Primary Prevention of Mental and Behavioral Health Problems Among Urban Middle-School Students through Mindfulness Instruction: A Randomized Controlled Trial

Background: Many urban youth experience significant and unremitting negative stressors, including those associated with exposure to interpersonal and community violence, multi-generational poverty, failing educational systems, drug and alcohol use, limited avenues for success, and disproportionate health risks. Mindfulness instruction has been shown to reduce stress, among other benefits, in a variety of adult populations. Research for the benefits of mindfulness for youth is now beginning to emerge, with improvements in psychological symptoms, coping, and conflict avoidance.  We were interested in evaluating the potential for a school-based mindfulness-based stress reduction (MBSR) program to ameliorate the negative effects of stress among middle-school public school students.

Design/Methods: Participants were fifth through eighth grade students at two Baltimore City Public Schools.  Students were randomly assigned by grade to receive instruction in either an MBSR or health education (Healthy Topics – HT) program within the school curriculum. Self-report survey data were collected at baseline and post-program. State-mandated, standardized test results for reading and math were analyzed.  De-identified data were analyzed in the aggregate, comparing MBSR vs. HT classes, using regression modeling to assess for differences. P-values of 0.05 were set as the threshold for statistical significance.

Results: Two hundred ninety-nine students (5^th-8^thgrade; mean 12.0 years (SD 1.3; range 9-15) were in the MBSR and HT classes. Participants were balanced by sex (49% male) and 99.7% were African American. The groups were comparable at baseline in demographics and outcomes of interest. Post-program, MBSR students had significantly lower levels of somatization (p<0.05), depression (p<0.05), negative affect (p<0.01), negative coping (p<0.05), rumination (p<0.05), self-hostility (p<0.05), and post-traumatic symptom severity (p<0.05).  In addition, Maryland School Assessment scores for reading were significantly higher among students who had participated in the MBSR program. 

Conclusions: These findings support the hypothesis that mindfulness instruction improves psychological functioning, coping, and academic outcomes among vulnerable urban middle-school students. Additional research is needed to further identify the psychological, social, behavioral, and academic outcomes and mechanisms associated with mindfulness instruction.