A Randomized Controlled Trial of a Culturally Adapted, Community-Based, Remotely Delivered Mindfulness Program for Latinx Patients With Breast Cancer is Acceptable and Feasible While Reducing Anxiety

Maria Juarez-Reyes; Erica Martinez; Lan Xiao; Lisa Goldman Rosas

doi:10.1177/27536130241274240

A Randomized Controlled Trial of a Culturally Adapted, Community-Based, Remotely Delivered Mindfulness Program for Latinx Patients With Breast Cancer is Acceptable and Feasible While Reducing Anxiety

Glob Adv Integr Med Health. 2024 Aug 16:13:27536130241274240. doi: 10.1177/27536130241274240. eCollection 2024 Jan-Dec.

Authors

Maria Juarez-Reyes¹, Erica Martinez², Lan Xiao³, Lisa Goldman Rosas³

Affiliations

¹ Division of Primary Care and Population Health, Department of Medicine, Stanford University, Portola Valley, CA, USA.
² Program in Medical Education for the Latino Community (PRIME-LC), School of Medicine, University of California, Irvine, CA, USA.
³ Department of Epidemiology and Population Health, Stanford University, Palo Alto, CA, USA.

Abstract

Background/objective: Few Spanish mindfulness interventions have been evaluated in Latinx patients with cancer. We culturally adapted a mindfulness intervention for Spanish speaking Latinx patients. The objective was to measure feasibility and acceptability as primary outcomes, with changes in anxiety, depression, and sleep as secondary outcomes.

Method: Spanish-speaking Latinx patients with breast cancer (n = 31) were randomized, between April 2021 and May 2022 to either intervention or wait-list control groups. The mindfulness intervention consisted of 6-weekly 1.5-hour sessions remotely delivered by a novice facilitator. Cultural adaptations included language, metaphor, goal, concept, trauma informed, and acknowledgement of spirituality. Feasibility was benchmarked as 75% of participants attending their first session, 75% of participants completing 4 of 6 sessions, and scoring ≥ 4 on a 5-point Likert feasability scale measuring ability to implement changes after 6-weeks. Acceptability was measured as scoring ≥ 4 on a 5-point Likert scale measuring usefulness and relevance of the mindfulness intervention for each session. An intention-to-treat, linear mixed model with repeated measures analysis examined changes in anxiety, depression, and sleep at week 6 and 18 (3 months post intervention).

Results: All three feasibility benchmarks were met with 75% of first session attendance, 96% of participants completing 4 of 6 sessions, and 94% scoring ≥ 4, on the feasibility scale (Mean (SD) = 4.3 (0.6)). Acceptability scores for both usefulness and relevance questions were ≥ 4 across all 6 sessions. Anxiety was significantly reduced at 3 months (-3.6 (CI -6.9, -0.2), P = .04), but is of unclear clinical significance given the small change. Depression scores declined, but not significantly, and there were no changes in sleep.

Conclusion: This culturally adapted, remotely delivered mindfulness intervention using a novice facilitator was acceptable and feasible and demonstrated associated reductions in anxiety amongst Spanish speaking Latinx patients with breast cancer.

Trial registration: ClinicalTrials.gov ID# NCT04834154.

Keywords: cancer; community health partnership, mindfulness; mental health; randomized trial; telemedicine.

Associated data

ClinicalTrials.gov/NCT04834154