A Daily Digital Mindfulness Meditation to Reduce Stress from Discrimination Among Racially Diverse Sexual and Gender Minorities: Preparation Phase of the Multi-Phase Optimization Strategy (MOST).

Abstract

Young sexual and gender minorities (YSGM) experience disproportionate stress and poor mental health compared to young cisgender heterosexual individuals which may, in part, be due to exposure to discrimination. An app-based mindfulness meditation program may be an easily accessible intervention through which to improve mental health and well-being among this population. We utilized the preparation phase of the Multiphase Optimization Strategy (MOST) process to guide this work. We used a 23 (8- condition) factorial intervention to examine the acceptability, feasibility, and preliminary efficacy of three meditation components: Awareness, Connection, and Purpose. Participants (n = 72 YSGM; 95.65% people of color) were enrolled and randomized to one of the eight conditions, engaged in meditation exercises via a smartphone app, and completed daily surveys that assessed stress and well-being over 5 days. Post-intervention, participants completed a survey and were interviewed about their experiences with the app and study protocol. Qualitative analyses explored the feasibility and acceptability of the study protocol, and factorial ANOVAs examined preliminary signals from each component and their interactions in reducing perceived stress and improving well-being. The findings point toward the feasibility and acceptability of the intervention among YSGM participants; participants assigned to all three meditation components had the highest proportion of lost to follow-up. The omnibus test of the factorial model for perceived stress was not statistically significant, F(7, 64) = 1.44, p = 0.20, η 2 p = 0.136. The omnibus test for satisfaction with life was also non-significant, F(7, 64) = 0.98, p = 0.45, η 2 p = 0.097. Given non-significant omnibus tests, individual component effects should be interpreted with caution as preliminary signals rather than confirmed effects. Among individual components, the Connection component showed a potential signal for stress reduction (b = - 5.21, p = 0.04, η 2 p = 0.064). Research with larger sample sizes is needed to evaluate the effects of the intervention components more fully. Quantitative findings were largely non-significant, consistent with this study's preparation-phase design. However, this study points to areas for further inquiry, including future work with larger, more diverse SGM samples, greater inclusion of instructors from diverse backgrounds in meditation apps, and the identification of engagement strategies for diverse populations. https://clinicaltrials.gov/ct2/show/NCT05131360.