Effects of school-based mindfulness intervention on health-related quality of life: moderating effect of gender, grade, and independent practice in cluster randomized controlled trial

Maarit Lassander,Mirka Hintsanen,Salla-Maarit Volanen,Sakari Suominen,Tero Vahlberg,Sari Mullola

doi:10.1007/s11136-021-02868-4

Abstract

ObjectWe investigated the impact of a school-based 9-week mindfulness program vs. active control program (relaxation) and inactive control group on children’s self-reported Health-Related Quality of Life (HRQoL) moderated by gender, grade, and independent practice.MethodIn total 3519 (50/50% boys/girls) Finnish students aged 12–15 years from 56 schools were randomized into mindfulness intervention, active, and inactive control groups. HRQoL was measured at baseline, at 9 weeks, and at 26 weeks and analyzed with multilevel linear modeling.ResultsSignificant improvement on HRQoL was found (β = mean difference) (β = 1.587, 95% CI 0.672–2.502, p < 0.001) after 9 weeks and at 26 weeks of follow-up among students in the mindfulness group as compared to the active control group. Moderating effects on HRQoL were found for gender, grade, and independent practice: girls, 7th and 8th grade students, and students with regular independent mindfulness practice benefited most.ConclusionsGender and developmental stage may moderate the effects of mindfulness interventions on HRQoL and offer guidance in designing effective promotive interventions for children and adolescents.Trial Registration InformationHealthy Learning Mind—a school-based mindfulness and relaxation program: a study protocol for a cluster randomized controlled trial (RCT) ISRCTN18642659 retrospectively registered on 13 October 2015. The full trial protocol can be accessed at http://rdcu.be/t57S.

Highlights

Children’s satisfaction or happiness in various life domains can be assessed with Health-Related Quality of Life (HRQoL) measures [43, 46]
In the current cluster randomized study, we examine effects of mindfulness-based intervention [20] as compared with standard relaxation program “Relax” and inactive control group on HRQoL moderated by grade, gender, and independent practice
There was no difference between mindfulness intervention, active control, and inactive control group at baseline in HRQoL

Summary

Introduction

Children’s satisfaction or happiness in various life domains can be assessed with Health-Related Quality of Life (HRQoL) measures [43, 46]. Mindfulness-based school interventions have been found to produce small (effect size g = 0.22–0.40) or mixed results [23, 26] in the well-being of children and adolescents on a variety of measures, such as cognition, stress, anxiety and depression, and psychological well-being [8, 17, 18, 42] This lack of consistency (for reviews see [10, 33]), raises questions about the potential moderators for observed effects [19, 41]

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