Culturally tailoring a mindfulness meditation mobile app to reduce psychological distress in African American adults

Project Summary/Abstract

This K01 is a mixed methods research project in collaboration with an industry partner (i.e., Healthy Minds Innovations)

and will be conducted across three aims during a 5-year comprehensive training program. In this innovative proposal, the

candidate has identified a mentorship team and training goals to facilitate their transition to an independent research career focused on achieving health equity and advancing mind-body research by delivering culturally tailored digital health interventions to improve mental health and well-being in underserved populations. Background: African American (AA)

adults are 20% more likely to report serious psychological distress (e.g., stress, anxiety, depression) compared to white

adults. Racial discrimination, a significant source of stress in AA adults, increases psychological distress. AA adults lack access to quality mental health care and the compounding impact of the COVID-19 pandemic may further exacerbate mental

health disparities. Reducing psychological distress and increasing access to mental health care for AA adults is a public health emergency. Commercially available mindfulness meditation mobile apps may be an effective and efficient solution because they improve psychological distress, are highly scalable and can increase access to care. However, most are not

culturally tailored (i.e., include groups’ unique experiences, values, and beliefs). Culturally tailoring mindfulness meditation apps can enhance engagement and efficacy in racial/ethnic minority populations. Specific aims and research design: The goal of Aim 1 is to inform the development of an app prototype via focus groups (N=4, 5 participants each) in AA adults

(half meditators, half non-meditators). The goal of Aim 2 is to culturally tailor a commercial mindfulness meditation app (Healthy Minds Program app) through a User-Centered Design (UCD) workshop. AA adults (N=8) will attend a virtual

half-day UCD workshop where they will co-design an app prototype. After the prototype is built, participants will test it for

1 week and complete an exit interview to refine the app. Aim 3 will determine the feasibility of the culturally tailored prototype app following predetermined benchmarks. AA adults with elevated stress (N=72) will be randomized to use HMP

or a health education app (The Wellness App) for 8 weeks. Psychological distress, race-related stress, mindfulness, and self-

compassion will be measured at pre-, mid-, and post-intervention. Acceptability (ability to recruit, satisfaction, continued

use, appropriateness) will be assessed with a post-intervention satisfaction survey. Demand (adherence to treatment) will be measured by objective app usage data (sessions/minutes completed) and attrition rate. Mentoring and training: A team

of expert mentors and advisors (Vranceanu, Burnett-Zeigler, Gallo, and Roesch) will oversee the progress of this study and

contribute to mentoring the candidate across 4 training goals aimed to develop expertise in: 1) mental health disparities, 2)

cultural tailoring methods, 3) digital clinical trials, and 4) qualitative and mixed methods research and advanced statistics.

This proposal aligns with NCCIH’s funding priorities including the development of feasible mobile health (mHealth) mind- body interventions and reducing health disparities. Impact: Collectively, this career development award will serve as a

strong foundation toward the candidate’s independent research career and provides an innovative solution to improve access to mental health care for AA adults.