Applying Behavioral Theory to Increase Mindfulness Practice Among Adolescents: an Exploratory Intervention Study Using a Within-Trial RCT Design

Abstract

For mindfulness programs to have sustained benefits, participants should continue to practice mindfulness independently. Behavioral theories have been used to predict and change other health behaviors, but have rarely been applied to mindfulness practice. This research aimed to identify predictors/determinants of sustained mindfulness practice after a school-based mindfulness program (Study 1) and to develop and test a booster intervention to increase mindfulness practice (Study 2). These studies were embedded in a larger trial evaluating a school-based mindfulness program involving 12–15 year-olds (Healthy Learning Mind, HLM). Study 1 examined theory-based predictors of mindfulness practice among participants in Batch 1 of the HLM trial (n = 310). These findings were used to develop a brief motivational booster intervention, which Study 2 evaluated in a within-trial cluster-randomized controlled trial in Batch 3 of the HLM trial (HLM Only arm n = 177; HLM + booster arm n = 152). In Study 1, 40% of youths reported having practiced mindfulness at a 6-month follow-up. The perception that peers were practicing mindfulness exercises predicted mindfulness practice (β = .497, p = .002), and a key self-reported reason for non-practice was that they did not find mindfulness useful. The booster intervention (designed to specifically target these descriptive norms and outcome expectations) demonstrated some positive trends in the determinants of mindfulness practice, but did not increase mindfulness practice. The limited effectiveness of the booster intervention might be explained by the minimal contact time of the booster intervention or its delivery in the later lessons of HLM. This study demonstrates how behavior change theories can be applied to help promote independent mindfulness practice outside of intervention settings.