MHEAL at Brown University School of Public Health

Mindfulness for Health Equity Lab

We are dedicated to research, education, and advocacy to promote health among marginalized, minority populations through stress-reduction mechanisms such as mindfulness.

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Our Mission

This lab is dedicated to improving the health of historically marginalized communities, including sexual and gender minorities, racial minorities, and individuals from low-income backgrounds. Disproportionately, individuals of these communities experience more adversity and stress in life, including identity-based stress such as stigma, discrimination, and exclusion, resulting in poor health consequences.

Our work recognizes the resilience of marginalized individuals and communities. We aim to develop evidence-based mindfulness interventions to reduce stress that minority individuals face so often and improve mental and behavioral health.

Research Team

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Leadership

Staff & Students

Collaborators

Alumni

Shufang Sun, PhD

Lab Director
she/her

Nikole Giovannone, PhD

Project Manager
she/her

Chloe Chen

Research Assistant
she/her

Vedhalakshmi Rajasankar, MPH

Research Assistant
she/her

Ty Scott, MPH

Research Assistant
they/them

Kenneth Kang

Research Assistant
he/him

Nick McCarthy-Belash

Research Assistant
he/him

Na Nguyen

Research Assistant
she/her

Regan Gregory

MPH Student
she/her

J Banson

Research Assistant
they/them

Claire Pisani

Medical Student
she/they

Matthew Murphy

PhD Student
he/they

Runsen Chen, PhD

Co-Investigator
he/him

Danhua Lin, PhD

Co-Investigator
she/her

Don Operario, PhD

Co-Investigator
he/him

Simon Goldberg, PhD

Co-Investigator
he/him

Eric Loucks, PhD

Co-Investigator
he/him

Arryn Guy, PhD

Co-Investigator
she/they

Publications

2024

Sun, S., Simonsson, O., McGarvey, S., Torous, J., Goldberg, S. B. (2024). Mobile phone interventions to improve health outcomes among patients with chronic diseases: An umbrella review and evidence synthesis from 34 meta-analyses. (in press). The Lancet Digital Health.
Sun, S., Guy, A. A., Murphy, M. J., Zelaya, D. G., Fernandez, Y., & Operario, D. (2024). Minority stress, mental health, and mindfulness and self-compassion as moderators among young sexual minority men: A moderated structural equation analysis. Journal of Contextual Behavioral Science. https://doi.org/10.1016/j.jcbs.2024.100804
Guy, A. A., Murphy, M. J., Zelaya, D. G., Kahler, C. W., & Sun, S. (2024). Data integrity in an online world: Demonstration of multimodal bot screening tools and considerations for preserving data integrity in two online social and behavioral research studies with marginalized populations. (in press). Psychological Methods.
Yi, M., Li, X., Chiaramonte, D., Sun, S., Pan, S., Eisenstadt, B., Ljótsson, B., Hagaman, A., & Pachankis, J. E. (2024). Guided internet-based LGBTQ-affirmative cognitive behavioral therapy: A randomized controlled trial among sexual minority men in China. (in press). Behaviour Research and Therapy.
Wei, C., Israel, T., & Sun, S. (2024). Psychiatric symptoms, risk, and protective factors among bisexual people in Mainland China, Hong Kong, and Taiwan. (in press). LGBT Health.
Dejene, A., Carter, Z., Woo, E., Sun, S., Loucks, E., & Proulx, J. (2024). The evolution of MindfulnessBased Stress Reduction teacher training programs for people who serve historically underrepresented racial and ethnic groups. Global Advances in Integrative Medicine and Health. https://doi.org/10.1177/27536130241244744
Nardi, W. R., Kelly, P., Roy, A., Becker, S., Brewer, J., & Sun, S. (2024). A systematic review and metaanalysis of psychosocial interventions for persons with comorbid anxiety and substance use disorder. Journal of Substance Use and Addiction Treatment.
Frank, H. E., Albanese, A., Sun, S., Saadeh, F., Johnson, B. T., & Loucks, E. B. (2024). Mindfulnessbased Stress Reduction health insurance coverage: If, how, and when? An integrated knowledge translation (iKT) delphi key informant analysis. Mindfulness. https://doi.org/10.1007/s12671-024- 02366-x
Zhu, Z., Lu, X., Gao, P., Wang, X., Hu, X., Zhao, Y., Dai, Z., Zhang, H., Wang, J., Sun, Y., Liu, T., Sun, S., Cui, Y., Zaller, N., Zhang, Z., & Operario, D. (2024). Feasibility of WeTest-Plus for providing a continuum of HIV services for MSM at risk: Pilot study of a mobile health program in 3 cities in China. Current HIV Research. https://doi: 10.2174/011570162X280190240105063449

2023

Goldberg, S. B., Sun, S., Carlbring, P., & Torous, J. (2023). Selecting and describing control conditions in mobile health randomized controlled trials: A proposed typology. npj Digital Medicine. 6, 181. https://doi.org/10.1038/s41746-023-00923-7
Gathright, E. C., Salmoirago-Blotcher, E., Hughes, J. W., Sun, S., DeCosta, J., Balletto, B. L., Carey, M. P., Scott-Sheldon, L. A. (2024). Effects of stress management interventions on heart rate variability in adults with cardiovascular disease: A systematic review and meta-analysis. Journal of Behavioral Medicine. https://doi: 10.1007/s10865-024-00468-4
Johnson, B. T., Acabchuk, R. L., George, E. A., Nardi, W., Sun, S., Slmoirago-Blotcher, E., Scharf, J., , & Loucks, E. B. (2023). Mental and physical health impacts of mindfulness training for college undergraduates: A systematic review and meta-analysis of randomized controlled trials. Mindfulness, 14, 2077–2096 (2023). https://doi.org/10.1007/s12671-023-02212-6
Cai, C., Qu, D., Liu, D., Liu, B., Zhang, X., Chen, P., Chen, D., Sun, S., Tong, Y., An, J., Chen, R. (2023). Effectiveness of a localized and systematically developed gatekeeper training program in preventing suicide among Chinese adolescents. Asian Journal of Psychiatry. https://doi.org/10.1016/j.ajp.2023.103755
Sun, S., Pellowski, J., Pisani, C., Pandey, D., Go, M, Chu, M., Ruan, J., & Werner, E. F. (2023). Experience of stigma, psychological distress and facilitative coping among pregnant people with gestational diabetes mellitus. BMC Pregnancy and Childbirth, 23(1), 643. https://doi.org/10.1186/s12884-023-05949-z
Sun, S., Nardi, W., Murphy, M. J., Scott, T., Saadeh, F., Roy, A., & Brewer, J. (2023). Mindfulnessbased mobile health to address unhealthy eating among mid-age sexual minority women with early life adversity: A feasibility trial. Journal of Medical Internet Research. https://doi: 10.2196/46310
Crooks, N., Sun, S., Wise, A., DiClementi, R., & Sales, J. (2023). Does parental protective factors matter? Predicting HIV/STI risk among a sample of African American girls involved in the juvenile justice system. Children and Youth Services Review. https://doi.org/10.1016/j.childyouth.2023.106970
Yang, X., Sun, S., Zeng, C., Qiao, S., James, T., Brown, M., & Li, X. (2023). Associations between HIV disclosure and HIV care continuum outcomes among men who have sex with men living with HIV: Systematic review and meta-analysis. AIDS Care. https://doi.org/10.1080/09540121.2023.2188159
Sun, S., Xu, S., Guy, A., Guigayoma, J., Zhang, Y., Operario, D., Chen, R. (2023). Analysis of psychiatric symptoms and suicide risk among young adults in China by gender identity and sexual orientation. JAMA Network Open, 6(3): e232294. https://doi.org/jamanetworkopen.2023.229

2022

Goldberg, S. B., Torous, J., & Sun, S. (2022). Let’s decide what would be convincing, conduct randomized trials with rigorous comparison conditions, and report tests of moderation and publication bias in meta-analyses. PLOS Digital Health. https://doi.org/10.1371/journal.pdig.0000127
Sun, S., *Guy, A. A., *Zelaya, D. G., & Operario, D. (2022). Mindfulness for reducing minority stress and promoting health among sexual minority men: Uncovering intervention principles and techniques. Mindfulness. https://doi: 10.1007/s12671-022-01973-w
Operario, D., Sun, S., Bermudez, A. N., Masa, R., Shangani, S., van der Elst, E., & Sanders, E. (2022). Integrating HIV and mental health interventions to address a global syndemic among men who have sex with men. The Lancet HIV. https://doi.org/10.1016/S2352-3018(22)00076-5
*Xu, G., *Wang, Budge, S. L, & Sun, S. (2022). “We don’t have a template to follow”: Sexual identity development and its facilitative factors among sexual minority men in the context of China. (in press). Journal of Counseling Psychology. Senior author, PI of research
Sun, S., Sheridan, M. A., Tyrka, A., Donofry, S. D., Erickson, K., & Loucks, E. B. (2022). Addressing the biological embedding of early life adversities (ELA) among adults through mindfulness: Proposed mechanisms and review of converging evidence. Neuroscience and Biobehavioral Reviews. https://doi.org/10.1016/j.neubiorev.2022.104526
Sun, S., Sun, X., Wei, C., Shi, L., Operario, D., Yan, H., Zaller, N., & Yang, C. (2022). Prevalence of domestic violence among men who have sex with men in China during the COVID-19 lockdown. Journal of Interpersonal Violence. https://doi.org/10.1177/08862605211072149
Goldberg, S. B., Lam, S. U., Simonsson, O., Torous, J., & Sun, S. (2022). Mobile phone-based interventions for mental health: A systematic meta-review of 14 meta-analyses of randomized controlled trials. PLOS Digital Health. https://doi.org/10.1371/journal.pdig.0000002

2021

Wang, Y., Feng, Y., Han, M., Duan, Z., Wilson, A., Sun, S., & Chen, R. (2021). Methods of attempted suicide and risk factors in LGBTQ+ youth. Child Abuse & Neglect. https://doi.org/10.1016/j.chiabu.2021.105352
Qiao, S., Sun, S., Tam, C. C., Li, X., Zhou, Y., & Shen, Z. (2021). Provider burnout during the COVID-19 pandemic in HIV clinics in Guangxi, China. (in press). Journal of the Association of Nurses in AIDS Care.
Donofry, S. D., Stillman, C. M., Hanson, J. L., Sheridan, M., Sun, S., Loucks, E., & Erickson, K. (2021). Promoting brain health through physical activity among adults exposed to early life adversity: Potential mechanisms and theoretical framework. Neuroscience and Biobehavioral Reviews. https://doi.org/10.1016/j.neubiorev.2021.09.051
Kang, C., Sun, S., Yang, Z., Fan, X., Yuan, J., Xu, L., Wei, Y., Tong, H., & Yang, J. (2021). The psychological effect of internet-based mindfulness-based stress reduction on survivors of breast cancer during the COVID-19 pandemic. Frontiers in Psychiatry. https://doi.org/10.3389/fpsyt.2021.738579
Wang, Y., Duan, Z., Wang, G., Wilson, A., Sun, S., Yang, Y., & Chen, R. (2021). Identifying subgroups of sexual minority adolescents at risk of suicidality using latent profile analysis. (in press). Preventive Medicine.
Lu, X., Pan, G., Wang, X., Xia, W., Zhao, X., He, Q., Zhang, H., Wang, J., Sun, Y., Liu, T., Sun, S., Yang, C., Zaller, N., Zhang, Z., & Operario, D. (2021). User preferences for a mHealth approach to support HIV self-testing and linkage to care services for MSM in China. (in press). AIDS Education and Prevention.
Whiteley, L., Craker, L., Sun, S., Tarantino, N., Hershkowitz, D., Moskowitz, J., Arnold, T., Haubrick, K., Olsen, E., Mena, L., & Brown, L. K. (2021). Factors associated with PrEP adherence among MSM in Jackson, Mississippi. Journal of HIV/AIDS & Social Services. Online First Publication. https://doi.org/10.1080/15381501.2021.1956666
Tarantino, N., Matthews, C., Sun, S., Orchowski, L., Harrison, A., Abrahams, N., Berkowitz, A., Akande, M., & Kuo, C. (2021). Unique and shared correlates of sexual violence perpetration and sexual risk behavior among South African adolescent boys. AIDS Education and Prevention. https://doi.org/10.1521/aeap.2021.33.5.424
*Nardi, W., Loucks, E., Springs, S., Operario, D., Kronish, I. M., Gaudiano, B., & Sun, S. (2021). Mindfulness-based interventions for medication adherence: A systematic review and narrative synthesis. Journal of Psychosomatic Research, 149, 110585. Senior author, PI of research. https://doi.org/10.1016/j.jpsychores.2021.110585
Sun, S., *Nardi, W., Loucks, E., & Operario, D. (2021). Mindfulness-based interventions for sexual and gender minorities: A systematic review. Mindfulness. Online First Publication. https://doi.org/10.1007/s12671-021-01710-9
Sun, S., Goldberg, S. B., Loucks, E., & Brewer, J. A. (2021). Mindfulness-based interventions for people of color: A systematic review and meta-analysis. Psychotherapy Research. Online First Publication. https://doi.org/10.1080/10503307.2021.1937369
Sun, S., Lin, D., Goldberg, S., Shen, Z., Chen, P., Qiao, S., Brewer, J., Loucks, E., & Operario, D. (2021). A mindfulness-based mobile health (mHealth) intervention among psychologically distressed university students in quarantine during the COVID-19 pandemic: A randomized controlled trial. Journal of Counseling Psychology. Online First Publication. https://doi.org/10.1037/cou0000568
Taylor, V., Moseley, I., Sun, S., Ludwig, V., Roy, A., Smith, R., & Brewer, J. A. (2021). Effects of a digitized therapeutic mindfulness intervention on craving-related eating outcomes and eating behavior reward valuation. Journal of Behavioral Addictions. Online First Publication. https://doi.org/10.1556/2006.2021.00020
Sun, S., Yang, C., Zaller, N., Zhang, Z., Zhang, H., & Operario, D. (2021). Willingness to use PrEP and adherence self-efficacy among men who have sex with men with recent condomless anal sex in urban China. AIDS & Behavior. https://doi.org/10.1007/s10461-021-03274-0
Sun, S., Lin, D., & Operario, D. (2021). Interests in COVID-19 vaccine trials among university students in China: Willingness, reasons for hesitancy, and demographic and psychosocial determinants. Preventive Medicine Reports. https://doi.org/10.1016/j.pmedr.2021.101350
Sun, S., Goldberg, S. B., Lin, D., Qiao, S., & Operario, D. (2021). Psychiatric symptoms, risk, and protective factors among university students in quarantine during the COVID-19 pandemic in China. Globalization and Health, 17, 15. https://doi.org/10.1186/s12992-021-00663-x
Goldberg, S. B., Riordan, K. M., Sun, S., & Davidson, R. (2021). The empirical status of mindfulness-based interventions: A systematic review of 44 meta-analyses of randomized controlled trials. Perspectives on Psychological Science. Online First Publication. https://doi.org/10.1177/1745691620968771

2020

Qiao, S., Yang, X., Sun, S., Li, X., Mi, T., Zhou, Y., & Shen, Z. (2020). Challenges to HIV service delivery and the impacts on patient care during COVID-19: Perspectives of HIV care providers in Guangxi, China. AIDS Care. https://doi.org/10.1080/09540121.2020.1849532
Mi, T., Yang, X., Sun, S., Li, X., Tam, C., Zhou, Y., & Shen, Z. (2020). Mental health problems of HIV healthcare providers during the COVID-19 pandemic: The interactive effects of stressors and coping. AIDS and Behavior. https://doi.org/10.1007/s10461-020-03073-z
Tam, C. C., Sun, S., Yang, X., Li, X., Zhou, Y., Shen, Z. (2020). Psychological distress among HIV providers during the COVID-19 pandemic in China: Mediating roles of institutional support and resilience. AIDS and Behavior. https://doi.org/10.1007/s10461-020-03068-w
Sun, S., Hoyt, W. T., Tarantino, N., Pachankis, J. E., Whiteley, L., Operario, D., & Brown, L. K. (2020). Cultural context matters: Testing the minority stress model among Chinese sexual minority men. Journal of Counseling Psychology. https://doi.org/10.1037/cou0000535
Goldberg, S. B., Riordan, K. M, Sun, S., Kearney, D. J., & Simpson, T. L. (2020). Efficacy and acceptability of mindfulness-based interventions for military veterans: A systematic review and meta-analysis. Journal of Psychosomatic Research. Online First Publication. https://doi.org/10.1016/j.jpsychores.2020.110232
Arnold, T., G. Rogers, B., L. Norris, A., Schierberl Scherr, A., Haubrick, K., E. Renna, M., Sun, S., Danforth, M. M., Chu, C. T., Silva, E. S., Whiteley, L. B., & Pinkston, M. (2020). A brief transdiagnostic pandemic mental health maintenance intervention. Counselling Psychology Quarterly, 1-21. https://doi.org/10.1080/09515070.2020.1769026
Sun, S., Hou, J., Chen, Y., Lu, Y., Brown, L. K., & Operario. (2020). Challenges to HIV care and psychological health during the COVID-19 pandemic among people living with HIV in China. AIDS & Behavior. https://doi.org/10.1007/s10461-020-02903-4
Sun, S., Lin, D., & Operario, D. (2020). Need for a population health approach to understand and address psychosocial consequences of COVID-19. Psychological Trauma: Theory, Research, Practice, and Policy. https://doi.org/10.1037/tra0000618
Si, P., Sun, S., Li, X., Chen, J., Xiong, Y., He, Y., Pachankis, J. E. (2020) A pilot cultural adaptation of LGB-affirmative CBT for young Chinese sexual minority men’s mental and sexual health. Psychotherapy. https://doi.org/10.1037/pst0000318
Sun, S., Pachankis, J. E., Li, X., & Operario, D. (2020). Addressing minority stress and mental health among Chinese men who have sex with men: A systematic review. Current HIV/AIDS Reports, 17, 35-62. https://doi.org/10.1007/s11904-019-00479-w
Sun, S., Hoyt, W. T., & Pachankis, J.E. (2020). Predicting sexual risk behaviors in the age of internet: The case of internet-using Chinese men who have sex with men (MSM). AIDS Care. https://doi.org/10.1080/09540121.2019.1668525
Sun, S., Budge, S. L., Shen, W., Liu, M., Xu, G, & Feng, S. (2020). Minority stress and health: A qualitative investigation on the experiences of men who have sex with men in China and implications for health research and interventions. Social Science and Medicine, 252, 112917. https://doi.org/10.1016/j.socscimed.2020.112917
Sun, S., & Farber, E. (2020). An intersectionality-informed psychotherapy approach to reduce HIV stigma. Psychotherapy, 57(1), 23-28. https://doi.org/10.1037/pst0000265
Sun, S., Crooks, DiClemente, R. J., & Sales, J. M. (2020). Perceived neighborhood violence and crime, emotion regulation, and PTSD symptoms among justice-involved African American girls. Psychological Trauma: Theory, Research, Practice, and Policy, 12(6), 593-598. https://doi.org/10.1037/tra0000562. PMID: 32237877
Sun, S., Pickover, A. M., Goldberg, S. B., Bhimji, J., Nguyen, J. K., Evans, A., Patterson, B, & Kaslow, N. K. (2019). For whom cognitively-based compassion training (CBCT) work? An analysis of predictors and moderators of intervention outcome among African American suicide attempters. Mindfulness, 10(11), 2327-2340. https://doi.org/10.1007/s12671-019-01207-6

Previous Projects

Global Mental Health of LGBTQ+ People

Globally, LGBTQ+ people face social and structural stigma, such as violence, discrimination, lack of legal protection, which all contributes to poor mental and behavioral health. At Mindfulness for Health Equity Lab (mHEAL), investigators conduct research both to characterize the challenges LGBTQ+ people face across the globe, as well as to develop community-centered interventions to promote mental health among LGBTQ+ people and protocols to advance mental and medical providers’ competence in services.

Examples of this work include:

Mental and behavioral health of sexual minority men in China:
- Contextualizing the minority stress model in China: Sun Hoyt et al (2020).Cultural context matters: Testing the minority stress model among Chinese sexual minority men. Journal of Counseling Psychology.
- Understanding minority stress and health: Sun, Budge et al (2020). Minority stress and health: A grounded theory exploration among men who have sex with men in China and implications for health research and interventions. Social Science and Medicine.
- The role of minority stress in HIV testing among Chinese sexual minority men: Sun, Whiteley, Brown (2019). HIV testing among Chinese men who have sex with men: The roles of HIV knowledge, online social life, and sexual identity concerns. AIDS & Behavior.
- A literature review of minority stress and mental health among Chinese sexual minority men: Sun, Pachankis, Li, & Operario (2021). Addressing minority stress and mental health among men who have sex with men in China. Current HIV/AIDS Reports.

Early Life Adversity & Mindfulness

Early life adversity (ELA) consists various forms of maltreatment (abuse, neglect, violence), chronic poverty, loss of caregiver, malnutrition, etc., is linked to increased risk of mental health and chronic illnesses in adulthood. Despite well-documents associations between ELA and poor health outcomes, interventions to ameliorate such effects are scarce. Investigators at mHEAL at Brown School of Public Health explore the role of mindfulness for populations affected by early life adversity.

Examples of this work include:

Theoretical paper on addressing ELA through mindfulness: Sun Sheridan et al (2021). Addressing the biological embedding of early life adversities (ELA) among adults through mindfulness: Proposed mechanisms and review of converging evidence. Neuroscience and Biobehavioral Reviews.
Sexual minority women, ELA, and mindfulness: Our team recently completed a feasibility trial of a mindful eating mobile health program for sexual minority women who experienced early life adversities. Research paper from this trial is currently under-review.

Evaluating Internet, Mobile Health & Mindfulness Interventions

Internet-based and mobile health (mHealth) interventions have great potential to reach and engage potential participants and empower them to promote health outcomes. The amount of research in these areas is growing, yet this is also a very new area of research in its infancy and needs deeper understanding of current evidence. Mindfulness as a public health approach may also offer the opportunity to improve mental health and facilitate healthy decision making, while it has been criticized for historically lack of diversity in research trials and outreach. Our lab utilizes rigorous review as well as clinical trials methodology to evaluate evidence in these areas.

Examples of this work include:

Mindfulness mHealth for young adults’ mental health during the lockdown of COVID-19 pandemic in China: Sun et al. (2022). A mindfulness-based mobile health (mHealth) intervention among psychologically distressed university students in quarantine during the COVID-19 pandemic: A randomized controlled trial. Journal of Counseling Psychology.
An umbrella review of mHealth interventions for mental health: Goldberg, Lam, Simonsson, Torous, & Sun. (2022). Mobile phone-based interventions for mental health: A systematic meta-review of 14 meta-analyses of randomized controlled trials. PLOS Digital Health.

Resources

LGBTQ+ Resources

Pride Counseling

This LGBT-affirming online counseling network is where students can sign up and be matched with an LGBT-affirming mental health provider for low-cost sessions. They also have apps for android and iphone.

https://www.pridecounseling.com

The National LGBT Help Center

Offers free and confidential peer support and local resource database:

https://www.glbthotline.org/

Gay Men’s Domestic Violence Project

1-800-832-1901

Provides crisis intervention, support and resources for gay male survivors of domestic violence

http://gmdvp.org/gmdvp/.

Transgender Lifeline

1-877-565-8860

Designed for members of the transgender community in crisis and staffed by transgender people. Open 11 a.m. to 5 a.m. EST daily.

The Trevor Project

1-866-488-7386

The Trevor Project is the leading national organization providing crisis intervention and 24/7 suicide prevention services to lesbian, gay, bisexual, transgender, queer & questioning youth. The Trevor Project also offers other resources including the LGBT safe space social networking site, TrevorSpace. There are trained crisis counselors are available 24/7 at 1-866-488-7386, via chat www.TheTrevorProject.org/Help, or by texting START to 678-678.

https://www.thetrevorproject.org/