Background Systematic reviews suggest school-based mindfulness training (SBMT) shows promise in promoting student mental health. Objective The My Resilience in Adolescence (MYRIAD) Trial evaluated the effectiveness and cost-effectiveness of SBMT compared with teaching-as-usual (TAU). Methods MYRIAD was a parallel group, cluster-randomised controlled trial. Eighty-five eligible schools consented and were randomised 1:1 to TAU (43 schools, 4232 students) or SBMT (42 schools, 4144 students), stratified by school size, quality, type, deprivation and region. Schools and students (mean (SD); age range=12.2 (0.6); 11–14 years) were broadly UK population-representative. Forty-three schools (n=3678 pupils; 86.9%) delivering SBMT, and 41 schools (n=3572; 86.2%) delivering TAU, provided primary end-point data. SBMT comprised 10 lessons of psychoeducation and mindfulness practices. TAU comprised standard social-emotional teaching. Participant-level risk for depression, social-emotional-behavioural functioning and well-being at 1 year follow-up were the co-primary outcomes. Secondary and economic outcomes were included. Findings Analysis of 84 schools (n=8376 participants) found no evidence that SBMT was superior to TAU at 1 year. Standardised mean differences (intervention minus control) were: 0.005 (95% CI −0.05 to 0.06) for risk for depression; 0.02 (−0.02 to 0.07) for social-emotional-behavioural functioning; and 0.02 (−0.03 to 0.07) for well-being. SBMT had a high probability of cost-effectiveness (83%) at a willingness-to-pay threshold of £20 000 per quality-adjusted life year. No intervention-related adverse events were observed. Conclusions Findings do not support the superiority of SBMT over TAU in promoting mental health in adolescence. Clinical implications There is need to ask what works, for whom and how, as well as considering key contextual and implementation factors. Trial registration Current controlled trials [ISRCTN86619085][1]. This research was funded by the Wellcome Trust (WT104908/Z/14/Z and WT107496/Z/15/Z). Data are available upon reasonable request. The baseline data and codebook from the MYRIAD Trial are available from Prof Kuyken (willem.kuyken@psych.ox.ac.uk) upon request (release of data is subject to an approved proposal and a signed data access agreement). [1]: /external-ref?link_type=ISRCTN&access_num=ISRCTN86619085

中文翻译：

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与正常学校提供的普遍学校正念训练相比，在降低青少年心理健康问题风险和促进幸福感方面的有效性和成本效益：MYRIAD 集群随机对照试验

背景 系统评价表明，校本正念训练 (SBMT) 显示出促进学生心理健康的希望。目的 My Resilience in Adolescence (MYRIAD) 试验评估了 SBMT 与常规教学 (TAU) 相比的有效性和成本效益。方法 MYRIAD 是一项平行组、整群随机对照试验。85 所符合条件的学校同意并按 1:1 的比例随机分配到 TAU（43 所学校，4232 名学生）或 SBMT（42 所学校，4144 名学生），按学校规模、质量、类型、贫困和地区分层。学校和学生（平均值 (SD)；年龄范围 = 12.2 (0.6)；11-14 岁）广泛代表英国人口。43 所学校（n=3678 名学生；86.9%）提供 SBMT，41 所学校（n=3572；86.2%）提供 TAU，提供了主要终点数据。SBMT 包括 10 节心理教育和正念练习课程。TAU 包括标准的社会情感教学。参与者水平的抑郁症风险、社交情绪行为功能和 1 年随访时的幸福感是共同主要结果。包括次要和经济结果。结果 对 84 所学校（n=8376 名参与者）的分析没有发现 SBMT 在 1 年时优于 TAU 的证据。标准化平均差（干预减去对照）为：抑郁症风险为 0.005（95% CI -0.05 至 0.06）；0.02（-0.02 至 0.07）用于社交情绪行为功能；0.02（-0.03 至 0.07）表示幸福感。SBMT 在每质量调整生命年 20 000 英镑的支付意愿阈值下具有很高的成本效益 (83%) 概率。未观察到与干预相关的不良事件。结论 研究结果不支持 SBMT 在促进青春期心理健康方面优于 TAU。临床意义 需要询问什么有效、对谁有效以及如何有效，并考虑关键的背景和实施因素。试验注册当前对照试验 [ISRCTN86619085][1]。这项研究由 Wellcome Trust (WT104908/Z/14/Z 和 WT107496/Z/15/Z) 资助。可根据合理要求提供数据。MYRIAD 试验的基线数据和密码本可根据要求从 Kuyken 教授 (willem.kuyken@psych.ox.ac.uk) 获得（数据的发布取决于批准的提案和签署的数据访问协议）。[1]: /external-ref?link_type=ISRCTN&access_num=ISRCTN86619085 临床意义 需要询问什么有效、对谁有效以及如何有效，并考虑关键的背景和实施因素。试验注册当前对照试验 [ISRCTN86619085][1]。这项研究由 Wellcome Trust (WT104908/Z/14/Z 和 WT107496/Z/15/Z) 资助。可根据合理要求提供数据。MYRIAD 试验的基线数据和密码本可根据要求从 Kuyken 教授 (willem.kuyken@psych.ox.ac.uk) 获得（数据的发布取决于批准的提案和签署的数据访问协议）。[1]: /external-ref?link_type=ISRCTN&access_num=ISRCTN86619085 临床意义 需要询问什么有效、对谁有效以及如何有效，并考虑关键的背景和实施因素。试验注册当前对照试验 [ISRCTN86619085][1]。这项研究由 Wellcome Trust (WT104908/Z/14/Z 和 WT107496/Z/15/Z) 资助。可根据合理要求提供数据。MYRIAD 试验的基线数据和密码本可根据要求从 Kuyken 教授 (willem.kuyken@psych.ox.ac.uk) 获得（数据的发布取决于批准的提案和签署的数据访问协议）。[1]: /external-ref?link_type=ISRCTN&access_num=ISRCTN86619085 这项研究由 Wellcome Trust (WT104908/Z/14/Z 和 WT107496/Z/15/Z) 资助。可根据合理要求提供数据。MYRIAD 试验的基线数据和密码本可根据要求从 Kuyken 教授 (willem.kuyken@psych.ox.ac.uk) 获得（数据的发布取决于批准的提案和签署的数据访问协议）。[1]: /external-ref?link_type=ISRCTN&access_num=ISRCTN86619085 这项研究由 Wellcome Trust (WT104908/Z/14/Z 和 WT107496/Z/15/Z) 资助。可根据合理要求提供数据。MYRIAD 试验的基线数据和密码本可根据要求从 Kuyken 教授 (willem.kuyken@psych.ox.ac.uk) 获得（数据的发布取决于批准的提案和签署的数据访问协议）。[1]: /external-ref?link_type=ISRCTN&access_num=ISRCTN86619085