JMIR Publications

ABSTRACT

Background:

In conservative rural areas, including Appalachian Tennessee, anti-discrimination laws do not exist, and lesbian, gay, and bisexual (LGB) people in this region are at risk for excess stress due to discrimination. Stress-reducing interventions delivered via innovative channels to overcome access barriers are needed.

Objective:

This study investigated the feasibility and acceptability of online mindfulness-based stress reduction (OMBSR) with LGB people in Appalachian Tennessee.

Methods:

We ran two consecutive pilot studies involving pre- post- test designs. Participants completed 8-weeks of OMBSR, weekly activity logs, semi-structured interviews, and quantitative surveys of perceived and minority stress.

Results:

24 LGB people enrolled in and 17 completed OMBSR. 94% completed some form of mindfulness activities daily, including meditation. Participants’ enjoyed the program and found it easy to use. Time to complete daily activities was cited as the most common barrier to participation. Participants suggested that the program should be adapted to include a social component; this suggestion varied by gender. Women requested a digital social component to increase social connectedness between LGB women and for asking OMBSR-related questions of peers and researchers. Men requested an in-person social component to support accountability for daily mindfulness activities and program continuation over time. Participants’ qualitatively reported decreased stress and anxiety. Quantitative results demonstrated that perceived stress decreased 23% (women: M = 22.73 vs. M = 17.45; t = 3.12, p = 0.01) and 40% (men: M = 19.83 vs. M = 12.00; t = 3.90, p = 0.01) between baseline and post-program. Women demonstrated a 12% reduction in overall minority stress from baseline to 12-week follow-up (M = 1.87 vs. M = 1.57; t = 4.12, p = .002). Subscale analyses indicated that, women’s stress due to vigilance decreased 21% between baseline and 12-week follow-up (M = 2.24 vs. M = 1.77; t = 4.20, p = 0.002). Women’s stress arising from vicarious trauma decreased 20% from baseline to post-program (M = 4.21 vs. M = 3.36; t = 2.69, p = .02) and 26% from baseline to 12-week follow-up (M = 4.21 vs. M = 3.12; t = 3.67, p = 0.004).

Conclusions:

OMBSR was feasible and acceptable to LGB people in Appalachian Tennessee. OMBSR may be a useful tool to help LGB people reduce general and minority-specific stress in socially conservative regions lacking anti-discrimination policy.