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Objectives: In the context of adverse social conditions, adolescents may not progress to adulthood with the emotional and behavioral skills needed to effectively navigate inevitable life challenges. Appropriately timed, evidence-based interventions have the potential to improve youth developmental trajectories. This qualitative study explored adolescents' perceptions of two different types of school-based programs designed to promote healthy development and decision-making: mindfulness and health education. Method: Focus group data were analyzed to explore adolescent perceptions of how the programs impacted them. Ninth grade students (n = 79) in three schools serving marginalized urban communities, where traumatic experiences are common, were randomly assigned to one of the two interventions as part of a trial to identify mechanisms of behavioral change. Separate focus groups were conducted for participants in the mindfulness and health education programs at each school (n = 6 focus groups). Of the 70 participants who attended one or more program sessions, 45 participated in a focus group (mean age: 14.7 years; 86.7% Black; 51.1% female). Results: Four themes were identified through analysis of the focus group data: (1) enhanced emotional intelligence–emotion recognition, perspective taking, and empathy (mindfulness only); (2) a mindset shift toward cognitive control through greater focus, awareness, and intentionality; (3) utilizing program skills in other contexts to manage stress or make healthy choices; and (4) reinforced and transferred program learning through sharing. Conclusions: Students perceived benefits of program participation, many of which overlapped between programs. Enhanced emotional intelligence was unique to the mindfulness-based intervention. These findings have implications for the development and adaptation of school-based programs and selection of comparison or active control conditions in intervention trials. Preregistration: This study is registered with clinicaltrials.gov (NCT03989934). [ABSTRACT FROM AUTHOR]

Determining the factors that influence implementation of school-based wellbeing and health programs is essential for achieving desired program effects. Using a convergent mixed-methods, multiple informant design, this study considered factors that influence implementation of health programs for ninth grade students and in what ways implementation is differentially perceived by multiple informants (i.e., participants, instructors, and independent observers). Two types of programs—mindfulness and health education—were implemented with ninth graders (N = 70) in three schools situated in low-resourced urban neighborhoods. Study outcomes were derived from four data sources: (1) focus group participants (N = 45); (2) program instructor fidelity ratings; (3) independent observer fidelity ratings and notes; and (4) instructor open-ended session responses. Using thematic and mixed methods integration analyses, we identified themes related to implementation promoting or challenging factors. Theme names differed when data sources were separately analyzed by informant. Mixed methods integration analysis indicated that four themes were common across all informant groups: (1) competent, attentive, and engaging instructors are essential; (2) programs should involve interactive components (e.g., physical activities, applied learning opportunities); (3) adequate time for program delivery is key for student exposure and engagement; and (4) students' availability and preferences should guide program scheduling. A fifth theme, unique to instructor and observer perspectives, was that program implementation was negatively impacted by distractions from multiple sources, including instructors, students, and settings. Recommendations from students, instructors, and observers for implementation optimization are discussed. [ABSTRACT FROM AUTHOR]