Universal Mindfulness Training in Schools for Adolescents: a Scoping Review and Conceptual Model of Moderators, Mediators, and Implementation Factors

Abstract

There is evidence that universal school-based mindfulness training (SBMT) can have positive effects for young people. However, it is unknown who benefits most from such training, how training exerts effects, and how implementation impacts effects. This study aimed to provide an overview of the evidence on the mediators, moderators, and implementation factors of SBMT, and propose a conceptual model that can be used both to summarize the evidence and provide a framework for future research. A scoping review was performed, and six databases and grey literature were searched. Inclusion and exclusion criteria were applied to select relevant material. Quantitative and qualitative information was extracted from eligible articles and reported in accordance with PRISMA-ScR guidelines. The search produced 5479 articles, of which 31 were eligible and included in the review. Eleven studies assessed moderators of SBMT on pupil outcomes, with mixed findings for all variables tested. Five studies examined the mediating effect of specific variables on pupil outcomes, with evidence that increases in mindfulness skills and decreases in cognitive reactivity and self-criticism post-intervention are related to better pupil outcomes at follow-up. Twenty-five studies assessed implementation factors. We discuss key methodological shortcomings of included studies and integrate our findings with existing implementation frameworks to propose a conceptual model. Widespread interest in universal SBMT has led to increased research over recent years, exploring who SBMT works for and how it might work, but the current evidence is limited. We make recommendations for future research and provide a conceptual model to guide theory-led developments.

School-based mindfulness training in early adolescence: what works, for whom and how in the MYRIAD trial?

“…3 4 Because of their broad reach and central role in the lives of children and families, schools are seen as the primary setting where such social-emotional learning (SEL) programmes can be provided. 5 Based on theory, a scoping review and our pilot work, 6 we developed a high-level conceptual model (figure 1A) 7 that hypothesises for whom, in what implementation context and how, one such programme (universal school-based mindfulness training (SBMT)) is most likely to be effective. This model sets out potential moderators (eg, the wider school context and characteristics of the schools, teachers, and students), implementation factors (eg, intervention fidelity, dose, quality, reach and mindfulness practice) and mediators (eg, mindfulness skills and executive function).…”

“…This model sets out potential moderators (eg, the wider school context and characteristics of the schools, teachers, and students), implementation factors (eg, intervention fidelity, dose, quality, reach and mindfulness practice) and mediators (eg, mindfulness skills and executive function). 7 'My Resilience in Adolescence' (MYRIAD) was a cluster randomised controlled trial (RCT) asking if universal SBMT, compared with social-emotional teaching as usual (TAU), promotes mental health and well-being in early adolescence, as implemented in UK secondary schools. In the main analyses, we found no support for the SBMT's effectiveness compared with TAU on student mental health and well-being outcomes.…”

Effectiveness of universal school-based mindfulness training compared with normal school provision on teacher mental health and school climate: results of the MYRIAD cluster randomised controlled trial

“…We used a cluster RCT design, with schools (clusters) as the unit of randomisation, comparing SBMT and TAU, with regard to teachers' mental health and school climate. All mainstream schools (ages [11][12][13][14][15][16] in the four UK regions (England, Northern Ireland, Scotland and Wales) were eligible if they had a substantive appointed headteacher, had not been judged inadequate in their most recent official inspection (to mitigate any difficulties in trial implementation) and had a strategy/structure in place for delivery of adequate SEL curricula. Consent was sought at the school level by the corresponding headteacher and by all involved teachers.…”

“…While the SBMT programme's primary aim was to teach mindfulness skills that support young people's resilience, its wider aims included enhancing teachers' mental health and school climate. Informed by theory and implementation science, 16 SBMT was designed to be integrated into the school curriculum.…”

“…In addition, there is almost no research on the effects of SBMT on school climate. 16 This study is part of a larger programme of work examining the effectiveness, cost-effectiveness, mechanisms, scalability and implementation of SBMT ('MYRIAD: My Resilience in Adolescence'). [17][18][19]…”