Impact of Mindfulness-based Stress Reduction on Student Mental Health and Education Outcomes: Empirical Evidence from Pakistan

Last registered on June 21, 2023
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Pre-Trial

Trial Information

General Information

Title
Impact of Mindfulness-based Stress Reduction on Student Mental Health and Education Outcomes: Empirical Evidence from Pakistan
RCT ID
AEARCTR-0010019
Initial registration date
September 04, 2022

Initial registration date is when the trial was registered.

It corresponds to when the registration was submitted to the Registry to be reviewed for publication.

First published
September 08, 2022, 10:53 AM EDT

First published corresponds to when the trial was first made public on the Registry after being reviewed.

Last updated
June 21, 2023, 1:40 PM EDT

Last updated is the most recent time when changes to the trial's registration were published.

Locations

Country
Pakistan
Region
Faisalabad

Primary Investigator

Name
Jennifer Opare-Kumi
Affiliation
University of Oxford
Contact Primary Investigator

Other Primary Investigator(s)

PI Name
Zahra Mansoor
PI Affiliation
University of Oxford
Contact Investigator

Additional Trial Information

Status
Completed
Start date
2022-08-29
End date
2022-11-25
Keywords
Behavior, Education, Welfare
Additional Keywords
mental health, mindfulness, learning outcomes
JEL code(s)
I20; I31
Secondary IDs
Prior work
This trial does not extend or rely on any prior RCTs.
Abstract
Research shows that a significant proportion of mental health disorders surface in early childhood and adolescent years. Systematic reviews show that interventions focused on student mental health can have promising effects on mental health and education outcomes of children. Mindfulness-based stress reduction (MBSR) interventions are one such intervention. However, there is little evidence on the impact of MBSR programmes on student mental health and education outcomes, or on the mechanisms through which they operate. This gap in evidence is particularly stark in lower-middle income countries. This project aims to design and test the impact of an MBSR curriculum in the context of low-cost private schools in Pakistan through a pilot. We aim to answer two key questions: What is the impact of MBSR on the mental health, psychological outcomes, and education outcomes of young people? What are the underlying mechanisms through which MBSR impacts young people? We aim to, develop a proof-of-concept of our intervention design, and produce evaluation results from the pilot. The research embedded in the pilot will result in a paper identifying key lessons and findings, providing a pathway to scale. The findings from this evaluation will generate rigorous causal evidence and contribute to the limited (but growing) literature on the impact of mental health interventions for youth.
External Link(s)

Registration Citation

Citation
Opare-Kumi, Jennifer and Zahra Mansoor. 2023. "Impact of Mindfulness-based Stress Reduction on Student Mental Health and Education Outcomes: Empirical Evidence from Pakistan." AEA RCT Registry. June 21. https://doi.org/10.1257/rct.10019-1.1
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Experimental Details

Interventions

Intervention(s)
The Mindfulness-based Stress Reduction (MBSR) Programme will be rolled out over a 8-10 week period during September - October of the school term. The programme will be an introduction to mindfulness, and will help students explore their inner world by understanding their own thought processes and emotions to be able to ‘respond’ in difficult situations rather than ‘react’. Ultimately the course will help students learn:
• The tools on how to be mindful – as and when required by the situation they are in.
• To acquire a better focus on life, with improved attention span.
• How to deal with difficult situations and develop composed responses instead of reacting
to a situation.

The participating schools will all introduce an additional after school class with 8 additional weekly lessons. While the treatment students receive MBSR classes in this additional lesson time, control group students will receive a standard Quran class. Students in treatment (MBSR classes) and control (Quran classes) will both be admistered a baseline survey. At the end of the implementation period, all students will take the endline survey.

We hope to learn about curicullum adaptation through this pilot as well as improving measurment of mental health and other psyhological outcomes among young people in low resource settings.
Intervention Start Date
2022-09-05
Intervention End Date
2022-11-11

Primary Outcomes

Primary Outcomes (end points)
(1) Mental health outcomes (i.e., anxiety, depression,and behavioural and emotional diffculties)
(2) Educational outcomes (i.e., learning outcomes, attendance and attentional capacity)
Primary Outcomes (explanation)
(1) The mental heath outcomes are captured through psychometrically validated screening tools
- anxiety and depression captured through the revised child anxiety and depression scale (RCADS)
- behavioural and emotional difficulities captured through the strength and difficulities quesionnaire (SDQ)

(2) Educational outcomes
- learning outcomes (captured through test scores at the school level)
- attendance (data captured at the school level)
- attentional capacity (objectively captured through digital games)


Secondary Outcomes

Secondary Outcomes (end points)
(3) Mindfulness (five-facet mindfulness questionnaire)
(4) Other psychological outcomes (self-efficacy, growth mindset and perceived stress)
(5) Time-use
Secondary Outcomes (explanation)
(3) Mindfulness captures change in perspective on the self: observing, describing, activing with awarness, non-judging of inner experience, and non reactivity to inner experience
(4) other psychological outcomes
- self efficacy captured through the general self-efficacy scale
- growth mindset captured through the growth mindset scale, measures how much people believe they can get smarter if they work at it.
- perceived stress captured through the the perceived stress scale
(5) time-use (survey questions aksing learning how they spend their day)

Experimental Design

Experimental Design
The curriculum will be implemented to secondary school studens in grades 8, 9 and 10 from 2 schools managed by Sirajia Institutions. The two schools are boys only and girls only schools. The randomization will take place on the student-level with our strata constructed on the basis of classroom, learning outcomes, and mental health outcomes. Given such interventions can be beneficial for all students, we do not only offer the programme to children who are predisposed to depression and anxiety. Instead we block on these measures (to increase balance across treatment and control groups) and treat both those who may be predisposed as well as those who may not be predisposed. We can however do subgroup analysis to understand whether the impacts of treatment are stronger for those who are predisposed.
Experimental Design Details
Randomization Method
Randomization done using stata
Randomization Unit
The randomization will take place on the student-level with our strata constructed on the basis of classroom, learning outcomes, and mental health outcomes
Was the treatment clustered?
No

Experiment Characteristics

Sample size: planned number of clusters
214 students
Sample size: planned number of observations
214 students
Sample size (or number of clusters) by treatment arms
107 control
107 treatment
Minimum detectable effect size for main outcomes (accounting for sample design and clustering)
Supporting Documents and Materials
IRB

Institutional Review Boards (IRBs)

IRB Name
Blavatnik School of Government Research Ethics Committee (DREC)
IRB Approval Date
2021-12-02
IRB Approval Number
SSH/BSG_C1A - 21 - 18
Analysis Plan

Post-Trial

Post Trial Information

Study Withdrawal

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Intervention

Is the intervention completed?
No
Data Collection Complete
Data Publication

Data Publication

Is public data available?
No

Program Files

Program Files
Reports, Papers & Other Materials

Relevant Paper(s)

Reports & Other Materials