Equitable Mindfulness: The Practice of Mindfulness for All

Abstract

Background:

The benefits of mindfulness are well-documented; however, these benefits may not be evenly distributed across communities. Equitable Mindfulness aims to make these benefits accessible to a wider and more inclusive audience. The aim of this study was to investigate the applicability of Equitable Mindfulness and systemic barriers that prevent mindfulness programs from being equitably accessed across communities.

Methods:

Twenty-one participants were recruited for qualitative in-depth interviews during a two-day mindfulness conference. The constant comparison method was used to iteratively identify and categorize themes that emerged within and across interviews.

Results:

Five dominant themes emerged from the data: inherent equitability, accessibility, inclusiveness, awareness and knowledge-sharing, and acknowledgement of multiple perspectives.

Conclusion:

Having an applicable and meaningful term to use when describing mindfulness as an inclusive and equitable practice can facilitate the exploration of a new area of research. There is a need for future initiatives aimed at making mindfulness trainings and programs more equitable and accessible to all, regardless of socioeconomic status, race/ethnicity, or abilities/disabilities.

1. Introduction

There are many definitions of mindfulness; the challenge of providing a concise definition that leaves the door open for the layers of nuance in the term is challenging. For this paper, the definition selected was the intentional practice of attending to the details of one’s present experience in a non-judgmental way. Mindfulness emerged from a range of culturally, philosophically, and linguistically diverse, nonwhite, nonwestern monastic, and educational contexts. Many ancient wisdom traditions and faith practices have informed our present-day understanding and practice of mindfulness. Only more recently within Western cultures, such as the United States, has the practice of mindfulness as a mental health therapy become increasing popular (Black, 2011; Crane et al., 2013). Mindfulness-Based Stress Reduction (MBSR) is among the most well-studied mindfulness-based interventions (MBIs) and is widely used within behavioral health research (Kabat-Zinn, 2003). MBIs aim to teach personal coping skills for addressing physical, psychosomatic, and psychological concerns using mindfulness practices (Crane et al., 2017; Kabat-Zinn, 1994). While MBIs have had a profound impact on the uptake of mindfulness as a coping skill to improve health and well-being and reduce stress, a recent systematic review of 69 United States-based MBIs found that 79% of participants identified as Caucasian (Waldron et al., 2018). This review raised the concern that some individuals, groups, and communities are excluded, possibly due to systems and structures not being explicitly and intentionally inclusive and expansive (Waldron et al., 2018). This lack of diversity can also be witnessed in community based MBIs. Galla and colleagues (2015) found significant reduction in perceived stress and significant improvements in self-compassion following a 6-week community-based mindfulness program, but their sample was over 80% Caucasian and the median annual income of $150,000, demonstrating a need for community-based mindfulness programs accessible to more vulnerable members of the community.

Some would argue that mindfulness has been appropriated from a diverse array of cultures and backgrounds, for instance South, Central and East Asian Buddhists from 600 BC onwards, and misrepresented as an exclusive practice for those with lives of luxury. Which may make the term equitable mindfulness feel like a paradox; the impetus to provide pathways to mindfulness for all, framed within our current social context where many individuals face systemic inequities in access to many resources and things widely considered to be basic human rights (such as clean air, water, health care, and education), not just mindfulness practices. The inequities stand in contrast to the ancient emergence of mindfulness practices, where practitioners were overwhelmingly materially poor by western standards. The return of the intention to provide pathways for teaching, learning, and practicing mindfulness for all who are inclined is in many ways a return to the roots of mindfulness rather than a new idea.

Two very important core tenets of mindfulness, reflecting the Buddhist philosophical system, are the concept of the universal Buddha nature shared by all humans and the teaching of profound empathy toward all sentient beings (Gyatso, 1995). These two principles motivate the current discussion of equitable mindfulness and the humble acknowledgement that had our systems not veered so dramatically from these core tenets, a discussion of equity pertaining to mindfulness would be wholly unnecessary. Equity is included in the foundational conceptual underpinnings of mindfulness, and yet we experience the current reality in which access to mindfulness as a resource is far from equitable.

Mindfulness is a universal human capacity, attainable regardless of religious or philosophical belief (Olendzki, 2005). To reduce barriers for all to explore and experience mindfulness, regardless of belief or non-belief system, counselors and researchers often operationalize mindfulness as a secular practice (Stratton, 2015). As noted above, removing mindfulness from its original context presents inherent difficulties, and yet delineation of how mindfulness might be related to health and well-being, scientific and clinical curiosity created a strong appetite for a better understanding of the mechanisms and applications of mindfulness.

In recent decades, there is a growing body of research supporting the association between stress and the development and/or exacerbation of disease (i.e., depression, cardiovascular disease, human immunodeficiency virus/acquired immunodeficiency syndrome; HIV/AIDS) in animal models and human observation studies (Cohen et al., 2007; Selye, 1955). In a recent systematic review, Slavich (2016) summarized several detrimental health effects related to stress exposure including: acceleration of biological aging and premature mortality, increasing risk for poor clinical outcomes for rheumatoid arthritis (Cutolo & Straub, 2006), depression (Kendler et al.,1999), cardiovascular disease (Kivimaki et al., 2006), chronic pain (Loeser & Melzack, 1999), ovarian cancer (Lutgeendorf et al., 2013), and breast cancer (Bower, et al., 2014). MBIs show efficacy in improving physical well-being, medical symptoms, sensory pain, physical impairment, functional quality of life, and improving mental health (such as quality of life, depression, anxiety, and coping style) (Grossman et al., 2004).

1.1. Mindfulness Programs within vulnerable populations

In addition to its effectiveness on a wide range of mental and physical conditions, mindfulness programs have the advantage of being relatively brief, low cost to individuals, and flexible in implementation (Grossman et al., 2004). For individuals and communities that have developed a negative stigma surrounding mental health treatment, mindfulness may be an acceptable complementary or alternative practice to traditional treatments (Burnett-Zeigler et al., 2016). For these reasons, mindfulness programs may be especially suitable for underrepresented populations, who may lack time, financial, or community health resources. An individual’s larger community can also affect their health; therefore, it may be appropriate and beneficial to deliver community-level interventions as well. Perceived neighborhood social disorder has been shown to be a risk factor for depression for low- and middle-income African Americans/Blacks (Hastings & Snowden, 2019), while social cohesion is associated with decreased parenting stress, resulting in lower rates of maternal anxiety and depression (McCloskey & Pei, 2019).

Several studies have demonstrated the benefits of mindfulness interventions over control conditions in reducing stress among participants from marginalized and vulnerable populations (Adams et al., 2014; Alhusen et al., 2017; Witkiewitz et al., 2013). A study examining the associations of mindfulness and emotional responses over the course of smoking cessation treatment among predominantly low-socioeconomic status (SES) African American/Black smokers found that mindfulness was linked to lower volatility of negative emotions when faced with major life stressors (Adams et al., 2014). Women referred by the criminal justice system to a residential addiction treatment program had significantly fewer drug use days at follow-up when assigned to a mindfulness-based relapse prevention group as compared to a traditional relapse prevention group (Witkiewitz et al., 2013). Mindfulness has also shown advantages for close contacts (i.e., family) of the practicing individual. Mothers receiving services in a therapeutic nursery serving homeless children under the age of three, who participated in a mindfulness program noted benefits of self-regulation, connectedness with their child, and positive changes in their child’s behavior (Alhusen et al., 2017). Benefits in the child’s behavior were seen when the child modeled behaviors from their mother’s that were developed through mindfulness practice (Ihusen et al., 2017). Barr and colleagues (2021) proposed a model that incorporated peer-leaders as facilitators of a mindfulness and yoga-based program for youth experiencing homelessness. They found promising results in the reduction in violent behaviors. Benefits of the program are its low cost of few trained professional mental health educators and its sense of cultural relevance and personability using peers as facilitators.

1.2. Lack of diversity among those who practice traditional mindfulness training

Challenges to implementing mindfulness-based programs have been identified in the literature, including issues related to acceptability of rigid manualized programs among ethnoracially diverse low-income communities (Amaro, 2014) and barriers such as costs of training teachers, structure, and delivery modality being designed for groups rather than individuals (Crane & Kuyken, 2013). While these implementation barriers may create difficulties for the initial adoption and implementation, MBSR was found to reduce societal costs by over $700 a year and payer costs by over $900 a year among a sample of adults with chronic pain, while also increasing health-related quality of life, when compared to usual care (Herman et al., 2017). These findings suggest a long-term financial and health benefit for individuals and communities who engage in mindfulness practices.

Despite the abundance of potential benefits of delivering mindfulness-based programs, there remains a lack of diversity observed in those, who participate in these programs. Those with education beyond high school and non-Hispanic whites were found to have significantly higher odds of engaging in a mindfulness practice (Olano et al., 2015). Many MBI participants have been Caucasian with small sample sizes (Chiesa et al., 2013). This reflects the traditional WEIRD (White/Western, Educated, Industrialized, Rich, and Democratic) subpopulation, who also form the bulk of participants in the experimental branches of psychology, cognitive science, economics, and allied fields (Henrich et al., 2010).

1.3. Perceived barriers to making mindfulness more equitable

African American/Black participants have reported feeling hesitant to recommend an MBI to their friends and family because of their friends and family members’ limited openness to new experiences, religious ideology that considers mindfulness practice taboo, and personal preferences for other forms of stress management (Woods-Giscombé & Gaylord, 2014); these concerns should be addressed when introducing an MBI within Black communities. García-Campayo and colleagues (2017) list recommendations for teaching mindfulness and compassion to Latin patients as part of their conceptual framework for a culturally syntonic approach to implementing mindfulness and compassion interventions in Latin societies. Further, they suggest reducing the duration of formal practice to counter a lack of commitment, to emphasize interpersonal mindfulness because family plays an important role in Latin culture, and to be aware of religious and cultural influences (García-Campayo et al., 2017). There is a strong need and interest for mindfulness programs that are specifically designed for populations otherwise left out of the mindfulness movement (Cannon, 2016). Programs such as The Mindfulness Allies Project (Blum, 2014) for low-income communities and Mindfulness-Based ColorInsight Practices, which teaches mindfulness while acknowledging race and oppression (Magee, 2016a) have identified barriers and created programs to reduce the disparity in access to mindfulness teachings. Blignault and colleagues (2021) credit the success of their mindfulness-based program to the bilingual mental health professionals and community members who provided advice on translation and cultural adaptation of the program for a migrant community.

In support of the mindfulness for all movement and adapting mindfulness-based program to be more equitable, Jon Kabat-Zinn said “By its very nature, it [mindfulness] requires ongoing cultivation and nurturance by us as individuals if we care about living our lives fully and freely, and ultimately, as supportive and nurturing communities and societies (Kabat-Zinn, 2021, p. 1557). To make mindfulness programs equitable, we must first identify what equitable mindfulness would look like and how it would function to benefit individuals and society.

1.3. Current Study

The term Equitable Mindfulness was coined out of the lack of inclusive language, access, and equity around the practices of mindfulness, particularly in white-and-educated-dominate spaces. “Equitable Mindfulness supports the intersections between mindfulness and social transformation, community activation, social justice, and equity. It is grounded in creating a more equitable world through sustained practice of compassion and mindfulness.” (Cash et al., 2021, p. 13). The foundations of Equitable Mindfulness are built upon the understanding that mindfulness has roots in all cultures and societies (Anālayo, 2020). The present study expands upon prior theoretical work that integrates social justice, inclusivity, and mindful awareness of community and others (Forbes, 2016; Magee, 2016b) to provide empirical data from individuals that practice mindfulness in the community. The aim of this study was to provide an intentional look at Equitable Mindfulness and systemic barriers to implementation.

2. Methods

2.1. Participants

Participants were recruited during a two-day mindfulness conference titled “Water and Stone: The Power of Mindfulness for Social Change.” The conference was a two-day summit, bringing together practitioners, community members, and health professionals to discuss the implications of mindfulness and the new term/concept “Equitable Mindfulness” in the community. All conference attendees (approximately 100 registrants) were invited to participate in 20–30-minute in-depth interview. Twenty-one participants volunteered for the qualitative in-depth interview. The participant sample ranged from 23 to 65 years old (M = 36.55, SD = 12.32), 81% female, and 91.5% had at least a 4-year college education. Regarding race and ethnic identity, participants identified as 57.1% Non-Hispanic White/European American, 19.0% other or multiracial, 9.5% Black or African American, 4.8% Latino, 4.8% Middle Eastern or Middle Eastern American, and 4.8% Asian or Asian American. More information regarding participant demographics can be found in Table 1. In addition to common demographic information, we also collected the participants past seven-day mindfulness practice activities to gain a sense for how frequently participants engaged in mindfulness. These results can also be found in Table 1.

Table 1:

Participants Descriptive Information (N=21)

Variable	Mean (SD) N (%)
Age	36.55 (12.32)
Gender
Male	1 (4.8%)
Female	17 (81.0)
Non-Binary	1 (4.8%)
Prefer not to answer	2 (9.5%)
Race/Ethnicity
White	12 (57.1)
Black	2 (9.5%)
Latino	1 (4.8%)
Asian	1 (4.8%)
Middle Eastern	1 (4.8%)
Other/Mixed	4 (19.0%)
Education
High School/GED	0 (0%)
Some College	2 (9.5%)
College Grad (4-year)	10 (47.6%)
Master’s Degree	5 (23.8%)
Doctorate	4 (19.0%)
Past 7 days Mindfulness Practices
Mind-body fitness (e.g., yoga, tai chi)	2.74 (2.58)
Breathing practice	5.42 (2.67)
Formal meditation	3.58 (2.53)
Other practice	3.56 (3.01)
Examples of Other Practices	Walking meditation, journaling, mindful eating, body scan, gratitude, compassion, and mindful communication

2.2. Procedures

The participants were recruited during the mindfulness conference through an announcement made after each session over two days. The participants were given an informed consent form with an attached demographic questionnaire. They were asked to read and to keep the consent form for themselves. Participation was completely voluntary; participants did not receive any incentive for their participation. The study was approved by the institutional review board (IRB) at the institution hosting the conference. Upon agreeing to participate, participants filled out the demographic questionnaire, which took approximately 5–10 minutes. They were then asked to participate in a one-on-one interview and were directed to a private area for the recorded interview with a trained research assistant. The recorded interview lasted 20–30 minutes depending on the level of detail provided by the participant. The recorded audio files were securely transferred to a third party for professional transcription. The third party completed human subjects responsible conduct of research training and was approved by the IRB. The audio files were transcribed verbatim, and grammar was not corrected.

2.3. In-depth Interview Focus Question

2.3.1. “What does equitable mindfulness mean to you?”

The main focus of the in-depth one-on-one interviews was to gather information related to the term “Equitable Mindfulness.” The first and primary question asked was “What does Equitable Mindfulness mean to you?” The interviewers were then able to further probe for additional explanation and examples from the participant depending on the participant’s initial answer. Some examples of possible probes were “Can you give me an example of ways in which mindfulness practice is and is not equitable?” “What areas of your life can equitable mindfulness be applicable?” and “Tell me more about what you mean by that.” The term “Equitable Mindfulness” was discussed and used multiple times throughout the conference. The goal of the focus question was to hear from the participants about what this term meant to them. Additional interview questions included those related to social change and participants’ satisfaction, favorite/lease favorite sessions, and recommendations for future conference topics.

2.4. Data Analysis Plan

The constant comparison method was used to iteratively identify and categorize themes that emerged within and across interviews (Charmaz, 2014). First, all transcripts were read, then beginning with the first interview, content of interviews was coded into major themes by two independent coders. Then, the two coders compared themes and reliability was calculated using Miles & Huberman (1994) formula, which divides the number of agreements by the number of agreements plus the number of disagreements. The average reliability across cases across raters was 0.80, which indicates good reliability. Finally, the disagreements in coding were discussed between the two independent raters and if they could not reconcile the code, a third rater reviewed the transcript and listened to the audio then met with the two raters to discuss the most accurate code. Themes were constantly refined and re-ordered during the process of thematic analysis (Braun and Clarke, 2006), which resulted in five codes from the 21 interviews.

3. Qualitative Findings

Below is the summary of the dominant themes that emerged from the interviews: (1) Mindfulness is inherently equitable. (2) Equitable Mindfulness is accessible. (3) Equitable Mindfulness is inclusive. (4) Equitable Mindfulness requires awareness and knowledge-sharing. (5) Equitable Mindfulness acknowledges multiple perspectives.

3.1. Mindfulness is inherently equitable

Many participants indicated that they felt the practice of mindfulness is inherently equitable and that the terms may be redundant when used together. This is an interesting perspective to consider because it would suggest that there could not be a form of mindfulness that is not equitable, and therefore adaptations to mindfulness practices are not necessary.

“It feels like mindfulness to me probably always has been [equitable] and now it’s even more better articulated is inherently equitable practice or a practice that you can’t really have mindfulness without social justice” (07–08-S)

“I’m absolutely committed the idea that in order to have either one of them [equity and mindfulness], you need the other one. There’s no one without the other. They are inseparable.” (10–18-M)

“To me mindfulness stands on its own two feet. It doesn’t require any qualifiers, or adjectives, or ads. It’s really the ability to be present in the moment of your life in a non-judgmental way. So, I’m not sure what equitable ads to that… I think humans inherently have that ability to do it.” (03–30-D)

“My initial gut response is that mindfulness is what it is, and it doesn’t need to be equitable or made to be equitable. It is equitable inherently because it is mindfulness.” (05–12-J)

“…we’re all human beings, and I think we all have an innate sense of wanting to just feel more connected and calm, and purposeful versus in states of chaos and conflict.” (12–16-T)

When coupled with other themes, we may conclude that mindfulness practices are already equitable, but the delivery and access are areas that may need improvement in equity. This theme is especially relevant and timely as many researchers and academia at-large have identified the importance of diversity, equity, and inclusion (DEI) initiatives in their institutions, understanding the inherent equity of mindfulness practice can be a prime foundation to the use of mindfulness in the academic setting.

3.2. Equitable mindfulness is accessible

The issue of accessibility was identified by multiple participants as a perceived barrier to making mindfulness more equitable. It was repeatedly stated that everyone should have access to mindfulness practices regardless of race/ethnicity, income, education, neighborhood, mental health, or resources.

“…making sure that mindfulness and being able to take that self-care and to do that self-reflection and to be self-aware is something that is a right for all and it’s something that is important for everybody to have access to and to be able to practice because it’s not just one group of people” (02–11-M)

“I think equitable mindfulness is mindfulness that is accessible to everyone. I understand people got to eat, we live in a capitalist system, but I honestly do not feel like people should charge for mindfulness trainings and stuff… I don’t think anyone should be barred entry to mindfulness because they can’t pay” (10–05-S)

“How do we make it accessible and not just this grand idea that is associated with money or spas or profound experiences even? … you [don’t] have to have the right clothes or the right chair, mat, or the right education, or the right training to do it. So, again, the word that it boils down to I think is access, but it encompasses some bigger ideas for me I think.” (01–17-L)

“…consistent access regardless of history regardless of diversity… it is a practice that you can – that you can foster.” (10–16-L)

“…equitable access and understanding and use of and meaning of mindfulness and what words might get at the same concept from different sociocultural groups… I practice an awareness of the barriers to accessibility and that – and I’m moving towards the practice of – of dismantling or eliminating at least maybe one or two of those barriers or starting to – to remove those barriers.” (12–06-M)

“Equitable mindfulness to me is to have access to mindfulness; have the space and the tools to practice mindfulness and be mindful.” (01–20-P)

“It’s not only about equity. It’s also about human rights and basic minimums and it’s not always a comparative thing. Equity raises the question of everybody having similar access to things, in this case I guess mindfulness. But I think it’s also just about basic wellness…” (10–18-M)

“…the people who don’t get opportunities to engage in mindfulness or have access to the resources or the ideas are the people who might benefit it from the most, people in poverty, people who have been through trauma, people who are marginalized or disadvantaged or in any way that a lot of times these concepts are sort of floating around amongst the more privileged and so the idea of bringing mindfulness out into communities might resonate with the idea of equitable mindfulness.” (07–08-S)

Accessibility is a pillar of the theoretical foundation for the development of the term Equitable Mindfulness. While other themes support the notion that everyone is capable of practicing mindfulness, this theme suggests that not everyone receives adequate access to these practices.

3.3. Equitable mindfulness is inclusive

Closely related to the theme of access, participants also discussed the theme of inclusivity. In this context, the notion of inclusivity goes beyond just providing access and further recommends making concerted and intentional efforts to ensure the access provided feels inclusive to everyone involved. Participants suggested inclusive acts such as personalized invitations, taking mindfulness practices into the communities and not expecting them to come to you, and meeting/greeting individuals with a supportive environment.

“…anybody who is more than willing to exclude other people I feel like aren’t practicing mindfulness…” (02–11-M)

“Mindfulness is not just an individual practice it’s – I think it’s a community base, a communal practice and – which means we want to bring people together and we create a certain supportive environment, so in that way, people can make their practice as a routine.” (08–23-Y)

“…equitable mindfulness, for me, is that it’s not exclusive to one group, one person, one race, one ethnicity, one – it’s about equanimity, and that everybody deserves the opportunity to experience mindfulness skills and to grow and learn from those.” (07–01-M)

“I see a lot of mindfulness yoga and those type of things in places like [city name] that are rich and white, and this is something that I would like to bring to my communities in [neighborhood name] and low-income communities and communities of color. So, I think that [equitable] mindfulness means getting out of the box that you’re in and bringing it out to communities.” (10–05-S)

“I’m relating it [equitable mindfulness] to like inclusivity – including everybody in mindfulness. It’s almost like it doesn’t matter what age you are, it has no religion, none of that makes any difference… Equitable mindfulness is the opportunity for anyone to practice. What it is not would be based solely on a certain demographic or something like that.” (12–16-T)

“I think one is just the loving, kindness kind of piece of recognizing the humanity and the suffering in everyone and offering it both to myself – offering kindness and compassion both to myself and then to everyone else, to the world as well. And I teach mindfulness and one of the things that I’m really – I feel very strongly about and I’m quite passionate about is as I teach is inviting everyone to bring their own experiences to it, their own beliefs, their own practices to it.” (01–17-L)

This theme is reflected in a famous quote by Verna Myers “Diversity is being invited to the party; inclusion is being asked to dance” (Myers, 2015, p.1). As mindfulness providers in the community, we must do more than provide access and assume everyone will feel included. Building from Myers’ analogy, we need to ask them to dance, which may mean allowing them to pick the music that fits the dance for their experience.

3.4. Equitable mindfulness requires awareness and knowledge-sharing

Some participants felt the foundation of Equitable Mindfulness was oriented towards increasing awareness and allowing everyone to share their knowledge. Participants felt that there may be sectors of the general population that are unaware of mindfulness as a practice, and that may be surprising or difficult to understand for individuals, who have been practicing mindfulness for their entire lives. In addition to increasing awareness about mindfulness, there is a need to increase awareness about the barriers to equity in general, such as individuals in positions of privilege acknowledging the privilege and increasing their awareness of the experiences of others through knowledge-sharing.

“Information is power at its basic level so to be able to provide any amount of knowledge about it is probably key and to be able to share that certainly.” (02–11-M)

“I think about that and then mindfulness is just also being aware, like being aware of your privileges so that you can understand why you might feel like you’re being pulled down even if that’s not really the case, and just understanding all of the experiences that people have and how we can create equity.” (04–09-L)

“…we can talk about mindfulness but it’s mindless to talk about mindfulness in a place where people don’t know what it is and expect that they should know or thinking that they are not mindful only because they’ve never been exposed to this.” (01–20-P)

“I think the world change so quickly and it’s – I think it’s better to learn, to keep learning, and to see if we can find new tools and to keep our practice now in order to be updated… I think it’s better to exchange among different people and to share their practice and learn from each other, and to say, “Well, okay, which approach works better? What I can do to make a difference?” (08–23-Y)

“Maybe practitioners need to be made more aware or build awareness. Not made to be more aware but build awareness around the availability of mindfulness in certain communities.” (05–12-J)

“The ability to understand equality or equity at its molecular level because there’s a superficial definition of what equity means to people in our society, and I think equitable mindfulness is more.” (ZZ-ZZ-Z)

This theme aligns nicely with the foundational attitude of mindfulness known as the beginner’s mind. The beginner’s mind is the experience of observing objects or situations as if it were the first time, the practice allows us to let go of filtering our experience through the lens of our beliefs, assumptions, expectations, and desires and use a lens of a beginner (Kabat-Zinn, 1990); each moment is then experienced as if it was the first time it was experienced, which in essence, and reality, is true.

3.5. Equitable mindfulness acknowledges multiple perspectives

Lastly, the theme of acknowledging multiple perspectives emerged as related to, but distinct from, the theme of knowledge-sharing. Acknowledging multiple perspectives is described as a way of respecting differences and appreciate differing views, practices, and believes. Many participants indicated that acknowledging perspectives includes listening to and accommodating others and learning from their experiences.

“…the practice of mindfulness is to be tolerable, to be resilient to people and to be open to opportunities and people’s points of views. And as well as yourself, and to know yourself and to know what your limits are and to understand what you have to bring to the table but also understand that other people have things to bring to the table as well.” (2–11-M)

“Not just one experience with mindfulness, there’s multiple experiences with mindfulness and we have to acknowledge, accommodate, and research those.” (10–18-S)

“…there’s so many different ways to do this, to practice mindfulness, to meditate, to bring it into our lives. And I think even just dispelling that idea that it is one thing and one way.” (01–17-L)

“I think it’s translating it into other cultures. And listening for the translation.” (12–06-M)

“I like to talk to – meet new friends. And maybe because we have different background, we may have different tools and – to handle our life. So, in those occasions, I really wanna meet new people and have real communication which means – involves active listening. I like to share my practice and I hope to learn from other people to see, okay, whether if there’s any better way for me to do it. I think I like to try different things. Because sometimes you are sort of use to a certain practice; it doesn’t mean that’s perfect. So, I think it’s helpful to learn from other people, and to maybe try different ways to keep us mindful in that way, I think we can have a better mindfulness practice.” (08–23-Y).

4. Discussion

The current study sheds light on the use of the term Equitable Mindfulness as a concept to represent the practice of mindfulness for all. Using in-depth interviews to collect qualitative text narratives, this study identified main themes that arose from the primary question “What does equitable mindfulness mean to you?” Five main themes (see figure 1) developed as key elements to understanding Equitable Mindfulness – Presenting the concept of mindfulness to everyone, while being active in our respective communities by removing personal and systematic barriers that work against inclusivity and transformative change. First, many participants felt that the practice of mindfulness is inherently equitable, the practice itself does not need to be altered to become equitable. The participants seemed to be expressing an incongruence between what mindfulness means to them (equitable) and the way they see it being implemented within and among their communities (inequitably). This theme raises the question: if some mindfulness programs are not equitable, are they truly teaching mindfulness? As mentioned, this theme is important in considering the ways in which mindfulness can be employed in spaces aiming to increase their diversity, equity, and inclusions (DEI). As researchers and practitioners begin to utilize the practices of mindfulness in conversations around equity, justice, and solidarity, this theme can be a prime foundation to the use of mindfulness as a tool for increasing DEI. While experienced meditators understand the room of mindfulness and can see mindfulness as inherently equitable, it is possible that not all communities perceive it as such, and because of this detachment, it is important that equity be a central focus within this work.

Figure 1:

Conceptual diagram of Euitable Mindfulness as illustrated through the five main themes developed through qualitative analyses.

Second, while mindfulness was identified as equitable, accessibility to mindfulness practices and programs emerged as a barrier. Historically marginalized or disenfranchised communities may see mindfulness as a practice of exclusivity – reserved for those with particular privilege such as class or spiritual ideologies. Further data collection is needed, ideally with a community-based participatory research methodology that allows these individuals and communities to speak for themselves about the barriers they may be facing. Third, even when mindfulness is accessible, Equitable Mindfulness goes beyond making participation available to making participants feel included and welcomed. Our data highlights the importance of inclusiveness, which involves a level of safety for all who participate in a shared space.

Fourth, awareness and knowledge-sharing among participants is required. Knowledge-sharing is defined as the “act of making knowledge available to others within the organization” (Ipe, 2003, p. 341). Giving space to awareness and knowledge-sharing, participants are able offer their experience and expertise to their peers, in-turn supporting community and social cohesion. Gerpott and colleagues (2020) found that knowledge-sharing was facilitated by respectful leadership within the workplace. This finding combined with our results suggests that mindfulness-based program facilitators/leaders can promote knowledge-sharing through demonstrating the utmost respect for the participants and everyone involved in the program.

Fifth, to promote inclusion and discourage exclusion, Equitable Mindfulness must acknowledge multiple perspectives and appreciate the diversity of varied thought and experiences. As mentioned, researchers and practitioners have illuminated ways in which mindfulness can be perceived as exclusionary and inaccessible. The concept of Equitable Mindfulness, however, works to break down barriers of inclusion by creating spaces through the foundations of mindfulness for participants to authentically express themselves and feel a part of the community.

4.1. Limitation and Future Directions

The results of this study should be evaluated in the context of the strengths and limitations. To the authors’ knowledge this is the first study to collect data using the term “Equitable Mindfulness.” While there is no agreed upon power analysis for qualitative research sample size, the present study reached an adequate saturation point with the 21 in-depth interviews and did not feel limited by the sample size (Dworkin, 2012; Sandelowski, 1995). Future quantitative studies should consider the development and psychometric testing of an Equitable Mindfulness scale based on the five dominate themes identified in the present study. Future research might also consider investigating what the term Equitable Mindfulness means to different populations. While the present sample can be categorized as individuals interested in the topics of equity and diversity, most of the participants were White Non-Hispanic, had a college education, and frequently practiced mindfulness which is not representative of the larger population, and may not be generalizable. Identifying the meaning of the term Equitable Mindfulness to a more ethnoracially diverse population with varying educational status and mindfulness experience may provide valuable perspectives that could greatly enhance the collective understanding of the term. Finally, while impressions and personal perspectives are important, further study is warranted to determine if inequities exist within the practices or if community health presentation and delivery of mindfulness is inequitable. It is important to distinguish perceived barriers and actual barriers that exist to the practice and administration of mindfulness training to determine if mindfulness is universally applicable.

4.2. Implications

Knowing the conditions required for Equitable Mindfulness within the current climate of systemic inequities allows us to identify provisions needed to overcome these barriers. As stated in the introduction of this study, it is often those who stand to benefit the most from mindfulness who are the least likely to engage in a mindfulness program. Even just reframing “mindfulness” as “Equitable Mindfulness” may help to disassociate mindfulness from an exclusive connotation, decreasing its taboo, and making mindfulness more accessible (Woods-Giscombé & Gaylord, 2014).

4.3. Conclusions

The term Equitable Mindfulness can be defined as mindfulness for everyone enacted through removing personal and systematic barriers that work against inclusivity and transformative change. The present study interviewed 21 individuals and developed a definition of Equitable Mindfulness based on their experience and expertise. Having a term to use when describing mindfulness as an inclusive and equitable practice can lead to a new area of Western research devoted to exploring strategies to make mindfulness trainings more equitable and accessible to all, regardless of socioeconomic status, race/ethnicity, or abilities/disabilities. The benefits of mindfulness practice have been well-documented in the literature, Equitable Mindfulness aims to make these benefits accessible to everyone. There is still much work to be done and some may still feel skeptical of the benefits of making mindfulness more equitable and inclusive within a society that struggles to combat systemic racism and provide basic human rights. While this study may not change the larger political system in which we practice, our hope is that community-based programs can become more reflective and adopt practices to work towards an equitable solution. We can aim to make big changes, while starting with the smaller steps right in front of us. Equitable Mindfulness aims to create pathways to practicing mindfulness and to access the inherent inclusiveness and social justice deemed constitutional in the essence of the practice. The goal of Equitable Mindfulness is to support social transformation, community activation, social justice, and equity among individuals and across communities. Through an enhanced and sustained lens of inclusivity, the practices of mindfulness may serve and support the health and well-being of all.