Piloting Mindfulness Training for Primary Care (MTPC) in Spanish: Analysis of quality improvement measures related to depression and self-compassion

Stephanie Cohen, MD

Cambridge Health Alliance – Faculty

Scientific Abstract

Background: The COVID-19 pandemic has exacerbated existing mental healthcare disparities between U.S. Spanish- and English-speaking populations and has led to an overwhelming need for care. Linguistically accessible group programs addressing mental health offer promise.

Methods: Spanish-speaking CHA primary care patients were enrolled in 3 pilot MTPC-Spanish group therapy cohorts. Each cohort included 8 weeks of 2-hour long videoconference sessions. Group 1 (NIH Stage 1A) focused on intervention refinement and qualitative data collection. Groups 2&3 (NIH Stage 1B) further piloted MTPC-Spanish by adding an orientation and pre- & post-group quantitative surveys collected by CMC’s Quality Improvement (QI) program, including the Patient Health Questionnaire (PHQ-2) and selected items from the Self-Compassion Scale (SCS). We conducted exploratory repeated measures analyses on the quantitative sample (first-time participants in groups 2&3 who completed the pre-survey) using linear mixed-effects models with a fixed time parameter for week 9 vs. baseline and participant-specific random intercepts. We expressed effect sizes as Cohen’s d and set significance at p<0.1.

Results: Twenty-two Spanish-speakers attended MTPC-Spanish during 3 pilot groups from 11/20 to 8/21. Participants were mostly middle-aged, female, Hispanic/Latinx, and Christian.  Four participants out of 10 in group 1 (40%) completed qualitative feedback after the group (n=4) and had largely positive comments. Nine first-time participants in groups 2&3 out of 12 (75%) completed the pre-survey. Thirteen participants (N=13) were eligible for QI analysis. Quantitative results (n=9) suggest that MTPC-Spanish may be associated with a medium effect size in improving depression (d=0.5,p=0.092) and self-compassion (d=0.5,p=0.006).

Conclusions: MTPC-Spanish may reduce depression and promote self-compassion. Limitations include small sample size and use of select SCS items rather than the fully validated battery. Further research should develop culturally-adapted digital resources in Spanish and test the feasibility, acceptability and preliminary efficacy of MTPC-Spanish through a randomized controlled clinical trial.

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research Areas


Stephanie C. Cohen, MD, Leah Howard, BA, Lydia Smith, BA, Esteban Da Cruz, BS, Stephanie Palacios, PsyD, MFT, Gabriella Conversano, BA, Rocio Hernandez Chavez, Hector Morillo Sarto, MA, Javier Garcia Campayo, MD, Zayda Vallejo, MLitt, Christina Luberto, PhD, Zev Schuman-Olivier, MD

Principal Investigator

Zev Schuman-Olivier, MD

Affiliated Website