A Telephone-Adapted Mindfulness-Based Stress Reduction Program: Preliminary Effects among Healthcare Employees

Healthcare employees often experience high stress and may benefit from accessible psychosocial interventions. In this pilot study, we explored preliminary feasibility, acceptability, and psychological effects of a telephone-based adaption of mindfulness-based stress reduction (MBSR) for healthcare employees. Eleven participants (M age = 49.9; 27.3% ethnic/racial minority) were enrolled in an eight-session group-based MBSR program adapted for telephone delivery. Feasibility was assessed using rates of program attrition and session completion; acceptability was explored qualitatively via participants’ responses to an open-ended item about their program experience. Participants also completed pre-and post-program assessments on psychosocial outcomes (distress (overall distress, depression, anxiety, somatization), mindfulness, and self-compassion). We characterized mean change scores, 95% confidence intervals, and effect sizes to explore preliminary program effects. With regard to preliminary feasibility, one participant dropped out prior to the intervention; of the remaining 10 participants, 90% completed at least half (≥4) of the sessions; 70% completed at least three-quarters (≥6 sessions). Feedback reflected positive experiences and included suggestions for program delivery. Participants reported reductions in distress post-program (M difference range = −5.0 to −9.4), showing medium to large effect sizes (d range = 0.68 to 1.11). Mindfulness scores increased from pre- to post-intervention (M difference range = 1.0 to 10.4), with small-to-medium effects (d range = 0.18 to 0.55). Almost all aspects of self-compassion remained stable over time, with the exception of common humanity, which increased post-program (M difference = 2.9, CI 95% 0.5 to 5.4, d = 0.91). Preliminary findings from our small pilot trial suggest that telephone-based adaptations of MBSR may be a useful mode of delivery for healthcare employees; however, larger studies are needed to provide further evidence of feasibility, acceptability, and program effects.

Examining Effects of a Multisite Youth Outreach Program: A Meta-analysis Approach

This paper presents the application of a meta-analysis approach to the evaluation of youth-learning data from the nationally distributed This is How We “Role” program. The application of meta-analysis for examining the impact of other multisite youth programs encountering similar data analysis challenges is discussed. At each This is How We “Role” program site, university partners collected data to examine youth-participant learning. Data analysis from these unique sites was challenging as the approach had to accommodate the innate heterogeneity across sites due to differences in implementation, sample size, and learning context. The meta-analysis method revealed details of the underlying variation between sites that could be masked by typical regression approaches, estimated overall program effects, examined subgroups and identified heterogeneity across project sites. The results showed the This is How We “Role” program generally increased learning at each site and as a whole, even though the program effects varied across sites. This example demonstrates the utility of using the meta-analysis approach to similar multi-site youth development programs.

Sanitation and Marriage Markets in India: Evidence from the Total Sanitation Campaign

This paper analyses the marriage decisions of men and women, focusing on the added attractiveness of sanitation within the living arrangement, in rural India. We exploit district and time variation from the Total Sanitation Campaign (TSC) which increased sanitation by 6.6 percent among households with marriage eligible children and generated an exogenous increase in the composition of households with sanitation. Using data from the Indian Human Development household survey (IHDS) and district level census, we show that exposure to TSC increased the probability of marriage for men and women, from poorer households, by 3.8 pp and 6.5 pp respectively. The reduced form estimates incorporate both general equilibrium effects and heterogeneous program effects – two important components of equilibrium marital behavior. To decompose the overall policy impact on marriage market equilibrium we formulate a simple matching model where men and women match on observed and unobserved characteristics. Through model simulations, we show that cohorts within TSC exposed markets experienced a shift in marital gains both across matches but also within a given match. Specifically, the resultant sorting patterns display a marked gender asymmetry with an increase in marital surplus among matches where men are wealthier than their spouse, and a decrease in surplus where the wife is wealthier. Moreover, the increased access to sanitation for TSC exposed women implied a decline in their expected control over resources within the marriage.

Mindful Coping Power: Comparative Effects on Children’s Reactive Aggression and Self-Regulation

Coping Power (CP) is an evidence-based preventive intervention for youth with disruptive behavior problems. This study examined whether Mindful Coping Power (MCP), a novel adaptation which integrates mindfulness into CP, enhances program effects on children’s reactive aggression and self-regulation. A pilot randomized design was utilized to estimate the effect sizes for MCP versus CP in a sample of 102 child participants (fifth grade students, predominantly low-middle income, 87% Black). MCP produced significantly greater improvement in children’s self-reported dysregulation (emotional, behavioral, cognitive) than CP, including children’s perceived anger modulation. Small to moderate effects favoring MCP were also observed for improvements in child-reported inhibitory control and breath awareness and parent-reported child attentional capacity and social skills. MCP did not yield a differential effect on teacher-rated reactive aggression. CP produced a stronger effect than MCP on parent-reported externalizing behavior problems. Although MCP did not enhance program effects on children’s reactive aggression as expected, it did have enhancing effects on children’s internal, embodied experiences (self-regulation, anger modulation, breath awareness). Future studies are needed to compare MCP and CP in a large scale, controlled efficacy trial and to examine whether MCP-produced improvements in children’s internal experiences lead to improvements in their observable behavior over time.

Effects of Brief Interventions on Internalizing Symptoms and Substance Use in Youth: A Systematic Review

Internalizing problems (e.g., depression, anxiety) and substance use are common among young people and often co-occur. However, youths face myriad barriers to access needed treatment, and existing evidence-based interventions tend to focus on internalizing problems or substance use, rather than both simultaneously. Brief interventions that target both problems may therefore be an efficient and accessible resource for alleviating youth difficulties; however, this possibility has been insufficiently evaluated. This systematic review evaluated the intervention characteristics and quality of six studies spanning 2015 to 2019 that examined intervention effects on internalizing and substance use outcomes. Based on independent calculations and author reports (respectively), 3-4 interventions significantly reduced youth internalizing symptoms; 3-5 reduced youth substance use; and 2-3 reduced symptoms in both domains. All six interventions identified substance use as a primary target. Four interventions were administered by interventionists to youths in inpatient, outpatient, primary care, or school settings. The remaining two studies delivered content through voicemail messages or an online design. Interventions ranged from ~15 minutes to 240 minutes. Results highlight the sparsity and heterogeneity of youth-focused brief interventions that have evaluated program effects on both internalizing problems and substance use outcomes, suggesting a clear need for integrated supports that are also designed for accessibility. Future investigations of brief youth-focused interventions should assess program effects on both internalizing and substance use outcomes; examine mechanisms driving the varied efficacy of identified interventions; and create, refine, and test interventions with potential to address co-occurring internalizing problems and substance use in young people.

Parenting Programs for Disruptive Child Behavior in China: A Meta-Analysis and Systematic Review

Purpose: To synthesize evidence of parenting program effects on disruptive child behavior in China and compare three program approaches: behavioral, relational, and cognitive. Methods: We searched five databases (four English and one Chinese) and identified 45 studies; 29 studies were included in a multilevel meta-analysis (92 effect sizes; total N total = 3,892; M child age = 6.12 years). Results: We found large overall effects on reduced disruptive child behavior ( d = −1.28, 95% CI [−1.86, −0.70], p < .001), reduced harsh and inconsistent parenting ( d = −1.70, 95% CI [−2.91, −0.49], p <.001), and improved parental warmth and positive behavioral management ( d = 2.67, 95% CI [0.41, 4.93], p <.001). Behavioral programs were more effective than relational programs (Δ d = .89, 95% CI [−1.7, −0.13], p = .034), and cognitive programs were too rare to analyze separately. Conclusions: Parenting programs for disruptive child behavior can effectively support Chinese families, especially those adopting a behavioral approach.