[WITHDRAWN] Preliminary Efficacy of Virtual Reality-Based Mindfulness-Positive Psychological Intervention for Older Korean Americans

Background: Hate crimes in the U.S. targeting adults of Asian descent have sharply increased during the COVID-19 pandemic. Older Korean immigrants/Americans are experiencing elevated levels of psychological distress, fear, and anxiety due to racism stemming from and exacerbated by the pandemic. However, older Korean Americans are likely to experience barriers to mental healthcare services largely due to demographic factors, English proficiency, and cultural factors. With this concern in mind, there remains a critical need to identify practical, well-accepted, culturally tailored, and sustainable individualized therapeutic strategies to alleviate adverse mental health profiles in older Korean immigrants/Americans with perceived discrimination during the pandemic. Thus, this study is to investigate the preliminary efficacy of a culturally-tailored virtual reality-based mindfulness-positive psychological intervention for older Korean Americans with discrimination-related stress during the pandemic.

Methods: We recruited the participants from Korean non-profit organizations and church sites in Illinois. Using the REDCap randomization module (stratified random sampling; sex, income, and insurance), we randomly assigned 32 participants into two groups, an intervention group and a waitlist control group. Each week, participants (N = 15) were introduced to a new skill and meditation exercise. This intervention consisted of four modules: 1) recognizing positive life events, 2) amplifying positive life events, 3) recognizing gratitude, and 4) understanding and practicing mindfulness-meditation. Participants completed the following quantitative questionnaires at baseline and/or post-intervention: sociodemographic status and preliminary efficacy – racism-related stress, negative mental health (e.g., depression, anxiety, and stress), and positive psychiatric domains (e.g., optimism, positive affect, life engagement, and mindful awareness). We tested the preliminary efficacy via frequency/descriptive, paired-sample t-test, and regression analyses.

Results: There were no significant differences between the intervention group (N = 15) and the waitlist control group (N = 16) when it comes to sociodemographic, discrimination experiences, and psychological well-being variables. The mean scores of negative mental health in the intervention group decreased perceived stress (Mean Difference [MD] = - 3.20), anxiety (MD = - 2.13), and depression (MD = - 1.93) at post-intervention assessment. In addition, the mean scores of positive psychological well-being increased positive affect (MD = 2.20), life engagement (MD = 4.93), and mindful attention awareness (MD = 13.33) at post-intervention assessment. Participants showed an increase in optimism at post-intervention assessment, but there was no statistical significance (MD = 3.27). However, there were no significant changes among those in the waitlist control group. Regression analysis indicated that older Korean immigrants/Americans in the intervention group showed a decrease in discrimination-related stress (primary outcome; B = -2.98, p < 0.01) and perceived stress (B = -4.39, p < 0.01) and an increase in positive affect (B = 2.89, p < 0.05), life engagement (B = 4.62, p < 0.01) and mindful attention awareness (B = 11.83, p < 0.01) when compared to those in the waitlist control group.

Discussion: Our study highlights the potential for utilizing technology to deliver effective psychological intervention for minority immigrants with adverse mental health. Further research needs to collect more participants to secure statistical power.