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Mindfulness Based Flourishing Program: A Cross-Cultural Study of Hong Kong Chinese and British Participants

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The Mindfulness Based Flourishing Program (MBFP) is an online 8-week intervention developed for enhancing wellbeing with the use of mindfulness practices, through targeting a range of positive variables. The efficacy of the MBFP has been demonstrated in a randomized controlled trial, and in order to further establish it as an intervention with widespread application, cross-cultural validation is warranted. The current study was conducted with the primary aim of testing the validity of the MBFP with a Hong Kong Chinese population, as well as verifying its positive effects. A randomized wait-list controlled design was adopted with 115 participants (92 females, mean age = 31.50). Intervention outcomes were compared between Hong Kong Chinese and British participants. Five positive variables were examined (self-compassion, meaning in life, positive and negative emotions, gratitude, and mindfulness), and measures were taken pre- and post-intervention. Significant gains in wellbeing measures were observed in both the Hong Kong Chinese and the British experimental groups. Levels of wellbeing post-intervention were also higher for the two experimental groups as compared to their control counterparts. The current study provides preliminary evidence for the MBFP’s cross-cultural validity, and strengthens previous claims for its efficacy as a new, accessible alternative for enhancing wellbeing.
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1 23
Journal of Happiness Studies
An Interdisciplinary Forum on
Subjective Well-Being
ISSN 1389-4978
J Happiness Stud
DOI 10.1007/s10902-017-9919-1
Mindfulness Based Flourishing Program:
A Cross-Cultural Study of Hong Kong
Chinese and British Participants
Itai Ivtzan, Tarli Young, Hoi Ching Lee,
Tim Lomas, Daiva Daukantaitė & Oscar
N.E.Kjell
1 23
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RESEARCH PAPER
Mindfulness Based Flourishing Program: A Cross-
Cultural Study of Hong Kong Chinese and British
Participants
Itai Ivtzan
1
Tarli Young
1
Hoi Ching Lee
1
Tim Lomas
1
Daiva Daukantait_
e
2
Oscar N. E. Kjell
2
Springer Science+Business Media B.V. 2017
Abstract The Mindfulness Based Flourishing Program (MBFP) is an online 8-week
intervention developed for enhancing wellbeing with the use of mindfulness practices,
through targeting a range of positive variables. The efficacy of the MBFP has been
demonstrated in a randomized controlled trial, and in order to further establish it as an
intervention with widespread application, cross-cultural validation is warranted. The cur-
rent study was conducted with the primary aim of testing the validity of the MBFP with a
Hong Kong Chinese population, as well as verifying its positive effects. A randomized
wait-list controlled design was adopted with 115 participants (92 females, mean
age =31.50). Intervention outcomes were compared between Hong Kong Chinese and
British participants. Five positive variables were examined (self-compassion, meaning in
life, positive and negative emotions, gratitude, and mindfulness), and measures were taken
pre- and post-intervention. Significant gains in wellbeing measures were observed in both
the Hong Kong Chinese and the British experimental groups. Levels of wellbeing post-
intervention were also higher for the two experimental groups as compared to their control
counterparts. The current study provides preliminary evidence for the MBFP’s cross-
cultural validity, and strengthens previous claims for its efficacy as a new, accessible
alternative for enhancing wellbeing.
Keywords Positive psychology Mindfulness Cross-cultural Wellbeing Randomized
controlled trial
Electronic supplementary material The online version of this article (doi:10.1007/s10902-017-9919-1)
contains supplementary material, which is available to authorized users.
&Itai Ivtzan
i.ivtzan@uel.ac.uk
1
Department of Psychology, The University of East London UEL, Stratford Campus,
London E15 4LZ, UK
2
Department of Psychology, Lund University, Paradisgatan 5P, 22350 Lund, Sweden
123
J Happiness Stud
DOI 10.1007/s10902-017-9919-1
Author's personal copy
1 Introduction
Mindfulness can be broadly defined as a state of sustained awareness of the present
moment with an attitude of non-judgmental acceptance of what is happening in one’s own
mind and body, as well as in the immediate environment (Grossman et al. 2004). Mind-
fulness is most commonly cultivated through meditation but can be enhanced through any
activity which involves focusing on the present with the appropriate attitude (Kabat-Zinn
1990). In a state of mindfulness, internal and external stimuli are non-judgmentally
observed, and habitual reactions to them are reduced. This deliberate dissociation between
perception and response enables an individual to be reflective, rather than reflexive (Bishop
et al. 2004).
Mindfulness has its roots in Buddhist meditative practices, in which it is believed to be
important for the mind, as well as the body, through the understanding of human expe-
rience (Mikulas 2011). Within Buddhism, mindfulness has historically been regarded as an
innate capacity which people possess to varying extents. The purpose of Buddhist mind-
fulness practices is to elicit this innate capacity, and develop it for spiritual growth (Kabat-
Zinn 2003) and psychological wellbeing (Shapiro 2009) including positive psychological
experiences such as joy, awareness and compassion (Garland et al. 2015).
Traditional Mindfulness practices have been adapted by Western Psychology, in which
the primary purpose has been altered towards clinical interventions for psychological
distress and maladaptive behaviour (Shapiro 2009). For instance, Mindfulness Based Stress
Reduction (MBSR), which is an approach that integrates meditation and yoga, was
developed to assist with chronic pain (Kabat-Zinn 1982). Other Western programs include
the Mindfulness Based Cognitive Therapy (MBCT; Segal et al. 2002), Dialectical Behavior
Therapy (DBT; Linehan 1993), and Mode Deactivation Therapy (MDT; Swart et al. 2014).
These programs have been widely applied to a range of psychological difficulties, such as
anxiety disorders (Grossman et al. 2004) and suicidal behavior (Linehan 1993). There is
considerable evidence for the effectiveness of mindfulness practices in treating symptoms
of mental illnesses, preventing relapse, and alleviating psychological distress associated
with long-term health problems (e.g. Teasdale et al. 2000; Zainal et al. 2013). But there
have been few mindfulness programs targeting positive variables such as wellbeing.
In recent years, Mindfulness has become increasingly influential in the field of positive
psychology (Ivtzan and Lomas 2016); a relatively recent branch of psychology that
investigates the facilitation of flourishing lives (Lomas et al. 2014). Positive psychology
focuses research on positive variables such as wellbeing. Shapiro et al. (2002) suggest the
field can offer perspectives in better alignment with the original Buddhist aims of mind-
fulness. In line with this suggestion, the Mindfulness Based Flourishing Program (MBFP)
was developed by Ivtzan et al. (2016) to integrate mindfulness practices with positive
psychology into an 8-week online program, designed to enhance wellbeing. In addition to
targeting overall wellbeing, each of the 8 weeks focuses on a positive variable. For
example, five of the positive variables are based on the Psychological Wellbeing model
(Ryff and Keyes 1995): autonomy, meaning in life, self-compassion, positive relations
with others, and self-efficacy. These are all considered important dimensions of Eudai-
monic wellbeing, which emphasises the wellbeing that comes from living in a meaningful
and deeply satisfying manner (Ryan and Deci 2001). In addition, two variables, gratitude
and engagement, were included in the MBFP to enhance Hedonic wellbeing, which
emphasises the attainment of pleasure and pain avoidance (Deci and Ryan 2008).
The MBFP is one of the few existing mindfulness programs developed with the
intention of enhancing positive variables. In the context of mindfulness, intentions are an
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individual’s goals in practicing mindfulness, and it is argued that they significantly
influence the outcomes of the practice (Shapiro et al. 2006). Shapiro et al. (2006)
emphasize this in their IAA model of mindfulness, which posits intention as a key aspect
which connects practitioners with their goals, visions and aspirations. Intention is similarly
an important component of positive psychology interventions (PPIs) which focus, by
definition, on the goal of increasing positive variables (Sin and Lyubomirsky 2009; Parks
and Biswas-Diener 2013). The MBFP incorporates mindfulness with PPIs and positive
psychology theory with the explicit intention of increasing wellbeing and positive vari-
ables. Both Mindfulness and PPIs enhance positive variables in their own right, and the
MBFP is designed so they mutually enhance each other, leading to improvements in
Hedonic and Eudaimonic well-being. The mutually supportive relationship between PPIs
and Mindfulness is described in the ‘positive Mindfulness cycle’ which forms the theo-
retical basis for the MBFP (Ivtzan et al. 2016).
The positive Mindfulness cycle suggests that PPIs shape the intention for mindfulness
practice. While existing Mindfulness programs (e.g. MBSR and the MBCT) aim to
decrease negative variables; the MBFP utilizes PPIs to set positive intentions. As part of
the MBFP, each PPI includes a talk on the positive variable targeted and an invitation to
increase this variable through an evidence-based activity. The focus on positive intentions
aligns with Positive Psychology’s focus on flourishing, which goes beyond the mere
elimination of psychological distress and can be achieved only if positive variables are
involved (Keyes 2002). Thus the PPIs in the MBFP set positive intentions for the mind-
fulness component of the program and support increases in wellbeing.
In turn, the ‘positive Mindfulness cycle’ proposes that mindfulness supports the use of
PPIs through the process of savouring. Savouring relates to generating and prolonging
enjoyment and appreciation (Bryant and Veroff 2007) and has been identified as a potential
pathway through which mindfulness enhances positive variables (Garland et al. 2015).
Mindfulness is a key dimension of savouring (Ritchie and Bryant 2012) and allows
practitioners increased awareness of positive emotions and outcomes triggered by PPIs.
While PPIs often lead to the experience of positive events or emotions, without savouring,
the practitioner may not be able to appreciate or prolong these positive outcomes. Mind-
fulness promotes savouring, which is required to fully utilise the benefits of PPIs. Thus,
through the positive mindfulness cycle, Mindfulness and PPIs, in the MBFP, continuously
enhance each other, leading to greater increases in wellbeing than their impact as separate
practices.
The efficacy of the MBFP is promising as demonstrated through a recent randomized
controlled trial with a non-clinical population (Ivtzan et al. 2016). While the wait-listed
control group showed no significant changes, the experimental group showed significant
increases in a range of positive variables, including gratitude, self-compassion, meaning,
and strengths. In addition, experimental group participants showed significant decreases in
depression and perceived stress, indicating the MBFP is also effective in reducing psy-
chological distress.
The MBFP was developed in the UK by researchers from Western backgrounds. In the
original study of the MBFP, participants came from 20 countries, with the majority from
Western cultures including the United Kingdom (29.8%), Canada (27.8%), United States
(12.6%) and Australia (10.6%). It is therefore important to test the efficacy of the program
cross-culturally, to examine whether or not similar effects would be found, since the
experience of mindfulness differs across cultures.
Cross-cultural studies show that people with distinct cultural backgrounds might have
different conceptualizations or experiences of mindfulness. For example, a cross-cultural
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mindfulness study by O
¨zyesil (2012) found that American students had greater psycho-
logical needs and were more mindful than Turkish students. In a separate study of
mindfulness measures, Christopher et al. (2009b) found that Thai students had greater
ability to focus with undivided attention, while American students appeared to be more
accepting of events that occurred around them. The same study also identified that these
populations had different conceptualizations of mindfulness, as the predominantly Bud-
dhist Thai population sees mindfulness as only one component of a larger system of
teachings; whereas Western secular mindfulness is not necessarily connected to a wider
system of wisdom and morality (Christopher et al. 2009a,b). More broadly, O
¨zyesil (2012)
proposed that collectivist cultures might hamper attempts to be more mindful due to
cultural norms that put much emphasis on the society’s approval or disapproval, and thus
hinder the adoption of a non-judgmental life view.
These studies exemplify how Mindfulness can vary among cultures and it is also
important to note that Western Mindfulness interventions and scales have adapted mind-
fulness to fit with Western ideals and tastes (Kabat-Zinn 2003). As such, it is important that
Western mindfulness interventions are culturally validated before being put to use else-
where. Systematically assessing a mindfulness program in a target culture facilitates the
identification of areas that need to be adjusted (e.g. mode of delivery, format) for the
purpose of proper adaptation, and is therefore a vital step before the test or program can be
implemented with the population concerned (e.g. Woods-Giscombe
´and Gaylord 2014).
There have been a number of such cross-cultural studies on mindfulness interventions; for
instance research on the MBSR (Roth and Robbins 2004) which suggest the intervention
can be used successfully in different cultures, but as yet, there is no cross-cultural study on
the MBFP.
Despite the research suggesting the MBFP is a viable new alternative to enhance
wellbeing, the breadth and width of its reach could remain limited without an assessment
of its cross-cultural validity. The primary aim of the current study is to test the effec-
tiveness of the program in the context of an Eastern culture. Specifically, the MBFP will be
tested with a sample of Hong Kong Chinese, and their intervention outcomes will be
compared to those of a British sample.
Hong Kong was chosen as a comparison culture as it is distinct from the Western
cultures tested in the original study (Ivtzan et al. 2016). While Hong Kong was previously
under British rule, the two cultures are very different. Approximately 94% of Hong Kong’s
population are ethnically Chinese and 96% speak Cantonese (Census and Statistics
Department 2011). Most people in Hong Kong follow Buddhist, Taoist or Confucian faiths
(Hong Kong Yearbook 2015) and align with traditional Chinese culture and customs
(Ralston et al. 1993). These demographics have led researchers to treat Hong Kong as a
representative of Eastern culture (e.g., Go
¨kc¸en et al. 2014; Maxwell et al. 2005; Ralston
et al. 1993). A variety of studies highlight the differences between the UK and Hong Kong;
for example Hofstede (2001) found Hong Kong has a more pragmatic and collectivist
culture than Britain: while British citizens tend to score higher in terms of indulgence,
Hong Kong adults scored lower on extraversion and higher on social desirability and
Psychoticism than British adults (Eysenck and Chan 1982) and higher on anger rumination
(Maxwell et al. 2005). In addition to the cultural differences the two populations are
situated in vastly different geographical regions and were chosen to represent Western and
Eastern cultures as per previous research (e.g., Go
¨kc¸en et al. 2014; Maxwell et al. 2005).
While there are many studies on the differences between Hong Kong and Britain, there
is no documented research that directly compares Hong Kong and Britain in terms of
mindfulness. As such, while this study aims to test the MBFP across the two cultures, it
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may also shed light on any differences or similarities in the two populations regarding
mindfulness in general. Another motivation for the current study is the lack of interven-
tions designed to enhance wellbeing available for Eastern populations. Mindfulness pro-
grams tested on Asian populations (e.g. Chien and Thompson 2014; Lee et al. 2011), have
generally focused on reduction of negative variables (e.g. stress, schizophrenic symptoms).
Mindfulness-based interventions for improving positive variables have not yet been
empirically tested in an Eastern culture. This study aims to test the MBFP as a potential
evidence-based approach for achieving flourishing in an Eastern culture.
The main objective of this study is to assess the cross-cultural validity of the MBFP.
This is done in two ways; firstly, by assessing whether the MBFP was successful with the
Hong Kong experimental group compared to the Hong Kong control group; and secondly
by comparing the results of Hong Kong participants and British participants to ascertain
whether the MBFP was equally effective in both populations. Specifically, two related
hypotheses were tested. The primary hypothesis was that participation in the MBFP, as
compared with participating in the waitlist condition, leads to significant improvements
from pre-test to post-test in six dependent variables (mindfulness, gratitude, self-com-
passion, meaning in life, positive and negative effects) in both countries. The secondary
hypothesis was that the MBFP is equally effective in improving the six dependent variables
when comparing results of the experimental groups from Hong Kong and the UK.
2 Method
2.1 Design
The study used a randomized wait-list control trial. Balanced randomization was executed
by means of a predefined list (115 numbers, range 1–2, balanced) created automatically by
the study’s online platform. The between-subjects independent variables were 1) condition
(allocation to either the control, waitlist group, or the MBFP, experimental group, and 2)
country (Great Britain or Hong Kong). The within-subject independent variable was time
(pre- and post-intervention measurements). The dependent variables were: mindfulness,
gratitude, self-compassion, meaning in life, positive affect and negative affect. Dependent
variables were measured through quantitative, self-report scales completed online.
2.2 Participants
Participants were recruited through health-related online forums and social networks, as
well as from meditation centres in Great Britain and Hong Kong. Participation was
completely voluntary and no compensation of any kind was offered. Participants were only
eligible if: (1) they were permanent citizens of either Hong Kong or Great Britain, and (2)
they had resided in either place for no less than 5 years. All Hong Kong participants had to
confirm that they were ethnically Chinese. These inclusion criteria were set to ensure that
participants adequately represented the two cultures under study.
A total of 222 participants signed up for the study and were assessed for eligibility. Nine
of the recruited participants were disqualified for severe signs of depression, as there is
evidence that meditation can negatively affect individuals with high levels of depression
(Shapiro 1992). Out of these 213 participants, 107 did not start the study. The remaining
115 participants (47% male; 53% female), with the age range from 18 to 70 (M=31.50,
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SD 13.50) years, commenced the study by completing at least the pre-intervention ques-
tionnaires, while 79 participants of 115 (43% male; 57% female) completed the entire
study (see Fig. 1for more details).
2.3 Procedure
Ethics approval was obtained from the Research Ethics Committee of the University of
East London. Before commencing the program, all recruited individuals were emailed an
invitation letter, which briefly outlined the study. Participants within each culture group
were randomly allocated into either the experimental or the control group. They were then
emailed a link to an online platform which hosted the questionnaires and MBFP. Partic-
ipants were asked to complete the consent form and screened for depression using the
Patient Health Questionnaire-2 (Kroenke et al. 2003) a 2-item validated scale with a score
range of 0-6. A cut-off score of 5 was chosen as this provides a positive predictive value of
84.6% regarding depressive disorders (Kroenke et al. 2003). Participants who passed
screening completed the pre-test questionnaires; comprised of demographic questions and
five questionnaires to provide pre-intervention measures (see measurements).
After completing pre-tests, the procedure differed for the experimental and control
groups. Participants in the control groups (from both Great Britain and Hong Kong) were
wait-listed for 8 weeks. After this time, they were asked to complete the same five
questionnaires to provide post-test results. They were then able to begin the MBFP. The
Figure 1. Participant flow diagram
Assessed for eligibility
(British: n=112; HK: n=110)
Excluded
Screened for depression
(British: n=7; HK: n=2)
Completed post assessment
(British: n=22; HK: n=19)
Allocated to experimental group
(British: n=56; HK: n=55)
Did not complete any pre-test scales
(British: n=23; HK: n=28)
Allocation
Follow-Up
Randomized
(British: n=105; HK: n=108)
Enrollment
Fig. 1 Participant flow diagram
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MBFP was presented in English as it is one of the official languages of Hong Kong (Bolton
2000).
Participants in the experimental groups were immediately allowed to start the 8-week
MBFP following the pre-tests. The MBFP lasted 8 weeks, and each week focused on a
different theme: (1) self-awareness, (2) positive emotions, (3) self-compassion, (4)
autonomy, (5) self-efficacy, (6) meaning in life, (7) positive relations with others, and (8)
engagement. Each week, participants were provided with a short video (approximately
10 min) that explained the theory of the topic that week and invited them to undertake
activities to increase the relevant positive variable. They were also provided with an audio
file (12-15 min) which contained a guided meditation and a daily practice. The daily
activity was related to the week’s topic, and was to be performed outside of meditation
sessions. A written transcript of the audio file and the daily activity was also available for
download. Participants were asked to watch each video once and complete the meditation
and daily activity each day for the following week. Table 1summarizes the program
throughout the 8 weeks.
At the end of each week, participants received an email with a link to the following
week. They were also sent reminder emails 3 days into each week to encourage adherence.
Upon starting each subsequent week, they were asked to report the number of times they
had meditated and completed the daily activity during the past week. The above procedure
was repeated for 8 weeks.
Upon completion of the MBFP, participants were asked to complete the same five
questionnaires to provide post-intervention measures. All experimental and control par-
ticipants were given a debrief letter that concluded the program. Figure 1shows a flow
chart of the procedure and participant numbers.
2.4 Measures
Depression was screened by using the Patient Health Questionnaire-2 (PHQ-2; Kroenke
et al. 2003), which comprises two questions about the frequency of anhedonia and
depressive mood over the last 2 weeks. The two items are answered with rating scales
ranging from 0 (‘‘not at all’’) to 3 (‘‘nearly every day’’); where a score of C5 is considered
a severe depression screening cut-point (Kroenke et al. 2003; Yu et al. 2011). The PHQ-2
has also been found valid and reliable using the Chinese version of the PHQ-2 in a Hong
Kong sample (Yu et al. 2011). The internal reliability for the PHQ-2 was (alpha =.66,
omega =.67) for the UK sample and (alpha =.32, omega =.32) for the Hong Kong
Chinese sample.
Mindfulness was measured using the Freiburg Mindfulness Inventory, Short Form
(FMI), which has 14 items scored on a 4-point Likert scale and good internal reliability
(Walach et al. 2006). The FMI has been tested cross-culturally and a translated version was
validated with a Chinese population (Chen and Zhou 2014). The internal reliability for the
FMI was good in both the UK (pre-test: alpha =.88, omega =.88; post-test: alpha =.93,
omega =.93) and Hong Kong (pre-test: alpha =.84, omega =.84; post-test:
alpha =.81, omega =.81) samples.
Positive Affect and Negative Affect were assessed with the Positive and Negative Affect
Schedule (PANAS), which contains two 10-item mood scales, both with high internal
consistency (Watson et al. 1988). The PANAS has been validated cross-culturally with a
Chinese population using a translated version (Weidong et al. 2004). The internal relia-
bility for the positive affect scale was good in both the UK (pre-test: alpha =.90,
omega =.91; post-test: alpha =.91, omega =.91) and Hong Kong (pre-test:
Mindfulness Based Flourishing Program: A Cross-Cultural
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alpha =.89, omega =.90; post-test: alpha =.90, omega =.91) samples. The internal
reliability for the negative affect scale was also good in both the UK (pre-test: alpha =.92,
omega =.92; post-test: alpha =.91, omega =.91) and Hong Kong (pre-test:
alpha =.91, omega =.92; post-test: alpha =.92, omega =.92) samples.
Gratitude was assessed with the Gratitude Questionnaire-6-Item Form (GQ-6) which
has six items on a 7-point Likert scale and good internal reliability (McCullough et al.
2002). The GQ-6 has been noted as valid and reliable in a study with the Hong Kong
Table 1 Topics, materials and activities each week of the MBFP
Week Target
variable
Content of video Meditation Daily activity
1 Self-
awareness
Introduction to
mindfulness, self-
awareness, positive
psychology and
meditation
Introductory meditation
focused on awareness
of breath, body and
emotions
Being aware of thoughts
and reactions throughout
the day and returning to
the breath
2 Positive
emotions
Explanation of the benefits
of positive emotions and
gratitude
Gratitude meditation
focused on who or
what one appreciates
Expressing gratitude for
positive situations
3 Self-
compassion
Explanation of self-
compassion concept and
research; and methods to
increase self-compassion
Adaption of Loving-
Kindness meditation
focused on self-
compassion (Neff and
Germer 2013)
Replacing internal
criticism with statements
of kindness
4 Self-efficacy Introduction to character
strengths and self-
efficacy including
enhancement methods
Meditation focused on a
time when participant
was at their best and
using character
strengths
Completing the VIA
character strengths
questionnaire (Peterson
and Seligman 2004) and
using strengths
5 Autonomy Introduction to autonomy
and connection with
wellbeing
Meditation on authentic
self and action
Taking authentic action
and noticing external
pressure on choices
6 Meaning Talk on meaning and
wellbeing. Completion
of writing exercise,
‘Best Possible Legacy’
adapted from the
Obituary Exercise
(Seligman et al. 2006)
Meditation on future
vision of self, living
one’s best possible
legacy
Acting according to best
possible legacy.
Choosing meaningful
activities
7 Positive
relations
with others
Talk on benefits of
positive relationships
and methods for
enhancing
Loving-Kindness
Meditation
Bringing feelings of
loving-kindness into
interactions
8 Engagement Introduction to
engagement and
savouring and their
connection to positive
emotions
Savouring meditation
focused on food
Using savouring to engage
with experiences
Conclusion Summary of the program.
Discussion of personal
growth and invitation to
continue meditations
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Chinese population (Chan 2010). The internal reliability for the GQ-6 was mostly good in
both the UK (pre-test: alpha =.76, omega =.74; post-test: alpha =.73, omega =.71)
and Hong Kong (pre-test: alpha =.80, omega =.83; post-test: alpha =.68,
omega =.65) samples.
Self-Compassion was measured with the Self-Compassion Scale, Short Version (SCS;
Raes et al. 2011). The SCS has 12 items on a 5-point Likert scale and good internal
reliability (Raes et al. 2011). The SCS (translated) were used in a cross-cultural study in
Taiwan, Thailand and United States, and were found to have good internal consistency in
all three populations (Neff et al. 2008). The internal reliability for the SCS was good in
both the UK (pre-test: alpha =.90, omega =.91; post-test: alpha =.92, omega =.92)
and Hong Kong (pre-test: alpha =.84, omega =.84; post-test: alpha =.87,
omega =.88) samples.
Meaning in Life was assessed using the Meaning in Life Questionnaire-Presence Sub-
scale (MLQ-P) which has 5 items scored on a 7-point Likert scale and good internal
reliability (Steger et al. 2006). A translated MLQ was used within a sample of Hong Kong
Chinese caregivers and found to have the same factor structure as the original version of
MLQ (Chan 2014). The internal reliability for the MLQ-P was good in both the UK (pre-
test: alpha =.91, omega =.92; post-test: alpha =.86, omega =.87) and Hong Kong
(pre-test: alpha =.94, omega =.95; post-test: alpha =.93, omega =.94) samples.
Demographic questions encompassed asking for gender, age, household income in US
dollars, and highest level of education.
2.5 Statistical Analyses
Chi square and t-tests were used to compare the experimental and the control groups within
each cultural stratum as well as between the two countries on demographic variables. To
assess the program efficacy in the two countries, we used mixed 2 9292 design
ANOVAs (Between Countries: Great Britain and Hong Kong) 9(Between Groups:
Experimental and Control) 9(Within Group Repeated Measures: Pre-intervention, Post-
intervention). We included partial eta squared as an indicator of effect size whenever
possible to reflect the proportion of variance that the independent variable accounted for.
We used values of .010, .059, and .138 as indicators of small, medium, and large effect
sizes (these are approximately equivalent to Cohen’s ds of 0.2, 0.5, and 0.8, respectively).
A significant two-way interaction (Condition 9Time) was interpreted as evidence for a
differential intervention effect irrespective of country, while a significant three-way
interaction (Country 9Condition 9Time) was interpreted as evidence for a differential
intervention effect between the two samples from different countries. The six dependent
variables were the outcome measures. The preliminary analyses are based on all partici-
pants that completed the interventions; but intention-to-treat with last values carried for-
ward was also examined as an alternative, more conservative analysis approach. All
analyses were completed with alpha set at .05.
3 Results
There were significant demographic differences between the Great Britain and Hong Kong
samples in terms of gender, household income, level of education as well as age. There
were no significant differences between the experimental and control groups in either
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Table 2 Baseline demographics and tests on differences between countries and the experimental and the control groups for participants completing pre- and post-tests
(N =79)
Demographics British (n =43)
n (%)
Hong Kong Chinese (n =36) n (%) Difference tests
Comparison between countries
Gender (male) 12 (27.9) 22 (61.1) v
2
(1) =8.81, p=.003
Household income (less than $25 k per year) 14 (32.6) 19 (52.8) v
2
(7) =18.39, p=.010
Level of education (bachelor’s degree) 15 (34.9) 24 (66.7) v
2
(4) =14.91, p=.005
M(SD)M(SD)
Age 39.79 (15.24) 24.33 (8.46) t(77) =5.42,
p\.001
Experimental
(n =33)
Control
(n =29)
Difference tests Experimental
(n =27)
Control
(n =26)
Difference tests
N(%) N(%) N(%) N(%)
Comparison between experiment and control groups within countries
Gender (male) 5 (22.7) 7 (33.3) v
2
(1) =0.60, p=.438 13 (68.4) 9 (52.9) v
2
(1) =0.91, p=. 342
Household income (less than $25 k per year) 7 (31.8) 7 (33.3) v
2
(5) =1.68, p=.892 12 (63.2) 7 (41.2) v
2
(5) =8.10, p=.151
Level of education (bachelor’s degree) 7 (31.8) 8 (38.1) v
2
(4) =2.71, p=.607 11 (57.9) 13 (76.5) v
2
(4) =9.42, p=.051
M(SD)M(SD)M(SD)M(SD)
Age 39.86 (17.30) 39.71 (13.18) t(41) =0.03, p=.975 23.37 (4.78) 25.41 (11.34) t(34) =-0.719, p=.477
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country (see Table 2). These results were similar when also including those participants
that started but did not complete the study (See Table S1 in the supplementary material).
There were no significant differences among the examined demographic variables
between participants completing and those not completing the study. (See Table S2 in the
supplementary material) However, at the pre-test, those completing the study reported
significantly less self-compassion and presence of meaning in life as well as significantly
more positive and negative affect than those not completing the study. The correlations
among the six dependent variables are presented in Table 3.
Overall, the MBFP had a significant and considerable large effect on the outcome
measures (see Table 4and Fig. 2for more details). The interactions between Condition
(MBFP or waitlist) and Time (pre- and post-intervention) in the mixed three-way ANO-
VAs for the six dependent variables, revealed significant (p\.001) increases in mind-
fulness, gratitude, self-compassion, and presence of meaning in life, and decrease in
negative affect. Positive affect did not change significantly (p=.571). All effect sizes
were large: for mindfulness (g2
p=.147), self-compassion (g2
p=.432), negative affect
(g2
p=.379), meaning in life (g2
p=.303) and gratitude (g2
p=.276). The intention-to-treat
analyses yielded similar results, with medium effect size for mindfulness and large
(although somewhat smaller) effect sizes for the other four constructs (See Table S3 in
Supplementary Material).
No significant three-way interaction (Country 9Condition 9Time) effects were found
for the six dependent variables. This indicates that the MBFP tends to have a similar effect
in both countries. Large effect sizes were found for experimental groups within both Great
Britain and Hong Kong for mindfulness, self-compassion, meaning in life and negative
affect; whereas the effect sizes for gratitude were large in Hong Kong and moderate
(almost strong) in Great Britain. For gratitude, there was a tendency (p=.057) for a
significant interaction effect with a small effect size (g2
p=.047). However, it is also worth
noting that the experimental group in Hong Kong reported considerably lower levels of
gratitude than all other groups at pre-test, which is likely to influence the interaction rather
than cross-cultural differences in the effects of the MBFP. The intention-to-treat analyses
yielded similar statistically non-significant results. In addition, controlling for age, gender,
household income and level of education did not change any of the reported interactions
considerably (See Table S4 in supplementary material).
Table 3 Pearson correlations among dependent variables pre-intervention for the Hong Kong Chinese
(lower triangle) and the British (upper triangle) samples
Measure 123456
1. Mindfulness (FMI) .29* .70*** .47*** .21 -.40**
2. Gratitude (GQ-6) .47*** .32* .36** .26* -.05
3. Self-compassion (SCS) .57*** .49*** .69*** -.05 -.52***
4. Meaning in life (MLQ-P) .47*** .70*** .52*** .17 -.32*
5. Positive affect (PANAS) .29* .18 -.03 .13 – .07
6. Negative affect (PANAS) -.28* -.32* -.55*** -.28* .34* –
N
Hong Kong Chinese
=53; N
British
=62; * =p\.05; ** =p\.01; *** =p\.001
Mindfulness Based Flourishing Program: A Cross-Cultural
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Table 4 Mean (SD) for dependent variables and the relevant interactions from the mixed three-way ANOVAs with time (within-subjects), condition (between-subjects) and
country (between-subjects) (N =79)
Dependent Variable Country Condition Pre-score
M (SD)
Post-score
M (SD)
2-way interaction:
Time * Condition
3-way interaction:
Time * Condition * Country
Cohen’s d for within-country
pre-post scores in exp. groups
Mindfulness (FMI) F(1,75) =12.88,
p=.001, g2
p=.147
F(1,75) =0.27,
p=.607, g2
p=.004
Great Britain Exp. 31.6 (8.6) 40.8 (6.0) -1.25
Cont. 31.0 (7.1) 32.8 (7.8)
Hong Kong Exp. 32.0 (6.7) 37.8 (5.5) -0.95
Cont. 36.6 (6.9) 36.9 (6.3)
Gratitude
(GQ-6)
F(1,75) =28.56,
p\.001, g2
p=.276
F(1,75) =3.81,
p=.055, g2
p=.048
Great Britain Exp. 32.7 (5.6) 36.3 (3.8) -0.76
Cont. 34.0 (3.8) 33.1 (5.0)
Hong Kong Exp. 24.6 (7.8) 33.3 (4.5) -1.41
Cont. 31.2 (3.9) 30.3 (5.0)
Self-compassion (SCS) F(1,75) =57.02,
p\.001, g2
p=.432
F(1,75) =1.37,
p=.245, g2
p=.018
Great Britain Exp. 30.9 (8.5) 45.6 (5.2) -2.17
Cont. 35.2 (10.0) 33.3 (9.4)
Hong Kong Exp. 32.9 (7.9) 45.2 (4.9) -1.93
Cont. 37.5 (5.8) 37.6 (7.9)
Meaning in life (MLQ-P) F(1,75) =32.59,
p\.001, g2
p=.303
F(1,75) =0.70,
p=.406, g2
p=.009
Great Britain Exp. 21.4 (7.6) 29.8 (3.0) -1.59
Cont. 24.3 (6.2) 22.4 (5.6)
Hong Kong Exp. 17.7 (9.4) 25.0 (6.0) -0.95
Cont. 24.7 (5.5) 24.4 (6.0)
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Table 4 continued
Dependent Variable Country Condition Pre-score
M (SD)
Post-score
M (SD)
2-way interaction:
Time * Condition
3-way interaction:
Time * Condition * Country
Cohen’s d for within-country
pre-post scores in exp. groups
Positive affect (PANAS) F(1,75) =.32,
p=.571, g2
p=.004
F(1,75) =1.13,
p=.292, g2
p=.015
Great Britain Exp. 30.2 (7.6) 32.4 (7.2) -0.30
Cont. 28.5 (7.8) 27.4 (6.8)
Hong Kong Exp. 25.7 (6.4) 24.3 (7.3) 0.22
Cont. 31.0 (7.9) 30.5 (7.3)
Negative affect (PANAS) F(1,75) =45.82,
p\.001, g2
p=.379
F(1,75) =.97,
p=.328, g2
p=.013
Great Britain Exp. 23.1 (9.7) 15.9 (5.9) 0.94
Cont. 17.3 (5.5) 21.7 (8.1)
Hong Kong Exp. 28.4 (7.6) 14.6 (4.9) 2.19
Cont. 21.6 (7.8) 23.4 (9.0)
n
(GB, Experiment)
=22, n
(GB, Control)
=21, n
(HK, Experiment)
=19, n
(HK, Control)
=17
Box’s Tests of Equality of Covariance Matrices were significant for gratitude, self-compassion, presence of meaning in life and negative affect, therefore Pillai’s Trace is
presented for all tests
Exp. =Experiment; Cont. =Control
Mindfulness Based Flourishing Program: A Cross-Cultural
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4 Discussion
The current study was conducted with a key objective: to test whether the MBFP is cross-
culturally valid. This was represented by two hypotheses: the first was that participation in
the MBFP would lead to significant improvements in six dependent variables for the
experimental groups from both countries, and significantly improve scores in all dependent
variables at post-test when compared to the control groups. The second hypothesis pro-
claimed that the MBFP would be equally effective when comparing results of the exper-
imental group from Hong Kong to the experimental group of Great Britain. Results appear
promising with regards to both cross-cultural validity and program efficacy.
Examining intervention outcomes independently within each cultural stratum, the
MBFP remains effective. Both the British and the Hong Kong Chinese experimental
gr. = Group
28
30
32
34
36
38
40
42
T1 T2
Mindfulness
20
22
24
26
28
30
32
34
36
38
T1 T2
Gratude
16
18
20
22
24
26
28
30
32
T1 T2
Meaning in life
23
28
33
38
43
48
T1 T2
Self-compassion
23
24
25
26
27
28
29
30
31
32
33
T1 T2
Posive affect
13
15
17
19
21
23
25
27
29
31
T1 T2
Negave affect
Fig. 2 The mean score for the outcome measures at pre- and post-tests for the experimental and control
groups in the Great Britain and the Hong Kong samples
I. Ivtzan et al.
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groups showed significant improvements, with large effect sizes, in mindfulness, gratitude,
self-compassion, meaning, and negative affect, but no significant improvement in positive
affect. The intention to treat analyses offers the same conclusions, with medium to large
effect sizes. These results support the first hypothesis and provide preliminary support
regarding the efficacy of the MBFP in the context of an Eastern culture.
Similar conclusions could be drawn from the three way interaction (Country 9Con-
dition 9Time) where no significant effects were found for the six dependent variables.
When comparing effect sizes for experimental groups from Britain versus those of Hong
Kong Chinese participants, the results indicate a great similarity: large effect sizes were
found for mindfulness, self-compassion, meaning, and negative affect, for both countries.
For gratitude, there was a minor difference, whereas the effect size in Hong Kong was
large versus a moderate one in Great Britain. These results clearly indicate that the MBFP
had a similar effect in both countries. It could be concluded that the MBFP is associated
with a cross-cultural pattern of benefits, and is valid within a Hong Kong Chinese
population.
It is important to consider these results in the context of the cross-cultural literature
relating to mindfulness. Past studies indicated there might be cultural differences in
relation to the understanding and conceptualization of Mindfulness (e.g., O
¨zyesil 2012;
Christopher et al. 2009a,b). However, MBSR cross-cultural studies found no difference in
the program’s influence when cultures were compared (e.g., Roth and Robbins 2004). The
results of the current study support the MBSR studies’ results and indicate that structured
programs lead to similar results even when the initial understanding of mindfulness might
be different. This would have to be further investigated by future studies, and yet these
results suggest that a structured and balanced program could overcome cultural theoretical
gaps and lead to similar results.
Response analyses indicated that completers differed from non-completers in their pre-
test scores of the wellbeing measures. For example, completers reported lower meaning
and self-compassion, in the pre-test, compared with non-completers. It might be that
participants with greater need for the program found it more relevant and thereby expe-
rienced an increased motivation to complete it. These results are in line with Ivtzan et al.
(2016), where participants with greater need (lower scores of positive variables and higher
scores of negative variables) were more consistent with the practice and gained more from
the program. A similar point of convergence between the studies is the program’s impact
on negative affect. Although the MBFP’s intention is to increase positive variables, it still
influences variables such as stress and depression (Ivtzan et al. 2016). Similarly, the current
study found significant reductions in negative affect. These are important results as they
indicate that a program’s intention focusing on flourishing does not mean that dysphoria is
being neglected. These results are in line with other positive psychology studies where it
has been shown that PPIs are highly effective for depression treatment (Sin and Lyubo-
mirsky 2009).
In summary, not only is the MBFP a program with significant efficacies, but also one
that shows potential for targeting heterogeneous populations. Its validity in the context of
the Hong Kong Chinese culture implies that it is feasible to put the MBFP into practical use
in Eastern cultures, after making appropriate adaptations. For example, the program could
be translated into Chinese in order to reach the proportion of the Chinese population that is
not proficient in English. The MBFP has many practical advantages that will promote easy
implementation. For example, due to the online nature of the MBFP, participants from
across different geographical locations can access it with ease. The incurred cost is also
relatively low as trained personnel are not required for the delivery of the program, nor are
Mindfulness Based Flourishing Program: A Cross-Cultural
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physical materials, such as paper notes or booklets. It is thus concluded that the MBFP is a
promising wellbeing program with a high level of practicality and the potential for cross-
cultural application.
Furthermore, the MBFP can be taken as a convenient tool for future research on the
relationships between mindfulness and wellbeing. Since the MBFP is explicitly designed
with a positive-oriented intention, it would be suitable for investigating the links between
mindfulness and positive variables. Because of the multi-faceted nature of the MBFP,
many different wellbeing variables can be studied in relation to mindfulness. The MBFP’s
cross-cultural validity also makes it possible to apply the program for the study of
mindfulness in other cultures, or to identify intercultural differences in mindfulness.
Although the current study was carried out with the practical intention of testing a
mindfulness-based wellbeing program, it does also serve to strengthen the existing evi-
dence base for the positive effects of mindfulness on wellbeing measures (e.g., Brown and
Ryan 2003; Carson et al. 2004). A host of positive variables were examined, and they all
demonstrated responsiveness to this mindfulness-based program. The versatility of
mindfulness appears encouragingly high in that in addition to its established role in alle-
viating mental distress (e.g. Grossman et al. 2004; Teasdale et al. 2000), it also appears
very useful for human flourishing.
More importantly, findings from this study suggest the benefits of mindfulness practices
are cross-cultural to an extent. While differences exist between cultures in terms of the
definition, practice, and measurement of Mindfulness (e.g. Christopher et al. 2009a,b;
Grossman 2011), it is increasingly evident that regardless of the conceptual fluidity of
mindfulness, the positive effects of mindfulness can transcend cultural boundaries.
A limitation with the sample of this study is its potential lack of generalizability.
Participants were predominantly recruited from health-related settings (i.e. mental health
forums and meditation centres). It is thus possible that participants had a higher than
average awareness of mental health, or greater interest in improving wellbeing. There was
also notable attrition in both countries, across both the experimental and the control groups.
However, the largest portion of the attrition was by participants that did not even complete
the pre-intervention measures, whereas 68.7% of those that completed the pre-intervention
measures also completed the post-intervention measures (which is comparable with Ivtzan
et al. 2016 study).
In addition, a methodological shortcoming of the current study is its reliance on sub-
jective, self-report measures. To assess the MBFP’s efficacy from a more objective per-
spective, future attempts to test the program could incorporate physiological and
behavioural measures that are linked to mindfulness (e.g., Campbell et al. 2012). Lastly,
while the internal consistency of the dependent measures tended to be good across time and
countries, the two-items measure used to screen for depression (the PHQ-2) yielded
unexpectedly poor internal consistency, especially in the Hong Kong sample. This low
reliability may indicate that the screening for depression was not as accurate as anticipated.
Another possible limitation is that the MBFP is delivered in English. Although English
is an official and common language in Hong Kong (Bolton 2000); research indicates it is
favoured by the middle class while those from lower socio-economic groups favour
Cantonese (Lai 2001). This may help explain the high education levels of participants from
Hong Kong. To counter this issue, future research should make the MBFP available in
multiple languages. This will also make it available to a wider audience.
Future research should also focus on the underlying mechanisms of the MBFP, by
measuring savouring and the incremental benefits provided by each element of the inter-
vention. Additional future research should aim to replicate the cross-cultural findings from
I. Ivtzan et al.
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the current study with a larger sample size. To present the MBFP as a truly cross-cultural
intervention, research is needed in other distinctive cultures with the program delivered in
the local language. A plausible starting point would be to test the program in other
primarily Buddhist cultures, such as Thailand and Vietnam.
Compliance with Ethical Standards
Ethical Approval This study received ethical approval from the Research Ethics Committee of the
University of East London, Water Lane, London E15 4LZ.
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Mindfulness Based Flourishing Program: A Cross-Cultural
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... The World Health Organization (WHO) defines mental health as having a positive attitude to achieve goals, being able to adapt to the social environment, having physical health, experiencing a sense of happiness and mental wellbeing, having effective interpersonal relationships with others, and coping effectively with problems (5). Mindfulness has been shown to positively influence the quality of relationships one may have across their personal, social, and work lives (6). Mindfulness is defined as the intentional attention of the present moment, observation as opposed to judgment, and acceptance of thoughts and feelings (7). ...
... Construct validity examines the empirical evidence in support of the hypothesized relationships between the items and the dimensions of the construct validity is evaluated in three steps: 1,7,15,16,18,19,23,24,26,27. Non-judgmental Acceptance items: 3,9,14,6,8,11,12,22. (a) Evaluation of factor loadings: As seen in Figure 1, the factor loading values did not violate these criteria, therefore all items remained in the questionnaire. ...
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Interpersonal mindfulness is a construct that significantly contributes to social interaction. To date, no validated measure assessing interpersonal mindfulness has been developed in Iran. Therefore, the aim of this study was to translate and validate the Interpersonal Mindfulness Scale (IMS) among Iranian undergraduate students. Participants in the study (370 undergraduate students; 220 females) from the Azad University completed the translated IMS, the Five Facet Mindfulness Questionnaire, and the Inventory of Interpersonal Problems Scale. The translated measure demonstrated acceptable face validity. All items had acceptable content validity and were deemed essential to the scale. The results of a Confirmatory Factor Analysis (CFA) confirmed a scale with four subscales (presence, awareness of self and others, non-judgmental acceptance, and non-reactivity), with acceptable internal consistency. The findings support the psychometric properties of the Persian translated Interpersonal Mindfulness Scale, which could be used to measure interpersonal mindfulness among undergraduate students in Iran.
... There were also inconsistencies when two or more cultures were compared. Ivtzan et al. (2018) tested an 8-week mindfulness program to promote flourishing via mindfulness in the United Kingdom and Hong Kong. Compared to the respective control groups, Hong Kong participants showed a decrease in the positive affect post-intervention, while UK participants demonstrated an increase. ...
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This short opinion piece raises an important point about the universality of mindfulness-based programs. The currently established mindfulness programs delivered worldwide are modeled mainly on the original Mindfulness-Based Stress Reduction program structure. Taken out from its original Buddhist context and developed in the West originally for Western practitioners, mindfulness techniques and definitions are now re-exporting back to Asia, gaining popularity in Asia. Studies in self-construal have pointed out the cultural differences between the West and the East. Hence the suitability of Western-developed programs would need to be re-examined. And there could be significant implications for the design and adaptation of mindfulness-based programs delivered across cultures.
... Individuals having higher levels of mindfulness have higher levels of flourishing. There is a wealth of evidence in the literature that supports the contribution of mindfulness to flourishing [38,39]. In a longitudinal mediation analysis, Duan and Ho (2018) reported that mindfulness improves flourishing [40]. ...
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Introduction: An important research avenue on flourishing is to understand the predictors and mechanisms associated with flourishing. Most evidence has been reported from western countries. However, little is known about whether the relationship between self-compassion and flourishing could be explained through mindfulness in a non-western country. Therefore, this study aimed to examine the mediating role of mindfulness in the association between self-compassion and flourishing in a sample of Arabic speaking adults. Methods: A cross-sectional research design was used to collect data from 396 (50% females) Arab adults recruited from the general public. Participants ranged in age fro 19 and 59 years with a mean age of 30.7 years (SD = 10.3). Participants completed online versions of the Self-Compassion Scale – Short Form, the Freiburg Mindfulness Inventory, and the Flourishing Scale. Results: The results of correlation analysis indicated significant positive correlations among self-compassion, mindfulness, and flourishing. The results of mediation analysis showed that self-compassion significantly predicted mindfulness and flourishing. Mindfulness also significantly predicted flourishing. Mediation analysis supported the hypothesis that mindfulness played a mediating role between self-compassion and flourishing. Discussion: The results suggest the importance of mindfulness in understanding the association between self-compassion and flourishing. Intervention efforts aimed at improving flourishing may benefit from increased mindfulness and self-compassion. Take-home message: In this study, individuals with high levels of self-compassion experienced more mindfulness and flourishing in their lives.
... Therefore, it is necessary to have measures that can be used to assess changes in mindfulness in different cultures (Raphiphatthana et al., 2019). Cross-cultural studies have shown that people with different cultural backgrounds differ in the conceptualization and experiences of mindfulness (Ivtzan et al., 2018). For example, it has been reported that U.S. students had greater psychological needs and were more aware than Turkish students (Özyeşil, 2012). ...
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The Spanish version of the 5-item Mindful Attention Awareness Scale (MAAS-5) is a brief measure of the general tendency to be attentive and aware of experiences in the present moment during daily life. The MAAS-5 has been used in different countries; however, an assessment of its cross-cultural measurement invariance (MI) has not been conducted. Therefore, the study aimed to evaluate the cross-cultural measurement invariance of the MAAS-5 in university students from two countries: Peru and Mexico. A total of 1144 university students from Peru ( N = 822) and Mexico ( N = 322) responded online to the Spanish version of the 5-item Mindful Attention Awareness Scale (MAAS-5). A multigroup confirmatory factor analysis was performed. Measurement invariance tests the hypothesis that the model behind a set of scores is comparable between groups. The results showed that the unidimensional structure of the MAAS-5 is the same between Peruvian and Mexican university students. Therefore, it is suggested that university students from both countries conceptualize the mindfulness in a similar way. As a result, the MAAS-5 can be used to compare differences between countries. No significant differences were observed in the MAAS-5 score between Peruvian and Mexican university students. The present study contributes to a better understanding of the psychometric properties of the MAAS-5 by presenting MI results in two Latin American countries. Implications of the findings are discussed, which will facilitate a more solid and reliable use of the MAAS-5 in future cross-cultural studies.
... Ghorbani et al. (2009) found similar patterns of positive correlation of mindfulness with the self-reported adjustment comparing the participants from Iran (Middle Eastern culture) and the USA (Western culture). In yet another study, Ivtzan et al. (2018) found that after an 8-week online Mindfulness-Based Flourishing Program (MBFP), both British and Chinese (Hong Kong based) experimental groups showed significant improvements, with large effect sizes, in mindfulness, gratitude, self-compassion, meaning, and negative affect compared to a control group, providing preliminary evidence for the MBFP's cross-cultural validity. The authors concluded that the structured mindfulness-based programs lead to a similar cross-cultural pattern of benefits even when the initial understanding of mindfulness might have been different. ...
... As a result, the increasing positivity creates a sense of meaning in life, which enhances eudaimonic well-being (Garland et al., 2015). Several other studies have also confirmed that MBIs are effective for mitigating stress and improving well-being (Shapiro et al., 1998(Shapiro et al., , 2011Cohen-Katz et al., 2005;Jain et al., 2007;Carmody and Baer, 2008;Vieten and Astin, 2008;Klatt et al., 2009;Robins et al., 2012;de Vibe et al., 2013;Flook et al., 2013;Malarkey et al., 2013;Nyklicek et al., 2013;Huang et al., 2015;Song and Lindquist, 2015;Ivtzan et al., 2016Ivtzan et al., , 2018van Dongen et al., 2016;Bartlett et al., 2017;Chu and Mak, 2020). ...
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Objectives: Better subjective and eudaimonic well-being fosters better health conditions. Several studies have confirmed that mindfulness-based interventions are effective for improving well-being; however, the samples examined in these studies have been limited to specific populations, and the studies only measured certain aspects of well-being rather than the entire construct. Additionally, few studies have examined the effect of mindfulness-based cognitive therapy on well-being. The present study examines the feasibility of mindfulness-based cognitive therapy and its effectiveness for improving subjective and eudaimonic well-being among community residents. Methods: The study design featured an 8-week randomized, waiting-list controlled, parallel-group study. 8 weekly mindfulness classes, followed by 2 monthly classes, were provided for healthy individuals aged 20–65 years who had a Satisfaction with Life Scale score of ≤ 24 indicating average to low cognitive aspect of subjective well-being. This trial was registered with the University Hospital Medical Information Network Clinical Trials Registry (ID: UMIN000031885, URL: https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000036376 ). Results: The results showed that cognitive aspect of subjective well-being and mindfulness skills were significantly improved at 8 weeks, and this effect was enhanced up to the end of the follow-up period. Positive affective aspect of subjective and eudaimonic well-being were significantly improved at 16 weeks. Conclusions: Eight weeks of mindfulness-based cognitive therapy with a 2-month follow-up period improves cognitive and affective aspects of subjective and eudaimonic well-being in healthy individuals. The order of improvement was cognitive, positive affective, and eudaimonic well-being. To verify these findings, multi-center randomized controlled trials with active control groups and longer follow-up periods are warranted.
... Ghorbani et al. (2009) found similar patterns of positive correlation of mindfulness with the self-reported adjustment comparing the participants from Iran (Middle Eastern culture) and the USA (Western culture). In yet another study, Ivtzan et al. (2018) found that after an 8-week online Mindfulness-Based Flourishing Program (MBFP), both British and Chinese (Hong Kong based) experimental groups showed significant improvements, with the large effect of sizes, in mindfulness, gratitude, self-compassion, meaning, and negative affects compared to a control group, providing preliminary evidence for the MBFP's cross-cultural validity. The authors concluded that the structured mindfulness-based programs lead to a similar cross-cultural pattern of benefits even when the initial understanding of mindfulness might have been different. ...
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Mindfulness practices form the core of numerous therapeutic programs and interventions for stress reduction and the treatment of different health conditions related to stress and life habits. Ways and means to regulate oneself effectively also form the foundation of the path of yoga in the accomplishment of holistic health and well-being. The self-awareness, self-regulation, and self-transcendence (S-ART) model can be considered as an overarching neurobiological framework to explain the self-regulatory mechanisms of well-being present in mindfulness-based practices. The current study, by connecting and applying the S-ART framework to the self-regulatory mechanisms in yoga and generating related hypotheses, provides a theory-led explanation of the action of yoga practices, which is sparse in the literature. Testing the S-ART model in yoga in two culturally diverse samples, assessing the model-mapped psychological mechanisms of action, and exploring the influence of perseverance in yoga practice are the original contributions of this study. The study sample comprised 362 yoga practitioners and non-practitioners (197 Indian and 165 Spanish), who completed four tests of psychological variables indicative of the aforementioned three S-ART abilities. These tests were Multidimensional Assessment of Interoceptive Awareness (MAIA), Experiences Questionnaire-Decentering (EQ-D) subscale, Difficulties in Emotion Regulation Scale (DERS), and Relational Compassion Scale (RCS). The results indicated significantly better s elf-awareness and self-regulatory abilities in yoga practitioners (Indian and Spanish in a combination) than non-practitioners, reflected in higher levels of interoceptive awareness and decentering abilities. Moreover, perseverance in yoga practice acted as a significant predictor of self-awareness and self-regulation in practitioners. An analysis of each cultural sample revealed some differences. Yoga practice and perseverance in it acted as a significant predictor of interoceptive awareness and decentering in Indian practitioners having more than 1 year of sustained yoga practice, but for the Spanish participants, physical exercise and frequency of yoga practice acted as better predictors of interoceptive awareness and decentering in comparison to yoga practice and perseverance in it. The obtained results suggested that the S-ART model provided preliminary but promising evidence for the self-regulatory mechanisms of action in yoga practice within a culturally diverse sample of yoga practitioners. This study also widens the scope of generating further hypotheses using the S-ART theoretical framework for testing the self-regulatory mechanisms of action in yoga practice.
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This short opinion piece raises an important point about the universality of mindfulness-based programs. The currently established mindfulness programs delivered worldwide are modeled mainly on the original Mindfulness-Based Stress Reduction program structure. Taken out from its original Buddhist context and developed in the West originally for Western practitioners, mindfulness techniques and definitions are now re-exporting back to Asia, gaining popularity in Asia. Studies in self-construal have pointed out the cultural differences between the West and the East. Hence the suitability of Western-developed programs would need to be re-examined. And there could be significant implications for the design and adaptation of mindfulness-based programs delivered across cultures.
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Full-text available
Second-generation mindfulness-based interventions (SG-MBIs) align well with positive psychology philosophy and practices, but trials of SG-MBIs have largely focused on ill-being. This study developed a mindfulness-based positive psychology (MBPP) intervention integrating positive psychology with an SG-MBI to enhance well-being. A randomized control trial was performed to compare MBPP with a waitlist condition among 138 Chinese participants. The results showed that MBPP significantly reduced negative emotions for subjective well-being and significantly improved environmental mastery for psychological well-being. Improvements in self-compassion and negative attitudes but not avoidance, mediated changes in well-being. Changes in positive emotions, positive relations, and awareness were associated with the amount of meditation practice. These findings showed that MBPP is promising for improving well-being and that the positive psychology components play important roles. Broadly, the study illustrated that positive psychology and SG-MBIs can be effectively integrated, and it supported the further application of SG-MBIs from the positive psychology perspective. Supplementary information: The online version contains supplementary material available at 10.1007/s10902-022-00525-2.
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Background: Numerous studies have demonstrated the effectiveness of Mindfulness-based programs' (MBPs) among both clinical and non-clinical populations. These data document positive impacts in the workplace, including reducing perceived stress and burnout and increasing wellbeing. However, the effectiveness for productivity, which is of most interest to managers and administrators, is still unclear. In addition, MBPs in the workplace tend to be modified by reducing the number of the program sessions or delivering content online to improve accessibility. To date, however, the impact on productivity of MBPs in the workplace that feature these modifications has not been investigated. Objective: The study aimed to investigate the effectiveness and cost-effectiveness of the online-delivered brief Mindfulness Based Cognitive Therapy (bMBCT) for improving productivity and other work related outcomes among healthy workers compared to the wait-list control. Methods: We conduct a four-week randomized controlled trial with a six-month follow-up. Employees are included in the study if they 1) are between the ages of 20-65 and 2) work longer than 30 hours weekly. Employees were randomly allocated to either the bMBCT group or wait-list control group. The primary outcome of the study is the mean difference of productivity measured by World Health Organization Health and Work Performance Questionnaire (WHO-HPQ) between the groups at 4, 16, 28 weeks. Secondary outcomes include several clinical outcomes and health economics evaluation. Results: We started recruiting participants in August 2021 and the intervention began in October 2021. A total of 104 participants have been enrolled in the study as of October 2021. The intervention is scheduled to be completed in December 2023. Data collection will be completed by the end of January 2024. Conclusions: The novelty of the study is that 1) it will investigate the bMBCTs' effectiveness on productivity, which is still unclear, 2) samples are recruited from three companies in different industries, etc. The limitations of the study are 1) all measures assessed are self-report format, 2) we lack an active control group. This study has the potential to provide new data on the relationship between MBPs and occupational health and productivity. Clinicaltrial: UMIN Clinical Trials Registry: UMIN000044721. Registered Jun 30, 2021.
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The purpose of the present study was to test the efficacy of an 8-week online intervention-based Positive Mindfulness Program (PMP) that integrated mindfulness with a series of positive psychology variables, with a view to improving well-being scores measured in these variables. The positive mindfulness cycle, based on positive intentions and savouring, provides the theoretical foundation for the PMP. The study was based on a randomised wait-list controlled trial, and 168 participants (128 females, mean age = 40.82) completed the intervention which included daily videos, meditations and activities. The variables tested included well-being measures, such as gratitude, self-compassion, self-efficacy, meaning and autonomy. Pre- and post-intervention data, including 1 month after the end of the intervention, were collected from both experimental and control groups. The posttest measurements of the experimental participants showed a significant improvement in all the dependent variables compared with the pre-test ones and were also significantly higher than those of the control group. One month after the intervention, the experimental group participants retained their improvement in 10 out of the 11 measurements. These positive results indicate that PMP may be effective in enhancing wellbeing and other positive variables in adult, non-clinical populations.
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Contemporary scholarship on mindfulness casts it as a form of purely nonevaluative engagement with experience. Yet, traditionally mindfulness was not intended to operate in a vacuum of dispassionate observation, but was seen as facilitative of eudaimonic mental states. In spite of this historical context, modern psychological research has neglected to ask the question of how the practice of mindfulness affects downstream emotion regulatory processes to impact the sense of meaning in life. To fill this lacuna, here we describe the mindfulness-to-meaning theory, from which we derive a novel process model of mindful positive emotion regulation informed by affective science, in which mindfulness is proposed to introduce flexibility in the generation of cognitive appraisals by enhancing interoceptive attention, thereby expanding the scope of cognition to facilitate reappraisal of adversity and savoring of positive experience. This process is proposed to culminate in a deepened capacity for meaning-making and greater engagement with life.
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In four studies, the authors examined the correlates of the disposition toward gratitude. Study 1 revealed that self-ratings and observer ratings of the grateful disposition are associated with positive affect and well-being prosocial behaviors and traits, and religiousness/spirituality. Study 2 replicated these findings in a large nonstudent sample. Study 3 yielded similar results to Studies 1 and 2 and provided evidence that gratitude is negatively associated with envy and materialistic attitudes. Study 4 yielded evidence that these associations persist after controlling for Extraversion/positive affectivity, Neuroticism/negative affectivity, and Agreeableness. The development of the Gratitude Questionnaire, a unidimensional measure with good psychometric properties, is also described.
Book
Mindfulness in Positive Psychology brings together the latest thinking in these two important disciplines. Positive psychology, the science of wellbeing and strengths, is the fastest growing branch of psychology, offering an optimal home for the research and application of mindfulness. As we contemplate mindfulness in the context of positive psychology, meaningful insights are being revealed in relation to our mental and physical health. The book features chapters from leading figures from mindfulness and positive psychology, offering an exciting combination of topics. Mindfulness is explored in relation to flow, meaning, parenthood, performance, sports, obesity, depression, pregnancy, spirituality, happiness, mortality, and many other ground-breaking topics. This is an invitation to rethink about mindfulness in ways that truly expands our understanding of wellbeing. Mindfulness in Positive Psychology will appeal to a readership of students and practitioners, as well as those interested in mindfulness, positive psychology, or other relevant areas such as education, healthcare, clinical psychology, counselling psychology, occupational psychology, and coaching. The book explores cutting edge theories, research, and practical exercises, which will be relevant to all people interested in this area, and particularly those who wish to enhance their wellbeing via mindfulness