Future MBI trials for youth should use scaled-up definitive designs with active intervention controls and embedded mechanism measures¶

Strategy · All strategies
Evidence · 2 claims (2 for) · 1 study (1 quant-synthesis), q3 · 1 of 1 report an effect size · 2 claims rest on one study

Description¶

The review recommends that future evaluations of MBIs for youth move beyond small pilot RCTs to "scaled-up definitive trial designs" that are fully powered, use representative samples, compare MBIs against plausible active control conditions with medium- to long-term follow-up, and embed a focus on "mechanisms of action". It specifically urges that future studies include active intervention control conditions to provide the most stringent test of efficacy or noninferiority, and that they measure mechanisms of change including mindfulness, which fewer than a third of current studies do.

Design Implications¶

Context¶

Requirements¶

• Trials must compare MBIs against active control conditions, ideally active intervention controls with active ingredients targeting the same outcomes

Constraints¶

• At present, no definitive evaluations of MBIs with children and adolescents are available; some categories in the current evidence base are populated by as few as five studies

Target Learners¶

• Children and adolescents aged 18 years or younger

Target Learning Goals¶

• Mental health and wellbeing
• Executive functioning and attention
• Mindfulness skills

Claims¶

• When only RCTs with active control groups are analysed, MBI benefits are restricted to Mindfulness (d = .42), Depression (d = .47) and Anxiety/Stress (d = .18) [+W]
• Publication bias is evident for Negative Behaviour and Anxiety/Stress across all RCTs and for Mindfulness in active-control RCTs, suggesting overestimation of MBI effects [+W]

Related Strategies¶

Examples¶

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Key Sources¶

• Dunning, D. L., Griffiths, K., Kuyken, W., Crane, C., Foulkes, L., Parker, J., & Dalgleish, T. (2019). Research Review: The effects of mindfulness-based interventions on cognition and mental health in children and adolescents – a meta-analysis of randomized controlled trials. Journal of Child Psychology and Psychiatry. https://doi.org/10.1111/jcpp.12980