"Coming Correct": Conducting Community Engagement Studios to Adapt Mindfulness-Based Cognitive Therapy for the Chronic Pain-Depression Comorbidity Among Older Black Adults.

Older Black adults experience disproportionately high rates of chronic pain (CP) and depression, yet inequities in access, recognition, and culturally resonant treatment persist. Mindfulness-based cognitive therapy (MBCT) is an evidence-based group intervention for depression with emerging promise for CP. However, adaptations for older Black adults with comorbid CP-depression remain underexplored. Guided by cultural intervention adaptation and community engagement principles, we conducted four Community Engagement Studios with 20 older Black adults in Boston (ages 51-84), all reporting CP (≥ 3 months) and mild to moderate depressive symptoms (PHQ-9 ≥ 15). Participants reviewed MBCT content and reflected on cultural relevance, barriers, and facilitators. Through thematic analysis of recorded transcripts, we identified themes pertaining to their perceptions of MBCT. Three themes emerged: (1) nuanced acceptance of mindfulness practices when adapted to faith, physical limitations, and language; (2) importance of instructors who are grounded in respect and shared cultural context; and (3) preference for flexible, sustainable delivery (community-based, hybrid options, shorter sessions). Our findings highlight MBCT's feasibility for older Black adults with the CP-depression comorbidity when adapted for cultural resonance, accessibility, and sustainability. Results will directly inform our adaptation of MBCT for the CP-depression comorbidity among older Black adults.