Feasibility and preliminary efficacy of a culturally adapted group-based meditation intervention among Black patients with advanced cancer: A randomized controlled trial.

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Background: Mindfulness meditation has shown promise for reducing physical and psychological distress and enhancing quality of life in cancer patients. Although most prior work has focused on early-stage or non-metastatic patients (particularly women with breast cancer), growing evidence supports its feasibility and benefit in advanced cancer. Yet Black patients, who are disproportionately diagnosed at advanced stages, remain underrepresented in mindfulness meditation trials. We therefore developed a culturally adapted, remotely delivered group-based meditation intervention for Black patients with advanced cancer and evaluated its feasibility and preliminary efficacy.

Methods: Black patients with advanced cancer (stage III-IV solid tumor) under active treatment were randomized to a meditation intervention or a dose-matched attention-control (AC) condition, each comprising 4 weekly Zoom sessions (~60 minutes). Feasibility was assessed across 5 domains using a priori benchmarks: enrollment rate, session attendance, assessment completion, remote delivery, and acceptability. Preliminary efficacy outcomes—symptom burden (MDASI), depressive symptoms (CES-D), and spiritual well-being (FACIT-Sp)—were assessed at baseline (T1), post-intervention (T2), and 12-week follow-up (T3), and analyzed using generalized linear models adjusting minimization factors (age, cancer stage, NCCN DT score) and baseline outcome values.

Results: 50 patients were enrolled (enrollment rate=57%), exceeding the ≥50% benchmark; 49 were randomized to meditation (n=26) or AC (n=23). Assessment completion exceeded the ≥70% benchmark at T2 (77% meditation; 83% AC) and T3 (77% meditation; 74% AC). Session attendance was high (meditation: M=3.73, SD=0.63; AC: M=3.95, SD=0.22), surpassing the ≥70% benchmark. Participants rated Zoom as easy to use, reported minimal difficulty sharing in the group setting; 90% of meditation and 84% of AC participants rated the program as useful, exceeding the ≥80% acceptability target. At T3, the meditation arm showed marginally lower cancer-related symptom severity (SMD=-0.52, p=.077) and marginally higher spiritual peace (SMD=0.43, p=.097) compared to AC; effect sizes for all outcomes are shown in Table 1.

Conclusions: A remotely delivered, group-based meditation intervention for Black patients with advanced cancer demonstrated strong feasibility across enrollment, retention, attendance, and acceptability, with promising signals of reduced symptom severity and enhanced peace. A fully powered trial is warranted to establish efficacy. Clinical trial information: NCT05763797 . Standardized mean differences for preliminary efficacy outcomes by time point. Outcome T2 T3 MDASI severity -0.03 -0.52 MDASI interference 0.21 -0.29 CES-D 0.13 -0.34 FACIT-Sp meaning 0.25 0.36 FACIT-Sp peace 0.23 0.43 FACIT-Sp faith -0.01 0.11