Addressing Diversity in Mindfulness Research on Health: A Narrative Review using the ADDRESSING Framework

Objective: Despite burgeoning popularity of mindfulness and mindfulness-based interventions (MBIs) in medicine, it remains unclear to what extent scientific evidence reflects diverse populations, including the medically underserved. The purpose of this review was to evaluate the current state of inclusion and diversity in mindfulness research focused on physical and mental health through Pamela Hays’ ADDRESSING Framework. Methods: Authors searched MEDLINE, PsycINFO, and Web of Science databases through September 2018. Articles were included if they were English, peer-reviewed articles detailing findings from a quantitative study on health-related outcomes. Review articles, letters to the editor, and qualitative studies were excluded. Results: The literature search produced 13,626 records and 201 full-text articles were reviewed of which 44 are highlighted in this paper. Using the ADDRESSING framework as a guide, mindfulness research increasingly includes historically underrepresented groups. Mindfulness-based interventions and trait mindfulness generate noteworthy improvements in mental health, for diverse populations facing chronic stressors and health disparities. These improvements in mental health are linked to beneficial changes in well-being and quality of life in many of the diverse populations studied. There is preliminary evidence that mindfulness training may improve some measures of physical health, like blood pressure, however, such findings are rare and need to be replicated. Conclusion: Even with mindfulness research increasingly drawing from diverse samples, and promising initial results, significant gaps for specific populations and health conditions remain, alongside challenges surrounding inclusivity, acceptability, feasibility and accessibility of MBIs for the often-underserved individuals in these groups. Addressing these challenges should be prioritized in formulating and implementing future studies, to ensure that mindfulness research on health is more inclusive of historically underrepresented groups, and thereby maximizes opportunities for health promotion and disease prevention. Keywords: mindfulness, race, gender, socioeconomic status, sexuality