Impact of Mindfulness Training on Adolescent Well-Being and Behavior
Condition: Substance Use; Mindfulness; Psychological Well-being
MeSH terms: Substance-Related Disorders
Study type: Interventional

Summary: 
      There is a broad consensus that preventing or delaying initiation of adolescent alcohol,
      tobacco, and other drug (ATOD) use can substantially improve both short- and long-term
      adolescent health. Despite the existence of effective prevention programs, adolescent ATOD
      use continues to be a substantial issue. Continued research on preventive interventions is
      needed. School-based mindfulness-based interventions (MBIs) have been shown to be feasible
      and effective at improving adolescent psychological well-being. Evidence from both
      quasi-experimental studies and randomized controlled trials suggests that incorporating MBIs
      into school-settings can lower levels of anxiety, depression, and stress, while improving
      capacity for emotional regulation. Greater mindfulness also been linked to reduced adolescent
      ATOD use via observational studies. There are strong theoretical reasons to believe that MBIs
      delivered in school settings can prevent or reduce ATOD use among youth. In particular, MBIs
      have been shown to improve psychological well-being among youth via multiple mechanisms also
      relevant for adolescent ATOD use. These mechanisms include enhanced attentional control,
      negative emotion regulation, promotion of positive emotion generation, and increased feelings
      of connectedness. Despite these connections, school-based MBIs are yet to demonstrate the
      ability to prevent or reduce adolescent ATOD use.

      The current study will examine psychological well-being and ATOD use among approximately 80
      participants in a quasi-experimental, school-based MBI. In early 2022, approximately 40 high
      school seniors were provided with one semester of a weekly, classroom-based MBI embedded into
      their Social Studies curriculum; approximately 40 high school seniors participated in the
      standard curriculum. The intervention group was provided with an adaptation of
      Mindfulness-Oriented Recovery Enhancement (MORE). MORE is an evidence-based therapeutic
      program that integrates mindfulness, cognitive-behavioral therapy, and positive psychology to
      treat addiction and enhance well-being. MORE has been shown to produce therapeutic benefits
      in the treatment of alcohol, tobacco, and other drug addiction in adult populations, but is
      yet to be tested as a preventive intervention for youth. Follow up data collection is planned
      for spring 2023 to assess psychological well-being, ATOD use, and proposed therapeutic
      mechanisms pre-intervention, post-intervention, and at 9-month follow up.
    

Detailed description: 
      There is a broad consensus that preventing or delaying initiation of adolescent alcohol,
      tobacco, and other drug (ATOD) use can substantially improve both short- and long-term
      adolescent health. Despite the existence of effective prevention programs, adolescent ATOD
      use continues to be a substantial issue. Continued research on preventive interventions is
      needed. School-based mindfulness-based interventions (MBIs) have been shown to be feasible
      and effective at improving adolescent psychological well-being. Evidence from both
      quasi-experimental studies and randomized controlled trials suggests that incorporating MBIs
      into school-settings can lower levels of anxiety, depression, and stress, while improving
      capacity for emotional regulation. Greater mindfulness also been linked to reduced adolescent
      ATOD use via observational studies. There are strong theoretical reasons to believe that MBIs
      delivered in school settings can prevent or reduce ATOD use among youth. In particular, MBIs
      have been shown to improve psychological well-being among youth via multiple mechanisms also
      relevant for adolescent ATOD use. These mechanisms include enhanced attentional control,
      negative emotion regulation, promotion of positive emotion generation, and increased feelings
      of connectedness. Despite these connections, school-based MBIs are yet to demonstrate the
      ability to prevent or reduce adolescent ATOD use.

      The current study will examine psychological well-being and ATOD use among approximately 80
      participants in a quasi-experimental, school-based MBI. In early 2022, approximately 40 high
      school seniors were provided with one semester of a weekly, classroom-based MBI embedded into
      their Social Studies curriculum; approximately 40 high school seniors participated in the
      standard curriculum. The intervention group was provided with an adaptation of
      Mindfulness-Oriented Recovery Enhancement (MORE). MORE is an evidence-based therapeutic
      program that integrates mindfulness, cognitive-behavioral therapy, and positive psychology to
      treat addiction and enhance well-being. MORE has been shown to produce therapeutic benefits
      in the treatment of alcohol, tobacco, and other drug addiction in adult populations, but is
      yet to be tested as a preventive intervention for youth. Follow up data collection is planned
      for spring 2023 to assess psychological well-being, ATOD use, and proposed therapeutic
      mechanisms pre-intervention, post-intervention, and at 9-month follow up. Trajectories of
      change will be assessed to test the following three aims.

      Aim 1 is to examine the impact of MORE on changes in students' psychological well-being
      (i.e., anxiety, depression, stress) and ATOD use relative to a standard curriculum. The
      investigators hypothesize that MORE will improve psychological well-being and reduce ATOD
      use, relative to the standard curriculum.

      Aim 2 is to examine the impact of MORE on changes in students' attentional control (i.e.,
      mindfulness), negative emotion regulation (i.e., positive reappraisal), positive emotion
      generation (i.e., savoring), and feelings of connectedness (i.e., self-transcendence)
      relative to a standard curriculum. The investigators hypothesize that MORE will improve
      attentional control, negative emotion regulation, and positive emotion generation, as well as
      increasing feelings of connectedness, relative to a standard curriculum.

      Aim 3 is to examine the extent to which MORE encourages improved psychological well-being and
      reduced ATOD use via the therapeutic mechanisms identified in Aim 2 (attentional control,
      negative emotion regulation, positive emotion generation, and feelings of connectedness). The
      investigators hypothesize that the relationship between MORE and positive outcomes will be
      mediated by the proposed therapeutic mechanisms.

      Hypothesis: Results of the current study will provide important information to advance the
      fields of both ATOD prevention and school-based MBIs. Additionally, results of this study
      will be of wide interest to school administrators, school counselors, and clinicians working
      to prevent adolescent substance use. Successful completion of this study will lead to
      multiple publications. Additionally, results of this study will provide essential pilot data
      to inform further testing of MORE for adolescents via randomized controlled trials and
      support multiple possible grant submissions. While MBIs have become a common part of
      substance abuse treatment among adults, school-based MBIs for ATOD prevention lack sufficient
      evidence and are yet to be regularly incorporated into standard prevention efforts.
    

Intervention name(s): Mindfulness-Oriented Recovery Enhancement
Intervention type(s): Behavioral
Intervention description(s): Mindfulness instruction incorporated in classroom-based curriculum
Allocation: Non-Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Prevention