Beyond Hub-and-Spoke Adaptation: Religiously and Culturally Responsive Implementation of Mindfulness for Global Public Health

Mindfulness has considerable potential to benefit global public health. The recently published article by Doug Oman, Mindfulness for global public health: Critical analysis and agenda, offers a comprehensive analysis of this potential and presents a set of axes for examining the correspondence between the priorities and capacities that have been respectively established in the fields of mindfulness and global public health. This commentary addresses the importance of religiously and culturally responsive, multi-level, and multi-sector interventions for equitable and effective application of mindfulness globally. We propose that implementation science, though not a direct focus of Oman’s article, is vital for the uptake of mindfulness into global public health efforts. Cultural adaptations of mindfulness-based interventions are likely to play an important role in mindfulness. However, several problems exist with established adaptation efforts that follow what we describe as a “hub-and-spoke” model of adaptation. These approaches to adaptation assume an established “core” mindfulness intervention (hub) that is adapted to diverse populations (spokes) based on need. We argue that this approach to adaptation replicates systemic inequities and prioritizes Westernized configurations of mindfulness. As an alternative, the “core” of mindfulness interventions should be expanded by allowing successful cultural adaptations to recursively inform and diversify intervention components. Implementation science models that emphasize health equity and interaction among multiple public health sectors may play an especially important role in developing and evaluating culturally responsive mindfulness interventions that can meet global public health needs.