, and 4 regional conference presentations (during this reporting period). What do you plan to do during the next reporting period to accomplish the goals? Nothing Reported

Impacts
What was accomplished under these goals? The following goals were accomplished: 1) Assessed the feasibility of providing mindfulness-based youth intervention to at-risk youth in Hawaii by conducting pilot studies with youth at the Hawaii Youth Correctional Facility, and youth at the Kapoliani Detention Facility. A published manuscript was a result of this study: Le, T.N., & Proulx, J. (2015). Feasibility of mindfulness-based intervention for mixed-ethnic Asian/Pacific Islander incarcerated youth. Asian American Journal of Psychology. Advance online publication. http://dx.doi.org/10.1037/aap0000019: 2) Provided trainings on mindfulness and mindfulness-based intervention in Hawaii. * A total of 10 total professional development workshops to juvenile justice, mental health, youth/family service professionals, and K-12 teachers, counselors, reaching more than 150 human/social service professionals. 3) Provided service and outreach through presentations at various regional conferences * A total of 17presentations were made (e.g.,13th Annual School Based Transition Conference: Kamalapua O Ko'olau; Project Dana's Leadership Meeting and Dana's Support Group; Center for Alternative Dispute Resolution: Judiciary State of Hawaii; Leilehua High School, etc.) 4) Development of 5 lesson plans that have been disseminated to K-12 teachers, counselors, and human/social service providers who participated in the professional development trainings. 5) Trained 4 mindfulness facilitators (2 on Kauai, 2 on Oahu) 6) Completed five peer-reviewed manuscripts (1 published, 3 under review, and 1 book chapter). 7) Provided 7 presentations at national conferences.

Publications

• Type: Conference Papers and Presentations Status: Published Year Published: 2016 Citation: Le, T.N. 2016. Experiencing wisdom among college students in a mindfulness course in Hawaii. 2016 International Symposium for Contemplative Studies. San Diego, CA.
• Type: Book Chapters Status: Awaiting Publication Year Published: 2018 Citation: Le, T.N. and Cerswell, L. (in press). The six Rs framework as mindfulness for suicide prevention. Invited book chapter for edited volume Positive Psychology and Suicide Prevention. To be published 2018.
• Type: Conference Papers and Presentations Status: Under Review Year Published: 2018 Citation: Le, T.N,, Alefaio, D., and Tannin, J. (under review) Subjective experiences of Hawaii educators in a professional development course on mindfulness. Under review at Professional Development in Education.
• Type: Journal Articles Status: Under Review Year Published: 2018 Citation: Le, T.N. and Alefaio, D. (under review) Professional development training on mindfulness for human service providers in Hawaii. Under review, Journal of Health and Human Services Administration.
• Type: Journal Articles Status: Under Review Year Published: 2018 Citation: Le, T.N., Steinhelfer, and Tanni, J. (under review) Hawaii college students experiences of wisdom in a mindfulness course.

Progress 10/01/15 to 09/30/16

Outputs
Target Audience:Target audience receiving the mindfulness-based training and curriculum includes: juvenile justice/court staff, youth correctional officers, case managers, social workers, K-12 Hawaii public school teachers, substance abuse counselors, mental health clinicians, youth and family advocates, youth and family service providers. Target audience receiving the mindfulness-based youth development intervention includes youth (males and females, 10-17 years old) at the Hawaii Youth Correctional Facility, and college students at UH Manoa. Changes/Problems: Nothing Reported What opportunities for training and professional development has the project provided?This project has provided a lot of training and professional development for youth and family serving staff across the Hawaii islands (Maui, Kauai, Hawaii, and Oahu) includingwith members atthe judiciary/court, health and human services, non-profit agencies, substance use and mental health staff and clinicians, social workers, therapists, and K-12 teachers. Collectively, about 150 professionals have received mindfulness-based training and intervention this year. How have the results been disseminated to communities of interest?The results have been disseminated via conferences at local, national, and international conferences. In addition, we did a Hoike Interview for public television on Kauai in March 2016, and two video segments for the University of Hawaii Manoa's Take Charge of Your Money series. What do you plan to do during the next reporting period to accomplish the goals?For the next reporting period, I plan to continue to conduct more training with youth and family serving staff and professionals, teachers across the Hawaii islands, and to develop community capacity in terms of recruiting trainers to be facilitators. I also plan to conduct mindfulness intervention for youth in detention and at HYCF, and to work with teachers and principals to implement mindfulness in the schools. I also plan to conduct a pilot study with UH Manoa students on their experiences with mindfulness training and practices.

Impacts
What was accomplished under these goals? For this fiscal year, we conducted another pilot intervention at the Hawaii Youth Correctional Facility in summer 2016. Due tokey administrative staff changes and leadership, we had to develop new relationships with new staff at the facility in order to be able to come in and provide mindfulness training to the youth. We are in the process ofpotentially collaborating with Kapolei Detention Facility to provide mindfulness training and intervention to correctional staff and detainees. We also started a project with college students at UH Manoa, collecting data onoutcomes associated with attendance and practice in a mindfulness course, as well as with social service providers. We have5 mindfulness modules that could be shared andused atthe training sites. Andthere are two trained local mindfulness facilitators, one on Kauai and one on Hawaii who will be able to continue and sustain the program. Three manuscripts are currently underway, and four presentations were conducted at local, national, and international conferences.

Publications

• Type: Conference Papers and Presentations Status: Published Year Published: 2016 Citation: Le, T.N. 2016. University students reflections of experiencing wisdom in a mindfulness course. The 23rd Congress of International Association for Cross-Cultural Psychology. August 2, 2016. Nagoya, Japan.
• Type: Conference Papers and Presentations Status: Published Year Published: 2016 Citation: Le, T.N. and McKenzie, N.L. 2016. Mindfulness with at-risk youth in Hawaii. 13th Hawaii International Summit Preventing, Assessing, & Treating Trauma Across the Lifespan. March 31, 2016. Honolulu, HI.
• Type: Conference Papers and Presentations Status: Published Year Published: 2016 Citation: Le, T.N. 2016. University students reflections of experiencing wisdom in a mindfulness course. The 31st International Congress of Psychology. July 26, 2016. Yokohama, Japan.

Progress 10/01/14 to 09/30/15

Outputs
Target Audience:The target audience reached during this reporting period includes: 12 High School students at Leilehua High School, representing different ethnic groups including Native Hawaiian, Pacific Islander, African American, Asian, and mixed-ethnicity; 78 K-12 Hawaiiteachers; 15 adults at the Hawaii Department of Accounting & General Services: 20 grandparents of the Foster Grandparent Program; 50 adults at the Center for Alternative Dispute Resolution, The Judiciary State of Hawaii; 30 parents from Support Parent Information Network; and 30 K-12 Hawaii school counselors. Changes/Problems: Nothing Reported What opportunities for training and professional development has the project provided? Nothing Reported How have the results been disseminated to communities of interest?Multiple outreach, extension activities were conducted during this reporting period including providing presentations on mindfulness and well-beingto local Hawaii social service organizations andK-12teachers/counselors through a professional development courseon Oahu. What do you plan to do during the next reporting period to accomplish the goals?For the next reporting period, I plan to: 1) Continueto provideand conduct professional development trainings and classesfor Hawaii teachers, social service and health professionals on mindfulness and the lesson plans developed from the curriculum. And to continue to foster collaboration and networking through these trainings and seminars. 2) Continue data collection with youth and young adults on feasibility and uptake of mindfulness practices in implementing the lesson plans and course on mindfulness & skillful living. 3) Present at one national conference and two international conferences on lessons learned from the extension/outreachactivity inproviding mindfulness trainings to educational and social service professionals, as well asthe effect of mindfulness on focus, attention, stress, and self-regulation among youth and young adults. 4) Develop more lesson plans on mindfulness to complement the existing curriculum. 5) Train a cadre of professionals on mindfulnesswho can implement the mindfulness-based lessons plans. 6) Provide research training to one graduate student related to mindfulness-based interventions.

Impacts
What was accomplished under these goals? For this reporting period, the following goals were accomplished: 1) Various professional trainings on mindfulness was conducted and provided to Hawaii K-12 school teachers, counselors, and behavioral specialists. This resulted in networking potential whereby Investigator has had meetings with school principals to consider implementing mindfulness lessons with students, particularly those considered at-risk. Two 10 week mindfulness-based trainings were also provided to Office of Youth Services contracted grantees, and this has resulted in strong collaborative ties. 2)A mixed-methodsresearch study is currently being conducted with 25 undergraduate students enrolled in a mindfulness course at UH Manoa to examine whether the course improves attention, focus, self-regulation, and decreases stress and maladaptive behaviors. 3) Lessons plans were created based on the mindfulness-based intervention curriculum, to provide greater ease and feasibility to teachers to implement mindfulness at their respective schools. 4) Presentations to school, social service, and health professionals were conducted across Hawaii including with the Department of Accounting and General Services, Foster Grandparents Program, Judiciary State of Hawaii, Support Parent Information Network, Peer Mediation Conference, and School Counselor Conference. 5) Abstracts were developed and submitted to present at national and international conferences.

Publications

Progress 10/01/13 to 09/30/14

Outputs
Target Audience: Target audience reached during this reporting period includes: youth at-risk, incarcerated youth, K-12 teachers and counselors, and youth and family serving professionals. Changes/Problems: Nothing Reported What opportunities for training and professional development has the project provided? The project has provided mindfulness-based trainings to K-12 teachers and counselors on Oahu, and a Professional Development Educational (PDE) course was developed and approved by Hawaii Dept of Education. In addition, the project secured a training contract with the Office of Youth Services to provide mindfulness trainings to youth and family serving agencies in Hawaii. How have the results been disseminated to communities of interest? The results have been disseminated via national peer-reviewed conferences, peer-reviewed journals, local conferences, and via news media coverage. What do you plan to do during the next reporting period to accomplish the goals? Current activities to accomplish the goals will focus on publications in peer-reviewed journals and fine-tuning of curricula and training materials.

Impacts
What was accomplished under these goals? Many activities were accomplished this year that fulfilled the goals of this project including: 1) submission and currently under review, a manuscript of the mindfulness-based youth intervention with incarcerated youth at the Hawaii Youth Correctional Facility; 2) an accepted and published manuscript entitled Mindfulness and the Aloha Response in the Journal of Indigenous Social Development ; 3) media coverage of the mindfulness-based intervention with the Native Hawaiian/Pacific Islander incarcerated youth on Hawaii News Now; 4) six conference presentations at peer-reviewed national conferences; 5) mindfulness trainings and development of a professional development education course for K-12 teachers and counselors; 6) collaboration and contract with the Office of Youth Services to provide mindfulness training to youth and family serving agencies in Hawaii; and 7) development of curricula and training materials.

Publications

• Type: Journal Articles Status: Published Year Published: 2014 Citation: Le, T.N. & Shim, P. (2014). Mindfulness and the aloha response. Journal of Indigenous Social Development, 3(1) 1-11. http://hdl.handle.net/10125/33336
• Type: Journal Articles Status: Published Year Published: 2014 Citation: Le, T.N. (2014). Mindfulness-based adventure camp for military youth. Journal of Extension, 52(2), #2FEA5. (acceptance rate 2013: 27.8%)
• Type: Conference Papers and Presentations Status: Published Year Published: 2014 Citation: Le, T.N. (April, 2014). Translation & implementation of mindfulness-based intervention in three different cultures. Invited Keynote speaker for Symposium: Cultivating a Mindfulness Community, Center for Public Health Practice. Colorado State University: Fort Collins, CO.
• Type: Conference Papers and Presentations Status: Published Year Published: 2014 Citation: Le, T.N. (March 20th, 2014). Mindfulness with aloha among mixed-ethnic/Native Hawaiian-Pacific Islander youth. 2014 society for Research in Adolescence Biannual Meeting. Austin, TX. Poster selected for presentation at the special event Adolescence in Diverse Contexts. Austin, TX.
• Type: Conference Papers and Presentations Status: Published Year Published: 2014 Citation: Le, T.N. (Sept 7th, 2014). Mindfulness with youth in school and correctional facility in Hawaii & Vietnam. International Conference: Mindfulness, Education, and Transformation. Nan Tien Institute. Wollongong, Australia.
• Type: Conference Papers and Presentations Status: Published Year Published: 2014 Citation: Le, T.N., & Proulx, J. (April, 5th, 2014). Mindfulness with aloha among mixed-ethnic/Native Hawaiian Pacific Islander Incarcerated Youth. Investigating and Integrating Mindfulness in Medicine, Health Care, and Society: 12th Annual International Scientific Conference for Clinicians, Researchers, and Educators. Boston, MA.
• Type: Conference Papers and Presentations Status: Published Year Published: 2014 Citation: Le, T.N. (March 29th, 2014). Mindfulness with aloha among mixed-ethnic/Native Hawaiian Pacific Islander Incarcerated Youth. 2014 Society for Research in Human Development Biennial Meeting. Austin, TX.
• Type: Conference Papers and Presentations Status: Published Year Published: 2014 Citation: Le, T.N. (March 20th, 2014). Preventing violence: Implementation & outcome of a mindfulness-based intervention in Hawaii & Vietnam. Chair & panel presentation at the Numata Conference in Buddhist Studies: Violence, Nonviolence, and Japanese Religions: Past, Present, and Future. Honolulu, HI. Study was featured on Hawaii News Now on March 18th & 19th, 2014

Progress 10/01/12 to 09/30/13

Outputs
Target Audience: The target audience for this reporting period was incarcerated youth, ages 14-18, males and females, at the Hawaii Youth Correctional Facility. Changes/Problems: Nothing Reported What opportunities for training and professional development has the project provided? Eight members from the community representing various professions (social work, youth corrections, mental health, education) were provided with mindfulness and the mindfulness-based positive youth development curriculumtraining over 2-days. How have the results been disseminated to communities of interest? Abstracts to present at national conferences were submitted to national conferences, and is currently under consideration. A manuscript is currently under preparation. What do you plan to do during the next reporting period to accomplish the goals? Actitivites for the next reporting period include: 1) to continue the mindfulness-based positive youth development program at HYCF, and to expand the mindfulness program to reach other at-risk youth and communities in Hawaii (e.g., homeless youth, truant youth, military youth); 2) to continue to conduct pilot studies to evaluate the impact of the mindfulness program; 3) to train additional community members who are interested in implementing the program; 4) to develop grant proposals for funding to continue the program; 5) to present preliminary results of the HYCF experience at national peer-reviewed conferences; and 6) to publish the HYCF experience in a peer-reviewed journal.

Impacts
What was accomplished under these goals? During this reporting year, the following activities were accomplished: 1) Program Director established a collaborative partnership with Office of Youth Services/Hawaii Youth Correctional Facility (HYCF) to determine the feasibility and to implement the mindfulness-based positive youth development program at HYCF; 2) a pre-post pilot study was conducted with 34 incarcerated HYCF youth, ages 14-18, males and females, who received the mindfulness program; 3) analyses revealed statistically significant reductions in stress (assessed by salivary cortisol), impulsivity, and improved functioning in immune response (assessed by IgA), self-regulation, and mindfulness; 4) A curriculum was developed and adapated that could be replicated and used for other populations in Hawaii; 5) abstracts were submitted for presentations at national peer-reviewed conferences, and a manuscript is currently under preparation.

Publications