Comparing Two Ways to Mitigate the Impact of the COVID-19 Pandemic on Mental Health among Adults from Underserved and Racial Minority Communities

Project Summary Worry is defined as a chain of thoughts and images, negatively affect-laden and relatively uncontrollable. It has been conceptualized as a coping strategy to reduce the experience of anxiety. Though worry is a normal part of life, when it is persistent, it may exceed one's ability to cope and become harmful stress. In a recent Kaiser Family Foundation poll, nearly half of adults in the United States reported that their mental health has been negatively impacted due to worry and stress over COVID-19. This stress manifests itself physiologically, leading to increased incidence of multiple health problems which are already a concern for many African Americans and others living in disadvantaged communities across the country. The introduction of COVID-19 has further exacerbated the profound inequities in health care for communities of color. Due to shelter-in-place orders and social distancing policies, patients and the healthcare system have encountered challenges as behavioral health interventions have traditionally been delivered in-person. With the emergence of COVID-19, there is an urgency to expand the use of technology to help people who need routine behavioral health care, while also keeping vulnerable populations in their homes to ensure safety while maintaining access to the care they need. The proposed research aims to use a randomized, controlled, comparative-effectiveness trial to: (1) compare the effectiveness of a teleconference mindfulness-based stress reduction (MBSR) versus an MBSR mobile app in reducing worry (primary outcome) and improving other mental health outcomes including anxiety, stress, depression, loneliness, isolation, sleep, mindfulness, and quality of life (secondary outcomes) among adults living in predominantly low-income, mental health-underserved and minority neighborhoods: and (2) examine if the effectiveness of these two MBSR interventions can sustain at three month follow-up. We will also examine the implementation potential of teleconferencing and the mobile app MBSR.