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Logo of nihpaAbout Author manuscriptsSubmit a manuscriptHHS Public Access; Author Manuscript; Accepted for publication in peer reviewed journal;
 
Psychol Sch. Author manuscript; available in PMC 2018 January 1.
Published in final edited form as:
Published online 2016 November 28. doi:  10.1002/pits.21979
PMCID: PMC5486971
NIHMSID: NIHMS826762

A Qualitative Exploration of Implementation Factors in a School-Based Mindfulness and Yoga Program: Lessons Learned from Students and Teachers

Abstract

Identifying factors relevant for successful implementation of school-based interventions is essential to ensure that programs are provided in an effective and engaging manner. The perspectives of two key stakeholders critical for identifying implementation barriers and facilitators – students and their classroom teachers – merit attention in this context and have rarely been explored using qualitative methods. This study reports qualitative perspectives of fifth and sixth grade participants and their teachers of a 16-week school-based mindfulness and yoga program in three public schools serving low-income urban communities. Four themes related to program implementation barriers and facilitators emerged: program delivery factors, program buy-in, implementer communication with teachers, and instructor qualities. Feedback from students and teachers is discussed in the context of informing implementation, adaptation, and future development of school-based mindfulness and yoga programming in urban settings.

Keywords: qualitative, implementation, mindfulness, school-based, students, teachers, yoga, urban, schools, barriers, facilitators, program delivery

Introduction

Implementation challenges limit the impact of interventions on participants (Durlak, Weissberg, Dymnicki, Taylor, & Schellinger, 2011; Durlak & DuPre, 2008; Meyers & Durlak, 2012; Naylor & McKay, 2008) and can affect program fidelity (Ransford, Greenberg, Domitrovich, Small, & Jacobson, 2009; Dariotis et al., 2008; Domitrovich & Greenberg, 2000). Research on school-based yoga and mindfulness programs has become increasingly popular in recent years. The literature, primarily focused on outcome-based research, has shown positive effects on student’s behavior, perceived stress, emotional regulation, and academic performance (Zenner, Hermleben-Kurz, & Walach, 2014; Sibinga et al., 2013; Mendelson et al., 2010). The importance of studying yoga and mindfulness programs is substantiated by the benefits these have demonstrated in multiple domains, including promotion of psychological (e.g., reduced anxiety; Khalsa, S. B. S., Hickey-Schultz, L., Cohen, D., Steiner, N., & Cope, 2012; Kirkwood, Rampes, Tuffrey, Richardson, & Pilkington, 2005), cognitive (e.g., increased attentiveness; Greenberg & Harris, 2012), physical (e.g., Ross & Thomas, 2010); and behavioral (e.g., improved social skills and reduced externalizing behaviors; Schonert-Reichl & Lawlor, 2010) health.

There is a need for research on implementation of mindfulness and yoga programs in schools. As Forman and colleagues wrote: “high-quality intervention research cannot be conducted without consideration of issues of implementation in ‘real-world’ practice settings” (Forman et al., 2013, 93). Questions regarding program implementation can be usefully examined from multiple perspectives (e.g., program recipients, outside observers) apart from the implementers themselves. This study aims to explore these two questions as they relate to a school-based mindful yoga program.

This study reports qualitative feedback about program implementation from students who participated in a mindful yoga program and from their classroom teachers who did not participate in the program but were impacted by it administratively. The study contributes to the literature in several ways. First, the use of qualitative data allows for a rich, process-oriented examination of implementation practices of a school-based mindful yoga program. There has been little process-orientated data describing program implementation practices and strategies that serve as barriers or facilitators to effective interventions (Domitrovich & Greenberg, 2000). This paper reports qualitative perspectives on a school-based mindful yoga program delivered in three economically-disadvantaged urban public schools.

Second, program participants and their classroom teachers provide unique perspectives. Studies that address implementation challenges and lessons learned have focused primarily on feedback from program implementers (Feagans Gould, Mendelson, Dariotis, & Greenberg, 2014; Mendelson et al., 2013). Although the perspective of implementers is important, the fact that they are intimately involved with the program is both a strength (e.g., program knowledge) and a limitation (e.g., bias). By contrast, students and teachers have different vantage points, investment, and information sources. For instance, implementer characteristics or behaviors may serve as barriers to program attendance by students. Additionally, teachers are responsible for students’ whereabouts and can impact how much program exposure students receive, as well as the reasons (e.g., administrative, logistic) for varying levels of program attendance. Finally, students and teachers may voice opinions about the acceptability of program content and delivery that may ultimately help refine intervention procedures and optimize intervention effectiveness.

This paper aims to improve the delivery of mindful yoga and other school-based programs by gathering perspectives from both participants (students involved in the program) and key stakeholders (classroom teachers). Our research was guided by two overarching questions: (1) What aspects of the program were well- and ill-received by students and teachers? and (2) What additional factors – programmatic, contextual, perceptions – promoted or hindered program participation? Of utmost interest were identifying programmatic (e.g., implementer characteristics) and non-programmatic (e.g., environment) factors that impeded or promoted effective program adoption (Forman et al., 2013).

Methods

Sample

Twenty-two fifth and sixth grade students participated in six focus groups, two at each of the three participating schools. Students were identified for focus group participation by classroom teachers out of the total sample of 122 intervention participants (18.0% of intervention youth participated in focus groups). To maximize sample heterogeneity, teachers were asked to recruit students based on grade, sex, program attendance, and program engagement. Over half of the participants were fifth graders (n=14; 63.6% compared with 59.2% for the intervention sample). Slightly more females (n=12; 54.6% compared to 44.6% for the intervention sample) participated than males (n=10; 45.4%) with more females participating at School 1 (n=6) and more males participating at School 2 (n=6). Students ranged in age from 10 to 13 years old with the vast majority (82%) ages 11 or 12. Approximately 72% of focus group participants were Black (compared to 86% of the intervention sample). The focus group sample, did resemble the distribution of demographic characteristics of the intervention sample although not exactly, as one would expect with a smaller focus group sample. A total of nine classroom teachers (7 female; 5 Black; 6 sixth grade) participated out of a possible 11 fifth and sixth grade teachers across the three schools.

School Context

The three schools where the intervention was implemented served highly economically-disadvantaged communities as verified by neighborhood, state and national statistic comparisons (Table 1). The schools served neighborhoods characterized by crime rates far exceeding state and national rates. Unemployment, median household income, and educational attainment statistics for these areas suggest that youth attending study schools were exposed to high levels of adversity, on the order of two-fold compared to state and national levels. Free and reduced meal eligibility for these schools ranged from 78 to 91%, indicating high levels of student poverty. The decision to implement a mindful yoga program with this student population was motivated by research on the harmful consequences of chronic stressors and adversities for youths’ self-regulation.

Table 1
School and Neighborhood Characteristics

Program Description

This program aimed to enhance students’ emotional and cognitive regulatory capacities through mindful yoga practices. The universal school-based mindful yoga program, implemented with 5th and 6th graders in three Baltimore primary schools (identified here as Schools 1, 2, and 3), used yoga-based body movements and breathing to promote mindfulness (described in Feagans Gould, Mendelson, Dariotis, & Greenberg, 2014; Mendelson et al., 2013). The intervention was provided by an outside agency, not by school personnel. We worked with a volunteer student sample because the research protocol required that students provide parental permission to participate. As a result, select students from different classrooms participated; the intervention was not offered to all students in a grade or all students in a given classroom. Teachers were not directly involved with the program. Focus groups were conducted with a subgroup of fifth and sixth grade participants, and participants’ classroom teachers were interviewed.

The intervention was developed and provided by three yoga instructors, the co-founders of the Baltimore-based non-profit Holistic Life Foundation (HLF). Program implementation occurred in the context of a six-school study, in which the other three schools were assigned to a wait-list control. Participants were offered 45-minute sessions twice a week over the course of 16 weeks during their resource time (e.g., art, library, or music in Schools 1 and 3) or during part of lunch (School 2). Fifth and sixth grade students attended intervention classes separately at two of the schools (School 1 and 3), whereas at School 2 intervention classes included students from both grades. Typical sessions included centering practices that encourage quieting the mind and present moment awareness, then active yoga-based poses (e.g., sun salutes), breathing techniques, guided mindful reflection, and brief discussions on health-related topics (e.g., nutrition, environment). At the start, practices were basic and became increasingly more complex over the 16 weeks (see Feagans Gould et al., 2014 for detail on program components).

Youth Focus Groups

All youth provided assent and parental consent to be enrolled in the study prior to the first mindful yoga session. All focus group discussions (FGD) and interviews were conducted following completion of the intervention. FGDs and interviews were led by a female moderator using a semi-structured interview guide, were held in private locations at participating schools during resource or lunchtime, and averaged 35 minutes in length. Focus group sizes varied from two to six students. Fifth and sixth graders were interviewed separately for five of the six focus groups. All but one group had both female and male participants. Participants were provided with snacks at the conclusion of group discussions. FGD and interviews were audiotaped to facilitate later transcription; nonverbal agreement or disagreement was not quantified, although participants were encouraged to verbalize perspectives.

The focus group guide was adapted from a protocol used to assess different programs implemented among similar aged youth (Smith, Dariotis, & Potter, 2003). The purpose of the protocols was to capture normative beliefs about the program rather than individual impressions, making focus group discussions a more appropriate format compared to one-on-one interviews. Students were instructed to share their thoughts openly and with respect for each other (especially when responses differed). A round-robin approach was used so that all participants had an opportunity to respond to each question. The focus group facilitator would ask for clarification when needed. Topics discussed during student focus groups specifically pertaining to program barriers and facilitators include recommendations for program improvement (e.g. “If you took the program again next year, what would you change?”), characteristics they liked most and least about their program instructors, as well as how having a different instructor implement the program would affect the quality of the program (e.g. given all three instructors are male, youth were probed about having a female instructor if they were to take the program again), and how the instructors treated students compare to other adults in their lives (focus group and interview guides are available upon request from the corresponding author).

Classroom Teacher Focus Groups and Interviews

Two fifth grade teachers from one school (School 1) could not be interviewed because of scheduling. Seven teachers participated in focus groups (one with five participants including fifth and sixth grade teachers; one with two sixth grade teachers) and two teachers (from School 3) participated in individual interviews due to scheduling. The same questions were asked of teachers in both focus groups and interviews. Topics discussed with teachers pertaining to program barriers and facilitators included teacher willingness to incorporate program components in the classroom; teacher interactions with program implementers (e.g. “What was your experience in working with the instructors?”), research staff (e.g. “What was your experience in working with the research team?”), and the program itself (e.g. “Were you able to observe or participate in the program?”); recommendations for improving the implementation of a similar program in the future; support needs for creating a program teachers could implement in classrooms in the future; teacher buy-in of student participation in the program (e.g. “How did you feel about having some of your students participate in the program?”); and logistical aspects of the program (e.g. “Did the program fit well into the students’ schedules, or was it disruptive?”).

Qualitative Analysis

All focus groups and interview audio recordings were transcribed verbatim. Using an inductive coding process, three members of the team (each with training and experience collecting, coding, and analyzing qualitative data for multiple studies) independently conducted line-by-line coding of the transcripts using thematic analysis (Boyatzis, 1998). This type of inductive coding allows for summarizing and consolidating qualitative data into meaningful themes and allows for theory generation. Emerging major and subthemes were discussed during meetings and any differences resolved. As a last step, each coder took the lead role organizing themes and subthemes for approximately three transcripts. Once codes were categorized by theme for each of the assigned transcripts, a second coder verified these themes and supplementary material or subthemes where added where appropriate before a third coder conducted a final verification. Researchers chose not to use specific qualitative coding software for analysis due to the limited number of transcripts (n = 10).

Results

Four broad themes with related subthemes were identified relating to barriers and facilitators to program implementation: program delivery factors, implementer communication with teachers, promoting program buy-in, and instructor qualities. A more detailed list of themes and subtheme content is reported in Table 2.

Table 2
Lessons Learned from Teacher (T) and Student (S) Perspectives

Theme One: Program Delivery Factors

The sentiment across participants at all three schools and in both grades was that they would not change anything about the program content. In general, students also seemed pleased with the way the program was run. Students and teachers, however, offered a great deal of feedback regarding factors related to program delivery, including program timing (when during the day the program was offered), the physical environment (where the program took place), and program logistics (how the program was delivered).

Program timing

A recurring theme across Schools 1 and 3, where the yoga program was offered during resource time, was that students felt conflicted about attending yoga because attending yoga required them to miss other activities they enjoyed. A 5th grade female teacher remarked: “A lot of the feedback from the kids is they did not like missing art the whole time the program was involved” (School 3). Several youth verified this sentiment. As a solution, one student suggested expanding the amount of resource periods so that each activity, including yoga, could be offered during resource time at least once per week: “We want to make sure we have at least one of each resource. At least one day of art, at least one day of library, at least one day of music. At least one day of each” (fifth grade female student, School 3).

Teachers reported that the conflict between yoga and resource time was a major challenge to youth program participation. Often attending yoga became a “day-by-day battle depending on what resource class [the students] were missing. Some said they didn’t want to go, you know, they wanted to go to their resource. And then the next day, ‘well I want to go to yoga, I don’t want to go to this class’” (sixth grade female teacher, School 3). Dissatisfaction with missing out on resource time activities was exacerbated by the fact that classmates not participating in the yoga program could attend resource time. According to one fifth grade teacher, this fueled participant resentment toward the yoga program and a conflict for youth who both “like yoga, but they also wanted art” (fifth grade female teacher, School 3). When the suggestion of holding the program after school was explored with students at School 3, however, students stated that they preferred the program to be held during school, twice a week. In School 2, where the program was offered during part of lunchtime, no student conflicts were reported, but the yoga classes had substantially lower attendance and very few students participated on a regular basis (38% of sessions attended, on average).

Physical environment

Youth perceived several distracting elements related to the program space. In School 1, one sixth grade male recounted how windows in the doors gave non-program youth the ability to peak through, a distraction from the program: “It was a bunch of like stuff that distracts you… people used to look through the window [in the door].” Space set aside for the program often times lacked cleanliness. Youth spoke about dust, bugs, and wetness in the space: “…with bugs and stuff because when it rained, it would get wet. And because like the doors, something happened to the door where it was halfway open and when it rained, it would go all down like the steps” (fifth grade male student, School 3). As a possible solution to these distracting environmental elements, students at two different schools suggested that the program be held outside with one youth recommending alternating weeks: “I would have like one week you’d be inside doing all the breathing techniques and Sunrise and all of that, then the other week you would go outside and do exercises so you can get more oxygen…” (sixth grade male student, School 3). Holding the program outside would have the added benefit of breathing in fresh air. Other less frequently mentioned changes to the environment included the desire for more props, a quieter environment, and a space with better temperature control. One male fifth grade student mentioned that holding the program “somewhere else with more equipment” (School 2) would be a welcome change.

Program logistics

Teachers noted the importance of considering their students’ schedules when planning program specifics. For instance, at School 2, instructors came to pick the students up for the program at the same time that non-participating students were going to lunch. This created a chaotic environment for teachers who felt somewhat burdened trying to figure out which students were supposed to go where: “Standing next to their friends and you have to figure out which one…” (sixth grade male teacher, School 2) and “Constantly asking them: Do you have yoga? Do you have yoga?” (fifth grade female teacher, School 2). These teachers recommended having instructors pick up program students about 5 minutes early to allow for a clear delineation of which students were to go to which place: “… the people who worked with them got them right before their lunchtime. So it was a crowd of kids coming out at the same time. So maybe, if they would have grabbed them, well maybe five minutes earlier, so there was a clear delineation between who was going to yoga and who was going anywhere else. It would run more efficiently” (fifth grade female teacher, School 2). While teachers at School 2 only cited the pick-up issue, teachers at School 3 mentioned a related efficiency problem with drop off. Teachers at School 3 remarked on the added time they had to spend looking for their students after the program ended and recommended program implementers escort students back to the classroom: “What would be helpful is if he helped bring the kids back because a lot of times he just released them so I had to roam around the building and find them at the same time as walk around the rest of the class who I picked up from the other resource they were in. So like if he could escort them to that class especially so they’re not running around” (sixth grade female teacher, School 3).

Theme Two: Implementer communication with teachers

A second theme that emerged from teacher accounts was related to the importance of establishing effective lines of communication between teachers and program implementers. Feedback on communication is presented under three subthemes: communication about program goals, communication about program logistics, and communication concerning students.

Communication about program goals

While teachers reported positive expectations of the program, they did not recall learning about the intended program goals at the outset which resulted in teachers at all three schools not feeling sufficiently informed about program goals: “He did introduce himself and said what he’s there to do. But I don’t know what the ultimate goal was by the end of the year, what it’s for. I mean, I know a little bit about yoga. So I kind of found out what it’s trying to do. But ultimately I didn’t know what the whole program was for” (sixth grade female teacher, School 3).

Communication concerning students

Communication about the program’s day-to-day occurrences was perceived as inadequate by teachers. Teachers at all three schools related how they would have welcomed more frequent and timely communication. While email messages were reported as an effective means of communication between program instructors and teachers at School 1, it was expressed that regular “check-ins” would have been better than the occasional email. Additionally, teachers at School 1 noted that communication with the instructors was limited and centered on getting the youth to and from the program: “I only saw him when I took the kids there. That was it. And it was like, there was no talk about what’s going on, what is happening. That was it. I’d drop them off and I’d keep it moving” (sixth grade female teacher, School 1).

Communication about program logistics

Classroom teachers also remarked on the importance of appropriately timing and updating the exchange of information with implementers concerning program logistics. For instance, although the team provided a list of students enrolled in the study during the fall following recruitment, some teachers believed they were given this information too far in advance to be useful: “We were given a list [of student participants] but like it was so far before the program started that I was like ‘toss’… kind of toss it to the side and never paid attention to it when it was time for it to come up” (fifth grade female teacher, School 2). Teachers suggested that providing them with an updated student roster closer to the start of the program would have been helpful. Teachers at School 3 also remarked on the importance of updating the program calendar: “It would be helpful to have a clear list of dates that people are going to be coming. If you update it, email a calendar because there was miscommunication when [intervention instructor] was away doing yoga somewhere. So I misunderstood an email and I thought he was coming. He wasn’t coming, so um, that would help because then the art teacher’s not prepared for 25 kids” (fifth grade female teacher, School 3).

Additionally, teachers expressed a desire for a more collaborative relationship with the instructor that would include communication about student behavior, attendance, and progress. These teachers felt that there was a missed opportunity for open collaboration and communication where “everybody kind of collaborates, so you know what’s going on.” (female teacher, School 2). Teachers reported a desire to hear about how students were doing in the program. The level of collaboration desired and the solutions offered to sustain it varied by teacher and school. For instance, one teacher thought that simply making “some time to talk about it, you know, before the session or right after the session” would foster more collaboration (sixth grade female teacher, School 1). By contrast, a male teacher at a different school noted that the time right before or after the session was insufficient for discussing students’ progress (sixth grade male teacher, School 2). Sharing the attendance sheet with the teachers was offered by a teacher as a strategy that not only would allow teachers to track where their students were on a particular day, but that could also serve as a type of progress report. One fifth grade female teacher explained: “That [attendance sheet] would be helpful to have too because occasionally someone would ask ‘oh where was this student today’ and we wouldn’t be able to account for where they were and we’d have to… you know eventually some of the other students would know: ‘oh they were in yoga’ or whatever the case. Yeah, so and so was here, this is how the day went maybe” (School 2).

Theme Three: Promoting Program Buy-in

A great deal of student and teacher feedback focused on factors that could promote buy-in from students and teachers. Subthemes included use of program skills in the classroom, teacher training, optimal program exposure, incentives, and voluntary participation.

Promoting skills generalization

Teachers spoke about the importance of taking the practice off the mat and applying it to the classroom setting. One sixth grade female teacher remarked that program instructors should observe students’ classroom behaviors and then tailor the program to target those behaviors: “… if he knows what the daily behaviors are like outside the yoga room, that may be able to help him implement certain skills in them during his instruction” (School 3). Other teachers recommended didactic classroom sessions involving discussion, role playing, and problem solving using program skills: “… act it in a session… to demonstrate certain situations and to see how they would handle those things” (sixth grade female teacher, School 1). Students at a different school also felt role-playing may promote use of program techniques: “Every once in a while we should go in the gym and learn how to, how to control our anger when, say like we went to the gym, we’re playing basketball, somebody pushed someone, they’re mad at the other one…. Having… a role playing contest” (fifth grade male student, School 2).

Some teachers recommended ways to promote use of program skills in the classroom, including having a yoga instructor lead a brief classroom demonstration every few weeks or having teachers themselves deliver the intervention: “It’d be nice if there was some way that the teachers could attend the class with the students or the yoga teacher could come up here and do work up in the classroom” (fifth grade female teacher, School 3). Teachers voiced a willingness to integrate program techniques if trained: “If teachers knew what they were doing in the yoga class and were familiar with, then that’s something that I know we would be happy to work back into the classroom as it could help us as well…” (sixth grade female teacher, School 3).

Teachers across schools recognized the program’s potential to provide students with valuable self-regulation tools. A fifth grade female teacher noted: “So in between subjects it could kind of be like a breathing thing. Okay then put your notebook away, then you do this quick movement and then you do you get your next book or your pencil or whatever. So I mean it might be something to help them between transitions” (fifth grade female teacher, School 2). Teachers at another school also suggested using program techniques during school activities: “Yeah, you could do that during the drills, like during the warm ups or something like that. Or maybe like before you leave to go to your next class, stuff like that. Probably 10, 15 minutes out of your time” (sixth grade female teacher, School 1). Teachers stressed the importance of practicing program techniques regularly, as students respond best to routines: “If there’s a routine, you know if we always did it at the beginning part of the day… keeping a set schedule… consistent” (sixth grade female teacher, School 3).

Teacher training

Across all schools, teachers expressed willingness to attend mindfulness training if the principal integrated it within existing meetings. Teachers repeatedly expressed reluctance to take on additional commitments due to busy schedules: “And then most of are like working through our lunch so because we don’t get those extra breaks. So for teachers its highly unlikely that we are going to make it to do anything else” (fifth grade female teacher, School 2). Teachers recommended that the training could either be held during professional development days or during monthly faculty meetings. Administrative support would be necessary to facilitate teacher training: “It would have to be up to the principal because that’s how jam packed some of that stuff can be with all the training… I would say if you kept it to an hour or less than they may be able to squeeze it in” (fifth grade female teacher, School 2).

Teachers also felt training should include quality assurance in the form of observations by instructors: “I think once a week, once every two weeks, having them come in to observe to see if we’re doing it right, demonstrating, even leading it as a class” (sixth grade female teacher, School 3). Teachers also noted that materials such as posters in the classroom would be helpful as a reminder of program techniques: “With either pictures of certain breathing or steps, I think that would definitely help… they could look at the poster and maybe internalize it from there” (sixth grade female teacher, School 3).

Optimizing student exposure to program skills

Teacher strategies to promote program success included targeting earlier grades and providing longer-term exposure. There were diverse opinions about when the program should begin and which grades it should span. One fifth grade teacher said: “… starting at fourth might be a little better. You might get a little more buy in and they’re less hormonal” (female fifth grade teacher, School 3). Some teachers suggested starting the program in even earlier grades to effect long-term behavioral change: “As early as kindergarten … like as early as they enter the school. I mean I’m sure all of us would agree that we see some of those behaviors [disruptive anger, inability to express themselves, impulsivity] very, very early even in this school” (sixth grade female teacher, School 2).

Teachers and students felt the program was not long enough to ensure internalization of program skills: “It would be good if they could continue so they could learn to deal with raging hormones and breathe through that” (fifth grade female teacher, School 3) and “I’m hoping to see at least with the rising fifth graders if they do it another year, they’ll start to really understand it and see if they use some of the strategies that he’s taught them in class” (sixth grade female teacher, School 3). Fifth graders echoed the need for longer-term participation. One fifth grade female noted she needed a longer program to learn more techniques to deal with stress: “because we didn’t learn everything so I would like to learn more things” (School 3).

Incentives for teachers

Teachers and students were asked to identify incentives that would promote program buy-in. Across all three schools, teachers agreed that the best incentive for teachers would be the expectation that the program will improve student classroom behaviors and reduce the time teachers spend disciplining students: “It would benefit them behavior wise and academically cause you can get more of your lesson done without spending a lot of time trying to deescalating, diffuse situations” (sixth grade female teacher, School 1); “Yeah, if the children benefit from it and their behaviors change and their, um, grades improve, then yes, it is [worth the effort]” (sixth grade female teacher, School 1).

Teachers at two schools felt material incentives would be a sure way to promote teacher participation in training. A fifth grade female teacher noted: “I mean just like with everything, the more giveaways you have, the more free things you have, the more people are going to be inclined to stay” (School 1). At School 1, a sixth grade female teacher stated money would be a key motivator for her, although this was an isolated sentiment not articulated by other teachers: “I’m not interested in yoga. But if it is going to benefit the children, I will do it, but I’m not going to do it for free.” Teachers at Schools 1 and 3 remarked that the chance to benefit personally from mindfulness and yoga practices would be an incentive to complete training: “Well, if they [teachers] understood that… it’s a way to de-stress… to take a minute to just get it together and breathe. I think that’s something that we could easily buy into because we get stressed out” (sixth grade female teacher, School 3). Another teacher remarked that there was benefit in receiving a yoga class they would otherwise have to pay for: “I’ve heard teachers say ‘I wish I could take the course too because that stuff costs a lot of money to do’” (sixth grade female teacher, School 1).

Voluntary participation

Several students and teachers expressed the view that student participation in the yoga program should be voluntary, not mandated by parents or teachers. A fifth grade female student remarked: “… if the people who don’t wanna do it, they shouldn’t have to” (School 1). Another fifth grade female noted: “If they don’t wanna do it, then they shouldn’t force them. When they’re in the mood they can go to yoga and stuff, but when they’re not in the mood they can’t because they’re gonna disrupt the class” (School 1). Teachers also remarked on the importance of not being forced to attend trainings or integrate the program into their classrooms. “I think it should remain optional though. I don’t think it should be something that’s forced upon every teacher because every teacher isn’t going to be open and receptive and the less receptive they are, the less receptive their students are going to be ‘cuz it’s, you know, it’s a forced thing” (fifth grade female teacher, School 2).

Theme Four: Yoga Instructor Qualities

A fourth and final theme to emerge from student and teacher feedback on program implementation is related to the qualities of the yoga instructors who led the program. By far the most frequently mentioned instructor quality valued by youth was “respect”, which the youth associated with “fairness,” “being nice,” and “not yelling a lot”. A fifth grade female describes how the instructor showed her respect by not ordering her around: “[instructor treats us] like we’re equals. And like, well, he’s like, he like my big brother to me, and he shows me respect instead of like ‘go do this, go do that’” (School 2). This was contrasted to how the youth perceived most adults treat them. Students commented that instructors modeled the behavior that they expected youth to display: “He treats us like, like we’re adults… like we’re [equals]… and, because most, most adults are hypocrites. He’s not. He’s one of the more powerful ones to do the right thing. Like they [other adults] will tell you to do something, not, they tell you not to do something, [and then] they will go right and do it” (male student, School 2). Teachers also cited the opportunity for students to identify with a positive role model as a strength of the program. “And having that interested person, and I have to say interested male, is wonderful. And having a male who’s sort of Zen so they have that whole other role model not just this butch beat ‘em, shoot ‘em, fight ‘em guy, but who’s just more let-it-be and they need more of that” (fifth grade female teacher, School 3). Some students reported becoming attached to instructors as this student recalls: “Like [the instructor] as soon as he started it seemed like everybody was attached because he wasn’t really like most people were, I know I was, I’m saying to like be attached with him. Yeah because he was real cool” (sixth grade female student, school 3).

Students interpreted various behaviors on the part of the instructors as respectful – behaviors that depicted fairness, not yelling, or the provision of material goods. Fairness in discipline, for instance, was highly valued across all three schools: “When people are doing the wrong thing he’d scream out the people who are doing the wrong thing and not the people who are doing the right thing” (fifth grade male student, School 2); “‘I see you are doing a good job, thank you’ and then would go talk to students who were being disruptive about why they were misbehaving and try to encourage them to stop” (sixth grade male student, School 2); “He was nice and was something like one person would doing something and he didn’t yell at the whole group. He was nice. Not a lot of yelling” (fifth grade girl, School 3). The differences in the amount of yelling done by the instructors when compared to other adults in the students’ lives was also noted as a form of respect: “He’s [instructor] nice like he’ll give you a warning before. He’s not yelling and loud. He’ll respect you. Like he showed you what you’re going to be in the future” (sixth grade female student, School 1); “He never got mad. Most adults would get mad and yell at a kid but he didn’t” (fifth grade female student, School 3). Rewards for good behavior – such as free pizza, going outside, or free time within the program – was also seen as a sign of respect. As an example, a sixth grade female student remarked: “Compared to teachers, he treated us with more respect because some of the teachers in the school they don’t really care if you fail. But he kept being on our side and he never let us do nothing. Yeah he said like ‘you do this, I do this.’ So like if we do something he liked, he’d give us like, we’d go outside or something. Or get free time” (sixth grade female student, School 2).

Students also brought up the gender characteristic mentioned earlier by a teacher –the influence of a male role model, with male youth at two of the schools noting a preference for male instructors. A female student adds: “Because they’re um more female, there was more females in the classroom. So a woman would have probably related more because the man he related more to the boys than the girls so. Maybe there could have been two yogas with boys and girls” (sixth grade female student, School 1). Students repeatedly mentioned how having a female teacher would change the feeling of the program, going on to state that female instructors “might be bossy” (fifth grade male student, School 2) or “wouldn’t be as fun and they probably wouldn’t give us pizza” (fifth grade female student, School 2).

Across all three schools, students described program instructors as nice, playful, and fun. These were the qualities, in addition to respect, that the students most valued from the instructors and remarked would be most important for future instructors to have.

Discussion

We identified four themes related to program implementation barriers and facilitators: program delivery factors, communication with teachers, promoting program buy-in, and program instructor qualities. Student and teacher comments expressed a range of experiences and opinions, such as enthusiasm for program goals and activities, ambivalence about aspects of program participation, and suggestions regarding implementation. Below we reflect on the emergent themes and provide recommendations based on the lessons learned from this mindful yoga program that may translate and generalize to other school-based programs.

Program Delivery Factors

During early phases of intervention testing, an intervention may need to be offered to a subset of students with parental permission (as in the current study) rather than at a classroom- or grade-wide level. This strategy, however, creates certain challenges. The fact that only a portion of students participated in the program while their peers attended other enjoyable school activities (e.g., art, music) made many participants feel ambivalent about attending the program consistently. Monitoring which students were supposed to attend the intervention and supervising those students so that they arrived on time to the intervention session and returned promptly to class afterward was also difficult for teachers. While administrative constraints may limit when a program can be offered, program scheduling merits careful exploration in collaboration with school administrators, as it is closely tied to student motivation and program attendance. Options to consider when feasible include incorporating mindful yoga into a school’s physical education or health curriculum, as some other researchers have done (Khalsa, Hickey-Schultz, Cohen, Steiner, & Cope, 2012; Noggle, Steiner, Minami, & Khalsa, 2012).

Difficulties with program settings – lack of privacy, noise, and lack of cleanliness – also posed barriers to student engagement. Resource constraints are a common issue in underserved urban schools. Although not all physical limitations can be effectively addressed, solutions may include covering windows with paper and having instructors prepare the room to ensure program participants have an optimal experience. For yoga programs, ensuring that a large enough space is available for yoga mats and movement is key. Space arrangements should be clearly established in the initial phases of developing a school partnership.

Quality, Detail, and Timeliness of Communication

Effective communications with teachers and administrators are critical for ensuring the success of school-based interventions. It is important to determine these stakeholders’ preferences regarding frequency, timing, and content of communications. A key challenge for our team during study implementation was in gaining consistent access to busy administrators and teachers without burdening them. The qualitative data indicated that teachers did not perceive our outreach efforts as adequate. Our experience highlighted that a difficult balance must be achieved between asking for too much time or involvement from busy teachers on the one hand, and maintaining effective communication and program engagement on the other. The qualitative data also highlighted that communication was important for motivating teachers to support program delivery and to promote classroom skills use. In this way, teachers can become part of the support system Meyers and colleagues characterized as key for program success (Meyers et al., 2012). The degree of program description required to engage teachers likely depends on an intervention’s content. In the case of mindfulness and yoga interventions, teachers may have stereotypes or misperceptions about program content or intent; educating them about these practices is important for ensuring their buy-in. Our data suggested some teachers may value having an abbreviated curriculum and materials to hang in the classroom to prompt skills use (e.g., breathing, yoga poses). We recommend that researchers and practitioners implementing mindful yoga in schools consider the initial phase of informing and educating teachers—as well as subsequent phases of updating and “checking in” with teachers – as critical steps for facilitating program implementation.

Promoting Buy-In

Our findings regarding stakeholder buy-in are consistent with literature on other types of school-based program implementation. For instance, two studies about implementation from program developers’ perspectives highlighted the critical role of administrative buy-in and support (Forman, Olin, Hoagwood, Crowe, & Saka, 2009; Langley, Nadeem, Kataoka, Stein, & Jaycox, 2010). Strategies recommended by teachers and students in our sample to promote stakeholder buy-in included training classroom teachers, providing incentives for teachers, training students to utilize skills in the classroom, and making program participation voluntary.

Training teachers in mindful yoga is likely to increase teacher buy-in for the intervention (Durlak & DuPre, 2008; Domitrovich & Greenberg, 2000) and will also provide teachers with the information and confidence to promote program skills in the classroom. Classroom use of skills to help students generalize what they have learned to “real” world scenarios is expected to increase buy-in because perceived program utility and generalizability should promote engagement from both teachers and students (Le & Gobert, 2013). Teacher training, however, requires time and resources. Incentivizing teachers – at least initially – may be important for motivating them to participate in training; the content of incentives (e.g., continuing education credits) requires careful consideration.

Not all schools have the resources or climate necessary to support effective program implementation. Researchers should evaluate a school’s “readiness” for program implementation – including the potential to involve teachers – by conducting a school-based readiness assessment. Such an assessment could include teachers, administrators, and students, and whenever possible, parents given all are stakeholders, impacting and potentially being impacted by school-based programming.

Several teachers and students advocated for voluntary participation in mindful yoga. This is a complex issue, given our experience that having a subset of students participate in the program may create conflicted feelings about program attendance, increase logistic challenges related to student drop-off and pick-up, and complicate efforts to engage teachers. Programming considered key for positive student development (e.g., physical activity, health class) is not typically voluntary. Program implementation at a classroom, grade, or whole-school level likely creates a shift in school climate more broadly, facilitating administrative and teacher engagement. Indeed, previous studies have found that whole school interventions may increase the chances of program success (Naylor & McKay, 2008). Promoting program buy-in before the start of a school-based program may mitigate to some extent the concern regarding “choice” voiced by teachers and students (Durlak & DuPre, 2008; Ransford, et al., 2009; Kam, Greenberg, & Walls, 2003). Offering mindful yoga practices to students or teachers on a voluntary basis as an in-school “elective” or after school program is a different model of program delivery for researchers and instructors to consider (e.g., Ancona & Mendelson, 2014).

Instructor Qualities

Characteristics of program instructors should be considered important aspects of a program’s success. Of note, instructors in the current study were ethnic minority men, which may have influenced the extent to which the predominantly ethnic minority student participants trusted them. We anticipate, however, that a number of additional factors are important for forming positive instructor-student relationships. Regardless of race or ethnicity, instructors should be culturally competent in working with the target student population and knowledgeable about how to work with participants of the target developmental age. Skills in behavior and classroom management are also likely important when working with youth in school settings. We recommend that school-based mindful yoga programs explicitly address these sorts of instructor characteristics in their teacher selection and training protocols. Incorporating and assessing key instructor characteristics as part of a program’s hypothesized logic model may also facilitate systematic exploration of how these elements are linked with effective program implementation (Feagans Gould et al., 2014).

Limitations and Strengths

This study has several limitations. Only students who provided assent and parent permission participated in the original intervention study; this volunteer sample may have differed in certain ways from students who did not participate (e.g., potentially higher parental involvement). Typical of qualitative studies, only a subset of participants was included in focus group discussions; the distribution of focus group students’ demographic characteristics, however, approximated the larger intervention sample distribution. Due to scheduling difficulties, we were unable to interview two fifth grade teachers at one of the schools. Program implementation in three schools by different instructors coupled with significant overlap in themes across students and teachers adds confidence in the consistency of our findings across stakeholders and settings. Results are based on a single mindful yoga program and are not necessarily generalizable to other programs. Findings, however, are likely to have practical utility for other school-based programs – particularly mindfulness or yoga programs delivered in low-resource settings – since they address common concerns related to program scheduling, communication with teachers, and instructor characteristics.

Including student and teacher voices provided dual perspectives on relevant issues. Few studies on school-based mindful yoga programs have analyzed qualitative data from students and teachers as a way of understanding program implementation, particularly in elementary and middle school settings. This study’s process-oriented findings complement outcome-based studies by considering factors that influence program implementation. We hope these findings are useful to researchers and program developers who are grappling with the challenges of integrating mindful yoga programs successfully within school settings. We also hope our use of qualitative data may serve as a useful model for evaluating factors related to program implementation in a variety of school-based programs under development.

Future Directions

Including teacher and student perspectives on program implementation assists in identifying critical elements for successful implementation (Durlak & DuPre, 2008; Naylor & McKay, 2008). Our findings suggest several recommendations for delivering school-based mindful yoga programming, including scheduling programs strategically within the school day, obtaining an appropriate physical setting, promoting buy-in from teachers and students, maintaining effective communication with stakeholders, and ensuring program instructors have characteristics that positively engage youth. To achieve these goals, it is critical to involve key stakeholders in a meaningful way in discussions about program implementation from the start of the project. Future studies may benefit from collecting qualitative data from key stakeholders, including students, teachers, administrators, program developers, and parents. Triangulation of data from different sources is critical as both commonalities and differences across stakeholders are informative. Adaptation or development of quantitative measures to assess stakeholder engagement and satisfaction is needed, both for individual mindfulness and yoga program evaluations and for informing the field more broadly about relevant implementation factors. These efforts can help improve collaborations among mindfulness and yoga program developers, researchers, and school personnel so as to maximize program implementation and outcomes.

Acknowledgments

This work was supported by the National Institutes on Drug Abuse [grant number R34DA029237]. The opinions and conclusions expressed are solely the authors’ and should not be construed as representing the opinions of NIH or any agency of the Federal Government.

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