Racism, Stress, Psychological
Conditions
Brief summary
The primary aim of this study is to explore the feasibility, acceptability, and preliminary effectiveness of CBRT intervention among African Americans compared to a wait-list control group. The specific objectives include assessing feasibility, gathering participant feedback, evaluating CBRT's impact on psychological and biological outcomes, and exploring the mediating role of mindfulness. The study is a 1-group pretest-posttest design. 20 African American participants will be recruited from various sources and undergo baseline and follow-up assessments. The intervention involves a 10-week CBRT program focusing on mindfulness, compassion, self-awareness, and stress-reduction techniques. Measures include sociodemographics and psychological measures (race-based stress, depression, perceived stress, quality of life, social connectedness, sleep, and resilience) and biological measures ( allostatic load, saliva cortisol, telomere length, and gene expression. Data is collected at baseline and 10 weeks.
Detailed description
Racism and racial discrimination profoundly affect mental and physical health among historically disenfranchised ethnic groups, including Black, Indigenous, and People of Color (BIPOC). The negative health impacts are evident in elevated mortality rates, early disease onset, and increased comorbidity burden among BIPOC individuals. This study seeks to address these health disparities by investigating the potential of Contemplative-Based Resilience Training (CBRT) to mitigate the impact of racism-related stress. CBRT holds promise in countering the neurobiological changes attributed to chronic stress, aligning with the "weathering hypothesis" and Allostatic load theory. The primary aim of this pilot study is to explore the feasibility, acceptability, and preliminary effectiveness of CBRT intervention among African Americans compared to a waitlist control group. The specific objectives include assessing feasibility, gathering participant feedback, evaluating CBRT's impact on psychological and biological outcomes, and exploring the mediating role of mindfulness. The study utilizes a one-group pretest-posttest design, where participants are recruited from various sources and undergo baseline and follow-up assessments. The intervention involves a ten-week Cognitive-Based Resilience Training (CBRT) program focusing on developing mindfulness, compassion, self-awareness, and stress-reduction techniques. The study measures include socio-demographics and psychological measures such as race-based stress, depression, perceived stress, quality of life, social connectedness, sleep, and resilience, as well as biological measures including allostatic load, saliva cortisol, telomere length, and gene expression. Data is collected at baseline and after ten weeks of the program. Feasibility will be assessed based on recruitment rates, retention, attendance, and qualitative feedback. The impact of CBRT will be evaluated through various statistical analyses, considering intention-to-treat principles and controlling for covariates. Preliminary findings from a pilot investigation with 20 African-American participants suggest associations between psychological measures, mindfulness, sleep, coping, resilience, and racism-induced stress. These results underscore the potential of CBRT in addressing complex relationships among these factors. By investigating the potential benefits of CBRT in alleviating racism-induced stress and associated health disparities, this research aims to contribute insights into mindfulness-based interventions to address racism-related stress and its broader implications for the well-being of BIPOC communities.
Interventions
BEHAVIORALContemplative-Based Resilience Training (CBRT)
The intervention is a 10-week program that will address mindfulness, compassion, social-emotional self-care, exposing stress-reactive habits, self-awareness, visualization, and deep breathing. The rationale for applying this mindfulness intervention to promote psychological resilience following the development of race-based traumatic symptoms is based on the notion that mindfulness promotes acceptance of complex thoughts and feelings, reduces rumination, and improves psychological function, cognitive flexibility, and coping processes.
Sponsors
Rockefeller University
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
OTHER
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 50 Years
Healthy volunteers
Yes
Inclusion criteria
* Self Identity as African American or Black * 18-50 years old * Fluent in English
Exclusion criteria
* History of significant pre-existing brain disease or injury (e.g., dementia, stroke, seizure disorder, and head injury with cognitive sequelae or loss of consciousness more than 30 minutes, seizure disorder) * Reported history of learning disability/mental retardation * Current Attention Deficit Hyperactive Disorder (ADHD), depression, bipolar disorder, post-traumatic stress disorder (PTSD), or psychotic disorder diagnosis * Current psychotropic medication (as these medications are known impacts on brain function) e.g. antipsychotics, antianxiety * Severe/chronic medical illness (e.g., reported HIV+ status, cardiovascular disease, liver disease/cirrhosis, chronic kidney disease, current/past cancer with radiation/chemotherapy treatment, etc.) * Current methadone/suboxone/buprenorphine (or similar) maintenance * Use of illicit substances other than cannabis within the past 90 days * Pregnant * Major life events in the last 30 days (hospitalization, marriage, death in the family of friends, disaster)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Feasibility of Study | 10 weeks | number of participants who complete the study |
| Acceptability of CBRT (Qualitative Interview Findings) | at the end of the 10 week intervention | Acceptability was assessed using structured qualitative exit interviews conducted post-intervention. Interview transcripts were reviewed using structured thematic coding. Predefined themes reflecting participant experience were identified, including expectations alignment, perceived usefulness of meditation/emotional regulation tools, facilitator support, group dynamics, session structure, and behavioral impact. For reporting purposes, the number of participants who explicitly endorsed each theme during the interview was counted. Participants could endorse more than one theme; therefore, totals across themes do not sum to the overall sample size. Endorsement reflects a clear expression of agreement, perceived benefit, or experience related to the theme during qualitative analysis. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Allostatic Load Composite Score (NHANES Clinically Relevant Scoring 0-11 ) | Baseline (pre-CBT) to 10 weeks (post-CBT) | Allostatic load score is a composite score based on eleven biomarkers. Risk categories for the level of each biomarker are defined and points, high (Hi) (1 point), moderate (Mod) (0.5 points), or low (low) (0 points), are awarded based on established norms in clinical medicine. Allostatic Load is the sum of the points from the 11 biomarkers. High scores indicate a more significant risk. 1\) SBP: Hi ≥ 150 mmHg, Mod 120 to 149 mmHg, Low \< 120 mmHg; 2) DBP: Hi ≥ 90 mmHg, Mod 80 to 89 mmHg, Low \< 80 mmHg; 3) Total cholesterol: Hi ≥ 240 mg/dL, Mod 200 to 239 mg/dL, Low \< 200 mg/dL; 4) HDL cholesterol: Hi \< 40 mg/dL, Mod 40 to 59 mg/dL, Low \> 60 mg/dL; 5) Total/HDL cholesterol ratio: Hi ≥ 6, Mod 5 to \< 6, Low \< 5; 6) HgbA1C: Hi ≥ 6.5%, Mod 5.7 to \< 6.5%, Low \< 5.7%; 7) Waist-hip ratio (women): Hi ≥ 0.85, Mod \> 0.80 to \< 0.85, Low ≤ 0.80; Waist-hip ratio (men): Hi ≥ 1.0, Mod \> 0.95 to \< 1.0, Low ≤ 0.95; 8); BMI: Hi ≥ 30 kg/m2, Mod 25 |
| Cortisol Awakening Response (CAR) | Baseline (Pre-CBRT) and 10 weeks (Post-CBRT) | Cortisol Awakening Response (CAR) was calculated as the difference between salivary cortisol concentration measured 30 minutes after awakening and at waking (µg/dL). Positive values reflect a physiologic increase in cortisol following awakening. |
| Composite CTRA Gene Expression Score | comparison from baseline (pre-CBT) to 10 weeks (post-CBT) | CTRA gene expression was assessed using genome-wide transcriptional profiling of peripheral blood samples. Expression levels of 45 pre-specified CTRA indicator genes were quantified as log2-transformed mRNA abundance values. Gene expression values were mean-centered and weighted using established contrast scores reflecting pro-inflammatory and antiviral gene contributions. A composite CTRA score was calculated by averaging the weighted expression values across all genes, with higher scores indicating greater pro-inflammatory and lower antiviral gene expression activity. |
| Telomere Length | 10 weeks | Quantitative Polymerase Chain Reaction (PCR )will determine average telomere length. |
Countries
United States
Contacts
PRINCIPAL_INVESTIGATORRachel W Kimani, DNP
Rockefeller University
Participant flow
Recruitment details
Participants were recruited through community outreach, flyers, and word of mouth in New York City. Eligibility: self-identified African American adults between 18 and 50 years of age. A total of 35 individuals were screened, and 22 were enrolled.
Pre-assignment details
Of the 22 enrolled, 1 participant was lost to follow-up prior to beginning the intervention. Thus, 21 participants began CBRT.
Baseline characteristics
| Characteristic | — |
|---|---|
| Age, Customized Age | 36.1 years STANDARD_DEVIATION 8 |
| Race (NIH/OMB) American Indian or Alaska Native | 0 Participants |
| Race (NIH/OMB) Asian | 0 Participants |
| Race (NIH/OMB) Black or African American | 19 Participants |
| Race (NIH/OMB) More than one race | 0 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 0 Participants |
| Race (NIH/OMB) White | 0 Participants |
| Sex: Female, Male Female | 11 Participants |
| Sex: Female, Male Male | 8 Participants |
Adverse events
| Event type | EG000 affected / at risk |
|---|---|
| deaths Total, all-cause mortality | 0 / 21 |
| other Total, other adverse events | 0 / 21 |
| serious Total, serious adverse events | 1 / 21 |
Outcome results
None listed