Fidelity of Mindfulness Training and Delivery for Adolescent Mental and Metabolic Health
Sarah E. D. Perzow, Michele Chen, Samantha Bothwell, Lauren D. Gulley, Rachel G. Lucas‐Thompson, Laura Pyle, Talia Thompson, Natalia Sanchez, Doris Elizabeth Estrada, Marian Tanofsky-Kraff, Megan K. Kelsey, Eleanor R Mackey, Lauren B Shomaker
Mindfulness September 3, 2026 DOI: 10.1007/s12671-026-02975-8 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Pilot randomized controlled trial Peer reviewed |
|---|---|
| Sample size | 17 |
| Population | Facilitators at four U.S. sites trained to deliver group interventions to adolescents at risk for type 2 diabetes with elevated depression symptoms |
| Intervention | cognitive behavioral therapy (CBT) |
| Topics | Meditation |
| Registration | NCT04992299 |
| Key findings | Facilitators achieved the prespecified 80% threshold for knowledge, competence, and adherence after standardized training, with knowledge scores improving significantly in all three conditions and median competence/adherence ratings meeting or exceeding 80% in both mock and pilot sessions. The authors report that results support the feasibility of high-fidelity training and implementation of MBI, CBT, and HE across diverse settings. |
Abstract
Adolescent-onset type 2 diabetes (T2D) is increasing, and depression symptoms amplify T2D risk, highlighting the need for interventions addressing mental and metabolic health. This multisite pilot RCT assessed whether facilitators could be trained consistently to deliver group MBI, cognitive behavioral therapy (CBT), and a matched health education condition (HE) to adolescents at risk for T2D with elevated depression symptoms. It was hypothesized that facilitators would achieve ≥ 80% on knowledge, competence, and adherence following standardized training. Facilitators at four U.S. sites received training in MBI, CBT, and/or HE through didactics and supervised virtual mock sessions. Training fidelity was assessed through pre/post-training knowledge tests and expert ratings of adherence/competence in mock sessions. Intervention delivery fidelity was assessed with expert ratings of virtual pilot group sessions with adolescents. Contamination across conditions was evaluated. Seventeen facilitators were trained in MBI ( n = 11), CBT ( n = 10), and/or HE ( n = 9). Descriptive feasibility metrics are presented; between-arm comparisons are not made. Knowledge scores improved across conditions (MBI: 76% → 96%, p = 0.01; CBT: 68% → 92%, p = 0.01; HE: 84% → 96%, p = 0.02). Median competence/adherence met or exceeded the 80% threshold for mock (MBI = 80%/85%, CBT = 86%/90%, HE = 82.5%/80%) and pilot (MBI = 90%/100%, CBT = 90%/90%, HE = 97.5%/96%) sessions. Contamination was limited to overlapping MBI-CBT content. Results support the feasibility of high-fidelity training and implementation of MBI, CBT, and HE across diverse settings, informing future research into integrated adolescent health prevention strategies. ClinicalTrials.gov #NCT04992299.
Comparable studies
Other randomized controlled trials on meditation, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Alterations in Brain and Immune Function Produced by Mindfulness Meditation Healthy employees in a work environment | 2003 | Randomized controlled trial | n = 41 |
| Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Recovered recurrently depressed patients | 2000 | Randomized controlled trial | n = 145 |
| Open hearts build lives: Positive emotions, induced through loving-kindness meditation, build consequential personal resources. Working adults | 2008 | Randomized controlled trial | n = 139 |
| Short-term meditation training improves attention and self-regulation Undergraduate Chinese students | 2007 | Randomized controlled trial | n = 40 |
| Mindfulness-Based Cognitive Therapy for Depression: Replication and Exploration of Differential Relapse Prevention Effects. Recovered recurrently depressed patients | 2004 | Randomized controlled trial | n = 73 |
Citations in the library
Cites 13
- Research Review: The effects of mindfulness‐based interventions on cognition and mental health in children and adolescents – a meta‐analysis of randomized controlled trials Journal of Child Psychology and Psychiatry October 22, 2018
- Home practice in Mindfulness-Based Cognitive Therapy and Mindfulness-Based Stress Reduction: A systematic review and meta-analysis of participants' mindfulness practice and its association with outcomes Behaviour Research and Therapy May 10, 2017
- How Does Mindfulness Training Affect Health? A Mindfulness Stress Buffering Account Current Directions in Psychological Science December 1, 2014
- Prospects for a clinical science of mindfulness-based intervention. American Psychologist October 1, 2015
- Differentiating mindfulness-integrated cognitive behavior therapy and mindfulness-based cognitive therapy clinically: the why, how, and what of evidence-based practice. Frontiers in Psychology 2024
and 8 more in the library