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. 2020 Dec 15:9:2164956120964738.
doi: 10.1177/2164956120964738. eCollection 2020.

Training School Teachers to Deliver a Mindfulness Program: Exploring Scalability, Acceptability, Effectiveness, and Cost-effectiveness

Catherine Crane PhD  1 , Poushali Ganguli PhD  2 , Susan Ball MSc  3 , Laura Taylor PhD  1 , Sarah-Jayne Blakemore PhD  4 , Sarah Byford PhD  2 , Tim Dalgleish PhD  5   6 , Tamsin Ford PhD  7 , Mark Greenberg PhD  8 , Willem Kuyken PhD  1 , Liz Lord Ma  1 , Jesus Montero-Marin PhD  1 , Anna Sonley MEd  1 , Obioha C Ukoumunne PhD  3 , J Mark G Williams PhD  1
Affiliations

Training School Teachers to Deliver a Mindfulness Program: Exploring Scalability, Acceptability, Effectiveness, and Cost-effectiveness

Catherine Crane PhD et al. Glob Adv Health Med. .

Abstract

Background: There is growing research support for the use of mindfulness training (MT) in schools, but almost no high-quality evidence about different training models for people wishing to teach mindfulness in this setting. Effective dissemination of MT relies on the development of scalable training routes.

Objective: To compare 4 training routes for school teachers wishing to deliver MT differing in intensity and potential scalability, considering teaching competency, training acceptability, and cost-effectiveness.

Methods: Schools were randomized to an existing route comprising an 8-session instructor-led personal mindfulness course, combined with 4-day MT program training, or 1 of 3 more scalable, lower intensity, alternatives: an instructor-led personal mindfulness course combined with 1-day MT program training, a self-taught personal mindfulness course (delivered through a course book) combined with 4-day MT program training, and a self-taught personal mindfulness course combined with 1-day MT program training.

Results: Attrition from training was substantial across all routes. The instructor-led course was more effective than the self-taught course in increasing teachers' personal mindfulness skills. Even the most intensive (existing) training route brought only 29% of the teachers commencing training, and 56% of those completing the study protocol, to the required minimum competency threshold (an advanced beginner rating on an adapted version of the Mindfulness-based Interventions Teaching Assessment Criteria). The differences in levels of competency achieved by existing training compared with the more scalable alternatives were modest, with economic evaluation suggesting that the existing route was both more expensive and more effective than lower intensity alternatives, but with no statistically significant differences between routes.

Conclusions: This research questions the move toward abbreviating teacher training to increase scalability and suggests instead that many teachers require additional support to ensure competency from first delivery of MT in the classroom.

Keywords: acceptability; effectiveness; implementation and dissemination; mindfulness-based programs; teaching competency; training.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: CC, LT, AS, and LL were affiliated with the Oxford Mindfulness Centre and employed on a Wellcome Trust Strategic Award exploring the effects of mindfulness training in adolescence at the time this work was conducted. JMM was involved in the project as a visiting academic and is now employed on the Wellcome Trust Strategic Award. However, they do not receive any additional remuneration of teaching, training, or publications related to mindfulness. JMGW is the author of the course book used in this study: Mindfulness, Finding Peace in a Frantic World, and receives royalties from the sale of the book. WK is a director of the Oxford Mindfulness Centre, a charitable organization, and co-author of a book on mindfulness for which he receives royalties. None of the other authors have interests to disclose.

Figures

Figure 1.
Figure 1.
Participant Flow.
Figure 2.
Figure 2.
Cost-effectiveness Acceptability Curve Showing the Probability That Standard Instructor-Led, 4-Day Training is Cost-effective Compared to Less Intensive Training Routes for Different Values of Willingness to Pay for Percentage Point Increase in Teachers Reaching the Minimum Competency Threshold (Advanced Beginner or Above) Among Those Who Were Randomized (Primary Analysis) and Those Who Completed the Study Protocol (Scenario Analysis). IL4D, instructor-led, 4-day; ST4D, self-taught, 4-day; IL1D, instructor-led, 1-day; ST1D, self-taught, 1-day.
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