Feasibility of Collecting Stress Biomarkers Among Youth Experiencing Homelessness
Condition: Stress, Physiological
Study type: Interventional

Summary: 
      The study will examine changes in acute stress (biological and psychological) via salivary
      cortisol and alpha amylase levels as well as survey measures of self-reported anxiety in
      response to either (a) a free online guided mindfulness meditation available at
      (https://www.uclahealth.org/marc/mindful-meditations); (b) a guided mindfulness meditation
      via virtual reality (https://guidedmeditationvr.com/) or (c) a virtual reality platform of
      historic photographs and written narratives (https://lookingglassvr.com/). Participants will
      also complete an interviewer administered survey to measure sociodemographic factors, mental
      and physical health status, substance use, and medication use and provide a hair sample to
      measure cortisol.
    

Detailed description: 
      Homeless youth experience many daily stressors, including hunger, poor sleep, harassment, and
      violence. Many also have been victims of child abuse and/or neglect, witnessed family and/or
      community violence, and/or lived in foster care prior to leaving the home setting - exposures
      labeled as adverse childhood experiences known to increase the risk for poor physical and
      mental health. Because homeless youth are often disconnected from families, friends and
      institutions (e.g. health care, schools, jobs), they are at greater risk for "toxic stress"
      resulting in impaired biological stress responses with high or low levels of the stress
      hormone, cortisol, and increased inflammation in the cells of the body. High levels of
      inflammation are associated with sickness behavior syndrome (e.g. fatigue), depression, and
      suicidal thoughts, which may lead youth to engage in risky behaviors (e.g. substance use, HIV
      risk behaviors) in an attempt to reduce symptoms. However, few studies have collected
      biological measures of stress among homeless youth despite prior research linking exposure to
      violence and trauma to impaired biological stress responses in the general population.
      Because homeless youth experience a greater number of adverse exposures and with higher
      levels of severity on a daily basis and across their lifetime than youth in the general
      population, our lack of understanding of the biological impact that these exposures have on
      homeless youths' physical and mental health in the short-term as well as across their life
      span limits understanding of which youth are most vulnerable to poor outcomes. This study's
      purpose is to test the feasibility of collecting acute and chronic stress response biomarkers
      in homeless youth for use with future planned research. The study will also assess changes in
      acute stress (biological and psychological) via salivary cortisol and alpha amylase levels as
      well as survey measures of self-reported anxiety in response to either (a) a free online
      guided mindfulness meditation available at
      (https://www.uclahealth.org/marc/mindful-meditations); (b) a guided mindfulness meditation
      via virtual reality (https://guidedmeditationvr.com/) or (c) a virtual reality platform of
      historic photographs and written narratives (https://lookingglassvr.com/). Participants will
      also complete an interviewer administered survey to measure sociodemographic factors, mental
      and physical health status, substance use, and medication use and provide a hair sample to
      measure cortisol.
    

Intervention name(s): Virtual Reality with Meditation; Audio Control; Virtual reality Control
Intervention type(s): Behavioral; Behavioral; Behavioral
Intervention description(s): The Guided Meditation Virtual Reality is a mindfulness meditation app provided on a virtual reality platform that includes a 10 minute audio meditation for relaxation along with a 3D visualization of natural settings (e.g. forest, beach, mountain).; The UCLA Mindful App is an audio only mindfulness meditation for relaxation called Breath, Sound, Body Meditation that is 12 minutes in length.; The Looking Glass Virtual Reality is a stereographic 3D photo viewer provided on a virtual reality platform featuring photos from around the world dating back to approximately a century ago that participants will view for 10 minutes.
Other intervention name(s): Guided Meditation Virtual Reality; UCLA Mindful App; Looking Glass Virtual Reality
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Supportive Care
Keywords: stress; cortisol; alpha-amylase; homelessness; biomarkers; virtual reality; meditation