Table 1.

Studies Examining Mind Body Approaches to Treating Mental Health Symptoms Among Disadvantaged Populations

Author, year	Population	Diagnostic group	Intervention type	Sessions (n)	Control group?	Participants (n)	Outcome measures	Main findings (results)
Roth and Creaser, 1997	Participants from an inner-city community health center	No formal diagnosis required. Frequent diagnoses included chronic pain, depression, and anxiety.	MBSR	8-wk course	No	86	Medical Symptom Checklist, Symptom Checklist-90-Revised, Beck Anxiety Inventory, Coopersmith Self-Esteem Inventory, Rosenberg Self-Esteem Scale	Participants reported decreased use of medications for pain, sleep, and anxiety; greater peace of mind; and improvement in overall well-being.
Roth et al., 2001	Primarily Hispanic, low SES (39.% on welfare, 28.8% Medicaid, 20.5% no insurance)	A wide range of medical diagnoses were included.	MBSR	8 wk course	No	47	Medical chart review to assess healthcare utilization; number and diagnoses of health center visits.	The average number of participants' chronic care visits decreased by 1.7 in the year after MBSR intervention.
Roth et al., 2004	Inner-city, primarily Hispanic, chronic stress associated with low SES	A wide range of medical diagnoses were included. Most patients experienced chronic stress.	MBSR	8 weekly 2-h sessions	Yes	86	SF-36	The intervention group showed significant improvements in SF-36 scores. The MBSR program was feasible and acceptable, with 66% completing the program.
Samuelson et al., 2007	Drug abuse–related incarceration	No formal diagnosis required	MBSR	6–8 wk, 1–2 sessions per wk, 1–1.5 h long	No	1350	Cook and Medley Hostility Scale, Rosenberg Self-Esteem Scale, Profile of Mood States	MBSR participants showed significant improvements in hostility, self-esteem, and mood disturbance. Women showed more improvement than men.
Abercrombie et al., 2007	Low-income, multiethnic women	Abnormal Papanicolaou smear	Adapted MBSR	6 wk, 2-h weekly sessions	No	8	State-Trait Anxiety Inventory, 25-item Self Compassion Scale, 11-item written-item program evaluation	Women viewed the intervention favorably, although attrition rate was high. Anxiety scores significantly decreased between baseline and post-MBSR but not between baseline and 2-mo follow-up.
Hick and Furlotte, 2010	“Severely marginalized”: poverty stricken and with one or more physical/psychological conditions	History of a major depressive episode(s) and/or bipolar disorder	Radical mindfulness training	8 weekly sessions	No	11	Self-Compassion Scale, Satisfaction with Life Scale, qualitative feedback	Mindfulness training was feasible and acceptable in this population. Participants' self-compassion and satisfaction-with-life scores increased, but the sample size (8 completers) was too small to show significant results.
Dutton et al., 2013	Low-income, ethnic minority women, 67.3% African-American	PTSD, lifetime history of interpersonal violence	MBSR	Ten 1.5-h sessions	Yes	106	Focus groups and individual interviews to assess feasibility and acceptability	The intervention was feasible; 70% of women attended at least 5 of 8 sessions, and it was viewed favorably among participants. Women reported increased awareness, acceptance, and empowerment and decreased stress.
Smith et al., 2015	Inner-city patients from federally qualified health center, 87% African-American, 96.7% female	No formal diagnoses was required.	MBSR Short Form	4 session 120 min each	No	23	Philadelphia Mindfulness Scale, PSS, GAD-7, SF-36	20% reduction in stress on the PSS, significant reduction in GAD-7 scale, improved health-related quality of life
Bowen et al., 2006	Drug abuse–related incarceration	Substance use	Vipassana meditation	10-d intensive course	Yes	305	Daily Drug-Taking Questionnaire, Daily Drinking Questionnaire, Short Inventory of Problems, Drinking-Related Locus of Control Scale, White Bear Suppression Inventory, Brief Symptom Inventory, The Life Orientation Test	Compared with control, meditation patients showed decreases in alcohol-related problems, drug use, and psychiatric symptoms after release from jail, as well as increases in positive psychosocial outcomes.
Simpson et al., 2007	Drug abuse–related incarceration	PTSD, substance use	Vipassana meditation	10-d intensive course	Yes	302	Daily Drinking Questionnaire, Daily Drug-Taking Questionnaire, Short Inventory of Problems, Brief Symptom Inventory	Those who participated in the intervention reported less frequent drinking and illicit drug use 3 mo after intervention.
Moadel et al., 2007	Primarily African-American or Hispanic women with breast cancer	Breast cancer	Yoga	12-wk, 1.5-h weekly classes	Yes	164	Functional Assessment of Cancer Therapy, Functional Assessment of Chronic Illness Therapy-Fatigue and Spiritual, Distressed Mood Index	Control group patients reported significant decreases in well-being while patients in the intervention group reported stable scores over time.
Pullen et al., 2010	Patients with heart failure, 95% African-American	Advanced heart failure	Yoga	Sixteen 1-h sessions, biweekly	Yes	40	Treadmill stress test, blood pressure, Minnesota Living with Heart Failure Questionnaire, 12-lead ECG, girth measurements, serum biomarkers, waist circumference	Participants in the intervention group increased their exercise capacity as measured by a treadmill stress test and peak oxygen consumption. Participants also reported significant improvements in quality of life.
Kubo et al., 2011	Patients with heart failure, 62% African-American	Congestive heart failure	Yoga	Sixteen 1-h sessions, biweekly	No	14	Body weight, Depression-Arkansas Scale, Kansas City Cardiomyopathy Questionnaire	The intervention was feasible and acceptable, with 13 of 14 patients completing the program. Patients showed significant weight reduction, lessening of depressive severity, and trends toward increased quality of life.
Franzenblau et al., 2008	Women, 50% African-American	Female victims of interpersonal violence	Yogic breathing	4 d (45 min per day)	Yes	40	Beck Depression Inventory II	Women who were trained in yogic breathing techniques alongside giving testimonials about their experience with interpersonal violence experienced significant reduction in depressive symptoms.
Margolin et al., 2006	35% African-American, 19% Hispanic	Opiate Dependent (DSM-IV)	Buddhist-based spiritual self-schema therapy)	8 weekly session	Yes	72	Semi-structured interviews, Risk Assessment Battery, reaction time task, Multidimensional Measure of Religiousness/Spirituality, Likert scale measuring motivation for HIV prevention and daily expression of spirituality	Retention was high. Participants viewed the intervention favorably. The intervention group showed significant decreases in risk behaviors and drug use compared with the control group, increased motivation for HIV prevention, and increased meditation practice.
Beitel et al., 2007	54% African-American or Hispanic, 80% unemployed or disabled, 38% HIV-positive	Opiate dependent (DSM-IV); 77% also met criteria for cocaine abuse or dependence	Buddhist-based spiritual self-schema therapy	8- to 12-wk program course (12 wk for HIV-positive participants)	No	39	Post-treatment questionnaire used to assess health behavior change, semi-structured interviews designed to elicit responses regarding clients' experience in treatment	Intervention was very popular among participants and correlated to behavioral change (reduction of drug use) and improved personal functioning.
Jallo et al., 2008	African-American women	Pregnant	Relaxation guided imagery audio CDs	12 wk, daily CD use	No	30	Daily practice logs	Participants reported reduced anxiety and increased ability to handle stress as a result of the intervention.
Laperriere et al., 2005	67% African-American, 16% Hispanic, 80% unemployed	AIDS (CDC classification)	Cognitive-behavioral stress management	10 weekly 2-h sessions	Yes	451	Beck Depression Inventory	Cognitive-behavioral stress management was effective in lowering depression scores up to 1 year after study completion for both participants who received the in-person intervention and the low-intensity control group who received the same information via videotape.

MBSR, mindfulness-based stress reduction; SES, socioeconomic status; PTSD, post-traumatic stress disorder; PSS, Perceived Stress Scale; GAD-7, 7-item Generalized Anxiety Disorder; SF-36, 36-item short form; ECG, electrocardiography; DSM-IV, Diagnostic and Statistical Manual of Mental Disorders, fourth edition; CDC, Centers for Disease Control and Prevention.