{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T12:37:41Z","timestamp":1793709461598,"version":"4.6.1"},"reference-count":29,"publisher":"BMJ","issue":"3","license":[{"start":{"date-parts":[[2022,7,7]],"date-time":"2022-07-07T00:00:00Z","timestamp":1657152000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004440","name":"Wellcome Trust","doi-asserted-by":"publisher","award":["WT104908\/Z\/14\/Z"],"award-info":[{"award-number":["WT104908\/Z\/14\/Z"]}],"id":[{"id":"10.13039\/100004440","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004440","name":"Wellcome Trust","doi-asserted-by":"publisher","award":["WT107496\/Z\/15\/Z"],"award-info":[{"award-number":["WT107496\/Z\/15\/Z"]}],"id":[{"id":"10.13039\/100004440","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Evid Based Mental Health"],"accepted":{"date-parts":[[2022,3,3]]},"published-print":{"date-parts":[[2022,8]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Systematic reviews suggest school-based mindfulness training (SBMT) shows promise in promoting student mental health.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The My Resilience in Adolescence (MYRIAD) Trial evaluated the effectiveness and cost-effectiveness of SBMT compared with teaching-as-usual (TAU).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>MYRIAD was a parallel group, cluster-randomised controlled trial. Eighty-five eligible schools consented and were randomised 1:1 to TAU (43 schools, 4232 students) or SBMT (42 schools, 4144 students), stratified by school size, quality, type, deprivation and region. Schools and students (mean (SD); age range=12.2 (0.6); 11\u201314 years) were broadly UK population-representative. Forty-three schools (n=3678 pupils; 86.9%) delivering SBMT, and 41 schools (n=3572; 86.2%) delivering TAU, provided primary end-point data. SBMT comprised 10 lessons of psychoeducation and mindfulness practices. TAU comprised standard social-emotional teaching. Participant-level risk for depression, social-emotional-behavioural functioning and well-being at 1\u2009year follow-up were the co-primary outcomes. Secondary and economic outcomes were included.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>Analysis of 84 schools (n=8376 participants) found no evidence that SBMT was superior to TAU at 1\u2009year. Standardised mean differences (intervention minus control) were: 0.005 (95% CI \u22120.05 to 0.06) for risk for depression; 0.02 (\u22120.02 to 0.07) for social-emotional-behavioural functioning; and 0.02 (\u22120.03 to 0.07) for well-being. SBMT had a high probability of cost-effectiveness (83%) at a willingness-to-pay threshold of \u00a320\u2009000 per quality-adjusted life year. No intervention-related adverse events were observed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Findings do not support the superiority of SBMT over TAU in promoting mental health in adolescence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical implications<\/jats:title>\n                    <jats:p>There is need to ask what works, for whom and how, as well as considering key contextual and implementation factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration<\/jats:title>\n                    <jats:p>\n                      Current controlled trials\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"isrctn\" xlink:href=\"ISRCTN86619085\">ISRCTN86619085<\/jats:ext-link>\n                      . This research was funded by the Wellcome Trust (WT104908\/Z\/14\/Z and WT107496\/Z\/15\/Z).\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/ebmental-2021-300396","type":"journal-article","created":{"date-parts":[[2022,7,12]],"date-time":"2022-07-12T20:00:26Z","timestamp":1657656026000},"page":"99-109","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":245,"title":["Effectiveness and cost-effectiveness of universal school-based mindfulness training compared with normal school provision in reducing risk of mental health problems and promoting well-being in adolescence: the MYRIAD cluster randomised controlled trial"],"prefix":"10.1136","volume":"25","clinical-trial-number":[{"clinical-trial-number":"isrctn86619085","registry":"10.18810\/isrctn"},{"clinical-trial-number":"isrctn86619085","registry":"10.18810\/isrctn"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8596-5252","authenticated-orcid":false,"given":"Willem","family":"Kuyken","sequence":"first","affiliation":[{"name":"Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9937-4832","authenticated-orcid":false,"given":"Susan","family":"Ball","sequence":"additional","affiliation":[{"name":"NIHR Applied Research Collaboration South West Peninsula (PenARC), University of Exeter, Exeter, Devon, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"Crane","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, 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