"Cooling of the mind": Assessing the relevance of mindfulness training among people living with HIV using alcohol and other substances in South Africa.

Journal: Social science & medicine (1982)

Volume: 266

Issue: 

Year of Publication: 2021

Affiliated Institutions:  University of Maryland, College Park, B Biology-Psychology Building, College Park, MD, , USA. Electronic address: jmagidso@umd.edu. University of Maryland, College Park, B Biology-Psychology Building, College Park, MD, , USA; Massachusetts General Hospital, Bowdoin Square, Boston, MA, , USA. Electronic address: esatinsk@umd.edu. Massachusetts General Hospital, Bowdoin Square, Boston, MA, , USA; Harvard Medical School, Shattuck Street, Boston, MA, , USA. Electronic address: cluberto@mgh.harvard.edu. South African Medical Research Council, Tygerberg, South Africa; University of Cape Town, Groote Schuur Hospital, Cape Town, South Africa. Electronic address: Bronwyn.myers@mrc.ac.za. Massachusetts General Hospital, Bowdoin Square, Boston, MA, , USA. Electronic address: cjfunes@mgh.harvard.edu. Massachusetts General Hospital, Bowdoin Square, Boston, MA, , USA; Harvard Medical School, Shattuck Street, Boston, MA, , USA; University of Colorado, Boulder, Muenzinger Psychology Building, Colorado Avenue, UCB , Boulder, CO, , USA. Electronic address: Rachel.Vanderkruik@colorado.edu. University of Cape Town, Groote Schuur Hospital, Cape Town, South Africa. Electronic address: lena.andersen@uct.ac.za.

Abstract summary 

"Thinking too much" is a cultural idiom of distress identified across sub-Saharan Africa, including among people living with HIV (PLWH), which is associated with depression, substance use, and HIV medication nonadherence. Despite the relevance of mindfulness training to address thinking too much, improve HIV-related outcomes, and reduce substance use, efforts to adapt mindfulness training for this context and underserved populations more broadly have been limited.We explored in this context: (a) the experience of thinking too much among PLWH struggling with adherence and substance use; (b) the appropriateness of mindfulness training to address thinking too much; and (c) potential barriers and facilitators to implementing mindfulness training.We conducted semi-structured interviews with patients (n = 19) and providers (n = 11) at two clinics in a peri-urban area of Cape Town. Guided by the ADAPT-ITT model, we included an experiential mindfulness practice and participants shared their observations and descriptions of the intervention in the local language (isiXhosa).Participants found mindfulness relevant, culturally salient, and appropriate for refocusing the mind. Findings provide unique language offered by participants to tailor mindfulness training in the future (e.g., "hearing your veins," "cooling of the mind"). Participants identified potential implementation barriers, including lack of privacy, and facilitators to guide future adaptations.More research is needed to adapt and increase access to mindfulness training in resource-limited settings globally, while also maintaining treatment integrity and fidelity.

Authors & Co-authors:  Magidson Jessica F JF Satinsky Emily N EN Luberto Christina M CM Myers Bronwyn B Funes Christopher J CJ Vanderkruik Rachel R Andersen Lena S LS

Study Outcome 

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Statistics
Citations :  Andersen L, Magidson JF, O’Cleirigh C, Remmert JE, Kagee A, Leaver M, et al., 2018. A pilot study of a nurse-delivered cognitive behavioral therapy intervention (Ziphamandla) for adherence and depression in HIV in South Africa. J. Health Psychol. 23, 776–787.
Authors :  7
Identifiers
Doi : 10.1016/j.socscimed.2020.113424
SSN : 1873-5347
Study Population
Male,Female
Mesh Terms
HIV Infections
Other Terms
Global mental health;HIV;HIV medication Adherence;Mindfulness;South Africa;Substance use;Thinking too much
Study Design
Cross Sectional Study
Study Approach
Country of Study
South Africa
Publication Country
England