Participation in a Community-Based Mindfulness Program to Improve Sleep and Reduce Stress in Latinx Immigrants: Using the Capability, Opportunity, Motivation and Behavior (COM-B) Model

Background:

After adjusting for socioeconomic factors, Latinx immigrants living in the US are 2.7 times more likely to be short sleepers (<5 hrs.) than non-Latino Whites. Sleep deprivation has been linked to poor health and mental health outcomes. Mindfulness programs improve sleep, although research and interventions on this issue among Latinx immigrants has been minimal. This study qualitatively assessed the benefits, barriers and facilitators to participation in an 8-week online culturally-tailored community-based mindfulness program.

Methods:

Four focus groups with former participants (N=22) and three semi structured interviews with staff (n-=2) and directives (n=1) were conducted from the community-based organization. The first two focus groups comprised women who participated in five sessions or less (n=11). The other two focus groups were comprised of women who participated in six sessions or more (n=11); an average of 65 people participated in each focus group. The groups were held online through Zoom. We used thematic analysis and deductive coding to map results into the Capability, Opportunity, Motivation and Behavior (COM-B) Model.

Results:

In terms of barriers, both groups mentioned similar reasons that difficulted their participation in the program, including (1) need to complete chores or other social and family activities such as lack of child care, (2) not having a data plan and having a low-quality phone, (3) need to work, and (4) not having a private or quiet space to practice. The only difference between groups 1 and 2 was that group 1 reported the time of the day for the course as a barrier to participation and preferred times. Several benefits were identified, such as physical, social, mental, and spiritual benefits for both groups, including better sleep, weight loss, stronger immune system, better management of chronic pain and migraines, improved digestion, greater relaxation, increased sense of connectedness to others, improved relationships, increased self-love, resilience, hope and self-esteem, reduced stress, fear, depression and anxiety, and knowing how to manage difficult emotions such as anger. The most significant facilitator reported was free access to classes via Zoom. In terms of motivators, both groups included intrinsic motivators such as feeling better, calmer and more centered, and extrinsic motivators such as sharing in a group setting and the support from other women going through the same.

Conclusions:

Due to linguistic and cultural challenges, and inequities in access to health and mental health care, traditional options to enhance sleep (e.g., medication and behavioral interventions) and reduce stress, sadness, or anxiety are not always suitable, relevant, or available to Latinx immigrants. Participation in community-based mindfulness programs offered at the organizational level requires little to no financial investment from participants, can be delivered in Spanish in a culturally relevant way, and can be delivered remotely. The results from this study indicate that a culturally-relevant mindfulness program holds promise for all content areas of social work, from improving sleep and reducing stress among other health benefits, to also engaging historically marginalized communities such as Latinx immigrants in community-based health promotion programs.