Nursing Research

Overview Anxiety attacks severe enough to preclude school attendance occur at least once per semester among 20% of middle-school youth (Hank & Soto, 2000). Hindenburg & Smith (2010) estimated that missed school days cost over $2 million per year in the Tucson Independent School District. They found that 52% of youth who screen positive for anxiety fail to perform at grade level. Mindfulness meditation training has been shown to significantly reduce symptoms of anxiety in middle-school age primary-care patients (Dorchester & Smith, 2000, 2005). I believe that 8 weeks of mindfulness meditation training will reduce anxiety and increase school attendance among middle school students with anxiety, who have missed at least 5 days of school in the previous 60 days. I intend to measure five critical variables (Table 1). I will use the Magic Middle-school Anxiety Profile (MMAP) to assess level of anxiety before and after the meditation training intervention. All youth with a score > 15 on the MMAP who have missed 5 or more days in a 60 day period will qualify to participate (Hank & Soto, 1995). The MMAP is a self-administered survey that has been used in six validation studies with middle-school youth and has been shown to have excellent reliability and validity (Hank & Soto, 1995, 1997, 2000). I believe that meditation training will lower youth’s anxiety scores to below threshold levels (<6). Success in meditation training is traditionally measured by the ability of the initiate to control heart rate (Dorchester & Smith, 2000, 2005). Because anxiety is typically associated with elevated heart rate, the goal of training will be to have youth reduce heart rate by 50% (e.g., from 140 bpm to 70 bpm) over a 5 minute period (Dorchester & Smith, 2005). A secondary goal of my project is to demonstrate the intervention’s acceptability to youth. Thus, I will measure satisfaction by asking participants who complete training whether they would recommend the training to a friend or family member with anxiety (Dorchester, 2000). Finally, I will assess the cost effectiveness of the meditation intervention by the number of students who complete all eight sessions and the number of school days missed in the 60 day period following completion of the meditation intervention. I expect at least 90% of youth to finish the training and each of them to have fewer than 5 missed days in the 60 days following training.

Table 1 Data Structure Table

Variable type

Variable name

How defined

How measured

Criterion for success

Evidence for reliability/ validity

Clinical Outcome Anxiety MMAP

Change in total score over 8 weeks

Total score reduced from >15 to < 6

Hank & Soto (1995, 1997, 2000) Both

Clinical Outcome

Heart rate control BPM

Change in heart rate control over 8 weeks

BPM reduced by 50% within 5 minutes

Dorchester & Smith (2000, 2005) Both

Satisfaction Outcome Satisfaction

Exit interview

Recommend training to a friend

80% of students say yes

Dorchester (2000) Face validity

Cost Outcome

Complete training Log

Number of weekly classes attended

90% of students complete training

Dorchester (2000) Face validity

Cost Outcome

Missed school days

School record

Number of days missed in 60 days following training

Less than 5 days missed

Hindenburg & Smith (2010) Both

References Dorchester, L. (2000). Cost effectiveness of mindfulness meditation training. Journal of Nonsense, 6(2), 1–5. doi:12345X67890 Dorchester, L., & Smith, M. (2000). Assessment of heart rate control. Journal of No Nonsense, 17(3), 11–35. doi:123444X67890 Dorchester, L., & Smith, M. (2005). Norms for the measurement of heart rate control. Journal of Applied Nonsense, 7(2), 10–25. doi:123555X67890 Hank, F., & Soto, D. (1995). Scoring of the MMAP. Journal of Applied Nonsense, 7(2), 200– 225. doi:123335X67890 Hank, F., & Soto, D. (1997). Validation of the MMAP. Journal of Applied Nonsense, 17(2), 100–105. doi:123522X67890 Hank, F., & Soto, D. (2000). Norms for the MMAP. Journal of Nonsense, 77(22), 10–25. doi:123511X67890 Hindenburg, V., & Smith, R. (2010). Use of school records to track miscreants. Journal of Fun, 79(23), 10–15. doi:123888X67890