Feasibility and Effectiveness of a School-Based Mindfulness Intervention on Peer Relationships Among Chinese Migrant Children: A Cluster Randomized Controlled Study

Children’s peer relationships are considered to impact various aspects of their development and adjustment. Chinese migrant children, who migrate with their parents from rural to urban areas, are more likely to encounter peer problems than their urban peers due to multidimensional social inequalities. It is important to develop effective interventions targeting improving peer relationships for underserved migrant children.

Mindfulness-based interventions (MBIs) have been increasingly applied and have yielded promising results in improving children’s peer relationship, including increased peer acceptance, greater peer relationship quality, and reduced peer problems. Despite the promising preliminary findings, rigorously designed experimental study with active control groups is still scarce. This cluster randomized controlled trial aims to explore the feasibility and effectiveness of a school-based MBI on peer relationships relative to an active control group.

Methods

Students were recruited from a migrant school in China. Four classes in grade 4^th and grade 5^th were randomly divided into a school-based MBI group (n=51) and a psychosocial education control group (n=39). Self- and parent-reported questionnaires were used to measure children’s mindfulness level, peer relationships quality and peer problem, before and after the intervention.

The MBI protocol is a modified version of a previously validated 12-week mindfulness program that includes important topics based on the mindfulness concept. The psychoeducation group matches the mindfulness group in format and homework. All facilitators received a 2-day training before the intervention and were asked to rate the fidelity of implementation via a weekly checklist. Weekly home exercise was rated and record by facilitators.

Baseline characteristics were compared using t-test and chi-square test. To assess group differences over time, multiple one-way analyses of covariance (ANCOVAs) were conducted with pretest scores as covariate. All analyses were carried out using an intention-to-treat approach.

Results

Eighty-eight (ages 9-13) children completed the study, and all of them attended at least 11 out of the 12 sessions. The mean scores of homework were 17.8 and 15.8 (out of 36) for the mindfulness group and the control group, respectively. The intervention and control groups did not differ in any demographic background or homework scores. According to the fidelity checklist, the mean score of implementation adherence was 2.7 (out of 3) for the mindfulness group and 2.8 (out of 3) for the control group. The mean scores of implementation quality were 4.7 (out of 5) for the mindfulness group and 4.6 (out of 5) for the control group. The mean score of participant engagement was 4.3 (out of 5) for both groups.

ANCOVAs indicated that the groups did not differ in changes in target outcomes; however, gender difference was identified. Separate ANCOVAs were run for boys and girls. Relative to controls, boys in the MBI group reported significantly higher level of trust (f = 6.3, p = 0.017, η² = 0.145) and communication (f = 4.68, p = 0.037, η² = 0.112) during peer interaction.

Conclusions

These preliminary results suggest that school-based MBI may be feasible and acceptable to Chinese migrant children and may be beneficial for enhancing peer relationships for boys.