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. 2018 Jun:81:96-103.
doi: 10.1016/j.addbeh.2018.02.010. Epub 2018 Feb 7.

Race/ethnicity and racial group composition moderate the effectiveness of mindfulness-based relapse prevention for substance use disorder

Brenna L Greenfield  1 , Corey Roos  2 , Kylee J Hagler  2 , Elena Stein  2 , Sarah Bowen  3 , Katie A Witkiewitz  2
Affiliations

Race/ethnicity and racial group composition moderate the effectiveness of mindfulness-based relapse prevention for substance use disorder

Brenna L Greenfield et al. Addict Behav. 2018 Jun.

Abstract

Introduction: Mindfulness-based relapse prevention has shown promise as a treatment for substance use disorder but its efficacy according to racial/ethnic minority status and group composition is unknown.

Method: This is a secondary analysis of existing data (Bowen et al., 2014) testing individual race/ethnicity and racial/ethnic group composition as moderators of mindfulness-based relapse prevention (MBRP). Participants (N = 191; 29% female; 47% racial/ethnic minority; mean age = 39) with substance use disorder were randomized to MBRP or relapse prevention (RP). Outcomes were heavy drinking days (HDD) and drug use days (DUD) 12 months after treatment completion. Negative binominal regression models were conducted.

Results: Analyses accounted for drug of choice. Individual race/ethnicity was a significant moderator of substance use outcomes. White participants had lower HDD in MBRP than RP (IRR = 0, 95% CI: 0,0), whereas for minority participants, there was no treatment difference in HDD. Conversely, minorities had lower DUD in MBRP than RP (IRR = 0.03, 95% CI: 0.01, 0.10), whereas for whites there was no treatment difference in DUD. Group racial/ethnic composition was a significant moderator. Participants in groups with more than half whites had lower HDD in MBRP than RP (IRR = 0.01, 95% CI: 0, 0.09), whereas for participants in groups with more than half minorities there was no treatment difference in HDD. Exploratory analyses suggested MBRP resulted in better outcomes than RP when individual race/ethnic status was reflected in the group race/ethnicity (i.e., whites in groups with more than half whites or minorities in groups with more than half minorities).

Conclusions: Among whites, MBRP appears to be more effective than RP in preventing heavy drinking relapse. However, among racial/ethnic minorities, MBRP appears to more effective than RP in preventing drug use relapse. This suggests that the interaction between individual race/ethnicity and group composition may influence primary outcomes.

Keywords: Mindfulness-based relapse prevention; Minority, group psychotherapy; Race; Substance use disorder; Treatment moderators.

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Conflict of interest statement

Conflict of Interest

Drs. Bowen and Witkiewitz conduct MBRP trainings for which they sometimes receive monetary incentives, although the findings presented in this article have not yet been presented as part of these trainings. No other disclosures were reported.

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