Quinton, Christopher; (2024) School-based mindfulness programmes and executive functions: a systematic review and meta-analysis of complex intervention studies. Doctoral thesis (D.Ed.Psy), UCL (University College London).

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Abstract

This systematic review and meta-analysis investigated the differential effects of school-based mindfulness programmes (SBMPs) on cognitive processes associated with executive function (EF) in children and young people. The literature search yielded 30 controlled intervention studies that met the inclusion criteria. Sixty-nine outcomes from 27 studies were included in the random-effects meta-analyses exploring the impact of SBMPs on measures of cognitive flexibility, inhibition, working memory, attentional control, and global EF. Moderator analyses explored participant age and intervention characteristics as potential predictors of SBMP effectiveness. The overall pooled effect size of SBMPs on all EF-related outcomes was significant (p<0.0001) and small-to-moderate (g=0.33). Significant differential effects were found between working memory (g=0.48) and cognitive flexibility (g=0.21). Participant age was identified as a moderator of SBMP effectiveness that approached significance for cognitive flexibility and inhibition, with greater benefits seen in younger children. Overall methodological quality and relevance, measured through critical appraisal, were also found to influence effect sizes. Except for inhibition outcomes, total intervention dosage did not moderate SBMP effectiveness. The narrative synthesis highlighted the heterogeneity in SBMP interventions, which differed considerably in their programme components, dosage, administrator role, and fidelity of implementation. Intervention characteristics were inconsistently reported, which limited the replicability of the overall evidence base. This was also true of the reporting of SBMP acceptability and adherence to the intervention protocol. This review identified further limitations in research designs and how EF is measured. The findings suggest that SBMPs can improve EF in children and young people, with differential effects on specific cognitive processes and developmental stages. However, the robustness of this modest effect is limited by inconsistent methodological rigour and potential publication bias. To navigate the complexity of school-based interventions, future research must employ rigorous empirical methods to reflect the true effectiveness of SBMPs and provide actionable insights for education stakeholders.

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