Centering Black Women's Voices: Community Perspectives on a Culturally Grounded Mind-Body Toolkit Among Black Women at Cardiometabolic Risk

Background and Purpose: Black women face a particularly elevated risk of cardiometabolic health conditions (e.g., stroke and hypertension). Moreover, growing evidence suggests that exposure to chronic and social stressors increases risk for these conditions. To navigate stressors, many Black women engage in culturally relevant coping; however, these efforts can worsen the impact of stress on health. Although mindfulness has been demonstrated as a culturally relevant tool for stress reduction, many Black women do not consistently engage in these practices due to role strain and time constraints. Therefore, the present study sought to address this gap by introducing a six-component Multi-dimensional Mind-Body Toolkit (MDMBT) to a 10-member Community Advisory Board (CAB) of Black women at cardiometabolic risk, and gathering their feedback on the acceptability, feasibility, and cultural relevance of the toolkit.

Methods: CAB members were recruited from events celebrating the completion of the HARMONY Study, a randomized controlled trial of a culturally-tailored mindfulness-based stress reduction intervention for Black women at cardiometabolic risk. During a half-day retreat, CAB members were introduced to a six-component mind-body toolkit consisting of mindfulness affirmation meditation, mindful stretching, progressive muscle relaxation, reiki (a complementary relaxation and healing practice), guided journaling, and a mindfulness-based stress reduction body scan. CAB members were provided lunch and offered a $50 e-gift card incentive for their engagement. Following the retreat, CAB members provided feedback through seven structured questions in the form of one-on-one interviews or small focus groups. Interviews were digitally recorded, transcribed by a third-party service, and reviewed for accuracy by a research assistant. An interdisciplinary team with expertise in Black women's health and community health analyzed the data in Dedoose using an integration of applied and reflexive thematic analysis to identify relevant themes while accounting for coder biases. The team used the following process: (1) coded each transcript individually; (2) met in-person weekly to discuss codes, address discrepancies, and identify similarities; (3) defined and refined these codes to develop a codebook; and (4) repeated this process until all transcripts were coded. The team completed member checking with CAB members via virtual and in-person meetings to ensure trustworthiness and rigor.

Results: Four key themes were identified that reflected the acceptability, feasibility, and cultural relevance of the toolkit: (1) MDMBT as Bridging Dimensions of Wellness [Mind, Body, and Spirit]; (2) MDMBT Fosters Reclamation of Mindfulness as a Facilitator of Cultural/Spiritual Practices; (3) Perceived Benefits Drive Integration of MDMBT into Daily Life; and (4) MDMBT Fosters Community Care and Connection. Three additional areas of feedback emerged: Suggestions for Streamlining Mind-Body Interventions, Aspects that Strengthen Engagement with the Mind-Body Toolkit, and Desire for Sustained Engagement in Mind-Body Activities.

Conclusions and Implications: Overall, findings demonstrate the acceptability, feasibility, and cultural relevance of the MDMBT for Black women at cardiometabolic risk. CAB member feedback will be used to adapt the MDMBT for future implementation and community dissemination to support the health, healing, and well-being of Black women facing cardiometabolic and other health challenges.