Evaluation of Yoga for Preventing Adolescent Substance Use Risk Factors in a Middle School Setting: A Preliminary Group-Randomized Controlled Trial
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Adolescence is a key developmental period for preventing substance use initiation, however prevention programs solely providing educational information about the dangers of substance use rarely change adolescent substance use behaviors. Recent research suggests that mind–body practices such as yoga may have beneficial effects on several substance use risk factors, and that these practices may serve as promising interventions for preventing adolescent substance use. The primary aim of the present study was to test the efficacy of yoga for reducing substance use risk factors during early adolescence. Seventh-grade students in a public school were randomly assigned by classroom to receive either a 32-session yoga intervention (n = 117) in place of their regular physical education classes or to continue with physical-education-as-usual (n = 94). Participants (63.2 % female; 53.6 % White) completed pre- and post-intervention questionnaires assessing emotional self-regulation, perceived stress, mood impairment, impulsivity, substance use willingness, and actual substance use. Participants also completed questionnaires at 6-months and 1-year post-intervention. Results revealed that participants in the control condition were significantly more willing to try smoking cigarettes immediately post-intervention than participants in the yoga condition. Immediate pre- to post-intervention differences did not emerge for the remaining outcomes. However, long-term follow-up analyses revealed a pattern of delayed effects in which females in the yoga condition, and males in the control condition, demonstrated improvements in emotional self-control. The findings suggest that school-based yoga may have beneficial effects with regard to preventing males’ and females’ willingness to smoke cigarettes, as well as improving emotional self-control in females. However additional research is required, particularly with regard to the potential long-term effects of mind–body interventions in school settings. The present study contributes to the literature on adolescence by examining school-based yoga as a novel prevention program for substance use risk factors.
KeywordsYoga Substance use Adolescence Meditation Mindfulness School Addiction
We are thankful to the KYIS intervention teachers and program mentors: Janna Delgado, Iona Smith, Jordan Grinstein, Renee Merrill, Lucie Kasova, Monica Laitner-Laserna, Cara Masullo, Katherine Olson, and Mikki Pugh. We also acknowledge the headmaster, assistant headmasters, school staff, physical education teachers, and students at the school who facilitated and/or participated in the project. We are grateful to Mark Greenberg for providing guidance during the development and implementation of this project. We also thank Frankye Riley who assisted with preparing this paper for publication.
This work was funded by grants from the Institute for Extraordinary Living of the Kripalu Center for Yoga & Health and the National Institute on Drug Abuse (Grant No. R34 DA032756).
BB coordinated the study, conducted statistical analyses, and drafted the manuscript. AL assisted with the execution of the study and drafted portions of the manuscript. SHS and SBSK conceived of the study, supervised the coordination of the study, and drafted portions of the manuscript. All authors read and approved the final manuscript.
Conflict of interest
The authors report no conflicts of interest.
This study was reviewed and approved by the Brigham and Women’s Hospital Institutional Review Board (Partners Human Research Committee). All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Written parental consent and written child assent were obtained from all individual participants included in the study.
- Barnes, P. M., Bloom, B., & Nahin, R. L. (2008). Complementary and alternative medicine use among adults and children: United States, 2007. National Health Statistics Reports, 12, 1–23.Google Scholar
- Black, L. I., Clarke, T. C., Barnes, P. M., Stussman, B. J., & Nahin, R. L. (2015). Use of complementary health approaches among children aged 4–17 years in the united states: National health interview survey, 2007–2012. National Health Statistics Reports, 78, 1–19.Google Scholar
- Butzer, B., van Over, M., Noggle Taylor, J. J., & Khalsa, S. B. S. (2015). Yoga may mitigate decreases in high school grades. Evidence-Based Complementary and Alternative Medicine: eCAM, ID 259814, 1–8.Google Scholar
- CDC. (2014). YRBSS—youth risk behavior surveillance system—adolescent and school health. Retrieved July 2014 from http://www.cdc.gov/HealthyYouth/yrbs/index.htm
- Cohen, S., Kamarck, T., & Mermelstein, R. (1983). A global measure of perceived stress. Journal of Health and Social Behavior, 24, 385–396.Google Scholar
- Copeland, W., Shanahan, L., Costello, E. J., & Angold, A. (2011). Cumulative prevalence of psychiatric disorders by young adulthood: A prospective cohort analysis from the great smoky mountains study. Journal of the American Academy of Child and Adolescent Psychiatry, 50(3), 252–261. doi: 10.1016/j.jaac.2010.12.014.PubMedPubMedCentralCrossRefGoogle Scholar
- Daly, L. A., Haden, S. C., Hagins, M., Papouchis, N., & Ramirez, P. M. (2015). Yoga and emotion regulation in high school students: A randomized controlled trial. Evidence-Based Complementary and Alternative Medicine, Article ID 794928, 1–8.Google Scholar
- Ferreira-Vorkapic, C., Feitoza, J., Marchioro, M., Simões, J., Kozasa, E., & Telles, S. (2015). Are there benefits from teaching yoga at schools? A systematic review of randomized control trials of yoga-based interventions. Evidence-Based Complementary and Alternative Medicine, Article ID 345835, 1–17.Google Scholar
- Fishbein, D., Miller, S., Herman-Stahl, M., Williams, J., Lavery, B., Markovitz, L., & Johnson, M. (2015). Behavioral and psychophysiological effects of a yoga intervention on high-risk adolescents: A randomized control trial. Journal of Child and Family Studies,. doi: 10.1007/s10826-015-0231-6.Google Scholar
- Grant, B. F., Stinson, F. S., Dawson, D. A., Chou, S. P., Dufour, M. C., Compton, W., & Kaplan, K. (2004). Prevalence and co-occurrence of substance use disorders and independent mood and anxiety disorders: Results from the national epidemiologic survey on alcohol and related conditions. Archives of General Psychiatry, 61(8), 807–816.PubMedCrossRefGoogle Scholar
- Haden, S. C., Daly, L., & Hagins, M. (2014). A randomised controlled trial comparing the impact of yoga and physical education on the emotional and behavioural functioning of middle school children. Focus on Alternative and Complementary Therapies, 19(3), 148–155.PubMedPubMedCentralCrossRefGoogle Scholar
- Hagen, I., & Nayar, U. S. (2014). Yoga for children and young people’s mental health and well-being: Research review and reflections on the mental health potentials of yoga. Frontiers in Psychiatry, 5(35), 1–6.Google Scholar
- Hagins, M., Haden, S. C., & Daly, L. A. (2013). A randomized controlled trial on the effects of yoga on stress reactivity in 6th grade students. Evidence-Based Complementary and Alternative Medicine (Article ID 607134), 1–9. doi: 10.1155/2013/607134.
- Harris, P. A., Taylor, R., Thielke, R., Payne, J., Gonzalez, N., & Conde, J. G. (2009). Research electronic data capture (REDCap)—a metadata-driven methodology and workflow process for providing translational research informatics support. Journal of Biomedical Informatics, 42(2), 377–381.PubMedCrossRefGoogle Scholar
- Hill, J. P., & Lynch, M. E. (1983). The intensification of gender-related role expectations during early adolescence. Girls at puberty (pp. 201–228). Berlin: Springer.Google Scholar
- Johnston, L. D., O’Malley, P. M., Bachman, J. G., & Schulenberg, J. E. (2006). Monitoring the future: National survey results on drug use, 1975–2005. volume 1: Secondary school students, 2005. NIH Publication No. 06-5883. National Institute on Drug Abuse (NIDA).Google Scholar
- Kaley-Isley, L. C., Peterson, J., Fischer, C., & Peterson, E. (2010). Yoga as a complementary therapy for children and adolescents: A guide for clinicians. Psychiatry (Edgmont), 7(8), 20–32.Google Scholar
- Kendall, P. C., & Williams, C. L. (1982). Assessing the cognitive and behavioral components of children’s self-management. In P. Karoly & F. H. Kanfer (Eds.), Self-management and behavior change (pp. 240–284). New York, NY: Pergamon. Google Scholar
- Khalsa, S. B., Hickey-Schultz, L., Cohen, D., Steiner, N., & Cope, S. (2012). Evaluation of the mental health benefits of yoga in a secondary school: A preliminary randomized controlled trial. The Journal of Behavioral Health Services & Research, 39(1), 80–90. doi: 10.1007/s11414-011-9249-8.CrossRefGoogle Scholar
- KYIS. (2015). Kripalu yoga in the schools (KYIS). Retrieved March 2015 from http://www.kripalu.org/be_a_part_of_kripalu/812/
- Lohman, R. (1999). Yoga techniques applicable within drug and alcohol rehabilitation programmes. Therapeutic Communities-London-Association of Therapeutic Communiities, 20, 61–72.Google Scholar
- LoRusso, A. M., Butzer, B., Windsor, R., Riley, F., Frame, K., Khalsa, S. B. S., et al. (2015). A qualitative examination of yoga for middle school adolescents. Manuscript submitted for publication.Google Scholar
- Lynam, D., Smith, G., Whiteside, S., & Cyders, M. (2006). The UPPS-P: Assessing five personality pathways to impulsive behavior. West Lafayette, IN: Purdue University.Google Scholar
- MESE (Massachusetts Department of Elementary and Secondary Education). (2015). 2013–2014 class size by gender, selected populations, and race/ethnicity; cohort 2014 graduation rates. Retrieved March 2015 from http://profiles.doe.mass.edu/
- Miller, S., Herman-Stahl, M., Fishbein, D., Lavery, B., Johnson, M., & Markovits, L. (2014). Use of formative research to develop a yoga curriculum for high-risk youth: Implementation considerations. Advances in School Mental Health Promotion, 7(3), 171–183. doi: 10.1080/1754730X.2014.916496.CrossRefGoogle Scholar
- MTF (Monitoring The Future Survey). (2015). Monitoring the future 2015 survey results. Retrieved April 2016 from https://www.drugabuse.gov/related-topics/trends-statistics/infographics/monitoring-future-2015-survey-results
- Noggle, J. J., Steiner, N. J., Minami, T., & Khalsa, S. B. (2012). Benefits of yoga for psychosocial well-being in a US high school curriculum: A preliminary randomized controlled trial. Journal of Developmental and Behavioral Pediatrics : JDBP, 33(3), 193–201. doi: 10.1097/DBP.0b013e31824afdc4.PubMedCrossRefGoogle Scholar
- O’Connell, M. E., Boat, T., & Warner, K. E. (2009). Preventing mental, emotional, and behavioral disorders among young people: Progress and possibilities. Washington, USA: National Academies Press.Google Scholar
- Parker, A. E., Kupersmidt, J. B., Mathis, E. T., Scull, T. M., & Sims, C. (2014). The impact of mindfulness education on elementary school students: Evaluation of the master mind program. Advances in School Mental Health Promotion, 7(3), 184–204. doi: 10.1080/1754730X.2014.916497.PubMedPubMedCentralCrossRefGoogle Scholar
- Reddy, S., Dick, A. M., Gerber, M. R., & Mitchell, K. (2014). The effect of a yoga intervention on alcohol and drug abuse risk in veteran and civilian women with posttraumatic stress disorder. The Journal of Alternative and Complementary Medicine, 20(10), 750–756.PubMedPubMedCentralCrossRefGoogle Scholar
- Sale, E., Weil, V., & Kryah, R. (2012). An exploratory investigation of the promoting responsibility through education and prevention (PREP) after school program for African American at-risk elementary school students. School Social Work Journal, 36(2), 56–72.Google Scholar
- Serwacki, M. L., & Cook-Cottone, C. (2012). Yoga in the schools: A systematic review of the literature. International Journal of Yoga Therapy, 22, 101–109.Google Scholar
- Southam-Gerow, M. A. (2013). Emotion regulation in children and adolescents: A practitioner’s guide. New York: Guilford.Google Scholar
- Sproull, N. L. (2002). Handbook of research methods: A guide for practitioners and students in the social sciences. Lanham, MA: Scarecrow Press.Google Scholar
- Sureka, P., Govil, S., Dash, D., Dash, C., Kumar, M., & Singhal, V. (2014). Sudarshan kriya for male patients with psycho active substance dependence: A randomized control trial. ASEAN Journal of Psychiatry, 16(1), 28–37.Google Scholar
- Tercek, R. C. (2008). Impulsivity: Examining links to risk-taking behavior among adolescent detainees. ProQuest.Google Scholar
- Wang, D., & Hagins, M. (2016). Perceived benefits of yoga among urban school students: A qualitative analysis. Evidence-Based Complementary and Alternative Medicine, 2016. Article ID 8725654. doi: 10.1155/2016/8725654
- Warner, R. M. (2008). Applied statistics: From bivariate through multivariate techniques. Beverly Hills, CA: Sage.Google Scholar
- Whitesell, M., Bachand, A., Peel, J., & Brown, M. (2013). Familial, social, and individual factors contributing to risk for adolescent substance use. Journal of addiction, 2013, Article ID 579310. doi: 10.1155/2013/579310
- Wills, T. A., & Ainette, M. G. (2010). Temperament, self-control and adolescent substance use. In L. M. Scheier (ed.), Handbook of Drug Use Etiology: Theory, Methods and Empirical Findings (pp. 127–146). Washington, DC: American Psychological Association. Google Scholar
- Wills, T. A., Gibbons, F. X., Sargent, J. D., Gerrard, M., Lee, H. R., & Dal, C. S. (2010). Good self-control moderates the effect of mass media on adolescent tobacco and alcohol use: Tests with studies of children and adolescents. Health Psychology, 29(5), 539–549.PubMedPubMedCentralCrossRefGoogle Scholar
- Wills, T. A., Simons, J. S., & Gibbons, F. X. (2015). Self-control and substance use prevention: A translational analysis. In L. M. Scheier (Ed.), Handbook of adolescent drug use prevention: Research, intervention strategies, and practice (pp. 121–139). Washington, USA: American Psychological Association.CrossRefGoogle Scholar