Reply: The PHIOMM Framework for Implementing Mindfulness in Public Health, With Groundwork

Abstract

Abstract This paper presents the Public Health Implementation of Meditation and Mindfulness (PHIOMM) framework and its conceptual groundwork, as part of responding to commentary on “Mindfulness for Global Public Health: Critical Analysis and Agenda,” this special issue’s target article. The present reply also responds to diverse issues raised by commentators about mindfulness interventions. Issues include intervention moderators, safety, mediators of causal effects, ethics, suitability for children, religious adaptations, implementation through community partnerships, and branding. This reply agrees with commentators who suggest that the mindfulness field could be significantly strengthened by situating it more firmly within the broader study of contemplative practices. The reply also offers suggestions for how to begin formulating a definition of attentional health, which commentary suggested could be the basis for usefully reframing what is measured by some contemporary measures of mindfulness. Additional topics addressed in the reply include how to proceed in the face of diverse understandings of causal mediators of effects from mindfulness interventions (their “mechanisms”); the objectives of multi-level health interventions that incorporate mindfulness; and the need for a cross-culturally “expanded hub” resource base of contemplative practice interventions. Needed intervention programs include not only secularized mindfulness interventions, but also mantram repetition, and meditative interventions derived from diverse faith traditions.