Mindfulness-Based Health Promotion Program for Educators (MBHP - Educa).

Study Overview
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Brief Summary
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In the last few decades, the world has seen a significant increase in the occurrence of occupational diseases related to Burnout Syndrome (professional exhaustion) and stress in educators. These disorders affect mental health and teaching activity. In this way, they need to develop socio-emotional skills to cope with the psychosocial stressors related to the school environment. Currently, mindfulness-based therapies have been recommended to help educators acquire emotional self-control, and to improve self-esteem, metacognition, attention, resilience and affectivity, in addition to better the social skills needed in the school milieu. The main objective of the proposed research project is to elaborate a program of Mindfulness-Based Health Promotion - educators (MBHP - educa) to be applied to a population of Brazilian public school educators. The efficacy of the program will be evaluated by cognitive testing. Blood tests for the above-mentioned stress-related molecules will be performed. The goal of developing the MBHP - educa Program is to promote and ameliorate the health care of public school teachers. Developing such a research proposal will contribute to debate and implement public health policies focussed on promoting the health of public school teachers in Brazil.

Detailed Description
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In the last few decades, the world has seen a significant increase in the occurrence of occupational diseases related to Burnout Syndrome (professional exhaustion) and stress in educators. These disorders affect mental health and teaching activity. In this way, they need to develop socio-emotional skills to cope with the psychosocial stressors related to the school environment. Currently, mindfulness-based therapies have been recommended to help educators acquire emotional self-control, and to improve self-esteem, metacognition, attention, resilience and affectivity, in addition to better the social skills needed in the school milieu. A few published studies indicate that mindfulness practices also reduce some inflammation- and stress- related molecules such as cortisol, receptor-interacting serine/threonine kinase 2 (RIPK2), cyclooxygenase 2 (COX2), interleukin 6 (IL-6), tumor necrosis factor-α (TNF-α) and epigenetic-regulation related histone deacetilases (HDAC). These indicator molecules can be measured in blood. The World Health Organisation (WHO-2013) recommends the worldwide implementation of strategies for the promotion of mental health, which are particularly aimed at preventing occupational diseases. The main objective of the proposed research project is to elaborate a program of Mindfulness-Based Health Promotion - educators (MBHP - educa) to be applied to a population of Brazilian public school educators. The efficacy of the program will be evaluated by cognitive testing. Blood tests for the above-mentioned stress-related molecules will be performed. The goal of developing the MBHP - educa Program is to promote and ameliorate the health care of public school teachers. Developing such a research proposal will contribute to debate and implement public health policies focussed on promoting the health of public school teachers in Brazil.

Official Title
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Development and Implementation of Mindfulness-Based Health Promotion Program for Educators (MBHP - Educa): Evaluation of Cognitive Functions and Epigenetic Modifications.

Conditions
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Stress, Cognitive Impairment, Burnout Syndrome

Intervention / Treatment
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* Other: MBHP-Educa


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 1)Brazilian male or female aged between 23 and 65 years and (2) currently working in the classroom Exclusion Criteria: (1) the presence of medical conditions or medications use that might affect inflammatory pathways; (2) report of an infectious condition in the last 15 days before collecting a blood sample; (3) active psychiatric and/or clinical comorbidities potentially life-threatening such as psychosis or suicidal ideation; and (4) had previously practiced or currently practicing meditation, yoga or Tai-Chi

Ages Eligible for Study
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Minimum Age: 23 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: MBHP-Educa<br>Experimental: Intervention Group A novel Mindfulness-based Health Promotion program for Educators for active teachers will be employed. The intervention will be held once a week for 8-weeks, two-hour meetings (16.0-h total). Participants will be encouraged to meditate for 10-30 min/day via audio recording. | Other: MBHP-Educa<br>* This intervention is a meditative practice which the individuals will practice in their daily life following the MBHP-educa protocol<br>|
| No Intervention: Control Group<br>Control Group Teacher education as usual. These participants will participate in teacher training (Neuroscience for Education - Neuro Educa). The Neuro-Educa will be held once a week for 8-weeks, two-hour meetings (16.0-h total). | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| World Health Organization Quality of Life-BREF (WHOQOL-BREF) | To evaluate quality of life through five subscales: physical domain - mean of responses psychological domain - mean of responses relationships domain - mean of responses environment domain - mean of responses quality of life and perception of life - mean of responses *each question response range one to five points Higher scores - Better Quality of Life | Pre-test, Post-test and follow-up (12 months) | 
| Pittsburgh Sleep Quality Index | To evaluate the Sleep Quality - sum of responses score *each questions have a specific conversion to range zero to six Higher scores - better sleep quality | Pre-test, Post-test and follow-up (12 months) | 
| Morningness-eveningness questionnaire - sum *Range 16 to 86 *higher scorer - more morningness type | To evaluate person's circadian rhythm (biological clock) (sum of all responses) | Pre-test, Post-test and follow-up (12 months) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Glutathione metabolism from blood samples | GSH plasma levels, Cysteine and homocisteine serum levels | Pre-test, Post-test and follow-up (12 months) | 
| Perceived Stress Scale (PSS-10) | to evaluate the level of subjectively noticed stress, composed of 10 items | Pre-test, Post-test and follow-up (12 months) | 
| Determination of cytokine levels in serum samples. | To evaluate the interleukin-8 (IL-8), interleukin-1β (IL-1β), interleukin-6 (IL-6), interleukin-10 (IL-10), tumor necrosis factor (TNF) e interleukin-12p70 (IL-12p70) *Concentration in micromol per liter. (mean and standard deviation, median and quartile per groups) | Pre-test, Post-test and follow-up (12 months) | 
| Connor-Davidson Resilience Rating Scale | The CD-RISC is a 25-item measure of resilience. | Pre-test, Post-test and follow-up (12 months) | 
| Positive and Negative Affect Schedule (PANAS) | To evaluate positive and negative Affect through two subscales: positive affect - sum negative affect - sum each question range one to five higher score - more frequent | Pre-test, Post-test and follow-up (12 months) |