A Test of Feasibility and Acceptability of Online Mindfulness-Based Stress Reduction for Lesbian, Gay, and Bisexual Women and Men at Risk for High Stress: Pilot Study

Abstract

Background In conservative and rural areas, where antidiscrimination laws do not exist, lesbian, gay, and bisexual (LGB) people are at risk for excess stress arising from discrimination. Stress-reducing interventions delivered via innovative channels to overcome access barriers are needed. Objective This study aimed to investigate the feasibility and acceptability of online mindfulness-based stress reduction (OMBSR) with LGB people in Appalachian Tennessee at high risk for stress. Methods In 2 pilot studies involving pre-post test designs, participants completed 8 weeks of OMBSR, weekly activity logs, semistructured interviews, and surveys of perceived and minority stress. Results Overall, 24 LGB people enrolled in the study and 17 completed OMBSR. In addition, 94% completed some form of mindfulness activities daily, including meditation. Participants enjoyed the program and found it easy to use. Perceived stress (Cohen, perceived stress scale-10) decreased by 23% in women (mean 22.73 vs mean 17.45; t10=3.12; P=.01) and by 40% in men (mean 19.83 vs mean 12.00; t5=3.90; P=.01) between baseline and postprogram. Women demonstrated a 12% reduction in overall minority stress (Balsam, Daily Experiences with Heterosexism Questionnaire) from baseline to 12-week follow-up (mean 1.87 vs mean 1.57; t10=4.12; P=.002). Subscale analyses indicated that women’s stress due to vigilance and vicarious trauma decreased by 21% and 20%, respectively. Conclusions OMBSR may be a useful tool to help LGB people reduce general and minority-specific stress in socially conservative regions lacking antidiscrimination policies.

LGBTQ individuals’ lived experiences of hypervigilance.

“…Facilitating emotion regulation using therapeutic interventions such as mindful awareness, cognitive restructuring, and assertiveness training has shown promise in helping sexual minority men cope more effectively with minority stress (Burton et al, 2019) and may also be helpful to sexual minority women and gender minorities. For example, a pilot study of an 8-week online mindfulness-based stress reduction was found to reduce vigilance in sexual minority women by 21% (Jabson Tree & Patterson, 2019).…”

“…Several studies (e.g., Gonzalez et al, 2018; Jabson Tree & Patterson, 2019; Kranz & Pierrard, 2018) have used the Daily Heterosexist Experiences Questionnaire (Balsam et al, 2013), which includes a vigilance subscale; however, five of the six items assess concealment and hiding behaviors rather than hypervigilance. The Gender Identity Reflection and Rumination Scale (Bauerband & Galupo, 2014) assesses an internal process in reaction to perceived threats in the environment that differs from pervasive and chronic alertness to potential danger or threat.…”

Critical issues in cognitive behavioural therapy (CBT) with gender and sexual minorities (GSMs)

“…Felner et al, 2020). Mindfulnessbased interventions were found to effectively reduce depression, avoidance, the impact of traumatic events, and minority-related stress (Tree and Patterson, 2019).…”

A Mindfulness-Based Intervention to Alleviate Stress From Discrimination Among Young Sexual and Gender Minorities of Color: Protocol for a Pilot Optimization Trial

“…Mindfulness meditation is a practice that focuses on an individual’s attention on the present moment, leading to reduced levels of stress [ 11 ]. Web-based mindfulness interventions among SGMs have been associated with lower levels of perceived stress compared with baseline readings in both men and women, as well as reduced sexual minority stress in SGM women [ 12 ]. Mindfulness interventions can also lead to increased individual resilience toward discriminatory experiences [ 13 , 14 ].…”

“…The participants will be randomized to at least one of the 3 intervention components of awareness, connection, and purpose for this optimization study, which comprises the 8 conditions. Each of these components is known to be effective in reducing stress and promoting well-being among populations that experience high rates of discrimination (eg, SGMs) [ 12 - 14 ]. These components will be administered via the Healthy Minds Program (HMP) app with the goal of examining which combination of components most effectively reduces stress from discrimination among racial or ethnic SGMs.…”