Recipient Organization
UNIV OF HAWAII
3190 MAILE WAY
HONOLULU,HI 96822
Performing Department
Family & Consumer Sciences
Non Technical Summary
The project's aims include: 1) to engage in translational research of implementing the Mindfulness and Skillful Living training and program to educators and various youth and family serving agencies in Hawaii; 2) to develop a Hawaiian version of the mindfulness-based lesson plans that include cultural sensitivity to Native Hawaiian/Pacific Islanders' epistemology and phenomemology; 3) to provide mindfulness trainings to Hawaii youth/family service providers and educators; 4) to implement the mindfulness lesson plans to youth population in Hawaii including those involved in the juvenile justice system, those at risk for stress, anxiety, depression, and suicide, as well as other groups at-risk for maladaptive outcomes; and 5) to conduct a quasi-experimental trial to assess 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).Mindfulness-Based InterventionThe basis of the educational and life skills intervention is an adapted version of Mind Body Awareness Program's (MBA, see www.mbaproject.org) mindfulness-based curriculum for at-risk youth. The curriculum was developed by a working group of experts who applied mindfulness-based rehabilitation strategies to at-risk communities with a focus on incarcerated youth. The curriculum is grounded in teaching the life skills of mindfulness - the ability to pay non-judgmental attention to one's present moment experience - in youth language and through metaphors relevant to the experience of youth. The result of over a decade working with incarcerated youth, the curriculum retains a particular emphasis on using present moment awareness to regulate strong, negative emotional states.Based on this curriculum, ten lesson plans were developed that include: 1) Introduction to Mindfulness and Mindful Breathing, 2) Creating a Mind Jar; 3) Mindful Movements; 4) Mindfulness of Senses; 5) Mindfulness of Emotions; 6) Mindfulness of Thoughts; 7) Empathy & Compassion; 8) Mindful Communication; 9) Choice and Balance; and 10) Virtue and Ethics. Considering that Native Hawaiians/Pacific Islander youth are disproportionately represented in juvenile justice and human/social services serving agencies, these lesson plans are currently in the process of being adapted to include Native Hawaiian/Pacific Islander's cultural practices, metaphors, and stories. These lesson plans were developed with consideration to many socio-emotional competencies and life skills that are crucial for resiliency and optimal well-being. Because many youth and young adults struggle with impulse control, interpersonal relationships, and issues surrounding their own self-worth, the lesson plans incorporate a variety of centering techniques and modalities that appeal to different senses (sight, sound, smell, etc.), games (both solitary and interactive) and analogies to illustrate how mindfulness can be used to work with distress, trauma and painful emotions. Lesson plans also discuss how to manage and regulate difficult emotions and thoughts that can be very sticky. For example, when delivering the "mindfulness of emotions" lesson to youth, facilitators will play several hip-hop songs from the artist KRS-1 that talk about using breathing meditation to "interrupt" the sense that one always needs to retaliate physically when one's sense of self is threatened.Mindfulness and Skillful Living trainings have been conducted around Hawaii, covering all islands. The formal trainings have reached about 95 K-12 teachers and counselors, and about 120 health and human service providers. Informal trainings in terms of invitations to conduct 1-2 hours workshop and presentation have reached about 2,000 individuals who serve youth and families to date. This project will continue extension outreach to provide workshops, seminars, and professional development, with intention to scale up for greater penetration into schools and health/social service agencies.
Animal Health Component
75%
Research Effort Categories
Basic
(N/A)
Applied
75%
Developmental
25%
Goals / Objectives
The project's aims include: 1) to engage in translational research of implementing the Mindfulness and Skillful Living training and program to educators and various youth and family serving agencies in Hawaii; 2) to develop a Hawaiian version of the mindfulness-based lesson plans that include cultural sensitivity to Native Hawaiian/Pacific Islanders' epistemology and phenomemology; 3) to provide mindfulness trainings to Hawaii youth/family service providers and educators ; 4) to implement the mindfulness lesson plans to youth population in Hawaii including those involved in the juvenile justice system, those at risk for stress, anxiety , depression, and suicide, as well as other groups at-risk for maladaptive outcomes ; and 5) to conduct a quasi-experimental trial to assess 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). Stakeholders of this project include UH faculty in the Family & Consumer Sciences of CTAHR, the Department of Complementary & Alternative Medicine of School of Medicine, the Department of Psychiatry of School of Medicine, the Department of Urban and Region Planning College of Social Sciences, Office of Youth Services, and various youth and family health and social service agencies. Pl will utilize a community-based participatory research (CBPR) and Design Thinking approach to revise the existing mindfulness lesson plans to be culturally appropriate for communities in Hawaii. Outcomes for the project include increases in youth , family , and community well-being and resiliency, as well as greater institutional capacity among Hawaiian service providers to provide mindfulness interventions.
Project Methods
ProcessPI will utilize community-based participatory research (CBPR) and the Design Thinking approach to revise existing mindfulness-based lesson plans to be culturally and developmentally appropriate for at-risk youth in Hawaii (at-risk for anxiety/depression; truancy/school disengagement; and delinquency). PI will work with partners and Native Hawaiian practitioners to revise the lesson plans, and to develop the appropriate metaphors and 'talk stories' for the lesson plans.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 (at the partner's agency) and will be trained by seasoned mindfulness facilitators.Process measures will be developed 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. Human subject approval will be sought from the Human Subject Committee at the University of Hawaii to conduct a pilot trial with participants. Permission will be sought with each of the high schools, parents, and students involved. The timeline to complete the process components is estimated to take about 3-6 months for each new site.OutcomeFor 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. For example, measures for youth self-report will include at-risk behaviors check list (Elliott, Huizinga, & Ageton,1985); depression (CES-D Scale; Radloff, 1977), cognitive emotion regulation questionnaire (Garnefski & Kraaij, 2007), positive/negative affect (Watson & Clark, 1994), adolescent mindfulness measure (CAMM; Grego, Baer, & Smith, 2010).The qualitative data is intended to capture the phenomenological nature of the participants (i.e., what are the youth actually doing when they are doing the mindfulness exercises, for instance), and their insights/perspectives about it including whether and how it helped them or not. Quantitative data will be collected at multiple time points including at baseline (T1), during intervention, at termination, and at 3 months and/or 6 months post-termination. Survey data will be collected using touch screen tablets/laptops or paper-pencil format that will take about one hour to administer. Qualitative data will be collected using a semi-structured interview, conducted face-to-face with the participant, and will take about one hour to administer. At each data collection site, outcome data collection will be completed over a 2 year period. During the first quarter, IRB approval will be revisited and renewed, clinical trial and qualitative data collection protocol will be finalized, research staff will be recruited and trained, and participant randomization and recruitment will take place. Data collection will start in the second quarter of Y01 and will continue until 3-month or 6 months post-termination. This cycle will be repeated for each site. Analyses will be conducted starting 3 months after baseline for each site, and will continue until the end of the project. Conference presentations and manuscripts will be developed for dissemination beginning in quarter 1 of Y02. During the latter half of Y02, PI will also begin development of a R01 application for a larger randomized clinical trial.