Journal of the Georgia Public Health Association

Volume 7 Number 2 Article 6

Fall 2019

Implementing Mindfulness Practices With Parents of Young

Children in a Low-Socioeconomic Status Neighborhood
Author Affiliations
Andrew T. Roach
Roach, Georgia State University
Josephine Mhende
Mhende, Georgia State University
Brian A. Barger
Barger, Georgia State University
Douglas A. Roberts
Roberts, Georgia State University

Corresponding Author
Andrew T. Roach (aroach@gsu.edu)

Follow this and additional works at: https://digitalcommons.georgiasouthern.edu/jgpha

Part of the Public Health Commons

Recommended Citation
Roach, Andrew T.; Mhende, Josephine; Barger, Brian A.; and Roberts, Douglas A. (2019) "Implementing
Mindfulness Practices With Parents of Young Children in a Low-Socioeconomic Status Neighborhood,"
Journal of the Georgia Public Health Association: Vol. 7 : No. 2 , Article 6.
DOI: 10.20429/jgpha.2019.070206
Available at: https://digitalcommons.georgiasouthern.edu/jgpha/vol7/iss2/6

This original research is brought to you for free and open access by the Journals at Digital Commons@Georgia
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 Roach et al.: Implementing Mindfulness Practices With Parents of Young Children in a Low-Socioeconomic Status Neighborhood

Original Research
Implementing Mindfulness Practices With Parents of Young Children in a Low-
Socioeconomic Status Neighborhood
Andrew T. Roach, PhD1, Josephine Mhende, MPH1, Brian A. Barger, PhD1, and Douglas A. Roberts, MEd1
1
Center for Leadership in Disability, School of Public Health, Georgia State University

Corresponding Author: Andrew T. Roach  75 Piedmont Avenue Suite 514, Atlanta, GA 30303  (404) 413-1339  aroach@gsu.edu

ABSTRACT
Background: The purpose of this study was to investigate whether instruction in mindfulness practices would results in improved
self-reported mindfulness and reduced depression, anxiety, and family stress in parents of young children living in a low
socioeconomic status (SES) neighborhood.

Methods: The study utilized a pretest-posttest group design to evaluate the effectiveness of the Mindfulness Ambassador
Council-Interactive curriculum with attendees in a parent support program. Participants (n=15) were recruited from families with
young children who received support from a community-based organization in one low-SES neighborhood in Atlanta. Mental
health assessments, measures of family stress and parenting competency, and a demographic questionnaire with non-identifying
questions were administered to all participants during the first and last session of the 8-week mindfulness program.

Results: Participants reported increased mindfulness and decreased levels of anxiety and depression. Parent reports of family
stressors were relatively stable across the two time points, while self-reported parenting competence decreased.

Discussion: Based on the parents’ reports of program acceptability and the impact on their well-being, mindfulness training
appears to be a promising strategy for addressing the stressors experienced by parents of young children.

Keywords: Parenting, young children, mindfulness, stress, depression, anxiety

https://doi.org/10.20429/jgpha.2019.070206

INTRODUCTION well-being. From its initial application in 1979, MBSR has

proven effective in reducing chronic pain (Kabat-Zinn,
Building on ideas from Buddhist philosophy and 1982), depression, anxiety (Hofmann et al., 2010), and
psychology, mindfulness is experiencing rapid acceptance in stress (Kabat-Zinn, 1982). Participation in MBSR programs
the West as a set of concepts and practices with potential has also been associated with increased self-awareness
application across a variety of domains. Jon Kabat-Zinn, (Shapiro, Austin, Bishop, & Cordova, 2005) and self-
one of the most prominent mindfulness teachers in the West, reported relaxation (Kabat-Zinn, 1982).
defines mindfulness as “the awareness that emerges through
paying attention on purpose, in the present moment, and Mindfulness interventions have been implemented to
nonjudgmentally to the unfolding of experiences moment to address a range of concerns in a variety of settings
moment (Kabat-Zinn, 2003, p. 145). The ability to remain (Didonna, 2009). Researchers and practitioners are
present in each moment is part of what makes us human; continuing to develop approaches to promote mindfulness in
however, the capacity to sustain attention can be short lived, various contexts and investigate its effects with diverse
and we often are aware only briefly before becoming groups of participants. Many populations appear to benefit
reabsorbed into our on-going internal dialogue or distracted from the increased self-awareness, resilience, and
by external stimuli. As a skill that can be learned and empowerment that often result from engaging in meditation
cultivated, mindful awareness provides a strategy for and related contemplative practices like yoga or tai chi (a
ultimately altering our responses to the existential Chinese martial art that includes breath awareness and
challenges of our lives. Through repeated practice, gentle movement). However, some population subgroups
proponents of mindfulness believe everyone has the ability may be less likely to engage in mindfulness. For example,
to be more mindful. analyses of data from the 2002, 2007, and 2012 National
Health Interview Survey Alternative Medicine Supplement
Over the past 40 years, core mindfulness concepts and (Olano et al., 2014) indicated significant lower odds of
practices have been transported to medical and clinical engagement for Black and Hispanic respondents (vs. White
settings by researchers like Kabat-Zinn, who developed the respondents), and for respondents with a high school
Mindfulness-Based Stress Reduction (MBSR) program as a education or less (vs. respondents who attended at least
way of using meditation and related practices (e.g., gentle some college). A second analysis of the same data set
yoga, attending to body sensations) to promote healing and indicated that white-collar workers were far more likely to

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 Journal of the Georgia Public Health Association, Vol. 7, No. 2 [2019], Art. 6
engage in mindfulness and related practices than other accepting interactions with their children (Webster-Stratton,
worker groups (Kachan et al., 2017). Additional research is 1990).
needed to demonstrate the transportability and acceptability
of mindfulness practices to diverse participant groups. According to the Centers for Disease Control and
Prevention (CDC), adverse childhood experiences (ACEs)
Anxiety-related disorders are among the most common of may influence individuals’ future violence exposure,
mental health disorders, affecting 40 million adults in the victimization, and perpetration, and should thus be regarded
United States each year (National Institute of Mental Health, as a public health issue. This is especially salient for
2018). Anxiety is highly treatable, yet only 36.9% of people children living in low-SES neighborhoods, who face
who suffer from it receive treatment (National Institute of multiple external environmental stressors and risk factors
Mental Health, 2018). Anxiety disorders have been shown (Bethell et al., 2016). Research indicates that children in the
to have an adverse impact on quality of life, sleep, and self- U.S. who experience emotional, mental, or behavioral
esteem (Judd, et al., 2000; Olantunji, Cisler, & Tolin, 2007; challenges are at greater risk for exposure to multiple ACEs.
Starcevic, 2009). Furthermore, anxiety can be comorbid The more ACEs a child is exposed to, the more likely they
with depression; approximately half of people diagnosed are to experience lifelong mental, physical, and emotional
with depression are also diagnosed with an anxiety disorder trauma and chronic stress well into adolescence and
(National Institute of Mental Health, 2018). Individuals with adulthood (Bethell et al., 2016).
depression can experience fatigue, irritability, and rapid
fluctuations in body weight (Anderson, Freedland, Clouse, Mindfulness is most commonly associated with meditation
& Lustman, 2001). techniques that increase an individual’s awareness of the
present moment, reduce mindless responding, and enhance
Moreover, parental depression is one of the most significant non-judgmental observation (Kabat-Zinn, 2003). Building
risk factors for child emotional wellbeing (Galbally & on this definition, Duncan, Coatsworth, and Greenberg
Lewis, 2017). Research suggests children of depressed (2009) defined mindful parenting as “the intentional
mothers are more likely to experience breastfeeding bringing of moment-to-moment awareness to the parent-
problems, eating and sleeping disturbances, and inadequate child relationship.” Mindfulness interventions appear to be
preventative health care (Wachs, Black, & Engle, 2009). a promising strategy for building parenting capacity and
Children’s stress hormone levels also have been improving parent-child interactions (Parent et al., 2010;
demonstrated to correlate with their mothers’ SES and self- Duncan et al., 2009). Recent research suggests that higher
reported depression (Lupien et al., 2000). Parents with levels of mindful parenting may be associated with lower
young children who live in low-SES neighborhoods often levels of externalizing and internalizing problems in
report a variety of stressors including lack of financial children (Parent et al., 2015). Further, when mindfulness
resources (Bradley et al., 2002), unsatisfactory occupational practices were introduced as part of a treatment regime for
status (Santiago et al., 2011), and strained family parents in recovery from methadone addiction, researchers
relationships (Chen et al., 2006). observed a reduced risk of child abuse and improved family
function (Dawe and Harnett, 2007). Similarly, parents of
Researchers have reported that stress accounts for a children with developmental delays reported increased
significant amount of the variance in outcomes between levels of parental mindfulness, parenting satisfaction, and
children from low-SES families and their peers (Shonkoff positive parent-child interactions as well as decreased
and Phillips, 2000). Poverty may negatively affect parental stress after participating in a mindfulness
children’s social-emotional wellbeing because of its intervention (Singh et al., 2007).
influence on parents’ behavior toward their children
(McLoyd, 1990). The chronic strain associated with Corthorn and Milicic (2015) analyzed the association
persistent economic difficulties, unstable employment, and between mindfulness and parenting behaviors in mothers
family disruption can lead to a weakened sense of control who had not received formal meditation training. Sixty-two
over one’s life, and increased feelings of anger, depression, mothers of preschool children (ages 2 to 5) were asked to
and anxiety (Amato and Zuo, 1992; Bradley and Corwyn, complete self-reported questionnaires measuring
2002). Stress and depression also can negatively affect mindfulness, mindful parenting, parental stress, depression,
parenting behaviors, thus inhibiting children’s cognitive and and anxiety. Corthon and Milicic reported a significant
emotional development. Studies also have found a negative positive correlation between mindfulness and mindful
correlation between levels of parental stress and family parenting behaviors, and significant negative correlations
functioning (Sidebothan, 2001). Increased parental stress is between mindful parenting and parental stress and
associated with dysfunctional parenting and child behavioral depression.
problems, and these difficulties often persist into
adolescence (Bonds et al., 2002; Lippold et al., 2015). In Duncan et al. (2009) found that incorporating mindfulness
depressed mothers, parent-child interactions are negatively into parenting practices allows caregivers to shift their
affected, which can result in lowered maternal parenting attention to the present moment and away from negative
efficacy (Goodman and Gotlib, 2002). Parents who are ruminations. With mindfulness training, parents may
stressed or depressed tend to demonstrate more refusing and become more aware of moment-to-moment parenting
controlling behaviors, while engaging in less warm and decisions and more intentional in their actions. This is an
especially important finding since positive parent-child

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 Roach et al.: Implementing Mindfulness Practices With Parents of Young Children in a Low-Socioeconomic Status Neighborhood
interactions are critical for child brain development. For 3. Will participation in the MAC Interactive program lead
example, Siegel and Payne Bryson (2015) reported that the to reductions in family stress and improvements in
way parents interact and respond during moments of stress parenting competence as reported by participants?
and conflict greatly influences their children’s cognitive and 4. Do participants view mindfulness training an acceptable
social-emotional development. This is especially true for and useful component for inclusion in parenting
toddlers and preschoolers, whose brains and behavioral education programs?
repertoires are developing rapidly. Parents who are taught
mindfulness practices may be better able to handle difficult This study utilized a pretest-posttest group design to address
interactions with their children as they arise, modeling these questions and determine the effectiveness and
emotional regulation and problem solving for their children. acceptability of an integrated mindfulness-parenting
education program.
One area in need of further exploration is the effectiveness
of mindful practices with parents in low-SES communities
who may be at risk for higher levels of stress and METHODS
depression. Increasing parental mindfulness has been
hypothesized to allow parents to be more present during Institutional review board approval
daily activities with their child, resulting better moment-to- The research reported in this manuscript was reviewed and
moment parenting decisions and improving the quality of approved by the Georgia State University Institutional
parent-child interactions. It is important to demonstrate Review Board (IRB).
these effects when implementing mindfulness with parents
and children who may most at-risk for negative outcomes. Participants and setting
Mindfulness practices also may support parents of young Like many other communities locate within urban cores, the
children in interrupting the impact of adverse childhood neighborhood where we conducted the study has
experiences (ACEs) and other environmental stressors experienced entrenched, multi-generational poverty,
prevalent in low-SES communities (Bethell et al., 2016). elevated levels of crime and substance abuse, and
inadequate access to services and supports. The CBO where
The purpose of the current study is to investigate whether the study was conducted is located in the middle of this
mindfulness practices are useful in addressing feelings of neighborhood, making it a central meeting point for the
depression, anxiety, and stress in parents of young children families residing here. Based upon 2000-2016 data, this
living in low-SES neighborhoods. Based on neighborhood low-SES neighborhood has an area of approximately 0.464
parents’ feedback and requests, the community-based square miles with a population of under 3,000 people (City-
organization (CBO) that was providing A Great Start for data, 2016). Eighty-four percent of neighborhood residents
Parents & Children, a parent support program, decided to are African American and 45.7% of the population living
pursue including mindfulness in its offerings to address under the federal poverty level ($25,100 for
parents’ stress, build their social-emotional competence, and families/households of four people) (City-data, 2016). Lack
facilitate their effective parenting. The CBO reached out to of education and employment are significant neighborhood
researchers at GSU for assistance in including mindfulness problems; 32% of residents have less than a high school
training in the parent-focused offerings. The first and second diploma and 24.3% are unemployed. The neighborhood is
authors worked with CBO staff and a group of community considered “a food desert” (i.e. an area where access to
stakeholders to make small modifications to an existing fresh fruits and vegetables is limited), while accelerated
mindfulness curriculum to improve its alignment with the gentrification in surrounding areas of the city is leading to
needs of low-SES parents with young children. increased costs of living for neighborhood residents. More
than half of neighborhood households are cost-burdened
Implementation of the 8-week Mindfulness Ambassador when it comes to housing, using over 30% of their income
Council Interactive (MAC Interactive) program was to cover housing costs. The neighborhood also has a high
intended to (a) increase self-reported mindfulness, (b) crime-index, and it ranks third in Atlanta for the number of
decrease stress, anxiety, and depression, and (c) improve individuals incarcerated or returning from incarceration
participants’ sense of parenting competency. Data was (Participant Consulting, 2017).
collected and analyzed to address the following research
questions: The participants of this study were 15 parents and caregivers
1. Will participation in the MAC Interactive program lead of young children (birth to 5 years old) who expressed
to increased levels of mindfulness as reported by interest in a parent support group that was facilitated by the
participants? CBO as part of its services to neighborhood residents.
2. Will participation in the MAC Interactive program lead Parents were invited to participate in a mindfulness
to improved mental health for participating parents? curriculum, which was presented on the same evening as the
a. Will participation in the MAC Interactive existing parent support program. The average age of the
program lead to reductions in self-reported participants was 32.0 years old (SD = 9.7). Thirteen of the
anxiety? 15 participants (87%) were female. All participants (100%)
b. Will participation in the MAC Interactive identified as Black/African American. The average number
program lead to reductions in self-reported of children for each parent was 2.5 children (SD = 1.2).
depression? Thirty-three percent of participants were high school

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 Journal of the Georgia Public Health Association, Vol. 7, No. 2 [2019], Art. 6
graduates, while 14% of participants reported they only had demographic information for the participants. All
“some high school” education. Only two participants (13%) participants were compensated $100.00 for their time and
were college graduates, while six (40%) reported they had participation in this research study.
completed “some college.” Table 1 provides additional

Table 1. Demographic Data of Program Participants

Age 21-30 Age 31-40 Age 41+ Total
years (%) years (%) years (%)
Number 8 (53%) 6 (40%) 1 (7%) 15
Sex
Males 1 (7%) 1 (7%) 0 2
Females 7 (47%) 5 (33%) 1 (7%) 13
Number of Children
0-2 8 (53%) 1 (7%) 1 (7%) 10
3-5 0 5 (33%) 0 5
Age of Youngest Child in Home
Birth-5 years 8 (53%) 4 (27%) 0 12
6-12 years 0 0 1 (7%) 1
13-17 years 0 2 (13%) 0 2
Highest Level of Education
Some High School 1 (7%) 0 1 (7%) 2
High School Graduate 2 (13%) 3 (20%) 0 5
Some College 5 (33%) 1 (7%) 0 6
College Graduate 0 2 (13%) 0 2

Assessments and Measures respondents to report feelings of anxiety for the past month.
The following measures were administered to participants This inventory consists of 21 items with item response
following the first and eighth intervention session. options from 0 to 3, and a total possible score of 63 points.
In previous research, the BAI has demonstrated sufficient
The Five Facets of Mindfulness Questionnaire, Short Form internal consistence (α = .73) and test-retest reliability (.75)
(FFMQ-SF; Bohlmeiher et al., 2011) was used to assess as well as a moderate correlation (.51) with other measures
participants’ tendency to be mindful in their everyday lives. of anxiety (Beck et al., 1988).
Like the original form of the same instrument (Baer et al.,
2006), the FFMQ-SF is comprised of five subscales that The Center for Epidemiologic Studies Depression Scale
correspond with distinct components of mindfulness: (a) (CES-D) is a 20-item assessment that asks respondents to
observing internal and external experiences, (b) describing report how often in the past weeks they have experienced
or labeling internal experiences with words, (c) acting with symptoms of depression. Responses are scored on a 4-point
awareness, which includes attending to one’s activities in scale ranging from 0 (rarely, none of the time) to 3 (most, or
the moment, (d) non-judging of inner experiences (i.e. all of the time). Total scores for this measure can range from
taking a non-evaluative stance to thoughts and feelings), and 0-60; higher scores indicate more depressive symptomology
(d) non-reactivity to inner experiences, including allowing (Radloff, 1977). The CES-D has demonstrated sufficient
thoughts to come and go without being carried away by internal consistency with both clinical (α = .85) and non-
them. The FFMQ-SF consists of 24 Likert scale items and clinical (α = .91.-.94) samples. The CES-D provides a cutoff
takes less than 5 minutes to complete. In initial validation of score (16 or greater) that indicates the possible presence of
the FFMQ-SF (Bohlmeiher et al., 2011), the scale clinical depression (Lewinsohn, Seeley, Roberts, & Allen,
demonstrated a similar factor structure to the original 39- 1997).
item form. Possible scores ranged from 24 to 120, with
possible item response options ranging from 1 (never or The Family Event Checklist (FEC; Oregon Social Learning
very rarely true) to 5 (very often or always true). In previous Center, 1985) is a 41-item instrument used for examining
research, all five subdomains demonstrated sufficient different components of familial stress. FEC items ask
internal consistency (α = .73 to .91) and higher scores on the respondents to report if an event occurred in their family
FFMQ-SF were associated with higher self-report positive during the previous week and, if it occurred, the severity of
mental health (r = .20 to .37) and lower reported anxiety and the impact of that event. Item response options range from 1
depression (r = -.02 to -25). (no, the event did not occur) to 4 (yes, the event did occur
and had a very negative effect on you). A single measure of
The Beck Anxiety Inventory (BAI; Beck, Epstien, Brown, family stress is computed by summing respondents’ scores
& Steer, 1988) is a commonly used scale that asks

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 Roach et al.: Implementing Mindfulness Practices With Parents of Young Children in a Low-Socioeconomic Status Neighborhood
across the items. Total scores for the FEC range from 41- exception of the first session) began with an opening
164. mindfulness practice (e.g., breath observation). This was
followed by a council check-in, which provided facilitators
The Parenting Sense of Competence Scale (PSOC; (Gibaud- with an opportunity to “take the temperature” of the group
Wallston & Wandersman, 1978) is a 17-item measure of (e.g., participants were asked to share how they were feeling
two dimensions of parenting competence: parenting or something they had experienced since the last weekly
satisfaction and parenting efficacy. PSOC items have session). After council check-in, the group reviewed the
response options ranging from 1 to 6 resulting in a total home assignment from the last session, and had the
possible score of 102. Previous research with the PSOC has opportunity to share any challenges and or self-observations
resulted in varying factor structures across different from the home practice. A central feature of each session
samples. In light of this we used, the PSOC total scale score was council dialogue. During each session, participants
which has demonstrate acceptable internal consistency (α = were presented with videos and short readings that provided
.75-.88) in previous research (Ohan, Lueng, & Johnston, a prompt for deeper discussion of the instructional theme for
2000). that session (See Figure 1 for a list of themes and content
for each MAC session). After the video or reading was
The Mindfulness Ambassador Council (MAC) Student presented to the group, the facilitators posed council
Survey is a program-specific measure developed to evaluate dialogue questions and encouraged members to share
the effectiveness of the MAC curriculum. The MAC Student personal responses and insights (although members were
Survey consists of 11 Likert scale items with response reminded it was okay to pass and not to contribute to the
options ranging from 1 to 4, and a total possible score of 44 discussion).
points.
After the council dialogue, a second mindfulness practice
Procedures was presented with time for reflection and discussion.
The MAC Interactive curriculum was comprised of a total
of eight weekly lessons. Each week’s lesson (with the
1. Meeting One: Discovering Mindfulness
Mindfulness Practice: TAKE 5
2. Meeting Two: Mindfulness Basics
Mindfulness Practice: TAKE 5
3. Meeting Three: Paying Attention
Mindfulness Practice: TUZA
4. Meeting Four: Discovering Inside
Mindfulness Practice: TUZA
5. Meeting Five: Practicing Gratitude
Mindfulness Practice: mindful eating
6. Meeting Six: Noticing Emotional Triggers
Mindfulness Practice: TUZA
7. Meeting Seven: Exploring Open-Mindedness
Mindfulness Practice: body scan
8. Meeting Eight: Being the Change
Mindfulness Practice: pledge for mindful living
Mindfulness practices introduced during the MAC Interactive sessions
Take 5 involves slowly drawing five connected breaths. Participants are
instructed to focus on the sensation of the breathing.
Tuza is a breath awareness practice that involves attending to the breath for 3
to 4 minutes in order to develop mental focus and acceptance of self and
others.
Mindful Eating involves brings attention to the moment-to-moment
experience of eating. The intent is to slow down, take time to savor the taste
of each bite, and experience gratitude for having food to eat.
Body Scan involves paying attention to body sensations by placing attention
on different body parts in sequence. This guided meditation practice helps
participants develop greater sensitivity to body sensation and a feeling of
overall well-being.
Figure 1. Themes and content of Mindfulness Ambassador Council Interactive lessons

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 Journal of the Georgia Public Health Association, Vol. 7, No. 2 [2019], Art. 6
Finally, the facilitators closed the council by offering RESULTS
participants the opportunity to make a closing comment and
to participate in a specific community-building activity Statistical analyses were conducted using the Statistical
(e.g., sharing an intention for the upcoming week, giving a Package for the Social Sciences (SPSS) version 23. To
compliment to a peer). address Research Question 1, we used descriptive statistics
and paired samples t-tests to compare the post-test data from
Before the end of each weekly session, the co-facilitator the 5FMQ-SF with (a) pre-test and (b) retrospective pre-test
reviewed the homework assignment and reminded the data collected with the same measures. To address
participants to try their best to complete the home activities limitations of statistical significance testing with small
as they were an essential part of each participant’s samples, we also calculated effect sizes using Cohen’s d for
experience. Each week’s home assignment included a the measures of participant mindfulness. For Research
mindfulness practice. Participants were asked to complete a Questions 2 and 3, we calculated descriptive statistics for
written log to keep track of their use of the week’s specific the BAI, CES-D, FEC, and the PSOC. We also conducted
mindfulness practice and to briefly journal about how they paired samples t-tests to compare the pre- and post-test
felt after implementing the assigned practice. During the performance on each of these measures. We also evaluated
course of the program, participants were introduced to four for the study’s impact on the outcome variables by
different mindfulness techniques—Take 5, Tuza, Mindful calculating effect sizes using Cohen’s d. Finally, to address
Eating, and Body Scan—which are described in Figure 1 Research Question 4, we compared pre- and post-
below. Each weekly session opened up with one of these intervention means for items from the MAC Student Survey
mindfulness practices and a second mindfulness practice using descriptive statistics and paired samples t-tests.
was presented near the end of each class. Changes in self-reported mindfulness
Examination of the data suggested there was an increase in
Pre- and post-test data for each of the measures were participants’ self-reported mindfulness (i.e. total FFMQ-SF
collected during the first- and eighth-weeks’ sessions. In score) at the end of the MAC program (see Table 2).
week 8, we also collected retrospective pre-test data by However, paired samples t-tests conducted on both (a) pre-
asking parents to think back to before their participation in test and post-test means and (b) retrospective pre-test and
the 8-week MAC Interactive program and rate their post-test means were not statistically significant for either
recollection of their level of mindfulness on the FFMQ-SF the FFMQ-SF full scale or any of the measure’s subscales.
items. This result is not surprising in light of the small sample
sizes used for these comparisons.

Table 2. Mean, Standard Deviation, and Effect Size for Measures of Participant Mindfulness
Pre-Test Mean (SD) Post-Test Mean (SD) Cohen’s d
5FMQ-SF Total
Pre/Post (n=10) 79.0 (7.9) 80.0 (14.0) .09
Retro/Post (n=9) 75.4 (8.2) 80.1 (14.5) .46
5FMQ-SF Non-Reactive
Pre/Post (n=10) 16.4 (2.6) 17.2 (5.9) .18
Retro/Post (n=9) 15.3 (3.8) 17.3 (6.2) .39
5FMQ-SF Observing
Pre/Post (n=10) 15.8 (2.9) 14.3 (3.9) --
Retro/Post (n=9) 13.9 (4.0) 14.6 (3.7) .18
5FMQ-SF Acting with Awareness
Pre/Post (n=10) 15.3 (3.7) 17.7 (3.1) .70
Retro/Post (n=9) 17.0 (5.0) 18.1 (3.1) .26
5FMQ-SF Describing
Pre/Post (n=10) 18.2 (3.0) 17.9 (4.6) --
Retro/Post (n=9) 15.7 (3.3) 18.0 (4.8) .56
5FMQ-SF Nonjudging
Pre/Post (n=10) 13.3 (3.0) 12.9 (3.8) --
Retro/Post (n=9) 13.5 (3.7) 12.9 (4.0) --
Note: No pre/post or retro/post comparisons (paired sample t tests) were statistically significant at p > .05.

In light of this limitation, we also calculated Cohen’s d in participants’ self-reported mindfulness demonstrated
effect sizes to assess the magnitude of the changes in small effects on the total FFMQ-SF (d = .09) and the Non-
mindfulness over the course of the MAC program. When Reactive subscale (d = .18) as well as a large effect size (d =
considering the traditional pre- and post-test data, changes .70) on the Acting with Awareness subscale. When the

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 Roach et al.: Implementing Mindfulness Practices With Parents of Young Children in a Low-Socioeconomic Status Neighborhood
Cohen’s d was calculated using the retrospective pre-test Among the study participants, there was a moderate to large
FFMQ-SF scores in place of the traditional pre-test data, decrease in self-reported anxiety (d = 0.77) and self-
participants demonstrated a moderate change (d = .46) in reported depression (d= 0.80).
overall self-reported mindfulness (i.e. the FFMQ-SF Total).
Using the retrospective pre-test, participants also reported Changes in parental competence and family stress
small to moderate changes on the Non-Reactive (d = .39), Participants also reported decreased parenting competency
Observing (d = .18), Acting with Awareness (d = .26), and as measured by the PSOC. Although the change in PSOC
Describing (d = .56) subscales. scores was in an unanticipated direction, it was not
statistically significant. There was also a slight (but not
Changes in self-reported anxiety and depression statistically significant) decrease in the FEC scores from
Comparison of pre- and post-test data (Table 3) resulted in time 1 to time 2. These also was a very small effect for
statistically significant decreases in scores on the measures familial stress (d =.07) as reported on the FEC, indicating
of parental anxiety and depression. In order to evaluate the the presences of stressors in participants’ family contexts
magnitude of the MAC Interactive program’s effect, we were relatively stable across the 8-week period.
calculated Cohen’s d for each of the variables of interest.

Table 3. Paired sample t test and effect size for measures of mental health, stress, and parenting
Pre-Test Post-Test t Sig. Cohen’s d
Mean (SD) Mean (SD) (2-Tailed)
. BAI (n=12) 15.8 (8.7) 8.5 (10.3) 2.9 .014 0.77
CES-D (n=12) 29.3 (8.4) 23.2 (6.9) 2.7 .020 0.80
FEC (n=12) 83.9 (23.0) 82.3 (24.2) .29 .776 0.07
PSOC (n=12) 49.3 (12.3) 42.3 (11.3) 2.1 .056 --
Note: Beck Anxiety Inventory (BAI); Center for Epidemiologic Studies Depression Scale (CES-D); Family Event Checklist (FEC); Parenting
Sense of Competency Scale (PSOC)

Acceptability and Utility of Mindfulness as a Component reactions when I am triggered” (pre/post ∆ = .7) and “I have
of Parent Education and Support Programs been taught effective ways to calm down and reduce stress”
The MAC Student Survey measured participant’s pre- and (pre/post ∆ = .6). Three out of the 11 items saw no change
post- program experiences with and understanding of in mean score from pre- to post-test, and three items saw a
mindfulness concepts and practices. Each item was scored decrease in mean score after program completion.
from 1 (Not at all true) to 4 (True all of the time). Table 4 Differences on the two items showing the biggest decreases
shows the mean scores and standard deviation for each (“I am mindful in my daily life” and “I consider other
survey item. There was an increase in mean score for five of peoples’ perspectives when they differ from my own”)
the 11 items following program participation, but no items might reflect participants’ improved understanding of
demonstrated statistical significant changes. The largest mindfulness and greater self-awareness following program
positive changes in mean scores were observed on two participation
items: “I have been taught effective ways to manage my

Table 4. Mean pre- and post-intervention responses MAC student survey

Pre-Test Post-Test
Item Mean (SD) Mean (SD)
1. I am mindful in my daily life. 3.3 (.9) 2.9 .(7)
2. I have been taught effective ways to focus my attention. 3.3 (.5) 3.2 (.8)
3. I am aware of my personal strengths and weaknesses. 3.6 (.5) 3.6 (.5)
4. I consider other peoples’ perspectives when they differ from my own. 3.2 (.7) 2.9 (.9)
5. I understand how to make responsible decisions. 3.4 (.5) 3.7 (.5)
6. I communicate effectively with others. 3.5 (.5) 3.5 (.9)
7. I am grateful in my daily life. 3.7 (.7) 3.8 (.4)
8. I have been taught effective ways to manage my reactions when I am 2.7 (.7) 3.4 (.7)
triggered.
9. I have been taught effective ways to set goals and take action to 3.5 (.5) 3.5 (.7)
support the future I want for myself.
10. I help others in my daily life. 3.4 (.7) 3.8 (.4)
11. I have been taught effective ways to calm down and reduce stress. 2.7 (.7) 3.3 (.8)

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 Journal of the Georgia Public Health Association, Vol. 7, No. 2 [2019], Art. 6
DISCUSSION influenced some of the results. For example, instead of data
for the total sample of 15, we had completed pre- and post-
This study provided initial data on the effectiveness of test measures for only 10 or fewer participants on some
implementing mindfulness practices with parents of young constructs. The readability of the measures were also a
children in a low SES neighborhood. As reported by concern, as well as the time it took to complete each
participants, partaking in the MAC Interactive program lead measure. At least two participants had substantial difficulty
to increased levels of mindfulness. While the impact on reading and comprehending the measures (even with
participant mindfulness was relatively small when assistance from the research team) and we were unable to
comparing traditional pre- and post-test data, we observed a include their data in the analyses. Some additional
much more robust effect when we included a retrospective limitations included the relatively small sample size and the
pre-test in lieu of the traditional pre-test data. Retrospective reliance on self-report data for evaluating the intervention’s
pre-tests are sometimes used to address response-shift bias impact. In particular, the small sample size reduced the
in pre-intervention self-report measures. In other words, statistical power of a study, making it difficult to
some researchers theorize that intervention participants may demonstrate statistical significance and limiting our
develop increased awareness and insight about personal confidence in the generalizing these findings to other
characteristics and behaviors during the course of an populations. Another study limitation is the use of
intervention. This increased self-awareness can result in convenience sampling; in other words, our CBO partner
participants rating themselves more critically at the recruited the participants for this study from community
conclusion of an intervention program despite members that expressed an interest in the program. It is
demonstrating intervention-related improvements (Hill & possible that the participants in the study were not
Betz, 2005). We believe the use of a retrospective pre-test in representative of other parents in this (or similar) low-SES
our study may have addressed some of the validity concerns neighborhoods.
with self-reported measures of mindfulness identified by
Grossman (2011). Anecdotal feedback from participants indicated they
enjoyed the mindfulness sessions and were interested in
Program participants also reported statistically significant future opportunities to deepen their mindfulness practices.
decreases in self-reported anxiety and depression. In future studies, it might be helpful included more explicit
Conversely, program participation did not lead to increase in qualitative data collection (e.g., interviews, focus groups) to
self-reported parenting efficacy and satisfaction. We provide further insight into some of our quantitative
speculate that the length and linguistic complexity of the findings. Overall, the MAC Interactive program appeared to
measure of this construct may have caused confusion or be an acceptable and effective way for parents to increase
response fatigue in parents, resulting in less valid responses. their mindfulness and improve their well-being.
Another possible explanation for the lack of effect on the
parenting measure could be that, after completing the CONCLUSIONS
mindfulness training, participants were more aware of their
parenting challenges, resulting in lowered feelings of The utility and effectiveness of mindfulness programming
efficacy and satisfaction. for parents in low-SES neighborhoods is a topic in need of
further research. The literature details the effectiveness of
Based on our findings, we believe mindfulness training may mindfulness practices in addressing health and mental health
be a useful strategy for inclusion in parenting education and concerns across a variety of contexts and populations.
support programs in low-SES contexts. Participants’ Results from this study indicated that participation in
responses on the MAC Student Survey suggested they found mindfulness training was associated with decreased parental
the mindfulness content and practices helpful in their daily anxiety and depression, and a corresponding increase in
lives. In particular, the participants strongly endorsed the levels of parental mindfulness. This is a potentially
following items that align with the goals of the program: “I impactful finding because internalizing disorders in mothers
have been taught effective ways to manage my reactions are associated with diminished neurocognitive, social, and
when I am triggered” (3.3 out of 4) and “I have been taught health outcomes in their children (Gelaye, Rondon, Araya,
effective ways to calm down and reduce stress” (3.4 out of & Williams, 2016). By reducing their anxiety, stress, and
4). This suggests that participants found the mindfulness depression, parents may be able to interact with their
teachings beneficial in responding to difficulties and families in a healthier way. Research tells us that families
challenges in their everyday life. Specifically, the program living in low-SES communities may be particularly
included practices like mindful breathing that participants vulnerable to financial and economic stressors. Through
could use when they found themselves in difficult mindfulness training, participants in our study were given
situations, as well as information on how to identify tools to better cope with those stressors, which we hope will
emotional triggers and react to them mindfully. contribute to increased well-being, improved family
functioning, and positive child outcomes.
There were a number of context-specific barriers to
implementation and evaluation of the program. During the Acknowledgements
study, many participants had trouble attending each of the This research was conducted with the support of the Georgia
eight sessions due to difficulties with transportation and Department of Early Care and Learning (DECAL), Family
work schedules. This affected data collection and may have Engagement Opportunity Grant (#469-G16EDAFEO001). The
authors would like to thank Ellyn Cochran, Joseph Mole, Greg
https://digitalcommons.georgiasouthern.edu/jgpha/vol7/iss2/6
DOI: 10.20429/jgpha.2019.070206 56
 Roach et al.: Implementing Mindfulness Practices With Parents of Young Children in a Low-Socioeconomic Status Neighborhood
Cole, Ann Fowler, Charlotte Cameron, and Laura Wood for their Volume 1. Edition 1. Edited by Didonna, F. Springer, New
assistance with the research. York; 2009: 1-14.
Duncan, L. G., Coatsworth, J. D., Greenberg, M. T. A Model of
Statement of Student-Mentoring Relationship: The second Mindful Parenting: Implications for Parent–Child Relationships
author for this manuscript, Josephine Mhende, completed this and Prevention Research. Clinical Child & Family Psychology
study to meet the capstone project requirement of her Master of Review, 2009, 12(3): 255–270.
Public Health program. Dr. Andrew Roach, the senior and first Dunne, J. D. Mindfulness & Buddhist contemplative theory.
author, served as her mentor for the project. Integrating Mindfulness-Based Approaches & Interventions into
Medicine, Health Care, and Society, in press.
References Fisher, P. A., Fagot, B. I., Leve, C. S. Assessment of Family Stress
Anderson, R. J., Freedland, K. E., Clouse, R. E., Lustman, P. J. across Low-, Medium-, and High-Risk Samples Using the
The prevalence of comorbid depression in adults with diabetes: Family Events Checklist. Family Relations, 1998, 47(3): 215–
a meta-analysis. Diabetes care, 2001, 24(6): 1069-1078. 219.
Baer, R. A., Smith, G. T., Hopkins, J., Krietemeyer, J., Toney, L. Galbally, M., Lewis, A. J. Depression and parenting: the need for
Using self-report assessment methods to explore facets of improved intervention models. Current opinion in
mindfulness. Assessment, 2006, 13: 27-45. psychology, 2017, 15: 61-65.
Baer, R.A. Mindfulness training as a clinical intervention: A Gelaye, B., Rondon, M., Araya, A., Williams, M.A. Epidemiology
conceptual and empirical review. Clinical Psychology: Science of material depression, risk factors, and child outcomes in low-
and Practice, 2003, 10(2): 125–143. income and middle-income countries. Lancet Psychiatry, 2016,
Baron, L. J., Faubert, C. The role of Tai Chi Chuan in reducing 3(10): 973-982.
state anxiety and enhancing mood of children with special Goodman, S. H., Gotlib, I. Children of depressed parents:
needs. Journal of Bodywork & Movement Therapies, Mechanisms of risk and implications for treatment.
2005, 9(2):120-133. Transmission of risk to children of depressed parents:
Beck, A. T., Epstein, N., Brown, G., Steer, R. A. An inventory for Integration and conclusions. Washington, DC; 2002: 307-326.
measuring clinical anxiety: Psychometric properties. Journal of Grossman, P. Defining mindfulness by how poorly I think I pay
Consulting and Clinical Psychology, 1988, 56: 893-897. attention during everyday awareness and other intractable
Bethell, C., Gombojav, N., Solloway, M., Wissow, L. Adverse problems for psychology's (re)invention of mindfulness:
Childhood Experiences, Resilience and Mindfulness-Based comment on Brown et al. Psychol. Assess, 2011, 23: 1034–
Approaches: Common Denominator Issues for Children with 1040.
Emotional, Mental, or Behavioral Problems. Child and Hayes, S.C.W., Kelly, G. Mindfulness: Method and process.
Adolescent Psychiatric Clinics of North America, 2016, 25(2): Clinical Psychology: Science and Practice, 2003, 10(2): 161–
139–156. 165.
Bonds, D. D., Gondoli, D. M., Sturge-Apple, M. L., Salem, L. N. Hill, L. G., Betz, D. L. Revisiting the retrospective
Parenting stress as a mediator of the relation between parenting pretest. American Journal of Evaluation, 2005, 26(4): 501-517.
support and optimal parenting. Parenting Science and Practice, Hofmann, S. G., Sawyer, A. T., Witt, A. A., Oh, D. The effect of
2002, 2(4): 409–435. mindfulness-based therapy on anxiety and depression: A meta-
Bonura, K. B., Spadaro, N. M., Whittle Thornton, R. Mindful analytic review. Journal of Consulting and Clinical Psychology,
Fitness: Guidelines for Prenatal Practice. International Journal 2010, 78: 169–183.
Of Childbirth Education, 2016, 31(1): 14-17. Judd, L. L., Akiskal, H. S., Zeller, P. J., Paulus, M., Leon, A. C.,
Bradley, R. H., Corwyn, R. F. Socioeconomic Status and Child Maser, J. D., Endicott, J., Coryell, W., Kunovac, J.L., Mueller,
Development. Annual Review of Psychology, 2002, 53(1): 371– T.I., Rice, J. P. Psychosocial disability during the long-term
399. course of unipolar major depressive disorder. Archives of
Brooks-Gunn, J., Duncan, G.J. The effects of poverty on children. general psychiatry, 2000, 57(4): 375-380.
Future Child, 1997, 7(2):55–71. Kabat-Zinn, J. An outpatient program in behavioral medicine for
Cheatle, M. D. Depression, chronic pain, and suicide by overdose: chronic pain patients based on the practice of mindfulness
on the edge. Pain medicine, 2011, 12(s2). meditation: Theoretical considerations and preliminary results.
Chen, E., Hanson, M. D., Paterson, L. Q., Griffin, M. J., Walker, General Hospital Psychiatry, 1982, 4(1): 33–47.
H. A., Miller, G. E. Socioeconomic status and inflammatory Kabat-Zinn, J. Mindfulness-Based Stress Reduction (MBSR).
processes in childhood asthma: The role of psychological stress. Constructivism in the Human Sciences, 2003, 8(2): 73–83.
Journal of Allergy and Clinical Immunology, 2006, 117(5): Kachan, D., Olano, H., Tannenbaum, S., Annane, D., Mehta, A.,
1014–1020. Arheart, K., Fleming, L, Yang, X., McClure, L., Lee, D.
City-Data. 30315 Zip Code (Atlanta, Ga) Detailed Profile. Prevalence of mindfulness practices in the U.S. workforce:
Retrieved from http://www.city-data.com/zips/30315.html. 2018 National Health Interview Survey. Preventing Chronic Disease,
Coatsworth, J., Duncan, L., Greenberg, M., Nix, R. Changing 2017, 14: 1-12.
Parent’s Mindfulness, Child Management Skills and Kinser, P., Masho, S. Original article: “I Just Start Crying for No
Relationship Quality with Their Youth: Results from a Reason”: The Experience of Stress and Depression in Pregnant,
Randomized Pilot Intervention Trial. Journal of Child & Family Urban, African-American Adolescents and Their Perception of
Studies, 2010, 19(2): 203–217. Yoga as a Management Strategy. Women's Health Issues, 2015,
Corthorn, C., Milicic, N. Mindfulness and Parenting: A 25(2): 142-148.
Correlational Study of Non-meditating Mothers of Preschool Lippold, M. A., Duncan, L. G., Coatsworth, J. D., Nix, R. L.,
Children. Journal of Child and Family Studies, 2015, 25(5): Greenberg, M. T. Understanding How Mindful Parenting May
1672–1683. Be Linked to Mother–Adolescent Communication. Journal of
Dawe, S., Harnett, P. Reducing potential for child abuse among Youth and Adolescence, 2015, 44(9): 1663–1673.
methadone-maintained parents: Results from a randomized Lupien, S. J., King, S., Meaney, M. J., McEwen, B. S. Child’s
controlled trial. Journal of Substance Abuse Treatment, 2007, stress hormone levels correlate with mother’s socioeconomic
32: 381–390. status and depressive state. Biological Psychiatry, 2000, 48(10):
Didonna, F. Clinical Handbook of Mindfulness. Introduction: 976–980.
Where new and old paths to dealing with suffering meet.

Published by Digital Commons@Georgia Southern, 2019 57

 Journal of the Georgia Public Health Association, Vol. 7, No. 2 [2019], Art. 6
McLoyd, V. C. The Impact of Economic Hardship on Black Shapiro S.L., Astin J.A., Bishop S.R., Cordova M. Mindfulness-
Families and Children: Psychological Distress, Parenting, and based stress reduction for health care professionals: results from
Socioemotional Development. Child Development, 1990, 61(2): a randomized trial. International Journal of Stress Management.
311–346. 2005, 12 (2): 164-176.
U.S. Department of Health and Human Services, National Shonkoff JP, Phillips DA. From Neurons to Neighborhoods: The
Institutes of Health, National Institute of Mental Science of Early Childhood Development. Neighborhood and
Health. Anxiety-Disorders (NIH Publication No. QF 16-4677). Community. Volume 1. Edition 1. Edited by Shonkoff JP,
Bethesda, MD: U.S. Government Printing Office. 2018 Phillips DA. Washington, DC; 2000: 328-336.
Olano, H.A., Kachan, D., Tannenbaum, S.L., Mehta, A., Annane, Sidebothan, P. An ecological approach to child abuse: A creative
D., Lee, D. Engagement in mindfulness practices by U.S. use of scientific models in research and practice. Child Abuse
Adults: Sociodemographic barriers. Journal of Alternative and Review, 2001, 10: 97–112.
Complementary Medicine, 2014, 21: 100-102. Siegel, D., Payne Bryson, T. No-drama discipline: The whole-
Olatunji, B. O., Cisler, J. M., Tolin, D. F. Quality of life in the brain way to calm the chaos and nurture your child’s developing
anxiety disorders: a meta-analytic review. Clinical psychology mind. Your Brain on Discipline. Volume 1. Edition 1. Edited by
review, 2007, 27(5): 572-581. Siegel, D., Payne Bryson, T. New York, NY; 2015: 33-65.
Parent, J., McKee, L. G., Rough, J., Forehand, R. The Association Singh, N., Lancioni, G., Winton, A. S., Singh, J. Mindful parenting
of Parent Mindfulness with Parenting and Youth decreases aggression and increases social behavior in children
Psychopathology Across Three Developmental Stages. Journal with developmental disabilities. Behavior Modification, 2007,
of Abnormal Child Psychology, 2015, 44(1): 191–202. 31(6): 749–771.
Participant Consulting, LLC. The Emmaus House 2017-2019 Speca, M., Carlson, L.E., Goodey, E., Angen, M. A randomized,
Strategic Plan. Retrieved from wait-list controlled clinical trial: The effect of a mindfulness
https://www.emmaushouseatlanta.org/strategic-plan. 2017. meditation-based stress reduction program on mood and
Pinderhughes, E. E., Dodge, K. A., Bates, J. E., Pettit, G. S., Zelli, symptoms of stress in cancer outpatients. Psychosomatic
A. Discipline responses: Influences of parents’ socioeconomic Medicine, 2000, 62(5): 613–622.
status, ethnicity, beliefs about parenting, stress, and cognitive- Starcevic, V. Anxiety Disorders in Adults: A Clinical Guide.
emotional processes. Journal of Family Psychology, 2000, Anxiety Disorders: Introduction. Volume 1. Edition 2. Edited by
14(3): 380–400. Starcevic, V. New York, New York; 2010: 3-15.
Radloff, L.S. ‘The CES-D scale: A self-report depression scale for Wachs T.D., Black, M.M., Engle, P.L. Maternal depression: A
research in the general population’. Applied Psychological global threat to children's health, development, and behavior and
Measurement 1977, 1: 385-401. to human rights. Child Development Perspectives, 2009, 3: 51-
Santiago C.D., Wadsworth M.E., Stump J. Mindfulness-Based 59.
Stress Reduction for Health Care Professionals: Results From a Webster-Stratton, C. Stress: A potential disruptor of parent
Randomized Trial. Journal of Economic Psychology 2011, 32: perceptions and family interactions. Journal of Clinical Child
218-230. Psychology, 1990, 19: 302–312.

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