A Retrospective Systematic Review of Diversity Variables in Mindfulness Research, 2000–2016

As mindfulness-based programs (MBPs) become widespread, MBP research samples should be representative of the general public to avoid exclusion of minoritized groups. This systematic review retrospectively investigates demographic diversity in MBP research, based on reported variables and patterns of omission during that time.

We reviewed randomized controlled trials (RCTs) of standard MBSR and MBCT that targeted self-regulation outcomes through 2016 with healthy and clinical adult populations. Completeness of documentation and analyses for race, ethnicity, gender, sexual orientation, language, education, age, and intersectionality were extracted, compared with census data when possible, and tracked over time based on the date of publication.

The included 94 RCTs comprised populations that were predominantly White (79%), middle-aged (46 years), highly educated (15 years), and female (70%). The composition of studies from the USA differed significantly from the US census data. Only 41% of studies reported race or ethnicity, 95% reported gender without non-binary categories, 64% reported education, 89% reported age variance, 2% reported sexual orientation, 9% stratified analyses by demographic variables, and none reported identity multiplicity or intersectionality. MBP efficacy could not be determined for subgroups due to lack of subgroup analyses. Temporal trends show limited improvements in diversity composition and reporting of race over time.

MBPs’ potential benefit for diverse populations will depend on adequate reporting of currently underreported demographic variables. To develop culturally responsive interventions, MBPs research must include underrepresented populations to counter observed systemic bias and address inclusion disparities in the field. We offer recommendations to further this aim.

The PROSPERO review registration (number: CRD42016051765 (Loucks et al., American Journal of Health Behavior 40:258–267, 2016)) with a review protocol was submitted on December 9, 2016, and confirmed on December 16, 2016.