Identifying factors relevant for successful implementation of school-based interventions is essential to ensure that programs are provided in an effective and engaging manner. The perspectives of two key stakeholders critical for identifying implementation barriers and facilitators – students and their classroom teachers – merit attention in this context and have rarely been explored using qualitative methods. This study reports qualitative perspectives of fifth and sixth grade participants and their teachers of a 16-week school-based mindfulness and yoga program in three public schools serving low-income urban communities. Four themes related to program implementation barriers and facilitators emerged: program delivery factors, program buy-in, implementer communication with teachers, and instructor qualities. Feedback from students and teachers is discussed in the context of informing implementation, adaptation, and future development of school-based mindfulness and yoga programming in urban settings.
Previous studies on school-based mindfulness and yoga programs have focused primarily on quantitative measurement of program outcomes. This study used qualitative data to investigate program content and skills that students remembered and applied in their daily lives. Data were gathered following a 16-week mindfulness and yoga intervention delivered at three urban schools by a community non-profit organization. We conducted focus groups and interviews with nine classroom teachers who did not participate in the program and held six focus groups with 22 fifth and sixth grade program participants. This study addresses two primary research questions: (1) What skills did students learn, retain, and utilize outside the program? and (2) What changes did classroom teachers expect and observe among program recipients? Four major themes related to skill learning and application emerged as follows: (1) youths retained and utilized program skills involving breath work and poses; (2) knowledge about health benefits of these techniques promoted self-utilization and sharing of skills; (3) youths developed keener emotional appraisal that, coupled with new and improved emotional regulation skills, helped de-escalate negative emotions, promote calm, and reduce stress; and (4) youths and teachers reported realistic and optimistic expectations for future impact of acquired program skills. We discuss implications of these findings for guiding future research and practice.
School-based mindfulness and yoga studies generally measure stress-related outcomes using quantitative measures. This study answers the following research questions: how do youth define stress and in what ways, if any, was a mindful yoga intervention helpful to youth during experiences of stress. To explore youths’ own perspectives on stress, stressors in youths’ lives, and perceived changes in responses to stress post-intervention, we conducted focus group discussions with 22 middle school students from low-income urban communities following a 16-week mindful yoga intervention. Using thematic analysis, three themes emerged: (1) youth conflated stress with negative emotions; (2) peer and family conflicts were common stressors; and (3) youth reported improved impulse control and emotional regulation following the intervention. Study findings have implications for refining intervention content (e.g., discussions of stress), as well as informing the selection and development of quantitative measures for future research on stress and stress responses in urban youth.
Background: Despite a lower percentage of primary cesareans than non-Hispanic White and Black women, Hispanic women in the United States had the highest rate of repeat cesarean deliveries (RCD) in 2016; it is unclear if reasons for differences are due to known risk factors. Our study examined the association between ethnicity/race and RCD among women with one previous cesarean and whether demographic (age, marital status, education, language, and delivery year), anthropomorphic (height, prepregnancy body mass index), obstetrical/medical (parity, gestational age, infant birth weight, gestational diabetes, labor induction or augmentation, vaginal birth after cesarean delivery history), or health system (delivery day/time, payer source, provider gender) factors accounted for any observed differences by ethnicity/race. Methods: Our retrospective cohort study used logistic regression to evaluate the relationship between ethnicity/race and RCD based on data from electronic delivery and prenatal records from 2010 to 2016, including 1800 births to Hispanic and non-Hispanic women with one previous cesarean at a District of Columbia hospital. Results: Statistically significant differences by ethnicity/race were noted after adjustment for obstetric/medical factors, particularly parity and use of induction or augmentation methods. Hispanic (adjusted odds ratio, 2.48; 95% confidence interval, 1.03-6.01) and Black women (adjusted odds ratio, 2.83; 95% confidence interval, 1.67-4.81) had higher odds of RCD than White women. Conclusions: Adjustment for parity and use of induction or augmentation methods revealed higher odds of RCD for Hispanic and Black women than White women. Demographic and anthropometric factors did not alter these results. Our work is a first step in creating effective public health policy and programs that target potentially preventable RCD by highlighting the need to evaluate risk factors beyond those included in the literature to date.
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