Background: Approximately 13% of children and adolescents in the UK have a mental health problem and these rates are higher rates for adolescents from areas of high deprivation. Schools have a significant role to play in supporting and promoting positive mental health and wellbeing for their pupils. Yoga and mindfulness interventions have grown in popularity and both interventions have been shown to positively impact the psychological, cognitive, interpersonal, and behavioural functioning of adolescents. However, most of the evidence base to date has been conducted in the United States and/or delivered the interventions to a targeted group of adolescents. Therefore, the current thesis aimed to explore the acceptability and effectiveness of universally delivered yoga and mindfulness with a UK-based cohort of vulnerable adolescents from a highly deprived urban area.
Methods: Across two years, 354 12-13-year-old pupils in a single secondary school in central London were randomly assigned by class to participate in ten weeks of yoga, mindfulness, or a control group (PSHE as usual). This research adopted a mixed methods approach. Surveys and cognitive tasks were conducted with adolescents’ pre and post
intervention (n = 232) to measure any changes in wellbeing or cognitive skills. Interviews with a subset of pupils (n = 45) were conducted to explore their views, experiences, and
perceived benefits of school-based yoga and mindfulness. Furthermore, interviews with professionals (n = 16; intervention facilitators and school staff) were conducted to explore facilitators and barriers to implementation and delivery. Findings from both methodologies were integrated using a triangulation protocol to highlight areas of agreement, disagreement, and silence.
Results: The quantitative findings indicated that there were significant improvements in short-term mood and cognitive skills after participation in yoga and mindfulness. However, there were minimal changes on validated measures of wellbeing, in comparison to the control group. In contrast, the qualitative findings highlighted a range of perceived benefits for adolescents’ socioemotional health and concentration. For acceptability, both datasets demonstrated high levels of acceptability for school-based yoga and mindfulness; they were enjoyable, viewed as helpful, and adolescents held positive views about the intervention facilitators. Furthermore, several barriers and facilitators to implementation and delivery were raised by professionals, highlighting an overarching view that ten weeks was insufficient to enable meaningful change. Taken together, the findings emphasise the value of mixed methods research for exploring complex health interventions more comprehensively.
Conclusion: This research demonstrates the feasibility of conducting a three-arm RCT in a school setting in the UK, within a mixed methods paradigm. It has demonstrated the
acceptability of universally delivered yoga and mindfulness interventions for a novel population; adolescents from an area of high deprivation in the UK. The interventions have potential to positively impact the wellbeing of vulnerable adolescents. Nevertheless, for interventions to be most effective, schools may need to further embed mind-body interventions into the school day, to increase the frequency and sustain any benefits over a longer-term. Consequently, this research will assist schools in finding practical solutions to promote and support the wellbeing of adolescents, which has become even more imperative in the context of increasing mental health and wellbeing problems exacerbated by the COVID-19 pandemic.