Interrupting the "Costs of Competence" Through Mindfulness Intervention for High Achieving Minoritized Students: A Protocol for the Project STRIVE Mechanistic Trial.

In racially minoritized communities, students who overcome structural challenges to succeed academically are regarded as resilient. However, the same self-regulation skills that help minoritized youth excel despite chronic stress may also lead to physiological dysregulation that can contribute to health disparities. Structural racism and race-related stress may compel motivated youth to adopt a Striving Persistent Behavioral Style (SPBS), a high effort coping strategy that involves emotion suppression, experiential avoidance, and unmodulated perseverance. Mindfulness intervention has the potential to target these aspects of self-regulation while conserving achievement. We will conduct a randomized controlled trial in which 504 high-achieving students of color will be randomly assigned to either a mindfulness intervention or an attention control. Assessments will include self-report and behavioral measures of self-regulation, and self-report and biomarker measures of health outcomes at baseline, post-treatment, and 1-year follow-up. Project STRIVE (STudents RIsing aboVE) will address three aims: 1) Examine the impact of the STRIVE intervention on self-regulation processes associated with SPBS, 2) Assess the effects of the STRIVE intervention on the primary outcomes of allostatic load (a multisystem indicator of chronic physiological stress), health complaints, and internalizing mental health symptoms, and 3) Test the mechanistic pathways linking SPBS to health outcomes. Project STRIVE is a reverse translational study that uses a randomized trial design to provide a causal test of hypothesized mechanisms by which health disparities persist among upwardly mobile racially minoritized individuals. This trial is registered in the ClinicalTrials.gov Protocol and Results Registration System (NCT05846282).