Assessing Fidelity of Implementation (FOI) for School-Based Mindfulness and Yoga Interventions: A Systematic Review

Abstract

As school-based mindfulness and yoga programs gain popularity, the systematic study of fidelity of program implementation (FOI) is critical to provide a more robust understanding of the core components of mindfulness and yoga interventions, their potential to improve specified teacher and student outcomes, and our ability to implement these programs consistently and effectively. This paper reviews the current state of the science with respect to inclusion and reporting of FOI in peer-reviewed studies examining the effects of school-based mindfulness and/or yoga programs targeting students and/or teachers implemented in grades kindergarten through twelve (K-12) in North America. Electronic searches in PsychInfo and Web of Science from their inception through May 2014, in addition to hand searches of relevant review articles, identified 312 publications, 48 of which met inclusion criteria. Findings indicated a relative paucity of rigorous FOI. Fewer than 10% of studies outlined potential core program components or referenced a formal theory of action, and fewer than 20% assessed any aspect of FOI beyond participant dosage. The emerging nature of the evidence base provides a critical window of opportunity to grapple with key issues relevant to FOI of mindfulness-based and yoga programs, including identifying essential elements of these programs that should be faithfully implemented and how we might develop rigorous measures to accurately capture them. Consideration of these questions and suggested next steps are intended to help advance the emerging field of school-based mindfulness and yoga interventions.

A qualitative examination of yoga for middle school adolescents

“…While a small number of studies have discussed the feasibility, acceptability, and sustainability of school-based yoga and mindfulness programming (Dariotis et al, 2017; Feagans Gould, Dariotis, Greenberg, & Mendelson, 2016; Mendelson et al, 2013; Zenner et al., 2014), these topics are largely absent from the literature. The current study addresses this limitation by examining students’ personal perceptions of a school-based yoga program.…”

A Qualitative Evaluation of Student Learning and Skills Use in a School-Based Mindfulness and Yoga Program

“…Several students and teachers believed offering the program over more than 1 year would be necessary for producing meaningful changes, but we do not yet have data to indicate that this is the case. Indeed, the emerging field of school-based mindfulness and yoga research does not yet have empirically based recommendations regarding dosage (Cook-Cottone 2013; Feagans Gould et al 2015). At which ages are youths most likely to be receptive to mindfulness and yoga?…”

Assessing Implementation Fidelity of a School-Based Crisis Prevention Program with an Ex-Post-Facto Design: The NETWASS FOI Assessment System

“…Fidelity of implementation (FOI) refers to the "extent to which intervention delivery adheres to the protocol or program model as intended by the intervention developers" (Mowbray, Holter, Teague, & Bybee, 2003). In implementation science, FOI is widely regarded as a multidimensional construct (Dane & Schneider, 1998;Durlak & DuPre, 2008;Dusenbury, Brannigan, Falco, & Hansen, 2003;Gould, Dariotis, Greenberg, & Mendelson, 2016;Gould at al., 2014). Dane and Schneider (1998) described five major dimensions of FOI which informed the theoretical basis of the NETWASS FOI assessment system: (1) adherence, which is the extent to which core activities and processes are implemented as prescribed by the program model; (2) dosage, which reflects the amount of intervention received by the participants, e.g., the number of training sessions;…”

“…Although there is currently no consensus among implementation scientists on the optimum degree of FOI that is needed to achieve program effects, the majority of studies indicates that higher FOI is associated with better outcomes and should be favored over flexibility (Borrelli et al, 2005;Durlak & DuPre, 2008;Gould et al, 2016;Fagan & Mihalic, 2003). Nevertheless, to guarantee implementation compliance and sustainability across diverse settings, stakeholders must be allowed some flexibility to adjust a program to their needs and resources (August, Bloomquist, Lee, Realmuto, & Hektner, 2006).…”