Feasibility of conducting a pilot randomized trial of a mindfulness-based intervention among sheltered Young Adults Experiencing Homelessness

Diane Santa Maria^1*Paula Cuccaro²Erica Sibinga³Kimberly Bender⁴Ethel Jacko⁵Widumini Manesha Liyanage⁵Jennifer Diane Torres Jones⁵Stanley Cron⁵

• ¹Center for Nursing Research, Cizik School of Nursing, University of Texas Health Science Center at Houston, Houston, United States
• ²Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, United States
• ³Pediatrics, The Johns Hopkins University School of Medicine, Baltimore, United States
• ⁴University of Denver, Denver, United States
• ⁵Center for Nursing Research, The University of Texas Health Science Center at Houston, Houston, United States

Abstract Purpose Youth experiencing homelessness (YEH) are an underserved and difficult-to-reach population that experiences a disproportionate burden of trauma and stress compared to their housed peers. Prolonged trauma and stress can impact the development of negative emotions, reactive stress responses, and impulsive decision-making, which can lead to risk-taking behaviors. Growing research shows that Mindfulness-Based interventions (MBIs) can improve coping, impulsivity, emotion regulation, and executive function although no MBIs tailored for YEH have been tested. Methods We conducted a pilot attention-control randomized trial to test the feasibility and acceptability of an adapted MBI, .b4me (pronounced dot be for me), for youth living in a homeless shelter. .b4me is a five-session MBI adapted to address the unique considerations of YEH. We randomized youth to .b4me or the control condition, Healthy Topics. Each curriculum comprised five hour-long group lessons delivered by trained facilitators. Pre-and post-lesson assessments were collected, as well as baseline, immediate-, 3-and 6-month post-follow-ups. Benchmarks for feasibility and acceptability were set a priori, and survey measures to assess emotional and psychological well-being were tested for feasibility and appropriateness of using these measures in future trials among this population and in a shelter setting. Results The mean age of participants (N=90) was 21.5 years old, with the majority identifying as male (62.2%), non-Hispanic (71.1%), black (50.0%), and heterosexual (55.6%). All a priori feasibility 2 and acceptability benchmarks were surpassed and the reliability of most of the emotional and psychological well-being measures was confirmed. Conclusion This study demonstrates that an MBI tailored for YEH, .b4me, is acceptable, and it is feasible to conduct a pilot attention control randomized trial with YEH living in a shelter despite major environmental obstacles.