Method
Eligibility Criteria
Information Sources
Search
Study Selection
Data Collection
Risk of Bias
Synthesis of Results and Meta-analyses
Results
Study Selection
Study and Participant Characteristics
References | Samples | Studies | |||||||
---|---|---|---|---|---|---|---|---|---|
Total N (treatment N, control N) | Mean age (age range/grade levels) | % girls | Race/ethnicity | Mental/health conditions | Home SES: income/employment/education | Country | Design (type of controls) | Related outcomes (measures) | |
Ahola Kohut et al. (2020) | 15 (NA) | 14.6 (ages 13–17) | 44.4% | NR | Inflammatory bowel disease | NR | Canada | Single group (NA) | Friendship quality (PROMIS-P) |
Anand and Sharma (2014) | 33 (NA) | 14.2 (ages 13–15) | 45.5% | NR | NR | Middle class population | India | Single group (NA) | Peer difficulties (SSS) |
Berger et al. (2018) | 319 (173, 146) | 9.7 (grades 3-5) | 51.5% | 100% Israeli–Jewish | NR | Middle class population | Israel | Cluster RCT (WLC) | Readiness for social contact (RSC) |
Bokoch and Hass-Cohen (2020) | 83 (50, 33) | NR (ages 5–12) | 42% | 75% Latinx, 15% White, 5% Asian, 5% biracial | Internalizing symptoms, externalizing behaviors, and relational problems | Mostly low-SES population | USA | Quasi (WLC) | Peer difficulties (Conners-3) |
Carey (2017) | 28 (NA) | NR (ages 7–8) | 53.6% | NR | NR | NR | UK | Single group (NA) | Peer difficulties (SDQ) |
Carro et al. (2020) | 26 (19, 7) | NR (ages 7–8) | NR | NR | NR | Low-SES population | Argentina | Cluster RCT (WLC) | Social integration (SPI) |
Carro et al. (2022) | 33 (16, 17) | NR (grade 2nd) | 51.5% | 100% Hispanic/Latino | NR | NR | Argentina | Quasi (WLC) | Social integration (SPI) |
Faraji et al. (2019) | 20 (10, 10) | NR (grades 3–5) | NR | NR | Bully behaviors | NR | Iran | Quasi (NR) | Bullying (IBS) |
Haydicky et al. (2015) | 16 (NA) | 15.5 (ages 13–18) | 27.8% | 59% parents born in North America, 9% parents European origins, 21% parents from Asia, 9% parents from Caribbean | ADHD | 71% parents employed full-time, 97% parents have secondary school education or above | Canada | Single group (NA) | Peer difficulties (Conners-3) |
Liu et al. (2021) | 189 (92, 97) | 15.9 (grade 8) | 59.3% | 100% Chinese | NR | NR | China | Cluster RCT (TAU) | Bullying (OBQ-CV) |
Matsuba et al. (2021) | 82 (46, 36) | 12.7 (grades 5–6) | 59.8% | Mostly local Acholi Tribe | NR | NR | Uganda | Quasi (WLC & TAU) | Friendship (NIH-F) |
Meadows (2018) | 38 (27, 11) | 9.1 (grades K-8) | 49.2% | 84.6% African American, 7.7% White, 7.7% multi-racial | 10.8% emotional disturbances, 2.3% multiple disabilities, 8.5% special education | Low-SES population | USA | Cluster RCT (WLC) | Peer difficulties (SDQ) |
Mendelson et al. (2010) | 92 (48, 44) | 10.1 (grades 4–5) | 60.8% | 83.5% African American, 7.2% mixed race, 4.1% Latino, 4.1% White | NR | Low-SES population | USA | Cluster RCT (WLC) | Relations with peers (PIML) |
Menghetti (2015) | 24 (NA) | 15.5 (ages 14–18) | 75% | 75% Latino,13% African American, 8% White, 4% Vietnamese | Exhibit signs of emotional dysregulation | NR | USA | Single group (NA) | Bullying (IBS) |
Meyer and Eklund (2020) | 296 (138, 158) | 9.3 (grades 4–5) | 53% | 86.8% Hispanic/Latino, 13.2% others | NR | Mostly low-SES population | USA | Quasi (WLC) | Classroom cohesion and friction (MCI-SFR) |
Mueller (2014) | 22 (NA) | 6.3 (ages 5–7) | 50% | 72.7% New Zealand European ethnicity, 9.1% Maori ethnicity, 4.5% Maori/Cook Island ethnicity | NR | Mostly middle-class population | New Zealand | Single group (NA) | Positive and negative peer interactions (PBS & BPI) |
Ricard et al. (2013) | 303 (125, 178) | NR (NR) | 37.3% | 79.8% and 83% Hispanic for treatment and control group respectively | Violating school’s disciplinary code of conduct | NR | USA | Quasi (TAU) | Social isolation (YOQ-30.2) |
Schonert-Reichl et al. (2015) | 99 (48, 51) | 10.2 (ages 9–11.2) | 44% | 66% English first language, 25% East Asian, 10% other languages | NR | Mostly middle-class population | Canada | Cluster RCT (AC) | Peer acceptance (Peer nominations) |
Terjestam et al. (2016) | 309 (184, 125) | NR (grades 5, 7, 8) | 48.3% | NR | NR | Diverse SES | Sweden | Cluster RCT (AC) | Peer difficulties (SDQ) |
Valero et al. (2021) | 30 (15, 15) | 10.6 (ages 9–14) | 23.3% | NR | ADHD | 80% parents employed, 73.3% parents have high school education or above | Spain | RCT (WLC) | Peer difficulties (Conners-3) |
Waldemar et al. (2016) | 120 (62, 58) | 11.1 (grade 5) | 47.7% | 51.5% White, 32.6% Mixed, 12.1% Black, 1.5% Native Brazilians, 2.3% NR | NR | 15.2% middle class, 71.2% low middle class, 5.3% poor, 8.3% NR | Brazil | Quasi (WLC) | Peer difficulties (SDQ) |
Intervention Characteristics and Fidelity
References | Design | Training | Delivery | Receipt | Enactment | |
---|---|---|---|---|---|---|
– Program name – Implementation context | – Mindfulness content – Other activities included – Delivery dosage – Delivery approach | – Facilitator – Qualification and training | – Delivery adherence – Supervision | – Participant attendance – Participant engagement | – Mindfulness related outcome (measures) – Home practice – Adherence to home practice | |
Ahola Kohut et al. (2020) | – MBI-A – A pediatric tertiary hospital | – Modified MBSR for pediatric IBD – Activities adapted for pediatric IBD (e.g., the effects of stress on pain and physical symptoms) – 120 min/week for 8 weeks – Child-group + one-time parent workshop | – Two clinical psychologists – NR | – NR – NR | – Attendance and punctuality recorded – Satisfaction questionnaire and focus group about program benefits and satisfaction | – Significant improvement in mindfulness (CAMM) – Home practice required – Mean duration of home practice = 5.31min/day |
Anand and Sharma (2014) | – NR – A public high school | – Modified MBSR – Stress reduction (e.g., stress and its mechanisms) – 40 min/week for 8weeks – Classroom-based | – NR – NR | – NR – NR | – Intervention completers attended at least 5 sessions – Feedback proforma to obtain program benefits and satisfaction | – NR – Home practice required – Mean practice days = 47, mean duration of formal practice = 8.57 min |
Berger et al. (2018) | – C2C-I – 3 public elementary schools | – Manualized intervention based on SCT and ESPS programs with age-appropriate adaptations – SEL – 45 min/week for 24 weeks – Classroom-based | – Graduate research assistants with contemplative practice experience + homeroom teachers – 15-h training for research assistants | – Regular observation of the facilitators – Weekly off-site supervision | – NR – NR | – NR – Home practice required – Educated parents using school website, involved parents in home assignment, recorded mindfulness diaries |
Bokoch and Hass-Cohen (2020) | – MATG-P – Primary school | – Manualized intervention based on MBSR and MSC with age and cultural adaptations – Group art therapy – 45–60 min/week for 8 weeks – Child group + parent–child meeting + teacher meeting | – Doctoral student in Psychology – Formal MBSR training + regular meditation + 2 years mindfulness clinical practice | – NR – NR | – NR – NR | – No significant change in mindfulness (CAMM) – NR – NR |
Carey (2017) | – 60 mindful minutes – An inner-city Catholic primary school | – Age-appropriate MBP suited for classroom environment – NR – 50 min/week for 6 weeks – Classroom-based | – Trainee educational psychologist + class teacher – Extensive reading and independent practice in MBP for the trainee psychologist | – NR – NR | – NR – Student feedback form to explore program benefits and satisfaction | – Significant change in mindfulness at follow-up but not at posttest (CAMM) – Home practice required – Class teacher completed practices with children between sessions and kept weekly records |
Carro et al. (2020) | – NR – A public primary school | – General MBP – Interpersonal awareness activities – 60 min/week for 28 weeks – Classroom-based | – 2 mindfulness based-practices trainers + class teacher – NR | – NR – NR | – NR – NR | – NR – NR – NR |
Carro et al. (2022) | – NR – A private school | – General MBP – Activities fostered socio affective & socio cognitive processes – 60 min/week for 28 weeks – Classroom-based | – 2 researchers + class teacher – NR | – NR – NR | – NR – NR | – NR – NR – NR |
Faraji et al. (2019) | – NR – A primary school | – Manualized MBCT-C – NR – 90 min/week for 12 weeks – Group-based | – NR – NR | – NR – NR | – Exclusion criterion: absent for more than 4 sessions – NR | – NR – Home practice required – NR |
Haydicky et al. (2015) | – MYmind – NR | – Manualized intervention adapted from MBCT – NR – 90 min/week for 8 weeks – Child group + parent group | – Doctoral students in psychology – 12-week mindfulness course + regular mindfulness practice | – One facilitator ran all child groups and followed the manual closely – On-site and weekly supervision | – Intervention completers attended at least 6 sessions – Reflection sheets to gauge treatment impact and enhance motivation, rewarded for practicing in session and at home | – No significant change in experiential avoidance (AAQ) – Home practice required – Daily email and reminding messages, CDs, workbooks, and rewards to support home practice |
Liu et al. (2021) | – MiSP.b – A middle school | – Manualized 10-session mindfulness course for schools – NR – 40–45 min/week for 10 weeks – Classroom-based | – Trained mindfulness instructor – 8-week mindfulness training + teaching training on the MiSP.b | – NR – NR | – NR – NR | – Significant improvement in mindfulness (FFMQ) – Home practice encouraged + 10–15 min daily practice guided by instructor – Students recorded practice time in workbook |
Matsuba et al. (2021) | – MindUP – 2 private primary schools | – Manualized mindfulness program with cultural and age-appropriate adaptations – SEL – 45 min/week + 3min × 3 times/day for 15 weeks – Classroom-based | – Ugandan teachers – 7-day workshop + ongoing training support | – Teachers kept a record of program implementation – NR | – NR – NR | – NR – NR – NR |
Meadows (2018) | – NR – A public school | – Manualized intervention based on MBCT and MBSR – NR – 30 min × 2 times/week for 12 weeks – Classroom-based | – A trained mindfulness facilitator – NR | – NR – NR | – Inconsistent reporting of students’ attendance – NR | – NR – NR – NR |
Mendelson et al. (2010) | – NR – 4 urban public elementary schools | – General MBP – NR – 45 min × 4 times/week for 12 weeks – Group-based | – 2 instructors from Holistic Life Foundation – NR | – NR – NR | – 40–74% students completed at least 75% sessions across different schools – Student/teacher focus groups to explore program benefits | – Significant improvement in involuntary responses to stress (RSQ) – Home practice encouraged – NR |
Menghetti (2015) | – NR – A high school | – Standardized 10-week modified adolescent DBT – Distress tolerance, emotion regulation, and interpersonal effectiveness – 60 min/week for 10 weeks – Group-based | – NR – DBT protocol training from experts | – NR – Supervision from DBT experts | – NR – NR | – No significant change in emotion regulation (DERS) – NR – NR |
Meyer and Eklund (2020) | – Mindful Moments – 2 elementary schools | – Manualized intervention underpinned by MBSR – NR – 2 min × 3 times/day for 10 weeks – Classroom-based | – School teachers – 2-h training | – 68% completion rate (teacher log data), 93% (researcher observation) – Weekly consultation | – NR – NR | – No significant change in mindfulness (CAMM) – NR – NR |
Mueller (2014) | – NR – A primary school | – General MBP with age-appropriate adaptations – Conflict resolution skills – 10-15 min × 3 times/week for 6 weeks – Classroom-based | – A PhD candidate in Psychology + a registered class teacher – 3-day intensive training for the PhD researcher | – NR – NR | – NR – NR | – NR – NR – NR |
Ricard et al. (2013) | – Teen Talk – Disciplinary Alternative Education Program | – A briefer DBT infused skills group intervention adapted from standard DBT – Emotional regulation, distress tolerance, and interpersonal effectiveness – 45–50 min × 2 times/week for 4 weeks – Group-based | – Counseling interns (5 doctoral + 2 master’s level) – Monthly training | – NR – Regular staff meetings + daily site-based supervision | – Students receiving an average of 6 sessions – NR | – NR – NR – NR |
Schonert-Reichl et al. (2015) | – MindUP – 4 public elementary schools | – Manualized four units mindfulness program – SEL – 40–50 min/week + 3min × 3 times/day for 12 weeks – Classroom-based | – School teachers – Intensive 1-day training | – Completed 100% lessons and 81–95% daily practices – One booster session | – NR – NR | – Significant improvement in mindfulness (MAAS-C) – NR – NR |
Terjestam et al. (2016) | – Compas – 4 public secondary schools | – General MBP – SEL – 11-20 min × 3 times/week for 8 weeks – Classroom-based | – School teachers – 3 × 3 h training | – Fidelity informally checked during supervision meeting – Weekly supervision | – Attendance noted at each session – NR | – Significant improvement in effortful control (EC scale) – NR – NR |
Valero et al. (2021) | – MYmind – NR | – Manualized intervention adapted from MBCT – NR – 60 min/week for 8 weeks – Child group + parent group | – Professional certified by MYmind program + support observer – NR | – NR – NR | – NR – NR | – NR – Home practice required – Activity book and audio-recording given to each family |
Waldemar et al. (2016) | – M-SEL – 3 public elementary schools | – General MBP with age-appropriate adaptations – SEL – 60 min × 8-12 sessions – Classroom-based | – Young psychologists – NR | – NR – Weekly supervision meeting | – NR – NR | – NR – Home practice not required – NR |
Risk of Bias
Meta-analyses
Moderator Analyses
Study characteristics | Peer relationship | ||||
---|---|---|---|---|---|
k | Hedge’s g (95% CI) | Qb | df | p | |
Participant age | |||||
School-age children (6–12 years) | 10 | 0.43 (0.27, 0.58)*** | 7.85 | 2 | 0.02* |
Adolescents (13–18 years) | 7 | 0.67 (0.28, 1.05)*** | |||
Mixed | 3 | 0.20 (0.07, 0.34)** | |||
Participant gender | |||||
Predominantly female (female ≥ 50%) | 8 | 0.46 (0.22, 0.70)*** | 0.001 | 1 | 0.97 |
Predominantly male (female < 50%) | 10 | 0.45 (0.24, 0.66)*** | |||
Participant pre-existing condition | |||||
Predominantly clinical/at-risk | 7 | 0.44 (0.22, 0.67)*** | 0.08 | 1 | 0.78 |
None/not mentioned | 13 | 0.49 (0.30, 0.68)*** | |||
Type of mindfulness intervention | |||||
Manualized mindfulness-based program | 14 | 0.52 (0.30, 0.73)*** | 1.29 | 1 | 0.26 |
General mindfulness practice | 6 | 0.37 (0.22, 0.51)*** | |||
Any adaptation of intervention programb | |||||
Yes | 15 | 0.53 (0.34, 0.72)*** | 2.15 | 1 | 0.14 |
No | 5 | 0.32 (0.13, 0.52)** | |||
Other activities involved in intervention | |||||
Yes | 13 | 0.44 (0.29, 0.60)*** | 0.32 | 1 | 0.57 |
No | 7 | 0.56 (0.18, 0.94)** | |||
Dosagec | |||||
Low | 6 | 0.48 (0.20, 0.76)*** | 0.01 | 2 | 0.99 |
Medium | 7 | 0.47 (0.18, 0.75)** | |||
High | 7 | 0.47 (0.28, 0.65)*** | |||
Facilitator | |||||
Non-teaching personnel onlyd | 9 | 0.43 (0.22, 0.65)*** | 18.20 | 2 | 0.0001*** |
Schoolteacher only | 4 | 0.18 (0.09, 0.28)*** | |||
Mixed | 5 | 0.52 (0.39, 0.65)*** | |||
Intervention target | |||||
Children only | 16 | 0.48 (0.31, 0.65)*** | 0.01 | 1 | 0.93 |
Children and others (parents/teachers) | 4 | 0.46 (0.16, 0.77)** | |||
Group setting | |||||
Classroom-based intervention | 13 | 0.49 (0.30, 0.68)*** | 0.08 | 1 | 0.78 |
Group-based intervention | 7 | 0.44 (0.22, 0.67)*** | |||
Study design | |||||
Controlled studies | 14 | 0.39 (0.25, 0.54)*** | 1.93 | 1 | 0.17 |
Non-controlled studies | 6 | 0.74 (0.27, 1.20)** |