A Qualitative Exploration of Implementation Factors in a School-Based Mindfulness and Yoga Program: Lessons Learned from Students and Teachers.

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.

"The Program Affects Me 'Cause it Gives Away Stress": Urban Students' Qualitative Perspectives on Stress and a School-Based Mindful Yoga Intervention.

CONTEXT: School-based mindfulness and yoga studies generally measure stress-related outcomes using quantitative measures. OBJECTIVE: 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 stress experiences? DESIGN AND SUBJECTS: 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. RESULTS: Using thematic analysis, the following 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.

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

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

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.

Assessing fidelity of core components in a mindfulness and yoga intervention for urban youth: applying the CORE Process.

In the past years, the number of mindfulness-based intervention and prevention programs has increased steadily. In order to achieve the intended program outcomes, program implementers need to understand the essential and indispensable components that define a program's success. This chapter describes the complex process of identifying the core components of a mindfulness and yoga program for urban early adolescents through the systematic study of fidelity of implementation of the intervention. The authors illustrate the CORE Process [(C) Conceptualize Core Components; (O) Operationalize and measure; (R) Run analyses and Review implementation findings; and (E) Enhance and refine], based on data gained from a mindfulness and yoga intervention study conducted as a community-academic partnership in Baltimore city.

Emotional Distress May Increase Risk for Self-Medication and Lower Risk for Mood-related Drinking Consequences in Adolescents.

The current study examines indicators of emotional distress and coping that may define sub-populations of adolescents at risk for two potential affect-related mechanisms underlying substance misuse: self-medication and mood-related drinking consequences. Although theory and empirical evidence point to the salience of affect-related drinking to current and future psychopathology, we have little knowledge of whether or for whom such mood-related processes exist in adolescents because few studies have used methods that optimally match the phenomenon to the level of analysis. Consequently, the current study uses multilevel modeling in which daily reports of negative mood and alcohol use are nested within individuals to examine whether adolescents with more emotional distress and poorer coping skills are more likely to evidence self-medication and mood-related drinking consequences. Seventy-five adolescents participated in a multi-method, multi-reporter study in which they completed a 21-day experience sampling protocol assessing thrice daily measures of mood and daily measures of alcohol use. Results indicate that adolescents reporting greater anger are more likely to evidence self-medication. Conversely, adolescents displaying lower emotional distress and more active coping are more likely to evidence mood-related drinking consequences. Implications for identifying vulnerable sub-populations of adolescents at risk for these mechanisms of problematic alcohol use are discussed.

Feasibility and preliminary outcomes of a school-based mindfulness intervention for urban youth.

Youth in underserved, urban communities are at risk for a range of negative outcomes related to stress, including social-emotional difficulties, behavior problems, and poor academic performance. Mindfulness-based approaches may improve adjustment among chronically stressed and disadvantaged youth by enhancing self-regulatory capacities. This paper reports findings from a pilot randomized controlled trial assessing the feasibility, acceptability, and preliminary outcomes of a school-based mindfulness and yoga intervention. Four urban public schools were randomized to an intervention or wait-list control condition (n=97 fourth and fifth graders, 60.8% female). It was hypothesized that the 12-week intervention would reduce involuntary stress responses and improve mental health outcomes and social adjustment. Stress responses, depressive symptoms, and peer relations were assessed at baseline and post-intervention. Findings suggest the intervention was attractive to students, teachers, and school administrators and that it had a positive impact on problematic responses to stress including rumination, intrusive thoughts, and emotional arousal.

Conduct problems moderate self-medication and mood-related drinking consequences in adolescents.

OBJECTIVE: We tested whether conduct problems moderate the relation between negative mood and drinking in adolescents as consistent with either a self-medication or a drinking consequences model. METHOD: The sample included 75 rising ninth graders (i.e., in the summer before starting ninth grade) who completed a two-stage, multimethod, multireporter study. We used experience sampling to assess negative mood and drinking across 21 days and hierarchical linear modeling to test our hypotheses. RESULTS: Counter to predictions, both self-medication and drinking consequence mechanisms were evident only in youth with fewer conduct problems. CONCLUSIONS: Findings provide support for the importance of considering multiple mechanisms as underlying the relation between negative mood and drinking as pertaining to subpopulations of vulnerable youth. Implications for prevention and understanding negative mood-drinking relations in adolescents are discussed.