Examining the Feasibility and Acceptability of a Tailored Version of a Mindfulness-Based Intervention (MBI) Among Youth Experiencing Homelessness (YEH)

Study Overview
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Brief Summary
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A Mindfulness-Based Intervention (MBI), called .b, will be tailored to Youth Experiencing Homelessness (YEH) by using focus group discussions, key informant interviews, and iterative beta-testing with the Homeless Youth Working Group (HYWG). The purpose of this study is to assess the feasibility and acceptability of this tailored MBI in YEH (the tailored MBI called .b will be compared to an attention control condition). The results of this feasibility study will inform the design of a future randomized controlled trial that will aim to test the efficacy of the intervention for improving stress management, increasing emotional regulation, decreasing impulsivity in YEH.

Official Title
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Examining the Feasibility and Acceptability of a Tailored Version of a Mindfulness-Based Intervention (MBI) Among Youth Experiencing Homelessness (YEH) Aged 18-25 Years Old

Conditions
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Stress, Emotional

Intervention / Treatment
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* Behavioral: tailored MBI (.b)
* Behavioral: attention control condition


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria for Youth Participants: homeless youth receiving services at one of the recruitment sites in Houston, Texas area at the time of enrollment English speaking able to participate for the entire study period (i.e., not moving during the study) Inclusion Criteria for Service Providers: currently providing health or social services to YEH interested in participating in an interview or as a member of the Expert Advisory Panel Exclusion Criteria for Youth Participants: overtly exhibiting symptoms of severe, untreated mental illness criteria not staying at the shelter currently experiencing homelessness or unstable housing Exclusion Criteria for Service Providers: -not able to meet for the regularly scheduled meetings at least 75% of the time.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 25 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Other
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: tailored MBI (.b)<br> | Behavioral: tailored MBI (.b)<br>* The session will include brief didactic presentations, videos, and mindfulness practice followed by inquiry. We anticipate that sessions will take place twice a week. Sessions will be held on site at the Covenant House Texas (CHT) shelter in a quiet, designated learning space to ease access to sessions for the participants and to assure access to shelter staff (e.g., social workers and case managers) and services (e.g., food and shelter). CHT has onsite, weekday clinical and mental health care and established protocols for accessing needed resources 24/7. Selection criteria for the interventionist include maintaining a personal mindfulness practice for at least two years, trained in .b, and prior experience working with high-risk youth. The interventionist will receive additional training in Trauma-Informed Care as well as study procedures.<br>|
| Active Comparator: attention control condition<br> | Behavioral: attention control condition<br>* Participants will receive no training in MBI or meditation. Topics covered may include physical activity, nutrition, managing weight, understanding adolescence, personal care, avoiding tobacco, alcohol, and drugs though this will be finalized in YR-1 with the HYWG and advisory panel. The HT program will be led by a positive adult instructor with training in health education or a related field and experience working with YEH.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in Emotion Regulation as measured by Difficulties in Emotion Regulation Scale (DERS) | The DERS is a 36 item questionnaire and each item is scored from 1(almost never)-5 (almost always) ,higher score indicates greater problem with emotion regulation | Baseline, immediately after intervention (1day after baseline),3 months post intervention,6 months post intervention | 
| Change in Mindfulness as measured by Child and Adolescent Mindfulness Measure (CAMM) | The CAMM is a 10 item questionnaire and each item is scored from 0(never true)-4 (always true) ,higher score indicates higher levels of mindfulness | Baseline, immediately after intervention (1day after baseline),3 months post intervention,6 months post intervention | 
| Change in Mindfulness as measured by Cognitive and Affective Mindfulness Scale-Revised (CAMS-R) | The CAMS-R is a 12-item measure and each item is scored from 1( rarely/not at all)-4(almost always). Higher values reflect greater mindful qualities | Baseline, immediately after intervention (1day after baseline),3 months post intervention,6 months post intervention | 
| Change in Self-Compassion as measured by Self-Compassion Scale (SCS) | The SCS is a 26 item questionnaire and each item is scored from 1(almost never)-5 (almost always) ,higher score indicates ------- | Baseline, immediately after intervention (1day after baseline),3 months post intervention,6 months post intervention | 
| Change in Stress as measured by Perceived Stress Scale (PSS) | The PSS is a 10 item questionnaire and each item is scored from 0(never)-4(very often),higher score indicating a higher perceived stress. | Baseline, immediately after intervention (1day after baseline),3 months post intervention,6 months post intervention | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in Social Connectedness as measured Social Connectedness Scale | The scale is a 20 item questionnaire and each item is scored from 1(strongly disagree)-6(strongly agree),higher score indicating more connectedness to others. | Baseline, immediately after intervention (1day after baseline),3 months post intervention,6 months post intervention | 
| Change in Depression as measured by Short Mood and Feelings Questionnaire (SMFQ) | The scale is a 13 item questionnaire and each item is scored from 0(not true)-2(true),higher score indicating worse outcome | Baseline, immediately after intervention (1day after baseline),3 months post intervention,6 months post intervention | 
| Change in Anxiety as measured by Spielberger State-Trait Anxiety Inventory | This scale is a 40 item questionnaire,each question is scored from 1(very much so)-4 (not at all), a higher score indicates a worse outcome | Baseline, immediately after intervention (1day after baseline),3 months post intervention,6 months post intervention | 
| Change in Affect as measured by Positive and Negative Affect Scale (PANAS-SF) | PANAS-SF is a 20 item questionnaire, each item is scored from 1(very slightly or not at all)-5(extremely).Positive affect (items1, 3, 5, 9, 10, 12, 14, 16, 17, and 19) score ranges for 10-50 with higher scores indicating higher levels of positive effect.Negative affect ( items 2, 4, 6, 7, 8, 11, 13, 15, 18, and 20) score ranges form 10-50, with lower scores indicating lower levels of negative effect. | Baseline, immediately after intervention (1day after baseline),3 months post intervention,6 months post intervention | 
| Change in Vulnerability as measured by Psychological Vulnerability Scale | This is a 6 item questionnaire,each item is measured from 1(does not describe me at all)-5 describes me very well.A higher score indicates more vulnerability. | Baseline, immediately after intervention (1day after baseline),3 months post intervention,6 months post intervention | 
| Change in Distress as measured by Kessler Psychological Distress Scale (K10) | This is a 10-item questionnaire,each item is scored from 1(none of the time)-5(all of the time) for a total score ranging from 10-50 and a higher score indicating worse outcome | Baseline, immediately after intervention (1day after baseline),3 months post intervention,6 months post intervention | 
| Change in Risk Seeking as measured by Balloon Analogue Risk Task (BART) | The Balloon Analogue Risk Task (BART) is a computerized measure of risk taking behavior. Each click causes the balloon to incrementally inflate and money to be added to a counter up until some threshold, at which point the balloon is over inflated and explodes. The primary score used to measure BART performance is the adjusted average number of pumps on unexploded balloons, with higher scores indicative of greater risk-taking propensity | Baseline, immediately after intervention (1day after baseline),3 months post intervention,6 months post intervention |