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Psychol Sch. Author manuscript; available in PMC 2018 January 01.
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Published in final edited form as:

Psychol Sch. 2017 January ; 54(1): 53–69. doi:10.1002/pits.21979.
A Qualitative Exploration of Implementation Factors in a School-

Based Mindfulness and Yoga Program: Lessons Learned from
Students and Teachers
Jacinda K. Dariotis1,2, Roxanne Mirabal-Beltran3, Fallon Cluxton-Keller3, Laura Feagans
Gould4, Mark T. Greenberg5, and Tamar Mendelson6
1University
of Cincinnati, College of Education, Criminal Justice, and Human Services, Evaluation
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Services Center
2JohnsHopkins Bloomberg School of Public Health, Department of Population, Family, and
Reproductive Health, Center for Adolescent Health, Hopkins Population Center
3JohnsHopkins Bloomberg School of Public Health, Department of Population, Family, and
Reproductive Health
4Minds Incorporated, Washington, DC
5Pennsylvania State University, Department of Human Development and Family Studies,
Prevention Research Center
6Johns Hopkins Bloomberg School of Public Health, Department of Mental Health
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Abstract
Identifying factors relevant for successful implementation of school-based interventions is
essential to ensure that programs are provided in an effective and engaging manner. The
perspectives of two key stakeholders critical for identifying implementation barriers and
facilitators – students and their classroom teachers – merit attention in this context and have rarely
been explored using qualitative methods. This study reports qualitative perspectives of fifth and
sixth grade participants and their teachers of a 16-week school-based mindfulness and yoga
program in three public schools serving low-income urban communities. Four themes related to
program implementation barriers and facilitators emerged: program delivery factors, program buy-
in, implementer communication with teachers, and instructor qualities. Feedback from students
and teachers is discussed in the context of informing implementation, adaptation, and future
development of school-based mindfulness and yoga programming in urban settings.
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Keywords
qualitative; implementation; mindfulness; school-based; students; teachers; yoga; urban; schools;
barriers; facilitators; program delivery
Please address correspondence to Jacinda K. Dariotis, The University of Cincinnati, College of Education, Criminal Justice, and
Human Services, Evaluation Services Center, 2840 Bearcat Way, 3343 CRC, Cincinnati, OH 45221-0175,
jacinda.dariotis@gmail.com, phone: (513) 556-9056, fax: (513) 556-3516.
Dariotis et al. Page 2
Introduction
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Implementation challenges limit the impact of interventions on participants (Durlak,

Weissberg, Dymnicki, Taylor, & Schellinger, 2011; Durlak & DuPre, 2008; Meyers &
Durlak, 2012; Naylor & McKay, 2008) and can affect program fidelity (Ransford,
Greenberg, Domitrovich, Small, & Jacobson, 2009; Dariotis et al., 2008; Domitrovich &
Greenberg, 2000). Research on school-based yoga and mindfulness programs has become
increasingly popular in recent years. The literature, primarily focused on outcome-based
research, has shown positive effects on student’s behavior, perceived stress, emotional
regulation, and academic performance (Zenner, Hermleben-Kurz, & Walach, 2014; Sibinga
et al., 2013; Mendelson et al., 2010). The importance of studying yoga and mindfulness
programs is substantiated by the benefits these have demonstrated in multiple domains,
including promotion of psychological (e.g., reduced anxiety; Khalsa, S. B. S., Hickey-
Schultz, L., Cohen, D., Steiner, N., & Cope, 2012; Kirkwood, Rampes, Tuffrey, Richardson,
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& Pilkington, 2005), cognitive (e.g., increased attentiveness; Greenberg & Harris, 2012),
physical (e.g., Ross & Thomas, 2010); and behavioral (e.g., improved social skills and
reduced externalizing behaviors; Schonert-Reichl & Lawlor, 2010) health.
There is a need for research on implementation of mindfulness and yoga programs in

schools. As Forman and colleagues wrote: “high-quality intervention research cannot be
conducted without consideration of issues of implementation in ‘real-world’ practice
settings” (Forman et al., 2013, 93). Questions regarding program implementation can be
usefully examined from multiple perspectives (e.g., program recipients, outside observers)
apart from the implementers themselves. This study aims to explore these two questions as
they relate to a school-based mindful yoga program.
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This study reports qualitative feedback about program implementation from students who
participated in a mindful yoga program and from their classroom teachers who did not
participate in the program but were impacted by it administratively. The study contributes to
the literature in several ways. First, the use of qualitative data allows for a rich, process-
oriented examination of implementation practices of a school-based mindful yoga program.
There has been little process-orientated data describing program implementation practices
and strategies that serve as barriers or facilitators to effective interventions (Domitrovich &
Greenberg, 2000). This paper reports qualitative perspectives on a school-based mindful
yoga program delivered in three economically-disadvantaged urban public schools.
Second, program participants and their classroom teachers provide unique perspectives.
Studies that address implementation challenges and lessons learned have focused primarily
on feedback from program implementers (Feagans Gould, Mendelson, Dariotis, &
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Greenberg, 2014; Mendelson et al., 2013). Although the perspective of implementers is

important, the fact that they are intimately involved with the program is both a strength (e.g.,
program knowledge) and a limitation (e.g., bias). By contrast, students and teachers have
different vantage points, investment, and information sources. For instance, implementer
characteristics or behaviors may serve as barriers to program attendance by students.
Additionally, teachers are responsible for students’ whereabouts and can impact how much
program exposure students receive, as well as the reasons (e.g., administrative, logistic) for

varying levels of program attendance. Finally, students and teachers may voice opinions
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about the acceptability of program content and delivery that may ultimately help refine
intervention procedures and optimize intervention effectiveness.
This paper aims to improve the delivery of mindful yoga and other school-based programs
by gathering perspectives from both participants (students involved in the program) and key
stakeholders (classroom teachers). Our research was guided by two overarching questions:
(1) What aspects of the program were well- and ill-received by students and teachers? and
(2) What additional factors – programmatic, contextual, perceptions – promoted or hindered
program participation? Of utmost interest were identifying programmatic (e.g., implementer
characteristics) and non-programmatic (e.g., environment) factors that impeded or promoted
effective program adoption (Forman et al., 2013).
Methods
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Sample
Twenty-two fifth and sixth grade students participated in six focus groups, two at each of the
three participating schools. Students were identified for focus group participation by
classroom teachers out of the total sample of 122 intervention participants (18.0% of
intervention youth participated in focus groups). To maximize sample heterogeneity,
teachers were asked to recruit students based on grade, sex, program attendance, and
program engagement. Over half of the participants were fifth graders (n=14; 63.6%
compared with 59.2% for the intervention sample). Slightly more females (n=12; 54.6%
compared to 44.6% for the intervention sample) participated than males (n=10; 45.4%) with
more females participating at School 1 (n=6) and more males participating at School 2
(n=6). Students ranged in age from 10 to 13 years old with the vast majority (82%) ages 11
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or 12. Approximately 72% of focus group participants were Black (compared to 86% of the
intervention sample). The focus group sample, did resemble the distribution of demographic
characteristics of the intervention sample although not exactly, as one would expect with a
smaller focus group sample. A total of nine classroom teachers (7 female; 5 Black; 6 sixth
grade) participated out of a possible 11 fifth and sixth grade teachers across the three
schools.
School Context
The three schools where the intervention was implemented served highly economically-
disadvantaged communities as verified by neighborhood, state and national statistic
comparisons (Table 1). The schools served neighborhoods characterized by crime rates far
exceeding state and national rates. Unemployment, median household income, and
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educational attainment statistics for these areas suggest that youth attending study schools
were exposed to high levels of adversity, on the order of two-fold compared to state and
national levels. Free and reduced meal eligibility for these schools ranged from 78 to 91%,
indicating high levels of student poverty. The decision to implement a mindful yoga program
with this student population was motivated by research on the harmful consequences of
chronic stressors and adversities for youths’ self-regulation.

Program Description
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This program aimed to enhance students’ emotional and cognitive regulatory capacities
through mindful yoga practices. The universal school-based mindful yoga program,
implemented with 5th and 6th graders in three Baltimore primary schools (identified here as
Schools 1, 2, and 3), used yoga-based body movements and breathing to promote
mindfulness (described in Feagans Gould, Mendelson, Dariotis, & Greenberg, 2014;
Mendelson et al., 2013). The intervention was provided by an outside agency, not by school
personnel. We worked with a volunteer student sample because the research protocol
required that students provide parental permission to participate. As a result, select students
from different classrooms participated; the intervention was not offered to all students in a
grade or all students in a given classroom. Teachers were not directly involved with the
program. Focus groups were conducted with a subgroup of fifth and sixth grade participants,
and participants’ classroom teachers were interviewed.
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The intervention was developed and provided by three yoga instructors, the co-founders of
the Baltimore-based non-profit Holistic Life Foundation (HLF). Program implementation
occurred in the context of a six-school study, in which the other three schools were assigned
to a wait-list control. Participants were offered 45-minute sessions twice a week over the
course of 16 weeks during their resource time (e.g., art, library, or music in Schools 1 and 3)
or during part of lunch (School 2). Fifth and sixth grade students attended intervention
classes separately at two of the schools (School 1 and 3), whereas at School 2 intervention
classes included students from both grades. Typical sessions included centering practices
that encourage quieting the mind and present moment awareness, then active yoga-based
poses (e.g., sun salutes), breathing techniques, guided mindful reflection, and brief
discussions on health-related topics (e.g., nutrition, environment). At the start, practices
were basic and became increasingly more complex over the 16 weeks (see Feagans Gould et
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al., 2014 for detail on program components).
Youth Focus Groups

All youth provided assent and parental consent to be enrolled in the study prior to the first
mindful yoga session. All focus group discussions (FGD) and interviews were conducted
following completion of the intervention. FGDs and interviews were led by a female
moderator using a semi-structured interview guide, were held in private locations at
participating schools during resource or lunchtime, and averaged 35 minutes in length.
Focus group sizes varied from two to six students. Fifth and sixth graders were interviewed
separately for five of the six focus groups. All but one group had both female and male
participants. Participants were provided with snacks at the conclusion of group discussions.
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FGD and interviews were audiotaped to facilitate later transcription; nonverbal agreement or
disagreement was not quantified, although participants were encouraged to verbalize
perspectives.
The focus group guide was adapted from a protocol used to assess different programs
implemented among similar aged youth (Smith, Dariotis, & Potter, 2003). The purpose of
the protocols was to capture normative beliefs about the program rather than individual
impressions, making focus group discussions a more appropriate format compared to one-

on-one interviews. Students were instructed to share their thoughts openly and with respect
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for each other (especially when responses differed). A round-robin approach was used so
that all participants had an opportunity to respond to each question. The focus group
facilitator would ask for clarification when needed. Topics discussed during student focus
groups specifically pertaining to program barriers and facilitators include recommendations
for program improvement (e.g. “If you took the program again next year, what would you
change?”), characteristics they liked most and least about their program instructors, as well
as how having a different instructor implement the program would affect the quality of the
program (e.g. given all three instructors are male, youth were probed about having a female
instructor if they were to take the program again), and how the instructors treated students
compare to other adults in their lives (focus group and interview guides are available upon
request from the corresponding author).
Classroom Teacher Focus Groups and Interviews

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Two fifth grade teachers from one school (School 1) could not be interviewed because of
scheduling. Seven teachers participated in focus groups (one with five participants including
fifth and sixth grade teachers; one with two sixth grade teachers) and two teachers (from
School 3) participated in individual interviews due to scheduling. The same questions were
asked of teachers in both focus groups and interviews. Topics discussed with teachers
pertaining to program barriers and facilitators included teacher willingness to incorporate
program components in the classroom; teacher interactions with program implementers (e.g.
“What was your experience in working with the instructors?”), research staff (e.g. “What
was your experience in working with the research team?”), and the program itself (e.g.
“Were you able to observe or participate in the program?”); recommendations for improving
the implementation of a similar program in the future; support needs for creating a program
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teachers could implement in classrooms in the future; teacher buy-in of student participation
in the program (e.g. “How did you feel about having some of your students participate in the
program?”); and logistical aspects of the program (e.g. “Did the program fit well into the
students’ schedules, or was it disruptive?”).
Qualitative Analysis
All focus groups and interview audio recordings were transcribed verbatim. Using an
inductive coding process, three members of the team (each with training and experience
collecting, coding, and analyzing qualitative data for multiple studies) independently
conducted line-by-line coding of the transcripts using thematic analysis (Boyatzis, 1998).
This type of inductive coding allows for summarizing and consolidating qualitative data into
meaningful themes and allows for theory generation. Emerging major and subthemes were
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discussed during meetings and any differences resolved. As a last step, each coder took the
lead role organizing themes and subthemes for approximately three transcripts. Once codes
were categorized by theme for each of the assigned transcripts, a second coder verified these
themes and supplementary material or subthemes where added where appropriate before a
third coder conducted a final verification. Researchers chose not to use specific qualitative
coding software for analysis due to the limited number of transcripts (n = 10).

Results
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Four broad themes with related subthemes were identified relating to barriers and facilitators
to program implementation: program delivery factors, implementer communication with
teachers, promoting program buy-in, and instructor qualities. A more detailed list of themes
and subtheme content is reported in Table 2.
Theme One: Program Delivery Factors

The sentiment across participants at all three schools and in both grades was that they would
not change anything about the program content. In general, students also seemed pleased
with the way the program was run. Students and teachers, however, offered a great deal of
feedback regarding factors related to program delivery, including program timing (when
during the day the program was offered), the physical environment (where the program took
place), and program logistics (how the program was delivered).
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Program timing—A recurring theme across Schools 1 and 3, where the yoga program was
offered during resource time, was that students felt conflicted about attending yoga because
attending yoga required them to miss other activities they enjoyed. A 5th grade female
teacher remarked: “A lot of the feedback from the kids is they did not like missing art the
whole time the program was involved” (School 3). Several youth verified this sentiment. As
a solution, one student suggested expanding the amount of resource periods so that each
activity, including yoga, could be offered during resource time at least once per week: “We
want to make sure we have at least one of each resource. At least one day of art, at least one
day of library, at least one day of music. At least one day of each” (fifth grade female
student, School 3).
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Teachers reported that the conflict between yoga and resource time was a major challenge to
youth program participation. Often attending yoga became a “day-by-day battle depending
on what resource class [the students] were missing. Some said they didn’t want to go, you
know, they wanted to go to their resource. And then the next day, ‘well I want to go to yoga,
I don’t want to go to this class’” (sixth grade female teacher, School 3). Dissatisfaction with
missing out on resource time activities was exacerbated by the fact that classmates not
participating in the yoga program could attend resource time. According to one fifth grade
teacher, this fueled participant resentment toward the yoga program and a conflict for youth
who both “like yoga, but they also wanted art” (fifth grade female teacher, School 3). When
the suggestion of holding the program after school was explored with students at School 3,
however, students stated that they preferred the program to be held during school, twice a
week. In School 2, where the program was offered during part of lunchtime, no student
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conflicts were reported, but the yoga classes had substantially lower attendance and very few
students participated on a regular basis (38% of sessions attended, on average).
Physical environment—Youth perceived several distracting elements related to the

program space. In School 1, one sixth grade male recounted how windows in the doors gave
non-program youth the ability to peak through, a distraction from the program: “It was a
bunch of like stuff that distracts you… people used to look through the window [in the
door].” Space set aside for the program often times lacked cleanliness. Youth spoke about

dust, bugs, and wetness in the space: “…with bugs and stuff because when it rained, it would
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get wet. And because like the doors, something happened to the door where it was halfway
open and when it rained, it would go all down like the steps” (fifth grade male student,
School 3). As a possible solution to these distracting environmental elements, students at
two different schools suggested that the program be held outside with one youth
recommending alternating weeks: “I would have like one week you’d be inside doing all the
breathing techniques and Sunrise and all of that, then the other week you would go outside
and do exercises so you can get more oxygen…” (sixth grade male student, School 3).
Holding the program outside would have the added benefit of breathing in fresh air. Other
less frequently mentioned changes to the environment included the desire for more props, a
quieter environment, and a space with better temperature control. One male fifth grade
student mentioned that holding the program “somewhere else with more equipment” (School
2) would be a welcome change.
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Program logistics—Teachers noted the importance of considering their students’

schedules when planning program specifics. For instance, at School 2, instructors came to
pick the students up for the program at the same time that non-participating students were
going to lunch. This created a chaotic environment for teachers who felt somewhat burdened
trying to figure out which students were supposed to go where: “Standing next to their
friends and you have to figure out which one…” (sixth grade male teacher, School 2) and
“Constantly asking them: Do you have yoga? Do you have yoga?” (fifth grade female
teacher, School 2). These teachers recommended having instructors pick up program
students about 5 minutes early to allow for a clear delineation of which students were to go
to which place: “… the people who worked with them got them right before their lunchtime.
So it was a crowd of kids coming out at the same time. So maybe, if they would have
grabbed them, well maybe five minutes earlier, so there was a clear delineation between who
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was going to yoga and who was going anywhere else. It would run more efficiently” (fifth
grade female teacher, School 2). While teachers at School 2 only cited the pick-up issue,
teachers at School 3 mentioned a related efficiency problem with drop off. Teachers at
School 3 remarked on the added time they had to spend looking for their students after the
program ended and recommended program implementers escort students back to the
classroom: “What would be helpful is if he helped bring the kids back because a lot of times
he just released them so I had to roam around the building and find them at the same time as
walk around the rest of the class who I picked up from the other resource they were in. So
like if he could escort them to that class especially so they’re not running around” (sixth
grade female teacher, School 3).
Theme Two: Implementer communication with teachers

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A second theme that emerged from teacher accounts was related to the importance of
establishing effective lines of communication between teachers and program implementers.
Feedback on communication is presented under three subthemes: communication about
program goals, communication about program logistics, and communication concerning
students.

Communication about program goals—While teachers reported positive expectations

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of the program, they did not recall learning about the intended program goals at the outset
which resulted in teachers at all three schools not feeling sufficiently informed about
program goals: “He did introduce himself and said what he’s there to do. But I don’t know
what the ultimate goal was by the end of the year, what it’s for. I mean, I know a little bit
about yoga. So I kind of found out what it’s trying to do. But ultimately I didn’t know what
the whole program was for” (sixth grade female teacher, School 3).
Communication concerning students—Communication about the program’s day-to-

day occurrences was perceived as inadequate by teachers. Teachers at all three schools
related how they would have welcomed more frequent and timely communication. While
email messages were reported as an effective means of communication between program
instructors and teachers at School 1, it was expressed that regular “check-ins” would have
been better than the occasional email. Additionally, teachers at School 1 noted that
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communication with the instructors was limited and centered on getting the youth to and
from the program: “I only saw him when I took the kids there. That was it. And it was like,
there was no talk about what’s going on, what is happening. That was it. I’d drop them off
and I’d keep it moving” (sixth grade female teacher, School 1).
Communication about program logistics—Classroom teachers also remarked on the

importance of appropriately timing and updating the exchange of information with
implementers concerning program logistics. For instance, although the team provided a list
of students enrolled in the study during the fall following recruitment, some teachers
believed they were given this information too far in advance to be useful: “We were given a
list [of student participants] but like it was so far before the program started that I was like
‘toss’… kind of toss it to the side and never paid attention to it when it was time for it to
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come up” (fifth grade female teacher, School 2). Teachers suggested that providing them
with an updated student roster closer to the start of the program would have been helpful.
Teachers at School 3 also remarked on the importance of updating the program calendar: “It
would be helpful to have a clear list of dates that people are going to be coming. If you
update it, email a calendar because there was miscommunication when [intervention
instructor] was away doing yoga somewhere. So I misunderstood an email and I thought he
was coming. He wasn’t coming, so um, that would help because then the art teacher’s not
prepared for 25 kids” (fifth grade female teacher, School 3).
Additionally, teachers expressed a desire for a more collaborative relationship with the
instructor that would include communication about student behavior, attendance, and
progress. These teachers felt that there was a missed opportunity for open collaboration and
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communication where “everybody kind of collaborates, so you know what’s going on.”
(female teacher, School 2). Teachers reported a desire to hear about how students were doing
in the program. The level of collaboration desired and the solutions offered to sustain it
varied by teacher and school. For instance, one teacher thought that simply making “some
time to talk about it, you know, before the session or right after the session” would foster
more collaboration (sixth grade female teacher, School 1). By contrast, a male teacher at a
different school noted that the time right before or after the session was insufficient for

discussing students’ progress (sixth grade male teacher, School 2). Sharing the attendance
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sheet with the teachers was offered by a teacher as a strategy that not only would allow
teachers to track where their students were on a particular day, but that could also serve as a
type of progress report. One fifth grade female teacher explained: “That [attendance sheet]
would be helpful to have too because occasionally someone would ask ‘oh where was this
student today’ and we wouldn’t be able to account for where they were and we’d have to…
you know eventually some of the other students would know: ‘oh they were in yoga’ or
whatever the case. Yeah, so and so was here, this is how the day went maybe” (School 2).
Theme Three: Promoting Program Buy-in

A great deal of student and teacher feedback focused on factors that could promote buy-in
from students and teachers. Subthemes included use of program skills in the classroom,
teacher training, optimal program exposure, incentives, and voluntary participation.
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Promoting skills generalization—Teachers spoke about the importance of taking the

practice off the mat and applying it to the classroom setting. One sixth grade female teacher
remarked that program instructors should observe students’ classroom behaviors and then
tailor the program to target those behaviors: “… if he knows what the daily behaviors are
like outside the yoga room, that may be able to help him implement certain skills in them
during his instruction” (School 3). Other teachers recommended didactic classroom sessions
involving discussion, role playing, and problem solving using program skills: “… act it in a
session… to demonstrate certain situations and to see how they would handle those things”
(sixth grade female teacher, School 1). Students at a different school also felt role-playing
may promote use of program techniques: “Every once in a while we should go in the gym
and learn how to, how to control our anger when, say like we went to the gym, we’re playing
basketball, somebody pushed someone, they’re mad at the other one…. Having… a role
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playing contest” (fifth grade male student, School 2).
Some teachers recommended ways to promote use of program skills in the classroom,
including having a yoga instructor lead a brief classroom demonstration every few weeks or
having teachers themselves deliver the intervention: “It’d be nice if there was some way that
the teachers could attend the class with the students or the yoga teacher could come up here
and do work up in the classroom” (fifth grade female teacher, School 3). Teachers voiced a
willingness to integrate program techniques if trained: “If teachers knew what they were
doing in the yoga class and were familiar with, then that’s something that I know we would
be happy to work back into the classroom as it could help us as well…” (sixth grade female
teacher, School 3).
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Teachers across schools recognized the program’s potential to provide students with
valuable self-regulation tools. A fifth grade female teacher noted: “So in between subjects it
could kind of be like a breathing thing. Okay then put your notebook away, then you do this
quick movement and then you do you get your next book or your pencil or whatever. So I
mean it might be something to help them between transitions” (fifth grade female teacher,
School 2). Teachers at another school also suggested using program techniques during
school activities: “Yeah, you could do that during the drills, like during the warm ups or

something like that. Or maybe like before you leave to go to your next class, stuff like that.
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Probably 10, 15 minutes out of your time” (sixth grade female teacher, School 1). Teachers
stressed the importance of practicing program techniques regularly, as students respond best
to routines: “If there’s a routine, you know if we always did it at the beginning part of the
day… keeping a set schedule… consistent” (sixth grade female teacher, School 3).
Teacher training—Across all schools, teachers expressed willingness to attend

mindfulness training if the principal integrated it within existing meetings. Teachers
repeatedly expressed reluctance to take on additional commitments due to busy schedules:
“And then most of are like working through our lunch so because we don’t get those extra
breaks. So for teachers its highly unlikely that we are going to make it to do anything else”
(fifth grade female teacher, School 2). Teachers recommended that the training could either
be held during professional development days or during monthly faculty meetings.
Administrative support would be necessary to facilitate teacher training: “It would have to be
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up to the principal because that’s how jam packed some of that stuff can be with all the
training… I would say if you kept it to an hour or less than they may be able to squeeze it
in” (fifth grade female teacher, School 2).
Teachers also felt training should include quality assurance in the form of observations by
instructors: “I think once a week, once every two weeks, having them come in to observe to
see if we’re doing it right, demonstrating, even leading it as a class” (sixth grade female
teacher, School 3). Teachers also noted that materials such as posters in the classroom would
be helpful as a reminder of program techniques: “With either pictures of certain breathing or
steps, I think that would definitely help… they could look at the poster and maybe
internalize it from there” (sixth grade female teacher, School 3).
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Optimizing student exposure to program skills—Teacher strategies to promote

program success included targeting earlier grades and providing longer-term exposure.
There were diverse opinions about when the program should begin and which grades it
should span. One fifth grade teacher said: “… starting at fourth might be a little better. You
might get a little more buy in and they’re less hormonal” (female fifth grade teacher, School
3). Some teachers suggested starting the program in even earlier grades to effect long-term
behavioral change: “As early as kindergarten … like as early as they enter the school. I mean
I’m sure all of us would agree that we see some of those behaviors [disruptive anger,
inability to express themselves, impulsivity] very, very early even in this school” (sixth
grade female teacher, School 2).
Teachers and students felt the program was not long enough to ensure internalization of
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program skills: “It would be good if they could continue so they could learn to deal with
raging hormones and breathe through that” (fifth grade female teacher, School 3) and “I’m
hoping to see at least with the rising fifth graders if they do it another year, they’ll start to
really understand it and see if they use some of the strategies that he’s taught them in class”
(sixth grade female teacher, School 3). Fifth graders echoed the need for longer-term
participation. One fifth grade female noted she needed a longer program to learn more
techniques to deal with stress: “because we didn’t learn everything so I would like to learn
more things” (School 3).

Incentives for teachers—Teachers and students were asked to identify incentives that
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would promote program buy-in. Across all three schools, teachers agreed that the best
incentive for teachers would be the expectation that the program will improve student
classroom behaviors and reduce the time teachers spend disciplining students: “It would
benefit them behavior wise and academically cause you can get more of your lesson done
without spending a lot of time trying to deescalating, diffuse situations” (sixth grade female
teacher, School 1); “Yeah, if the children benefit from it and their behaviors change and
their, um, grades improve, then yes, it is [worth the effort]” (sixth grade female teacher,
School 1).
Teachers at two schools felt material incentives would be a sure way to promote teacher
participation in training. A fifth grade female teacher noted: “I mean just like with
everything, the more giveaways you have, the more free things you have, the more people
are going to be inclined to stay” (School 1). At School 1, a sixth grade female teacher stated
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money would be a key motivator for her, although this was an isolated sentiment not
articulated by other teachers: “I’m not interested in yoga. But if it is going to benefit the
children, I will do it, but I’m not going to do it for free.” Teachers at Schools 1 and 3
remarked that the chance to benefit personally from mindfulness and yoga practices would
be an incentive to complete training: “Well, if they [teachers] understood that… it’s a way to
de-stress… to take a minute to just get it together and breathe. I think that’s something that
we could easily buy into because we get stressed out” (sixth grade female teacher, School 3).
Another teacher remarked that there was benefit in receiving a yoga class they would
otherwise have to pay for: “I’ve heard teachers say ‘I wish I could take the course too
because that stuff costs a lot of money to do’” (sixth grade female teacher, School 1).
Voluntary participation—Several students and teachers expressed the view that student
Author Manuscript
participation in the yoga program should be voluntary, not mandated by parents or teachers.
A fifth grade female student remarked: “… if the people who don’t wanna do it, they
shouldn’t have to” (School 1). Another fifth grade female noted: “If they don’t wanna do it,
then they shouldn’t force them. When they’re in the mood they can go to yoga and stuff, but
when they’re not in the mood they can’t because they’re gonna disrupt the class” (School 1).
Teachers also remarked on the importance of not being forced to attend trainings or integrate
the program into their classrooms. “I think it should remain optional though. I don’t think it
should be something that’s forced upon every teacher because every teacher isn’t going to be
open and receptive and the less receptive they are, the less receptive their students are going
to be ‘cuz it’s, you know, it’s a forced thing” (fifth grade female teacher, School 2).
Theme Four: Yoga Instructor Qualities

Author Manuscript
A fourth and final theme to emerge from student and teacher feedback on program
implementation is related to the qualities of the yoga instructors who led the program. By far
the most frequently mentioned instructor quality valued by youth was “respect”, which the
youth associated with “fairness,” “being nice,” and “not yelling a lot”. A fifth grade female
describes how the instructor showed her respect by not ordering her around: “[instructor
treats us] like we’re equals. And like, well, he’s like, he like my big brother to me, and he
shows me respect instead of like ‘go do this, go do that’” (School 2). This was contrasted to

how the youth perceived most adults treat them. Students commented that instructors
Author Manuscript
modeled the behavior that they expected youth to display: “He treats us like, like we’re
adults… like we’re [equals]… and, because most, most adults are hypocrites. He’s not. He’s
one of the more powerful ones to do the right thing. Like they [other adults] will tell you to
do something, not, they tell you not to do something, [and then] they will go right and do it”
(male student, School 2). Teachers also cited the opportunity for students to identify with a
positive role model as a strength of the program. “And having that interested person, and I
have to say interested male, is wonderful. And having a male who’s sort of Zen so they have
that whole other role model not just this butch beat ‘em, shoot ‘em, fight ‘em guy, but who’s
just more let-it-be and they need more of that” (fifth grade female teacher, School 3). Some
students reported becoming attached to instructors as this student recalls: “Like [the
instructor] as soon as he started it seemed like everybody was attached because he wasn’t
really like most people were, I know I was, I’m saying to like be attached with him. Yeah
Author Manuscript
because he was real cool” (sixth grade female student, school 3).
Students interpreted various behaviors on the part of the instructors as respectful – behaviors
that depicted fairness, not yelling, or the provision of material goods. Fairness in discipline,
for instance, was highly valued across all three schools: “When people are doing the wrong
thing he’d scream out the people who are doing the wrong thing and not the people who are
doing the right thing” (fifth grade male student, School 2); “‘I see you are doing a good job,
thank you’ and then would go talk to students who were being disruptive about why they
were misbehaving and try to encourage them to stop” (sixth grade male student, School 2);
“He was nice and was something like one person would doing something and he didn’t yell
at the whole group. He was nice. Not a lot of yelling” (fifth grade girl, School 3). The
differences in the amount of yelling done by the instructors when compared to other adults
in the students’ lives was also noted as a form of respect: “He’s [instructor] nice like he’ll
Author Manuscript
give you a warning before. He’s not yelling and loud. He’ll respect you. Like he showed you
what you’re going to be in the future” (sixth grade female student, School 1); “He never got
mad. Most adults would get mad and yell at a kid but he didn’t” (fifth grade female student,
School 3). Rewards for good behavior – such as free pizza, going outside, or free time within
the program – was also seen as a sign of respect. As an example, a sixth grade female
student remarked: “Compared to teachers, he treated us with more respect because some of
the teachers in the school they don’t really care if you fail. But he kept being on our side and
he never let us do nothing. Yeah he said like ‘you do this, I do this.’ So like if we do
something he liked, he’d give us like, we’d go outside or something. Or get free time” (sixth
grade female student, School 2).
Students also brought up the gender characteristic mentioned earlier by a teacher –the
Author Manuscript
influence of a male role model, with male youth at two of the schools noting a preference for
male instructors. A female student adds: “Because they’re um more female, there was more
females in the classroom. So a woman would have probably related more because the man
he related more to the boys than the girls so. Maybe there could have been two yogas with
boys and girls” (sixth grade female student, School 1). Students repeatedly mentioned how
having a female teacher would change the feeling of the program, going on to state that
female instructors “might be bossy” (fifth grade male student, School 2) or “wouldn’t be as
fun and they probably wouldn’t give us pizza” (fifth grade female student, School 2).

Across all three schools, students described program instructors as nice, playful, and fun.
Author Manuscript
These were the qualities, in addition to respect, that the students most valued from the
instructors and remarked would be most important for future instructors to have.
Discussion
We identified four themes related to program implementation barriers and facilitators:
program delivery factors, communication with teachers, promoting program buy-in, and
program instructor qualities. Student and teacher comments expressed a range of
experiences and opinions, such as enthusiasm for program goals and activities, ambivalence
about aspects of program participation, and suggestions regarding implementation. Below
we reflect on the emergent themes and provide recommendations based on the lessons
learned from this mindful yoga program that may translate and generalize to other school-
based programs.
Author Manuscript
Program Delivery Factors

During early phases of intervention testing, an intervention may need to be offered to a
subset of students with parental permission (as in the current study) rather than at a
classroom- or grade-wide level. This strategy, however, creates certain challenges. The fact
that only a portion of students participated in the program while their peers attended other
enjoyable school activities (e.g., art, music) made many participants feel ambivalent about
attending the program consistently. Monitoring which students were supposed to attend the
intervention and supervising those students so that they arrived on time to the intervention
session and returned promptly to class afterward was also difficult for teachers. While
administrative constraints may limit when a program can be offered, program scheduling
merits careful exploration in collaboration with school administrators, as it is closely tied to
Author Manuscript
student motivation and program attendance. Options to consider when feasible include
incorporating mindful yoga into a school’s physical education or health curriculum, as some
other researchers have done (Khalsa, Hickey-Schultz, Cohen, Steiner, & Cope, 2012;
Noggle, Steiner, Minami, & Khalsa, 2012).
Difficulties with program settings – lack of privacy, noise, and lack of cleanliness – also
posed barriers to student engagement. Resource constraints are a common issue in
underserved urban schools. Although not all physical limitations can be effectively
addressed, solutions may include covering windows with paper and having instructors
prepare the room to ensure program participants have an optimal experience. For yoga
programs, ensuring that a large enough space is available for yoga mats and movement is
key. Space arrangements should be clearly established in the initial phases of developing a
Author Manuscript
school partnership.
Quality, Detail, and Timeliness of Communication

Effective communications with teachers and administrators are critical for ensuring the
success of school-based interventions. It is important to determine these stakeholders’
preferences regarding frequency, timing, and content of communications. A key challenge
for our team during study implementation was in gaining consistent access to busy

administrators and teachers without burdening them. The qualitative data indicated that
Author Manuscript
teachers did not perceive our outreach efforts as adequate. Our experience highlighted that a
difficult balance must be achieved between asking for too much time or involvement from
busy teachers on the one hand, and maintaining effective communication and program
engagement on the other. The qualitative data also highlighted that communication was
important for motivating teachers to support program delivery and to promote classroom
skills use. In this way, teachers can become part of the support system Meyers and
colleagues characterized as key for program success (Meyers et al., 2012). The degree of
program description required to engage teachers likely depends on an intervention’s content.
In the case of mindfulness and yoga interventions, teachers may have stereotypes or
misperceptions about program content or intent; educating them about these practices is
important for ensuring their buy-in. Our data suggested some teachers may value having an
abbreviated curriculum and materials to hang in the classroom to prompt skills use (e.g.,
Author Manuscript
breathing, yoga poses). We recommend that researchers and practitioners implementing

mindful yoga in schools consider the initial phase of informing and educating teachers—as
well as subsequent phases of updating and “checking in” with teachers – as critical steps for
facilitating program implementation.
Promoting Buy-In
Our findings regarding stakeholder buy-in are consistent with literature on other types of
school-based program implementation. For instance, two studies about implementation from
program developers’ perspectives highlighted the critical role of administrative buy-in and
support (Forman, Olin, Hoagwood, Crowe, & Saka, 2009; Langley, Nadeem, Kataoka, Stein,
& Jaycox, 2010). Strategies recommended by teachers and students in our sample to
promote stakeholder buy-in included training classroom teachers, providing incentives for
Author Manuscript
teachers, training students to utilize skills in the classroom, and making program
participation voluntary.
Training teachers in mindful yoga is likely to increase teacher buy-in for the intervention
(Durlak & DuPre, 2008; Domitrovich & Greenberg, 2000) and will also provide teachers
with the information and confidence to promote program skills in the classroom. Classroom
use of skills to help students generalize what they have learned to “real” world scenarios is
expected to increase buy-in because perceived program utility and generalizability should
promote engagement from both teachers and students (Le & Gobert, 2013). Teacher training,
however, requires time and resources. Incentivizing teachers – at least initially – may be
important for motivating them to participate in training; the content of incentives (e.g.,
continuing education credits) requires careful consideration.
Author Manuscript
Not all schools have the resources or climate necessary to support effective program
implementation. Researchers should evaluate a school’s “readiness” for program
implementation – including the potential to involve teachers – by conducting a school-based
readiness assessment. Such an assessment could include teachers, administrators, and
students, and whenever possible, parents given all are stakeholders, impacting and
potentially being impacted by school-based programming.

Several teachers and students advocated for voluntary participation in mindful yoga. This is
Author Manuscript
a complex issue, given our experience that having a subset of students participate in the
program may create conflicted feelings about program attendance, increase logistic
challenges related to student drop-off and pick-up, and complicate efforts to engage
teachers. Programming considered key for positive student development (e.g., physical
activity, health class) is not typically voluntary. Program implementation at a classroom,
grade, or whole-school level likely creates a shift in school climate more broadly, facilitating
administrative and teacher engagement. Indeed, previous studies have found that whole
school interventions may increase the chances of program success (Naylor & McKay, 2008).
Promoting program buy-in before the start of a school-based program may mitigate to some
extent the concern regarding “choice” voiced by teachers and students (Durlak & DuPre,
2008; Ransford, et al., 2009; Kam, Greenberg, & Walls, 2003). Offering mindful yoga
practices to students or teachers on a voluntary basis as an in-school “elective” or after
Author Manuscript
school program is a different model of program delivery for researchers and instructors to
consider (e.g., Ancona & Mendelson, 2014).
Instructor Qualities
Characteristics of program instructors should be considered important aspects of a
program’s success. Of note, instructors in the current study were ethnic minority men, which
may have influenced the extent to which the predominantly ethnic minority student
participants trusted them. We anticipate, however, that a number of additional factors are
important for forming positive instructor-student relationships. Regardless of race or
ethnicity, instructors should be culturally competent in working with the target student
population and knowledgeable about how to work with participants of the target
developmental age. Skills in behavior and classroom management are also likely important
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when working with youth in school settings. We recommend that school-based mindful yoga
programs explicitly address these sorts of instructor characteristics in their teacher selection
and training protocols. Incorporating and assessing key instructor characteristics as part of a
program’s hypothesized logic model may also facilitate systematic exploration of how these
elements are linked with effective program implementation (Feagans Gould et al., 2014).
Limitations and Strengths

This study has several limitations. Only students who provided assent and parent permission
participated in the original intervention study; this volunteer sample may have differed in
certain ways from students who did not participate (e.g., potentially higher parental
involvement). Typical of qualitative studies, only a subset of participants was included in
focus group discussions; the distribution of focus group students’ demographic
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characteristics, however, approximated the larger intervention sample distribution. Due to

scheduling difficulties, we were unable to interview two fifth grade teachers at one of the
schools. Program implementation in three schools by different instructors coupled with
significant overlap in themes across students and teachers adds confidence in the consistency
of our findings across stakeholders and settings. Results are based on a single mindful yoga
program and are not necessarily generalizable to other programs. Findings, however, are
likely to have practical utility for other school-based programs – particularly mindfulness or

yoga programs delivered in low-resource settings – since they address common concerns
Author Manuscript
related to program scheduling, communication with teachers, and instructor characteristics.
Including student and teacher voices provided dual perspectives on relevant issues. Few
studies on school-based mindful yoga programs have analyzed qualitative data from students
and teachers as a way of understanding program implementation, particularly in elementary
and middle school settings. This study’s process-oriented findings complement outcome-
based studies by considering factors that influence program implementation. We hope these
findings are useful to researchers and program developers who are grappling with the
challenges of integrating mindful yoga programs successfully within school settings. We
also hope our use of qualitative data may serve as a useful model for evaluating factors
related to program implementation in a variety of school-based programs under
development.
Author Manuscript
Future Directions
Including teacher and student perspectives on program implementation assists in identifying
critical elements for successful implementation (Durlak & DuPre, 2008; Naylor & McKay,
2008). Our findings suggest several recommendations for delivering school-based mindful
yoga programming, including scheduling programs strategically within the school day,
obtaining an appropriate physical setting, promoting buy-in from teachers and students,
maintaining effective communication with stakeholders, and ensuring program instructors
have characteristics that positively engage youth. To achieve these goals, it is critical to
involve key stakeholders in a meaningful way in discussions about program implementation
from the start of the project. Future studies may benefit from collecting qualitative data from
key stakeholders, including students, teachers, administrators, program developers, and
parents. Triangulation of data from different sources is critical as both commonalities and
Author Manuscript
differences across stakeholders are informative. Adaptation or development of quantitative

measures to assess stakeholder engagement and satisfaction is needed, both for individual
mindfulness and yoga program evaluations and for informing the field more broadly about
relevant implementation factors. These efforts can help improve collaborations among
mindfulness and yoga program developers, researchers, and school personnel so as to
maximize program implementation and outcomes.
Acknowledgments
This work was supported by the National Institutes on Drug Abuse [grant number R34DA029237]. The opinions
and conclusions expressed are solely the authors’ and should not be construed as representing the opinions of NIH
or any agency of the Federal Government.
Author Manuscript
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Table 1
School and Neighborhood Characteristics
Neighborhood Characteristics Economic Indicators

Dariotis et al.
Free and Reduced Crime Murder Less Median HH Income in Unemployment

Meals (FARM)1,2 Rate Rate3 Than Zip Code (2011 4,5
Index3 High Dollars) 4
School
Education
(%)3
Fifth Sixth
School
1 90.7 91.0 323 887 24.5 35,620 15.5
2 79.3 78.8 239 546 19.0 47,472 11.4
3 89.2 86.7 396 830 28.2 31,018 16.5
State 110 169 12.2 70,004 7.4
National 100 100 15.4 55,970 8.9
1
baltimorecityschools.org;
2
mdreportcard.org;
3
http://www.clrsearch.com;
4
city-data.com;
5
marylandpolicy.org/dnn/ResearchAnalysis/StateofWorkingMaryland/Employment.aspx;
Adapted from Dariotis, Mirabal-Beltran, Cluxton-Keller, Gould, Greenberg, & Mendelson. (forthcoming).

Page 19
Table 2
Lessons Learned from Teacher (T) and Student (S) Perspectives
School 1 School 2 School 3

Major Themes Subthemes Explanation
Dariotis et al.
T S T S T S
Program Program Not during resource times. x x x
Delivery timing
Hold during school hours, not after school. x
Physical Hold it outside. x x

environment
Cleaner facilities. x x
Bigger, quieter facilities with increased privacy. x
More props. x
Regulated temperature. Dryer room. x
Program Change nothing about program content. x x x

logistics
Escort students back to classroom after program. x
Need to consider students’ schedules. x x
Separate boys and girls. Provide more snacks. Play music during poses. x
Build in free time. x
Implementer About Teachers/students not aware of goals and expectations.

Communication program x x x
with Teachers goals
Concerning More frequent communication. Collaborative relationship with instructors. x x x

students
Provide timely and updated roster and attendance sheet. x
Email communication was an effective method. x

Provide updated calendar and list of program staff names. Follow up teacher recommendations. x
Promoting Applicability Applying/incorporating program to a classroom setting. x x x

Program Buy In outside of the
program Hold a classroom demonstration of the program. x x
Sessions involving modeling and problem solving. x x
Teacher For program reinforcement and integration into classroom. During existing
training work hours (i.e. staff meetings; professional development week prior to start x x x
of school)
Provide teachers with reference materials. Keep program time demands for
x x
teachers minimal.
Teachers do not have time to attend training during the school day or during x x
Page 20

T S T S T S
their personal time.
Should include behavioral/anger/grief management. x

Dariotis et al.
Provide formal invitation to teachers to observe program. x
Trainings should include school counselors to facilitate the use of program

x
techniques with students when program not in session.
Optimizing Begin earlier (before 4th grade). x x

exposure
Longer more intense program. x x
Incentives Improved classroom behaviors and transition times. x x x

for students
and Financial incentives for participating teachers. x x
teachers
Provision of free yoga classes to teachers. x x
Survey teachers to establish best incentives. x
Incentives for students throughout program. x
T-shirts for participating students. x
Parent incentives for after school program participation. x
Choice Allow teachers to opt out of program participation/training. x x x

to
participate Attain consent from students in addition to parents’ consent. x x x
Survey teachers to gauge willingness to participate. x
Removes disruptive students who do not want to participate. x
Require attendance by whole class. x
Require attendance by whole school. x
Yoga Instructor Likes Role model. Preference for male instructor. x x x

Qualities
Nice. Respectful. Funny. Doesn’t yell. Relaxed. x x x
Calm. Rewarded good behavior. x x
Fair. Fun. Provided unstructured time. x x
Joyful. Not just focused on yoga. Good tone. Able to relate to students.
x
Treated students as family. Vested interest in students.
Playful. Opportunities to take ownership of the class. x
Dislikes Not enough fun in sessions. Insufficient snacks. Differential treatment of

x
certain students.
Did not provide enough discipline of disruptive students. x

Page 21

T S T S T S
Investment Incorporate follow up of students and support outside the school.
x
in Youth
Dariotis et al.

Page 22

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Published in final edited form as:

A Qualitative Exploration of Implementation Factors in a School-

Implementation challenges limit the impact of interventions on participants (Durlak,

There is a need for research on implementation of mindfulness and yoga programs in

Greenberg, 2014; Mendelson et al., 2013). Although the perspective of implementers is

Psychol Sch. Author manuscript; available in PMC 2018 January 01.

Psychol Sch. Author manuscript; available in PMC 2018 January 01.

al., 2014 for detail on program components).

Youth Focus Groups

Psychol Sch. Author manuscript; available in PMC 2018 January 01.

Classroom Teacher Focus Groups and Interviews

Psychol Sch. Author manuscript; available in PMC 2018 January 01.

Theme One: Program Delivery Factors

Physical environment—Youth perceived several distracting elements related to the

Psychol Sch. Author manuscript; available in PMC 2018 January 01.

Program logistics—Teachers noted the importance of considering their students’

Theme Two: Implementer communication with teachers

Psychol Sch. Author manuscript; available in PMC 2018 January 01.

Communication about program goals—While teachers reported positive expectations

Communication concerning students—Communication about the program’s day-to-

Communication about program logistics—Classroom teachers also remarked on the

Psychol Sch. Author manuscript; available in PMC 2018 January 01.

Theme Three: Promoting Program Buy-in

Promoting skills generalization—Teachers spoke about the importance of taking the

playing contest” (fifth grade male student, School 2).

Psychol Sch. Author manuscript; available in PMC 2018 January 01.

Teacher training—Across all schools, teachers expressed willingness to attend

Optimizing student exposure to program skills—Teacher strategies to promote

Psychol Sch. Author manuscript; available in PMC 2018 January 01.

Theme Four: Yoga Instructor Qualities

Psychol Sch. Author manuscript; available in PMC 2018 January 01.

Psychol Sch. Author manuscript; available in PMC 2018 January 01.

Program Delivery Factors

Quality, Detail, and Timeliness of Communication

Psychol Sch. Author manuscript; available in PMC 2018 January 01.

breathing, yoga poses). We recommend that researchers and practitioners implementing

Psychol Sch. Author manuscript; available in PMC 2018 January 01.

Limitations and Strengths

characteristics, however, approximated the larger intervention sample distribution. Due to

Psychol Sch. Author manuscript; available in PMC 2018 January 01.

related to program scheduling, communication with teachers, and instructor characteristics.

differences across stakeholders are informative. Adaptation or development of quantitative

Psychol Sch. Author manuscript; available in PMC 2018 January 01.

Child Development. 2011; 82(1):405–432. [PubMed: 21291449]

Disease. Public Health Research, Practice, and Policy. 2007; 4(2):1–9.

Psychol Sch. Author manuscript; available in PMC 2018 January 01.

2012; 39:80–90. [PubMed: 21647811]

Abnormal Child Psychology. 2010; 38:985–994. [PubMed: 20440550]

Human Development. The Pennsylvania State University

Psychol Sch. Author manuscript; available in PMC 2018 January 01.

School and Neighborhood Characteristics

Neighborhood Characteristics Economic Indicators

Free and Reduced Crime Murder Less Median HH Income in Unemployment

Psychol Sch. Author manuscript; available in PMC 2018 January 01.

Lessons Learned from Teacher (T) and Student (S) Perspectives

School 1 School 2 School 3

Physical Hold it outside. x x

Bigger, quieter facilities with increased privacy. x

Regulated temperature. Dryer room. x

Program Change nothing about program content. x x x

Need to consider students’ schedules. x x

Build in free time. x

Implementer About Teachers/students not aware of goals and expectations.