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Do Adolescents Like School-Based Mindfulness Training? Predictors of Mindfulness Practice and Responsiveness in the MYRIAD Trial - 31/10/23

Doi : 10.1016/j.jaac.2023.02.016 
Jesus Montero-Marin, PhD a, b, c, Verena Hinze, DPhil a, Catherine Crane, PhD a, Nicola Dalrymple, MSc a, Maria E.J. Kempnich, DPhil a, Liz Lord, MSc a, Yasmijn Slaghekke, MSc a, Kate Tudor, PhD a,

The MYRIAD Team

Saz Ahmed, PhD, Matt Allwood, BSc, Susan Ball, MSc, Marc Bennett, PsyD, Sarah-Jayne Blakemore, PhD, Triona Casey, MSc, Katherine De Wilde, PGCE, Darren Dunning, PhD, Eleanor-Rose Farley, MSc, Katie Fletcher, HSD, Lucy Foulkes, PhD, Poushali Ganguli, MSc, Cait Griffin, MSc, Kirsty Griffiths, MSc, Ben Jones, PhD, Nils Kappelmann, MSc, Konstantina Komninidou, BEd, Rachel Knight, MSc, Suzannah Laws, BSc, Jovita Leung, MSc, Emma Medlicott, MSc, Elizabeth Nuthall, PGDip, Jenna Parker, MSc, Alice Phillips, MRes, Anam Raja, MSc, Lucy Palmer, PhD, Ariane Petit, MSc, Blanca Piera Pi-Sunyer, MSc, Isobel Pryor-Nitsch, MSc, Lucy Radley, BSc, J. Ashok Sakhardande, BSc Hons, Jem Shackleford, MA, MSc, Anna Sonley, MEd, Laura Taylor, PhD, Alice Tickell, BA, Maris Vainre, MA, Russell M. Viner, PhD, Brian Wainman, BEng, Lucy Warriner, BSc

Sarah Byford, PhD c, Tim Dalgleish, PhD e, Tamsin J. Ford, PhD d, Mark T. Greenberg, PhD f, Obioha C. Ukoumunne, PhD g, J. Mark G. Williams, PhD a, Willem Kuyken, PhD a,
a University of Oxford, Oxford, United Kingdom 
b Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan de Déu, Spain 
c Consortium for Biomedical Research in Epidemiology & Public Health (CIBER Epidemiology and Public Health - CIBERESP), Spain 
d University of Cambridge, Cambridge, United Kingdom 
e Cambridgeshire and Peterborough NHS Foundation Trust, Cambridgeshire, United Kingdom 
f Pennsylvania State University, Centre County, Pennsylvania 
g University of Exeter, Exeter, United Kingdom 

Correspondence to Willem Kuyken, PhD, Department of Psychiatry, Warneford Hospital, University of Oxford, Warneford Lane, Oxford, OX3 7JX, United KingdomDepartment of PsychiatryWarneford HospitalUniversity of OxfordWarneford LaneOxfordOX3 7JXUnited Kingdom

Abstract

Objective

We explored what predicts secondary school students’ mindfulness practice and responsiveness to universal school-based mindfulness training (SBMT), and how students experience SBMT.

Method

A mixed-methods design was used. Participants were 4,232 students (11-13 years of age), in 43 UK secondary schools, who received universal SBMT (ie, “.b” program), within the MYRIAD trial (ISRCTN86619085). Following previous research, student, teacher, school, and implementation factors were evaluated as potential predictors of students’ out-of-school mindfulness practice and responsiveness (ie, interest in and attitudes toward SBMT), using mixed-effects linear regression. We explored pupils’ SBMT experiences using thematic content analysis of their answers to 2 free-response questions, 1 question focused on positive experiences and 1 question on difficulties/challenges.

Results

Students reported practicing out-of-school mindfulness exercises on average once during the intervention (mean [SD] = 1.16 [1.07]; range, 0-5). Students’ average ratings of responsiveness were intermediate (mean [SD] = 4.72 [2.88]; range, 0-10). Girls reported more responsiveness. High risk of mental health problems was associated with lower responsiveness. Asian ethnicity and higher school-level economic deprivation were related to greater responsiveness. More SBMT sessions and better quality of delivery were associated with both greater mindfulness practice and responsiveness. In terms of students’ experiences of SBMT, the most frequent themes (60% of the minimally elaborated responses) were an increased awareness of bodily feelings/sensations and increased ability to regulate emotions.

Conclusion

Most students did not engage with mindfulness practice. Although responsiveness to the SMBT was intermediate on average, there was substantial variation, with some youth rating it negatively and others rating it positively. Future SBMT developers should consider co-designing curricula with students, carefully assessing the student characteristics, aspects of the school environment, and implementation factors associated with mindfulness practice and responsiveness. SBMT teacher training is key, as more observed proficiency in SBMT teaching is associated with greater student mindfulness practice and responsiveness to SBMT.

Le texte complet de cet article est disponible en PDF.

Key words : school-based mindfulness training, adolescents, mindfulness practice, responsiveness, mixed methods


Plan


 Drs. Montero-Marin and Hinze are joint co-first authors of this work.
 This research was funded in whole, or in part, by the Wellcome Trust (WT104908/Z/14/Z and WT107496/Z/15/Z) and supported by the National Institute for Health Research Clinical Research Network (NIHR CRN). For the purposes of Open Access, the author has applied a CC BY public copyright license to any accepted manuscript version arising from this submission. The funders of the study had no role in study design, data collection, analysis, or interpretation nor in writing the paper.
 This study involves human participants and was approved by the University of Oxford Medical Sciences Division Ethics Committee (R45358; 23/05/2016) and overseen by a Data Monitoring and Ethics Committee and the MYRIAD Trial Steering Committee. Schools, parents, and participants gave informed consent to participate in the study before taking part.
 The corresponding study protocol and update can be found at s13063-017-1917-4 and s13063-021-05213-9. The data and codebook from the MYRIAD Project are available from Prof. Kuyken upon reasonable request (release of data is subject to an approved proposal and a signed data access agreement).
 This work has been previously posted on a preprint server: fhwrm.
 This work has been prospectively registered: ISRCTN86619085.
 Dr. Ukoumunne served as the statistical expert for this research.
 Author Contributions
Conceptualization: Montero-Marin, Hinze, Crane, Byford, Dalgleish, Ford, Greenberg, Ukoumunne, Williams, Kuyken
Data curation: Montero-Marin, Lord, Tudor, The MYRIAD Team, Kuyken
Formal analysis: Montero-Marin, Ukoumunne, Hinze, Kempnich, Dalrymple, Slaghekke, Kuyken
Fundingacquisition: Kuyken, Byford, Dalgleish, Ford, Greenberg, Ukoumunne, Williams
Investigation: Montero-Marin, Kuyken
Methodology: Montero-Marin, Hinze, Ukoumunne, Kuyken
Project administration: The MYRIAD Team, Kuyken
Resources: Kuyken
Writing – original draft: Montero-Marin, Hinze, Kuyken
Writing – review and editing: Montero-Marin, Hinze, Crane, Dalrymple, Kempnich, Lord, Slaghekke, Tudor, The MYRIAD Team, Byford, Dalgleish, Ford, Greenberg, Ukoumunne, Williams, Kuyken
 The MYRIAD Team comprises Saz Ahmed, PhD, of University College London, Matt Allwood, BSc, and Louise Aukland, PGCE, of University of Oxford, Susan Ball, MSc, of University of Exeter, Marc Bennett, PsyD, Sarah-Jayne Blakemore, PhD, of University of Cambridge, Triona Casey, MSc, and Katherine De Wilde, PGCE, of University of Oxford, Darren Dunning, PhD, of University of Cambridge, Eleanor-Rose Farley, MSc, and Katie Fletcher, HSD, of University of Oxford, Lucy Foulkes, PhD, of University College London, Poushali Ganguli, MSc, of Kings College London, Cait Griffin, MSc, and Kirsty Griffiths, MSc, of University of Cambridge, Ben Jones, PhD, of University of Exeter, Nils Kappelmann, MSc, of Max Planck Institute of Psychiatry and International Max Planck Research School for Translational Psychiatry, Konstantina Komninidou, BEd, of University of Oxford, Rachel Knight, MSc, of University of Cambridge, Suzannah Laws, BSc, of University of Oxford, Jovita Leung, MSc, of University College London, Emma Medlicott, MSc, and Elizabeth Nuthall, PGDip, of University of Oxford, Jenna Parker, MSc, of University of East Anglia, Alice Phillips, MRes, and Anam Raja, MSc, of University of Oxford, Lucy Palmer, PhD, of King’s College London, Ariane Petit, MSc, of University of Oxford, Blanca Piera Pi-Sunyer, MSc, of University College London, Isobel Pryor-Nitsch, MSc, Lucy Radley, BSc, J. Ashok Sakhardande, BSc Hons, Jem Shackleford, MA, MSc, Anna Sonley, MEd, Laura Taylor, PhD, and Alice Tickell, BA, of University of Oxford, Maris Vainre, MA, of University of Cambridge, Russell M. Viner, PhD, of Institute of Child Health, London, Brian Wainman, BEng, of Plymouth University, and Lucy Warriner, BSc, of University of Cambridge. These individuals have worked across the MYRIAD strategic award “Promoting Mental Health and Building Resilience in Adolescence: Investigating Mindfulness and Attentional Control”; they are acknowledged as group authors in this article for their substantial contributions to the project development, in accordance with the MYRIAD Dissemination Protocol.
 Disclosure: Drs. Montero-Marin, Crane, Kempnich, and Tudor, and Mss. Dalrymple, Lord, and Slaghekke have reported affiliation with the Oxford Mindfulness Centre. Dr. Montero-Marin has a “Miguel Servet” research contract from the ISCIII (CP21/00080), and is supported by the CIBER of Epidemiology and Public Health (CIBERESP CB22/02/00052; ISCIII). Prof. Dalgleish has held grants from the UK Medical Research Council (MR/P017355/1; MC_PC_17213) and the Economic and Social Research Council (ES/R010781/1) not directly related to the current study. Dr. Hinze was supported by the Stiftung Oskar-Helene-Heim. Prof. Ukoumunne was supported by the National Institute for Health Research (NIHR) Applied Research Collaboration South West Peninsula. Prof. Kuyken is Director of the Oxford Mindfulness Centre. Profs. Byford, Ford, Greenberg, and Williams have reported no biomedical financial interests or potential conflicts of interest.


© 2023  American Academy of Child and Adolescent Psychiatry. Publié par Elsevier Masson SAS. Tous droits réservés.
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