Absence of conflict of interest.
Citation
Highlights
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The study's objective was to examine the impact of Cultivating Awareness and Resilience in Education (CARE) program on psychological distress and physical health. The CARE program is a mindfulness-based program to help reduce stress among teachers.
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The study used a randomized control trial design. The primary data sources were a baseline survey completed prior to participation in the CARE program and two follow-up surveys administered after the end of the program. One survey was administered in the spring of the same school year as random assignment and the other was administered in the fall of the following school year. In all surveys, teachers reported on measures related to their well-being and physical health. The authors used a statistical model to compare the outcomes of treatment and control group members.
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The study found that CARE program participants reported significant improvements in psychological distress and fewer ache-related physical symptoms compared to control group members.
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The study receives a high evidence rating. This means we are confident that the estimated effects are attributable to Cultivating Awareness and Resilience in Education (CARE), and not to other factors.
Intervention Examined
Cultivating Awareness and Resilience in Education (CARE)
Features of the Intervention
Elementary and secondary teachers face increasing levels of stress that have negative impacts on their health, which can lead to occupational burnout, low performance, high turnover, and reduced quality of education. One type of approach to help teachers cope with occupational stressors is mindfulness-based interventions, which aim to promote teacher social and emotional well-being. The CARE professional development program is a mindfulness-based intervention that aims to reduce teacher stress and its negative consequences on classroom instruction.
The CARE program aims to improve the social and emotional competence of teachers so they can better manage stress and facilitate positive student interactions and learning. The program uses a mix of instruction and skills practice and is delivered in five six-hour sessions over the course of the school year. Program content focuses on emotion skills instruction and mindfulness strategies. Between sessions, teachers receive individualized coaching to help them apply their learning in the classroom and develop a self-care plan and routine. Classes and instruction include activities to increase emotional awareness and regulation in school, mindfulness awareness of an individual's body, breath, and emotions, mindful walking and stretching, and listening and caring strategies.
The CARE program targeted teachers in New York City public K-5 elementary schools located in the Bronx and Manhattan boroughs with high rates of poverty. Teachers targeted for the CARE program were K-5 general education lead teachers who taught the same students the entire day and did not have classes separated by gender.
Features of the Study
The study used a randomized control trial design to assign 224 eligible teachers across 36 schools to participate in the CARE program or to a waitlist control group within each school. All 36 schools were high poverty, with more than 75 percent of students qualified for free or reduced-price school lunches.
Teachers assigned to receive the intervention participated in the CARE program over the course of the school year after baseline data collection and randomization. Teachers assigned to the control group participated in the typical professional development activities provided by their schools for the first school year after random assignment. These teachers were offered slots in the CARE program in the spring of the following school year after the study team completed data collection.
The primary data sources were a baseline survey completed prior to receipt of the CARE program and two rounds of post-program data collection (one in the spring of the same school year and another in the fall of the following school year). At baseline and follow-up, the study collected teachers’ self-reported outcomes related to psychological distress and physical health. The authors used a statistical model to compare the outcomes of treatment and control group members.
Ninety-three percent of participants in the study were female, and the median age of participants was 40. Thirty-three percent of the teachers in the study sample were White, 31 percent were Hispanic, 26 percent were African American/Black, 5 percent were Asian, and 5 percent were mixed race. Teachers reported having an average of 12.5 years of teaching experience. Teachers participating in the study taught grades K-5: 17 percent of the teachers taught Kindergarten, 18 percent taught 1st grade, 15 percent taught 2nd grade, 16 percent taught 3rd grade, 15% taught 4th grade, 18 percent taught 5th grade, and 1 percent taught in blended grade-level classrooms. Eighty-five percent of teachers were general education teachers.
Study Sites
Thirty-six schools were included in the study.
Findings
Health and Safety
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The study found that CARE program participants reported significantly lower rates of psychological distress compared to control group members. The study estimated that the average control group member would have seen a 6.4 percentile point decrease in their psychological distress if they had received the intervention.
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The study authors found that CARE program participants reported significantly reduced ache-related symptoms compared to the control group. The study found that participants in the intervention group had 18% more reduction in ache-related symptoms for each time interval compared to the control group.
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The study found no significant differences in reported gastrointestinal symptoms between CARE participants and control group members.
Considerations for Interpreting the Findings
The study authors estimated multiple related impacts on outcomes related to Health and Safety: psychological distress, ache-related symptoms, and gastrointestinal symptoms. Performing multiple statistical tests on related outcomes makes it more likely that some impacts will be found statistically significant purely by chance and not because they reflect program effectiveness. The author did not perform statistical adjustments to account for the multiple tests, so the number of statistically significant findings in these domains is likely to be overstated.
The study authors note several considerations readers should take into account when interpreting the study's findings. First, schools and teachers voluntarily participated in the study. Therefore, the findings cannot be generalized to apply to teachers if they were required to participate in CARE. Second, the overall size of the effects of the program are small. The study authors anticipated small effects because the CARE program was offered to the general population of teachers, rather than serving as a targeted intervention for teachers experiencing high levels of stress. Third, the study findings are based on teacher-reported outcomes with no verification from observations of classrooms. Finally, the data only capture outcomes up to nine and a half months after program enrollment, so the study was not able to determine whether impacts persist beyond the timeframe of data collection in the study.
Causal Evidence Rating
The study receives a high evidence rating. This means we are confident that the estimated effects are attributable to Cultivating Awareness and Resilience in Education (CARE), and not to other factors.