Creating a Multidimensional Mind-Body Toolkit: New Intervention Aims to Reduce Health Risks Among Black Women
Black women face an elevated risk of health issues such as diabetes, heart disease and stroke. While there are multiple reasons for this disparity, one key contributor is often overlooked: stress. The disproportionate stressors Black women are exposed to over a lifetime — including racism, microaggressions and socioeconomic disadvantages — mean that this population experiences a greater stress-related health burden than most.
Recognizing the considerable impact of stress on Black women’s health and well-being, Millicent Robinson, assistant professor at the University of North Carolina at Chapel Hill School of Social Work and adjunct professor with the Department of Social Medicine, is researching a promising response: a mindfulness-based stress reduction approach tailored specifically to this population.
Robinson’s multidimensional mind-body toolkit (MDMBT) is currently undergoing pilot testing to determine if it is acceptable, feasible and culturally relevant for Black women at risk of cardiovascular or metabolic conditions.
Stress and the mind-body connection
In her previous research, Robinson examined “John Henryism” — a means of coping with stress by pushing past one’s limits — which is prevalent among Black women.
While this method of stress management may be effective in the short term, when employed over an extended period it can increase the risk of significant negative health outcomes. Understanding the detrimental results of these kinds of stress responses motivated Robinson’s current project, which aims to identify healthier coping mechanisms that fit the specific needs and preferences of Black women. Mindfulness and other mind-body practices are well-established as effective means of reducing stress.
“The mind-body connection describes how our mental and emotional states directly impact our physical health,” Robinson said. “This relationship works both ways: our thoughts, feelings and attitudes affect our physical well-being, just as our physical state influences our mental and emotional health. Mind-body practices are techniques that nurture this connection.”
This connection between the mind and body can be seen in the myriad ways stress impacts health and well-being. Long-term exposure to stress takes a physical toll that can manifest in issues such as a disrupted endocrine system, high blood pressure, and elevated heart rate, as well as mental health difficulties like depression and anxiety.
Interventions that make use of the mind-body link can alleviate these consequences by altering how people respond to stress physically as well as mentally.
“Mindfulness and mind-body practices are particularly effective for stress reduction because they address how our bodies respond to stress,” Robinson said. “They counter the stress response by activating the parasympathetic nervous system, which helps the body relax and restore.”
Previous research has demonstrated the effectiveness of various mindfulness-based practices for stress reduction. The HARMONY study, led by UNC School of Nursing Professor Cheryl Woods Giscombé and UNC School of Medicine Professor Susan Gaylord, is currently examining the effectiveness of existing techniques specifically among Black women. Robinson’s project builds on this research while offering an important new angle.
Multidimensional Mind-Body Toolkit
“Before testing whether a mind-body toolkit intervention is effective, I wanted to understand if it was something Black women would want to use regularly and find culturally meaningful,” Robinson said. “Time constraints are one of the top barriers to engaging in consistent mindfulness practices for Black women. I decided to create a toolkit of multiple practices to introduce them to mindfulness in a way that honored their time and hopefully would make it feel more feasible to engage in on a consistent basis.”
To offer users a variety of practice options without requiring a substantial time commitment, the MDMBT provides brief introductions to six key mind-body modalities: mindfulness affirmation meditation, mindful stretching, progressive muscle relaxation, reiki, guided journaling, and a mindfulness-based stress reduction body scan.
As part of a community advisory board (CAB) for the HARMONY Study, Robinson’s project recruited Black women with cardiometabolic health risks to engage with and provide feedback on the mind-body practices included in the MDMBT. Board members were introduced to the toolkit during a half-day retreat before providing feedback on it via individual and small-group interviews.
To gauge the cultural relevance and acceptability of the intervention, Robinson included questions such as, “Were there any mind-body activities that you found challenging because of your cultural or spiritual beliefs?” and “How likely are you to share these mindfulness tools with a friend or family member?”
Refining the intervention
Robinson is currently completing the qualitative analysis of CAB member responses assisted by graduate students whose backgrounds reflect the project’s broad scope and multidisciplinary nature. Her research assistants include Delyla Makki, a dual-degree master’s student in the schools of social work and public health, and Taleah Frazier, a doctoral student in the School of Nursing.
Robinson noted that the benefits of bringing together the insights and efforts of researchers from a range of disciplines are multifold.
"The health challenges experienced by Black women require solutions that address the various domains impacting their lives and well-being,” Robinson said. “As a scholar with an interdisciplinary background, collaborating with researchers and students across social work, public health, nursing, and medicine has been such a strength and joy, as these integrated perspectives help us work towards comprehensive, sustainable, and culturally relevant interventions that improve health and well-being for Black women across the life course. Providing students with opportunities to learn and be trained in this area is so important, as they will eventually lead these efforts."
Findings from the research team’s qualitative analysis will inform the next step of the project: refining the MDMBT to improve its cultural relevance for Black women. Before finalizing any changes, however, Robinson will share her findings with the CAB for their feedback and approval.
For Robinson, this is another essential part of the research process.
“As researcher, I recognize that it is not for me to decide what a community wants or needs,” she said, “I don’t want to disseminate this intervention widely without getting community feedback first.”
Soliciting and incorporating this feedback will help Robinson ensure the final product of her research efforts is aligned with the project’s central aim.
“The ultimate goal,” she said, “is for Black women to access the benefits of mindfulness practice, which can reduce stress and contribute to better health outcomes across the life course.”
by Lydia Rose Rappoport-Hankins
Advancing equity. Transforming systems. Improving lives.
UNC School of Social Work
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