Response to Stress and Trauma among Racially/Ethnically Diverse Women in Different Health Settings: A Three-Study Dissertation

• Main Author: Waldron, Elizabeth M
• Format: Dissertation
• Language: English
• Published: ProQuest Dissertations & Theses 01.01.2022
• Subjects: Clinical psychology; Womens studies
• ISBN: 9798845417503

Stress, trauma exposure, and posttraumatic stress disorder (PTSD) are associated with chronic health conditions. In the U.S., women of color face trauma at up to four times the national rate. They also contend with chronic stress from the intersectional hardships of racism, discrimination, sexism, and economic hardship that is the result of historical and current institutional racism. Health systems and clinics can intercede in the cycle of trauma, stress, and chronic illness by integrating stress- and trauma-focused interventions within accessible settings where women of color receive their care. The aim of this three-study dissertation is to explore the potential for stress- and trauma-based interventions for women of color in primary and community health settings at three stages of intervention development. The first stage is to identify the need. The study, “Posttraumatic Stress, Adverse Birth Outcomes, and Prenatal Care Among Black/African American Women,” analyzes the associations of self-report posttraumatic stress symptoms and electronic health records of prenatal care and birth outcomes of Black/African American pregnant women. This analysis reveals that women with more severe symptoms are less likely to engage in adequate prenatal care and more likely to give birth preterm. This study’s findings emphasize the importance of more comprehensive trauma-informed outreach and obstetric and mental health care for Black/African American women. This dissertation’s second study focuses on intervention development. “Stress, Coping, and the Acceptability of Mindfulness Skills Among Pregnant and Parenting Women Living with HIV: A Focus Group Study” explores the psychosocial treatment needs of pregnant and parenting women living with HIV and assesses their receptivity to mindfulness in pursuit of developing a mental health intervention. This study shows that pregnant and parenting women living with HIV are open to mindfulness skills for coping with stress and to a non-stigmatizing group intervention to decrease their isolation. The final study of this dissertation is “The Impact of Participation in a Mindfulness-based Intervention on Posttraumatic Stress Symptomatology among Black/African Women: A Pilot Study.” This final study examines the efficacy of an adapted mindfulness-based intervention delivered in a community health setting. Findings reveal significant reductions in posttraumatic stress symptoms, depressive symptoms, perceived stress, and increases in mindfulness from baseline to end of treatment among Black/African American women with trauma histories. While stress and trauma are linked to chronic health conditions and poor health outcomes, interventions that are accessible and non-stigmatizing, like community-based mindfulness interventions, have great potential for improving the mental and physical health of women of color.