Family Health in Adult Education: A Missing Piece of the Health Literacy Puzzle.

Previous research and interventions define health literacy as an individual-level concept. Although it is necessary to design programs aimed at individual people, not all health decisions are made by patients themselves, and calls have been made to expand health literacy work beyond the individual. This brief report stems from a larger study in which personnel working for adult literacy coalitions identified family health as a priority topic for health-focused lessons, yet often felt ill-equipped to teach students in this area. This brief report examines adult educators' perspectives on the types of content needed for a family health module designed for the adult education curriculum. Personnel from adult literacy coalitions offered qualitative insights on their desires for health literacy content in the context of family care. Adult literacy coalition educators and staff can provide important insights regarding the health literacy needs of adults in vulnerable populations. Three key themes emerged: American Family Health, Nutritious Eating, and Identify and Act. Rather than using a personal approach, a program that frames health literacy as family health and offers a holistic view on caring for others may serve to provide important context for health decisions and communication for adults at literacy centers. [HLRP: Health Literacy Research and Practice. 2019;3(Suppl.):S75-S78.].

Mechanisms underlying mindfulness-based addiction treatment versus cognitive behavioral therapy and usual care for smoking cessation.

OBJECTIVE: To examine cognitive and affective mechanisms underlying mindfulness-based addiction treatment (MBAT) versus cognitive-behavioral therapy (CBT) and usual care (UC) for smoking cessation. METHOD: Participants in the parent study from which data were drawn (N = 412; 54.9% female; 48.2% African American, 41.5% non-Latino White, 5.4% Latino, 4.9% other; 57.6% annual income <$30,000) were randomized to MBAT (n = 154), CBT (n = 155), or UC (n = 103). From quit date through 26 weeks postquit, participants completed measures of emotions, craving, dependence, withdrawal, self-efficacy, and attentional bias. Biochemically confirmed 7-day smoking abstinence was assessed at 4 and 26 weeks postquit. Although the parent study did not find a significant treatment effect on abstinence, mixed-effects regression models were conducted to examine treatment effects on hypothesized mechanisms, and indirect effects of treatments on abstinence were tested. RESULTS: Participants receiving MBAT perceived greater volitional control over smoking and evidenced lower volatility of anger than participants in both other treatments. However, there were no other significant differences between MBAT and CBT. Compared with those receiving UC, MBAT participants reported lower anxiety, concentration difficulties, craving, and dependence, as well as higher self-efficacy for managing negative affect without smoking. Indirect effects of MBAT versus UC on abstinence occurred through each of these mechanisms. CONCLUSIONS: Whereas several differences emerged between MBAT and UC, MBAT and CBT had similar effects on several of the psychosocial mechanisms implicated in tobacco dependence. Results help to shed light on similarities and differences between mindfulness-based and other active smoking cessation treatments. (PsycINFO Database Record

Perceptions of Mindfulness in a Low-income, Primarily African American Treatment-Seeking Sample.

Individuals with low socioeconomic status (SES) and members of racial/ethnic minority groups often experience profound disparities in mental health and physical well-being. Mindfulness-based interventions show promise for improving mood and health behaviors in higher-SES and non-Latino White populations. However, research is needed to explore what types of adaptations, if any, are needed to best support underserved populations. This study used qualitative methods to gain information about a) perceptions of mindfulness, b) experiences with meditation, c) barriers to practicing mindfulness, and d) recommendations for tailoring mindfulness-based interventions in a low-income, primarily African American treatment-seeking sample. Eight focus groups were conducted with 32 adults (16 men and 16 women) currently receiving services at a community mental health center. Most participants (91%) were African American. Focus group data were transcribed and analyzed using NVivo 10. A team of coders reviewed the transcripts to identify salient themes. Relevant themes included beliefs that mindfulness practice might improve mental health (e.g., managing stress and anger more effectively) and physical health (e.g., improving sleep and chronic pain, promoting healthier behaviors). Participants also discussed ways in which mindfulness might be consistent with, and even enhance, their religious and spiritual practices. Results could be helpful in tailoring mindfulness-based treatments to optimize feasibility and effectiveness for low-SES adults receiving mental health services.