A small mixed-method RCT of mindfulness instruction for urban youth

Objective We aimed to explore the specific effects of mindfulness-based stress reduction (MBSR) for urban youth by comparing it with an active control program, designed to control for time, positive peer-group experience, and positive adult instructor. Methods Patients between the ages of 13-21 years who received primary pediatric care at our urban outpatient clinic were eligible for study participation. Those who were interested were consented and randomly assigned to an eight-week program of MBSR or Healthy Topics (HT), a health education curriculum. To increase sensitivity to outcomes of interest, mixed methods were used to assess psychological symptoms, coping, and program experience. Analysis of variance and regression modeling were used; interviews were audio-taped, transcribed, and coded for key themes. Results A total of 43 (26 MBSR, 17 HT) youths attended one or more sessions, of whom 35 [20 MBSR (77%), 15 HT (88%)] attended the majority of the sessions and were considered completers. Program completers were African American, 80% female, with average age of 15.0 years. Statistical analysis of survey data did not identify significant post-program differences between groups. Qualitative data show comparable positive experiences in both programs, but specific differences related to MBSR participants use of mindfulness techniques to calm down and avoid conflicts, as well as descriptions of internal processes and self-regulation. Conclusions Compared with an active control program, MBSR did not result in statistically significant differences in self-reported survey outcomes of interest but was associated with qualitative outcomes of increased calm, conflict avoidance, self-awareness, and self-regulation for urban youths. Importantly, based on qualitative results, the HT program functioned as an effective active control for MBSR in this sample, facilitating a more rigorous methodological approach to MBSR research in this population. We believe the promising effects elucidated in the qualitative data have the potential for positive affective and behavioral outcomes.