Date of Graduation

Spring 5-17-2019

Document Type


Degree Name

Doctor of Psychology in Clinical Psychology (PsyD)


School of Nursing and Health Professions




Clinical Psychology (PsyD)

First Advisor

Dhara Meghani, Ph.D.

Second Advisor

Dellanira Garcia, Ph.D.

Third Advisor

David Hoskins, Psy.D.


This study is a program evaluation with a mixed methods design that evaluated the effectiveness of Peer Engagement and Knowledge (PEAK), a six-week community-based group intervention that incorporates mindfulness-based interventions (MBIs) to address multiple health behaviors for multiracial youth in Hilo, Hawai‘i. A total of 51 youth, ages 12-23 years old, participated in this study which included pre-/posttest analyses of health risk factors such as substance use and depression and health promoting factors such as resilience, self-esteem, and mindfulness. Responses from two subsets of participants, who engaged in a focus group (n = 11) and composed gratitude letters (n = 12), were analyzed using a thematic analysis approach. At baseline, 41.17% of youth endorsed moderate or severe levels of depressive symptomatology, 29.41% endorsed using at least one substance within the past 30 days, 94.12% endorsed high levels of resilience, 31.37% endorsed high levels of self-esteem, and 7.84% endorsed high utilization of mindfulness skills. Following their completion of PEAK, youth demonstrated statistically significant improvements on their levels of depression, resilience, self-esteem, and mindfulness scores, but not on substance use behaviors. Overall, youth’s health risk profiles improved such that the number of health risks decreased and the number of health promoting factors increased. Youth also found the MBIs to be acceptable and beneficial to their overall well-being, as it served as a positive coping strategy for stress and a mechanism to improve decision-making skills. PEAK demonstrates promise to be an effective community-based group intervention that enhances multiple health behaviors for multiracial youth in Hilo. Due to the small sample size, generalizability of results is limited. Limitations and implications for future research are also discussed.