Illinois mindful wellbeing: A community-based implementation of an adapted mindfulness-based intervention with low-income adults

Santens, Ryan L

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https://hdl.handle.net/2142/129703 Copy

Description

Title

Illinois mindful wellbeing: A community-based implementation of an adapted mindfulness-based intervention with low-income adults

Author(s)

Santens, Ryan L

Issue Date

2025-04-22

Director of Research (if dissertation) or Advisor (if thesis)

Rogers, Wendy A

Doctoral Committee Chair(s)

Rogers, Wendy A

Committee Member(s)

• Alston, Reginald
• Woods, Amelia
• Laurent, Heidemarie

Department of Study

Health and Kinesiology

Discipline

Community Health

Degree Granting Institution

University of Illinois Urbana-Champaign

Degree Name

Ph.D.

Degree Level

Dissertation

Keyword(s)

• Intersectionality
• Health disparities
• Social marginalization
• Mindfulness
• Eudaimonic wellbeing
• Transdisciplinary

Abstract

Individuals who are disadvantaged experience disproportionate levels of acute and chronic stress leading to alarming health disparities. These disparities include early onset of chronic conditions and shorter life expectancy. Low socioeconomic status (SES), minority racial/ethnic group membership, and disability, for example, are intersectional social identities compounding positions of health-related disadvantage. Disproportionate cumulative stress arising daily for marginalized populations ranges from racism, prejudice, and discrimination to poverty, unemployment, and housing instability. Mindfulness-based interventions (MBI) develop effective appraisal and coping resources that can buffer against stress and have been shown to produce salutary benefits in the prevention and treatment of chronic mental and physical health conditions. However, there is a gap in the mindfulness literature implementing MBI with marginalized populations. Further, new MBI are needed that can address the intersectional complexities of stress events as they proliferate across social-ecological levels. In addition, new MBI are needed that can enhance positive functioning as well as decrease negative functioning (i.e., stress, anxiety, depression) providing pathways for disadvantaged populations to thrive and flourish even amidst uneven social structures and systems producing deleterious environments. Following the NIH Stage Model for Behavioral Intervention Development (NIH Stage Model), the objectives of the current study were to develop and pilot-test (including feasibility testing) an adapted MBI (i.e., Mindfulness-Based Eudaimonic Wellbeing (MBEW)) to meet the complex needs of marginalized populations to flourish and thrive. As a Stage IA/IB intervention of the NIH Stage Model, analysis was conducted to understand the feasibility and benefits of implementing MBEW with disadvantaged adults in a community-based setting. Applying a pre-test / post-test withing-groups mixed methods study design, study aims included: 1) assess the acceptability, appropriateness and feasibility; and 2) examine the benefits of MBI on psychological well-being, mindfulness, and stress. To achieve these aims, I applied the mindfulness to meaning (MMT) theory to guide adaptation of one of most researched evidence-based MBIs (i.e., mindfulness-based cognitive therapy). In these adaptations, I integrated elements of eudaimonic well-being (operationalized as Ryff’s scales of psychological well-being (PWB+)), second wave positive psychology (2WPP), and the hero (or heroine) archetype of comparative mythology to develop skills to buffer and reappraise adverse events. MBEW included formal and informal mindfulness practices and activities designed to target specific subscales of PWB+ (i.e., self-acceptance, purpose in life, environmental mastery, positive relations with others, personal growth, and autonomy), which have been associated with numerous mental and physical health benefits. Added implementation adaptations for disadvantaged populations included weekly class reminder emails, weekly home practice emails, and additional outreach via email and/or phone for participants who missed a class or mentioned a difficulty that may prevent them from continuing to remain in the study (e.g., family crisis, housing instability). Twenty participants (N=20) completed the study, with a retention of 83.3%. MBEW was shown to be acceptable, appropriate, and feasible. MBEW demonstrated significant changes in the primary outcome (i.e., PWB+) and secondary outcomes (i.e., mindfulness, stress). Additional qualitative data provided detailed descriptions supporting acceptability, appropriateness, and feasibility findings from quantitative measures. Themes from the qualitative responses discuss the benefits of completing MBEW. Benefits ranged from skillful response to adverse events, reduced stress, and feeling relaxed. Additional themes discussed daily home practice and the need for greater accessibility for disadvantaged communities to mindfulness training. These findings support calls for increased MBI research with disadvantaged populations. Applying aspects of cultural humility to guide the development of curated recruitment materials and MBI curricula paired with participant retention strategies employed throughout the intervention can produce retention rates equal to or greater than typical MBI research conducted with more affluent populations. Significant changes in PWB+, mindfulness, and stress for this population suggest MBIs are a promising cost-effective, non-pharmacological approach to address stress-related health disparities. Human service providers and community-based organizations in sectors where economic margins are slim can add MBIs to their service array creating an additional revenue stream while improving the health of the populations they serve.

Graduation Semester

2025-05

Type of Resource

Thesis

Handle URL

https://hdl.handle.net/2142/129703

Copyright and License Information

Copyright 2025, Ryan Santens

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