How effective is mindfulness-based stress reduction program in alleviating stress and trauma among low-income public middle school students of ethnic minority?
Data of publication of the randomized controlled trial: September 2015
Design
Randomized controlled trial(RCT).
Participants
300 students (mean age: 12.0 years, male %: 49.3%) who attended fifth to eighth grades, including special education, in public schools.
Intervention
A 12-week school-based mindfulness-based stress reduction (MBSR) program.
Comparator
Comparison: School based MBSR versus health education program.
Major Outcomes
Outcome 1: Depression measured by Children’s Depression Inventory— Short Form (CDI-S);
Outcome 2: Self-hostility measured by Differential Emotions Scale(DES);
Outcome 3: Somatization measured by Symptom Checklist-90-R (SCL-90R);
Outcome 4: Negative affect measured by Positive and Negative Affect Schedule (PANAS);
Outcome 5: Negative coping measured by the Brief COPE;
Outcome 6: Rumination measured by Children’s Response Style Questionnaire (CRSQ);
Outcome 7: Posttraumatic stress symptoms measured by Children’s Post-Traumatic Symptom Severity Checklist (CPSS).
Settings
This trial was performed in an outpatient setting.
Comparison    School based MBSR versus health education program
Main Results
Compared to students receiving health education program, MBSR participants had shown significantly lower level of depression (β: -0.16, p=0.02), self-hostility (β: -0.14, p=0.02), somatization (β: -0.13, p=0.03), negative affect (β: -0.19, p=0.003), negative coping (β: -0.13, p=0.04), rumination (β: -0.13, p=0.03) and posttraumatic stress symptoms (β: -0.15, p=0.02).
Comparison: School based MBSR versus health education among low-income public middle school students of ethnic minority
Outcomes No. of studies (Total number of participants) Mean score (SD)/ No. of participants Heterogeneity test (I2) β p value Overall quality of evidence*
Intervention Comparator
1 1 (300) 53.53(12.36)/159 57.59(13.74)/141 Not applicable as there is only 1 study. -0.16 0.02 Moderate
2 1 (300) 5.48(2.92)/159 6.60(3.47)/141 Not applicable as there is only 1 study. -0.14 0.02 Moderate
3 1 (300) 52.92(13.92)/159 57.40(14.04)/141 Not applicable as there is only 1 study. -0.13 0.03 Moderate
4 1 (300) 21.39(8.80)/159 24.61(8.41)/141 Not applicable as there is only 1 study. -0.19 0.003 Moderate
5 1 (300) 17.93(5.34)/159 19.66(5.11)/141 Not applicable as there is only 1 study. -0.13 0.04 Moderate
6 1 (300) 26.91(8.90)/159 28.93(7.87)/141 Not applicable as there is only 1 study. -0.13 0.03 Moderate
7 1 (300) 17.16(12.36)/159 21.55(13.04)/141 Not applicable as there is only 1 study. -0.15 0.02 Moderate
Keys: SD = standard deviation; β= beta coefficient; CI = confidence interval.
Comparison    School based MBSR versus health education program
Main Results
Compared to students receiving health education program, MBSR participants had shown significantly lower level of depression (β: -0.16, p=0.02), self-hostility (β: -0.14, p=0.02), somatization (β: -0.13, p=0.03), negative affect (β: -0.19, p=0.003), negative coping (β: -0.13, p=0.04), rumination (β: -0.13, p=0.03) and posttraumatic stress symptoms (β: -0.15, p=0.02).
Comparison: School based MBSR versus health education among low-income public middle school students of ethnic minority
Outcomes 1 2 3 4 5 6 7
No. of studies (Total number of participants) 1 (300) 1 (300) 1 (300) 1 (300) 1 (300) 1 (300) 1 (300)
Mean score (SD)/ No. of participants Intervention 53.53(12.36)/159 5.48(2.92)/159 52.92(13.92)/159 21.39(8.80)/159 17.93(5.34)/159 26.91(8.90)/159 17.16(12.36)/159
Comparator 57.59(13.74)/141 6.60(3.47)/141 57.40(14.04)/141 24.61(8.41)/141 19.66(5.11)/141 28.93(7.87)/141 21.55(13.04)/141
β -0.16 -0.14 -0.13 -0.19 -0.13 -0.13 -0.15
p value 0.02 0.02 0.03 0.003 0.04 0.03 0.02
Overall quality of evidence* Moderate Moderate Moderate Moderate Moderate Moderate Moderate
Keys: SD = standard deviation; β= beta coefficient; CI = confidence interval.
Conclusion
Benefits
School based MBSR program had shown significant benefits on reducing level of depression, self-hostility, somatization, negative affect, rumination and posttraumatic stress symptoms among low-income public middle school students of ethnic minority. For Outcome 1-7, the overall quality of evidence is moderate. Further research is fairly likely to have an important impact on our confidence in this estimate of effect.
Harms
No significant adverse events were reported in the trial.
Link to Original Article
https://www.ncbi.nlm.nih.gov/pubmed/26684478
The synopsis is based on the following article:
Sibinga EM, Webb L, Ghazarian SR, Ellen JM. School-based mindfulness instruction: an RCT. Pediatrics. 2016 Jan 1;137(1):e20152532.


* Interpretation of quality assessment results:
• Very low: Further research is most likely to have an important impact on our confidence in this estimate of effect.
• Low: Further research is likely to have an important impact on our confidence in this estimate of effect.
• Moderate: Further research is fairly likely to have an important impact on our confidence in this estimate of effect.
• High: Further research is unlikely to have an important impact on our confidence in this estimate of effect.
• Very high: Further research is most unlikely to have an important impact on our confidence in this estimate of effect.

Details of assessment method can be found at Chung VC, Wu XY, Ziea ET, Ng BF, Wong SY, Wu JC. Assessing internal validity of clinical evidence on effectiveness of CHinese and integrative medicine: Proposed framework for a CHinese and Integrative Medicine Evidence RAting System (CHIMERAS). European Journal of Integrative Medicine. 2015 Aug 31;7(4):332-41.