Mindfulness Interventions in Low-Income Schools: A Scoping Review of Implementation Barriers and Facilitators

Background and Purpose: Mental health concerns among youth are rising, yet many – particularly those from low-income households – lack access to essential support. While school-based mindfulness programs (SBMPs), often implemented at the school-wide level, have been shown to improve youth mental and behavioral health (Phan et al., 2022), their implementation in low-income schools presents unique challenges that remain poorly understood. To inform SBMP development and implementation, this scoping review aimed to: 1) synthesize existing evidence on the barriers and facilitators to SBMP implementation in PreK-12, low-income schools and 2) apply the Consolidated Framework for Implementation Research (CFIR; Damschroder et al., 2022) to map extracted evidence and identify actionable strategies for research and practice.

Methods: Searches were conducted in PsycINFO, ERIC, PubMed, and Web of Science, yielding 709 articles, including both peer-reviewed and grey literature. Studies were screened based on multiple inclusion and exclusion criteria, such as SBMPs being implemented in classroom settings during school hours with mindfulness as the core focus. Study characteristics – including research methodology, intervention details (name, duration, facilitator, and delivery setting), student grade level, school location, and sources of implementation insights – were analyzed and summarized. Qualitative data on implementation barriers and facilitators were extracted and analyzed using CFIR.

Results: Seven articles met the inclusion criteria for this review and were included in the qualitative synthesis, three of which were doctoral dissertations and four peer-reviewed articles. Five studies named a specific mindfulness-based intervention, while two described program components without citing a formal title. No study implemented the same program. Schools were geographically diverse, spanning the Northeastern, Southeastern, and Pacific Northwestern United States. A total of 54 implementation factors were mapped onto the CFIR framework, with 34 (63%) identified as facilitators and 20 (37%) as barriers. All studies (n = 7, 100%) discussed implementation factors related to the inner setting, such as classroom noise and peer pressure. Most (n = 5, 71%) identified factors related to innovation characteristics (e.g., adapting delivery for developmental levels), individual characteristics (e.g., facilitator self-efficacy, student motivation), and the implementation process (e.g., regular SBMP leadership team meetings to address logistical and administrative challenges). Only two studies (n = 2, 29%) addressed outer setting factors, such as collaboration with community organizations to support implementation.

Conclusions and Implications: Findings highlight the complexity of implementing SBMPs in low-income settings, emphasizing the need for researchers and schools to assess potential barriers and facilitators at the student, instructor, school, and intervention levels and integrate these considerations into implementation planning. Implications for school social work practice future research will be discussed.

References:

Damschroder, L. J., Reardon, C. M., Widerquist, M. A. O., & Lowery, J. (2022). The updated Consolidated Framework for Implementation Research based on user feedback. Implementation science, 17(1), 75.

Phan, M. L., Renshaw, T. L., Caramanico, J., Greeson, J. M., MacKenzie, E., Atkinson-Diaz, Z., ... & Nuske, H. J. (2022). Mindfulness-based school interventions: A systematic review of outcome evidence quality by study design. Mindfulness, 13(7), 1591-1613.