Lyons Matthew J, Kaplan Deanna M, Cross Sarah H, Palitsky Roman
Department of Health Promotion and Physical Education, Wellstar College of Health and Human Services, Kennesaw State University.
Program in Spiritual Health, Woodruff Health Sciences Center, Emory University.
Am J Orthopsychiatry. 2025 Mar 24. doi: 10.1037/ort0000841.
Mindfulness-based interventions (MBIs) are increasingly used in clinical and community settings and show significant potential to address a broad range of physical and mental health outcomes. This potential has led to calls for ever greater implementation of MBIs internationally, particularly with vulnerable populations and in low-resource settings. However, the effectiveness of MBIs has not been unequivocally demonstrated across populations, contexts, and health outcomes, with some studies failing to show treatment effects or even showing iatrogenic effects. Simultaneously, health care and public health systems globally struggle to address population health needs within a medical paradigm that, in general, individualizes pathology while obscuring the structural causes of health disparities. It is therefore critical to note that most research and practice in the mindfulness space have focused on change processes exclusively at the individual level. In populations lacking access to basic needs such as physical safety, food, shelter, social support, health care, education, and financial stability, change processes at the individual level do not adequately address the conditions that impact human development and produce disease. In this article, we make a call to action urging MBI implementers in global health to (a) center community ownership; (b) attend to inequities in power both within communities and between researchers and communities; (c) engage cross-sector networks of community stakeholders to identify resources, resiliencies, and areas of most urgent need; (d) address community-defined needs and change processes at multiple social-ecological levels; and (e) incorporate complementary interventions that address both basic needs and the social drivers of human development and disease. Drawing on developments in implementation science, social science, and community practice, we provide guidance on directions and methods for future work to achieve these ends. Using this guidance, researchers and interventionists may catalyze the development of a community-owned, materially engaged, relational model of MBI, which has the potential to effect positive social change. (PsycInfo Database Record (c) 2025 APA, all rights reserved).
基于正念的干预措施（MBIs）在临床和社区环境中越来越多地被使用，并显示出在解决广泛的身心健康问题方面具有巨大潜力。这种潜力促使国际上呼吁更广泛地实施MBIs，特别是针对弱势群体和资源匮乏地区。然而，MBIs的有效性在不同人群、背景和健康结果中并未得到明确证明，一些研究未能显示出治疗效果，甚至显示出医源性效应。与此同时，全球的医疗保健和公共卫生系统在一种总体上使病理个体化却掩盖健康差距的结构原因的医学模式下，难以满足人群的健康需求。因此，必须指出的是，正念领域的大多数研究和实践都只专注于个体层面的改变过程。在缺乏诸如人身安全、食物、住所、社会支持、医疗保健、教育和金融稳定等基本需求的人群中，个体层面的改变过程无法充分解决影响人类发展和导致疾病的条件。在本文中，我们呼吁采取行动，敦促全球健康领域的MBI实施者：（a）以社区所有权为核心；（b）关注社区内部以及研究人员与社区之间的权力不平等；（c）与社区利益相关者的跨部门网络合作，以确定资源、复原力和最迫切需要的领域；（d）在多个社会生态层面解决社区确定的需求和改变过程；（e）纳入既能满足基本需求又能解决人类发展和疾病的社会驱动因素的补充干预措施。借鉴实施科学、社会科学和社区实践的发展成果，我们为实现这些目标的未来工作方向和方法提供指导。利用这一指导，研究人员和干预者可以推动发展一种由社区所有、实质性参与、基于关系的MBI模式，这种模式有可能带来积极的社会变革。（PsycInfo数据库记录（c）2025美国心理学会，保留所有权利）
