Amanda Goff

Introduction/Problem

Concerns about children's mental health have increased due to the pandemic, mental disorders, and adverse childhood experiences, affecting their cognitive, emotional, and behavioral health. These challenges often manifest as somatic symptoms, leading students to visit the school nurse frequently, which reduces instructional time and hinders academic performance. School nurses are often the first to identify early anxiety symptoms, enabling timely intervention. Meeting students' mental and emotional needs is essential to enhance their social engagement, well-being, and academic success. Administrators and teachers adhere to social-emotional learning (SEL) standards established by the state board of education. They prioritize depth over breadth, encourage student-driven learning, and focus on applying real-world knowledge so that students can solve complex problems and face future challenges. Meeting students’ mental and emotional needs is key to enhancing their social engagement, well-being, and academic success. This initiative examined whether school nurse-led mindfulness interventions improved third-grade students’ (n 65) social, emotional, and academic behaviors, using a universal risk screening tool.

Methods

The school nurse developed fifteen mindfulness lessons on self-awareness and self-regulation that aligned with SEL standards. These brief, age-appropriate video lessons (5-10 minutes) taught students to identify and respond to their thoughts, emotions, and actions in a positive manner. Teachers chose when to show the videos allowing flexibility to fit their schedules. Activities were designed to engage students and support their self-awareness and self-regulation. Materials included slides, interactive lessons, and hands-on activities like glitter jars. Each student received a breathing board to support self-regulation, with extra sets in calming corners. Posters in the room reinforced key concepts and strategies introduced during instruction. Mindfulness practices in the intervention directly support self-awareness and self-management, helping students improve focus, emotional regulation, and impulse control.

Findings

The team ran six paired samples t-tests comparing pre- and post-intervention subscales, using one-tailed p-values to assess improvements. A Bonferroni correction was applied to control for family-wise error, with significance elevated at a more stringent threshold. Effect sizes were calculated using Cohen's d to assess the practical significance of the findings. Of the six paired t-tests, the social risk subscale showed a statistically significant improvement from pre- to post-intervention. Students’ scores on the social subscale showed meaningful gains from before to after the intervention. The other five subscales did not reach significance, though some showed improvement trends. Students and teachers shared positive comments about the mindfulness lessons. The QI team found that these lessons improved students’ well-being and underscored the value of self-regulation skills.

Practice Implications

Teaching students self-awareness and how to recognize early signs of emotional or behavioral dysregulation enables school nurses to provide tools for managing stress and frustration as they arise. Structured mindfulness lessons that build self-regulation skills can reduce somatic complaints, leading to fewer nurse visits and less missed class time.