Supporting Youth Mental Health Through a Health Coaching Intervention with a Mindfulness Component: A Pilot Randomized Controlled Trial During COVID-19

Background Youth mental health has declined since the COVID-19 pandemic began. Health coaching and mindfulness-based intervention may support therapeutic processes that promote resilience in the face of risk factors for adverse mental health outcomes. Building Resilience for Healthy Kids (HK) is a school-based intervention designed to support mental health through targeting these processes. Objective In this study, we tested HK in a pilot randomized controlled trial. Specifically, we examined intervention effects on the theoretically-informed therapeutic processes of emotion regulation, mindfulness, self-efficacy, and resilience and the clinical outcomes of depression and anxiety symptoms. The trial took place between April and June 2021, offering an opportunity to assess the impact of HK in the context of COVID-19. Methods Participants were early adolescents ( N = 230), randomized to HK or assessment-only. Participants in the intervention condition received weekly one-on-one sessions with health coaches. All youth completed validated self-report measures at baseline and post-intervention. Results Linear mixed effects models indicated that participants who received HK had a greater reduction in emotion regulation difficulties, relative to assessment-only controls ( d = 0.84, large effect). Follow-up analyses revealed that youth who endorsed negative affectivity at baseline experienced more benefits than those who did not, and youth who attended more HK sessions increased in self-efficacy, in addition to improved emotion regulation. Intervention effects did not reach significance for other outcomes. Conclusions Findings suggest that HK may support youth in reducing difficulties in emotion regulation, which are precursors to the development of mental health concerns in adolescence. TRN NCT04202913, 12/16/2019.