Over recent decades, there have been increasing trends in the prevalence of youth psychopathology in the United States, such as emotional problems and antisocial behavior, with an accompanying need for greater prevention and intervention to address these growing concerns (Collinshaw, 2014). While outpatient and other healthcare settings are central for delivering evidence-based intervention (EBI), around half of children needing mental health services do not consistently receive such support (Whitney & Peterson, 2019). Within this context, schools have become the most accessed mental health service setting for youth (Duong et al., 2021), especially for diverse and marginalized youth coming from socioeconomically disadvantaged families (Villagrana, 2010). School-based mental health interventions are key for supporting diverse and marginalized youth’s future health and success because they are associated with lower stigma and have higher utilization rates compared to clinic-based interventions (Jaycox et al., 2010).

Within school settings, mental health interventions are traditionally delivered via a multi-tiered system of support model, where students may receive universal access to low-intensity, skills-based prevention programming (Kilgus & Von der Embse, 2019; Stoiber, 2014). Skills taught at the Tier 1 level typically target broad social and emotional competencies that aid in navigating a host of mental health struggles, including coping with stress, managing anger, solving problems, and building courage to face fears. Many of these Tier 1 skills-based interventions are specifically planned through manualized programs and require substantial time and effort to both learn and implement within the classroom (see the CASEL Program Guide for an overview of common universal curricula for teaching social and emotional skills: https://pg.casel.org). Although well-intentioned and, in many cases, backed by empirical evidence, most manualized school-based prevention programs are incapable of addressing contextually varied problems faced by culturally diverse students (Shernoff et al., 2017). Contextual adaptation is therefore critical for appropriately supporting the needs of diverse and marginalized youth, who may experience a variety of chronic environmental stressors, including persistent poverty, systemic and individual discrimination, cultural stigmas, linguistic differences, and clashing cultural values (Phan & Renshaw, 2023). Therefore, EBIs that are flexible and amenable to adaptation may be especially useful for supporting diverse and marginalized youth, especially at the universal level within school-based prevention. We propose that mindfulness-based interventions (MBIs) may be one such universally effective and adaptable intervention.

Mindfulness-Based Intervention in Schools

Mindfulness is a contemporary psychological construct with historical roots in the Buddhist contemplative tradition. It is commonly defined as “paying attention in a particular way: on purpose, in the present moment, and nonjudgmentally” (Kabat-Zinn, 2003, p. 145). Other similar definitions of mindfulness have been published, and a widely agreed upon conceptualization comes from Bishop et al.’s (2004) seminal paper defining mindfulness as “the self-regulation of attention so that it is maintained on immediate experience” and accompanied by “a particular orientation towards one experience in the present-moment” (p. 232). Renshaw (2020) described mindfulness as the unification of two core skills—present moment awareness and responding with acceptance—that can be learned and taught like any other social-emotional skill. Mindfulness can be taught and practiced using a variety of strategies that are amenable to school and classroom settings, including mindful breathing, body scans, five-senses meditations, compassion-focused meditations, yoga, mindful check-ins, and even metaphorical exercises (Renshaw et al., 2022).

Research supporting the effectiveness of MBIs in schools has grown over the last 20 years (Black, 2015; Dunning et al., 2022; Klingbeil et al., 2017a; Maynard et al., 2017; Phan et al., 2022). A recent meta-analysis suggests that MBIs are safe and effective for achieving a broad host of desirable mental health outcomes in students, including those related to improved well-being and decreased psychopathology (Klingbeil et al., 2017). The average effect sizes across most of these outcomes are small to moderate (Renshaw et al., 2022). Previous reviews found that MBIs have positive outcomes for youth regarding cognitive performance, resilience to stress, mindfulness, executive functioning, attention, depression, anxiety, and negative behaviors (Chi et al., 2018; Dunning et al., 2019; Zenner et al., 2014). In addition, several reviews showed that MBIs with youth also improved socio-emotional competencies, rumination, internalizing problems, externalizing problems, prosocial skills, stress, physical health, positive emotions, coping, perceptions of peer relations, mood, quality of life, academic achievement, and disruptive behaviors (Bender et al., 2018; Black, 2015; Carsley et al., 2018; Kallapiran et al., 2015; Klingbeil et al., 2017a; Klingbeil et al., 2017; Maynard et al., 2017; Semple et al., 2017; Zoogman et al., 2015). In the most comprehensive systematic reviews of MBIs in schools to date, Phan et al. (2022) report that, although mindfulness is generally useful for improving youth outcomes, the quality of available evidence also varies by outcome. For example, they report that the strongest evidence (A grade) supports MBIs in schools for improving resilience and reducing anxiety, whereas strong evidence (B grade) indicates MBIs are effective for boosting the quality of social relationships, self-regulation, attention, and academic performance, among other things.

It now seems well-established that MBIs can be used effectively as school-based prevention, and that most MBIs used in schools are geared toward universal or Tier 1 programming (Renshaw et al., 2022). However, there is little empirical guidance regarding how to effectively use and adapt MBIs for supporting the mental health outcomes of diverse and marginalized students in school settings (DeLuca et al., 2018). Just as there is with other EBIs (Phan & Renshaw, 2023), there is significant need for guidance regarding cultural adaptations and context-specific delivery practices when implementing MBIs with marginalized youth (Phan & Renshaw, 2024).

Research indicates that high-quality interventions are rarely implemented with fidelity in diverse, under-resourced schools (Domitrovich et al., 2008). A recent report from the Adequacy and Fairness of State School Finance Systems reported that diverse youth are twice as likely than their White peers to attend under-resourced schools (Baker et al., 2022). The report also noted that educational spending for diverse youth was 13–21% below adequate levels compared to the White student population, which spends 21% above adequate levels. Delivering MBIs in schools must therefore take into consideration certain contexts in which these interventions are implemented with diverse youth in under-resourced schools. Schools are often under-resourced and under-funded, which results in fractured intervention practices including nonaligned teams spanning differing community agencies, limited staff involvement, and undertrained employees (Eiraldi et al., 2015). Given the limited resources, many of these schools do not have a school counselor, less than two-thirds have a school psychologist, and less than half have a social worker (Allensworth, 2014). Given that counselors, school psychologists, and social workers play a vital role in providing prevention and intervention, under-resourced schools facing the shortage of these professionals have further barriers to access universal prevention.

Purpose of the Present Paper

The purpose of this paper is to address this issue constructively by providing practice guidelines for increasing access to MBIs in under-resourced schools. We begin by presenting a brief overview of common ecological barriers to implementing MBIs in under-resourced schools, paired with potential solutions to these barriers. Following, we offer recommendations for de-implementing outdated interventions and implementing MBIs instead. Finally, we discuss how applying the Adapting Strategies to Promote Implementation Reach and Equity framework (ASPIRE; Gaias et al., 2022) can help guide culturally sensitive and equity-focused adaptations to MBIs in under-resourced schools. Ultimately, we hope these guidelines may prove useful for school staff who are interested in implementing MBIs via universal programming.

Addressing Ecological Barriers to Implementing MBIs

Implementing MBIs in under-resourced schools may be challenging for several reasons. Mental health teams consisting of both school district employees (e.g., school psychologists, counselors, social workers) and community mental health agency employees are often used in under-resourced schools (Markle et al., 2014). Having multiple providers from different organizations may lead to a system of care where goals are not aligned and roles and responsibilities are unclear (Eiraldi et al., 2015). Furthermore, in under-resourced schools, staff are often limited and competing priorities could potentially exacerbate staff shortage for MBI implementation in these settings (Caskey & Kuperberg, 2014). Although school-based support staff and other employees are often not trained in implementing MBIs, they might nevertheless be responsible for implementation even if they do not agree with that role or see it as a priority within the school (Benjamin et al., 2014).

We will discuss how to address ecological barriers to implementing MBIs in under-resourced schools via the four levels of Domitrovich et al.’s (2008) contextual framework: the individual-level, team-level, school-level, and macro-level. Addressing each of these four levels of context ensures high-quality implementation of both the intervention model and the support system for sustaining it. It is important to discuss barriers to implementation since schools’ experience slow adoption of EBIs into daily practice, which limits their effects on youth outcomes (Owens et al., 2014). Although MBIs may be incorporated in schools, they are seldomly implemented with fidelity or sustained over time, which is a concern given the link between high-quality implementation and desirable changes in youth social, emotional, and academic outcomes (Phan et al., 2023; Pipkin et al., 2010). As such, addressing the gap between research and practice is key to moving beyond development and efficacy studies to actually improving dissemination and implementation of MBIs by school staff. Moving forward, the term school staff will be used to refer to school psychologists, prevention specialists, educators, administrators, and anyone else responsible for implementation efforts.

Levels and Kinds of Barriers

Several individual-level factors that can impede implementation are professional characteristics, psychological characteristics, and perceptions of and attitudes toward the intervention (Domitrovich et al., 2008). Professional characteristics include the implementer’s training, experience, and attitudes toward the MBI, whereas psychological characteristics may include the individual’s anxiety, anger, or other emotions about the MBI. One logistical issue related to individual-level factors is the challenge for school staff in choosing the proper mindfulness exercise due to a lack of a central clearinghouse where all MBI programs can be examined and compared. For example, evaluative listings of MBIs for potential use in schools may be found via systematic reviews and meta-analyses, which may not be accessible to under-resourced schools (e.g., Carsley et al., 2018; Felver et al., 2016; Phan et al., 2022; Segal et al., 2021; Zenner et al., 2014). Instead of having a unified resource for reviewing MBIs, school staff tend to be responsible for navigating multiple resources with the assumption that they have access and funding to research articles. School staff also tend to be responsible for determining appropriate treatment protocols by deciding among different systems for evaluating and rating evidence supporting MBIs.

Beyond individual-level factors, under-resourced schools may face team-level challenges related to staff allocation, expertise level, and turnover that affect implementation and sustainment of EBIs such as MBIs (Markle et al., 2014; Mellin & Weist, 2011; Rubinson, 2002). The biggest barrier for any school-based team is not having enough time (Mellin & Weist, 2011). Staff turnover has also been reported to be the highest among teachers and non-teaching professionals in under-resourced schools (Mellin & Weist, 2011). As a result of high turnover, schools may have to train a new group of school staff each year. In under-resourced schools, EBIs related to mental health tend to be led by members in the school district or community mental health employees (Markle et al., 2014). Due to school staff shortages in under-resourced schools, teaching duties may be assigned to non-teaching staff such as school counselors and social workers (Fiscella & Kitzman, 2009). Consequently, this may reduce the availability of using EBIs in schools that would greatly benefit from their use.

In addition, school-level barriers may include funding and pragmatic issues related to the fit of the intervention setting (Forman et al., 2009; Glisson, 2007). Expenses related to using MBIs can be high due to the proprietary nature of protocols. Furthermore, interventions that require additional training or ongoing developer support may require additional costs. Interestingly, a recent systematic review evaluated the cost of MBIs and found that they are less costly and more effective than EBIs such as cognitive behavioral therapy (Zhang et al., 2022). However, this does not necessarily mean they are cost-free or even low-cost. Moreover, the preservation of fit between the intervention and context is important to consider. For example, the racial, ethnic, language, and socio-economic demographics of students may change in schools over time. These evolving demographics may affect the ability of the intervention to be culturally sensitive due to language barriers or changing in family attitudes towards the intervention (Eiraldi et al., 2015).

Finally, at the macro-level, community factors influence the quality of EBI implementation within under-resourced schools, such as policies and financing, partnerships within the community, service fragmentation, and coordination of care (Cammack et al., 2014; Guevara et al., 2005). These factors include characteristics of the intervention, characteristics of families using the service, and financial cost (Eiraldi et al., 2015). Since under-resourced schools may be targeted for new initiatives (Ahram et al., 2011), the implementation and sustainability of EBIs such as MBIs could be affected especially if it creates negative attitudes towards new initiatives. Other macro-level barriers may include the lack of participation from students and high dropout rates, which would influence intervention outcomes and add to the financial burden of the under-resourced schools investing in these services (Gross et al., 2011).

Potential Solutions to Barriers

To address individual-level factors, we suggest (a) having a support system for school staff, (b) addressing beliefs and attitudes toward implementation of MBIs, and (c) sustaining individual efforts by providing staff with consultative support from researchers and providing periodic booster training sessions. Regarding a support system for school staff, having an effective system of internal supervision may be beneficial. Train-the-trainer models have been successful in community mental health agencies and a similar approach could be applied in school settings (Southam-Gerow et al., 2014). For example, consultants with expertise in MBIs could become program administrators, and then these administrators could train and supervise school staff that provide direct services in schools.

Regarding beliefs and attitudes toward implementation of MBIs, it may be useful to access school staff beliefs about MBIs early on during the planning for implementation. These individual-level barriers could be addressed by identifying and correcting any misperceptions about MBIs. For example, a workshop could be developed to address attitudes toward MBIs and reinforce school staffs’ intentions to use MBIs before they are trained in the implementation (Cook et al., 2015). It is also important to gather parents’ beliefs and attitudes toward implementation of MBIs with their children at school. This conversation can be initiated by disseminating information about MBIs via written materials to send home or by contacting parents via email. It is recommended that parents are provided space to ask questions or express concerns by scheduling a time for discussion with a phone call, video conference, email, or even text message. Alternatively, a series of informational meetings may be held at a convenient time (e.g., virtual or in-person) for families to attend to learn more about MBIs. We suggest this latter approach may be an especially efficient and constructive way to gather support and alleviate parent concerns around new programs in the schools.

Regarding sustaining individual efforts, research shows that sustainment is only possible when teachers are motivated to continue the intervention after external support is no longer available (Han & Weiss, 2005). In this case, school staff commit to the sustainment of interventions when they experience success in the implementation, have administrative support from the school, and have the needed expertise to adapt the intervention to changing circumstances (Han & Weiss, 2005). Ongoing consultation and recurrent booster training sessions on MBIs may be provided by in-house leaders or community partners as a cost-effective sustainment strategy for under-resourced schools (Herschell et al., 2010).

Potential solutions for team-level factors involve (a) holding regular meetings to establish role clarity and responsibilities of MBI implementation, (b) discussing barriers and effectiveness of the implementation, (c) training someone at the administrative level in addressing staff turnover, (d) finding ways to accommodate and support school staff through their various needs and priorities, as well as (e) improving teamwork. Schools should be intentional about role clarity for the school staff tasked with implementing MBIs by holding regular check-in meetings. During the meeting, responsibilities are reviewed, and barriers to implementation should be discussed with the intention of generating feasible solutions. If possible, school administrators are encouraged to be involved in these meetings to provide resources, time, feedback, and support to the interdisciplinary team implementing the intervention (Markle et al., 2014). Furthermore, training administrative staff in MBIs is one potential solution for staff turnover as they are less likely to leave (e.g., assistant principal), although we recognize that this may require the individual to fill multiple supervisory roles. To accommodate and support the competing needs and priorities of MBI implementers, school staff and administrators could be brought together to find ways to develop an effective system to prioritize, communicate, and share information around the intervention. To improve teamwork, team training interventions such as TeamSTEPPS are recommended, which has been shown to improve communication, leadership, support, and role clarity in school teams (Wolk et al., 2019).

To address school-level factors related to lacking resources, we recommend following the ecological model developed by Cappella et al. (2008) that addresses contextual factors in under-resourced schools. This model focuses on learning goals within the context of EBI implementation, which could be conceptualized as mental health goals. Used in this way, schools with limited funding could promote learning while also addressing the mental health needs of youth using MBIs (Cappella et al., 2008). To improve the pragmatic issues related to the fit of the intervention setting, teachers are encouraged to first try a free sample mindfulness course with their classroom to gauge their personal and classroom interest and feasibility (Mindful Schools, 2019). If interest is expressed, the school may invest in a mindfulness workbook that could be shared among teachers and school staff through photocopies (Jennings, 2015). We also recommend adapting MBIs by shortening sessions to save on implementation time and implementer costs, as brief mindfulness exercises may still offer benefits to well-being (Fincham et al., 2023). Given that our recommendations are based on a Tier 1 classroom format, the intention is to serve more students in schools with fewer resources. Further, finding alignment between MBIs and the school’s philosophy, goals, policies, and other programs could increase buy-in from administration (Domitrovich et al., 2008). This alignment information may be used to increase the fit of MBIs within under-resourced schools.

To address macro-level factors, we suggest encouraging multisystem collaboration (i.e., partnering with administration in schools, other community mental health agencies, and parents of youth attending the school). Related to parent engagement, it is important to assess and acknowledge their values and expertise about their children. Families have different childrearing values and styles based on their histories, culture, income, and neighborhood environments (LeCuyer et al., 2011). For example, parents raising children in neighborhoods with gangs and violence are likely to have different rules and discipline than those raising children in resource-rich environments (Cruz-Santiago & Ramírez García, 2011). In acknowledging parents’ values and expertise on their children through group discussions about MBIs and problem-solving any misconceptions around the intervention, MBIs can be adapted to be flexibly applied with youths whose parents have wide-ranging cultural beliefs and attitudes. With parent engagement, it is also important to appreciate that they want to be good parents and to give them positive attention for their efforts in understanding and being open to their children participating in MBIs in schools. As such, collaboration with parents may present an opportunity for them to learn that MBIs for their children may also support their parenting in ways that are consistent with their goals and values (Gross et al., 2014).

Table 1 provides a summary of the ecological barriers to implementing MBIs in under-resourced schools, along with our proposed potential solutions. We suggest school staff might use this scheme as a guide for identifying local barriers and then problem-solving toward more effective implementation of MBIs. If school staff identify multiple barriers at multiple levels, we certainly do not recommend trying to address all these simultaneously, as that would be unrealistic and infeasible. Rather, we suggest identifying the most tractable barriers, rank-ordering these tractable barriers in terms of potential for success if addressed, and then moving forward by focusing on the most tractable barrier with the highest probability of success. Once that particular barrier is addressed, this triaging process may be repeated, as needed, to continue addressing additional barriers that might further increase access to MBIs within the school.

Table 1 Summary of ecological barriers, de-implementation barriers, ASPIRE framework and major recommendations
Full size table

De-Implementing Ineffective Programs

When working in under-resourced schools, it is necessary to consider effective and equitable resource allocation to ensure that sufficient resources can support the implementation of MBIs. When ineffective programs are continued despite data indicating that they are ineffective or no longer needed, under-resourced schools may be prevented from adopting more effective EBIs such as MBIs (Nadeem & Ringle, 2016). Several studies have shown that the discontinuation of ineffective programs is just as important as the adoption of new EBIs (Niven et al., 2015; Prasad & Ioannidis, 2014). De-implementation, defined as discontinuing or abandoning practices and programs that are not effective, less effective, or less cost-effective than an alternative practice, is therefore the focus of this section. We discuss and illustrate ways that de-implementation can lead to more access to MBIs in under-resourced schools.

Although de-implementation has received more emphasis in public health and health service settings, it also has clear benefits for under-resourced schools, such as more efficient resource allocation and a higher return on investment (Lobb & Colditz, 2013; McKay et al., 2018; Prasad & Ioannidis, 2014). Among school staff, school psychologists may be ideal for leading the de-implementation process given their training in data-based decision-making, problem-solving, consultation, and collaboration. However, with the national shortage of school psychologists and the lack of resources in many districts to hire more school psychologists (National Association of School Psychologists, 2023), we suggest that administrators may also be critical in the de-implementation initiative. Given that a guide to de-implementation in schools has already been provided by Clinkscales et al. (2023), we refer readers to that resource and instead expand on additional factors to consider when de-implementing programs in under-resourced schools (DeWitt, 2022).

There may be various reactions from school staff in under-resourced schools related to de-implementation. School staff might be skeptical or resistant to de-implementing programs or perceive it as an attempt to withhold access to evidence-based care (Prusaczyk et al., 2020). If the school staff are already facing these disparities, de-implementation efforts might cause distrust with the staff or team proposing the de-implementation and put a strain on the relationships within the school community. In other words, if the under-resourced school suspects that they are discriminated against and not receiving equal access to EBIs, the de-implementation efforts might be perceived as further evidence of discrimination. To address such distrust or perceived discrimination, we recommend using Christopher et al.’s (2008) strategies for building and maintaining trust between community members. Recommendations for building trust include (a) acknowledging personal and institutional histories, (b) understanding the historical context of the program, (c) being present in the school and listening to school staff, (d) acknowledging the expertise of everyone involved, and (e) being upfront about expectations and intentions (Christopher et al., 2008).

Further, even if they are ineffective, some of the existing programs might have significant importance to the school’s community or culture, which may result in school and other community members potentially resisting de-implementation efforts. For example, art and music have a basis in cultural values and shared experiences of communities, so targeting programs that include these elements may result in unintended but aversive reactions within or outside the school. Therefore, it is important to consider the community and cultural relevance when suggesting the de-implementing of programs in under-resourced schools.

Finally, school staff factors are not always prioritized when de-implementation is suggested. For instance, school staff in under-resourced schools might be facing burnout and may not have enough time to de-implement a program, as stopping programming that has become habitual can require intentional effort and management. As a result, school staff may not be motivated to incorporate MBIs because they may not see the direct benefit of de-implementing existing programs. Explaining and persuading the school staff that they should de-implement a program to implement a new MBI program may thus be challenging. Fostering motivation to change would require the school staff to be in an altruistic position, which may be difficult given the additional challenges mentioned previously. A study has found that when de-implementation was explained to patients with an altruistic pitch, patients did not respond favorably and rated the providers who made the altruistic pitch more negatively (Riggs et al., 2017). To address these barriers, it is important for the school to gather data and make an assessment on the need for de-implementation. Being clear, transparent, and framing de-implementation of programs as an opportunity for improvement while providing data could aid in the school staff’s understanding of the de-implementation relevance. School staff may not be motivated to incorporate MBIs if they do not understand why de-implementation is needed in the first place. Therefore, we recommend making time to listen to school staff’s concerns around de-implementation of the program and involving school staff in the de-implementation process. Including school staff in the process and asking for their input could increase their sense of empowerment and buy-in.

See Table 1 for summary of de-implementation barriers and our associated recommendations for addressing these. Using the ecological framework discussed in the previous section, it is possible that de-implementation barriers may also be encountered at the individual-level, team-level, school-level, and macro-level. However, the nature of these barriers does not necessarily change across levels; rather, it is the scope of who the barrier affects that changes. For example, distrust and burnout can affect individuals, teams, and whole school communities—yet the fundamental barriers are still the same (i.e., distrust and burnout). Therefore, we recommend that school teams using this scheme (see Table 1) to identify and problem-solve de-implementation barriers take a three-step process: first, identify the nature of the barriers (e.g., distrust vs. burnout); second, identify the scope or ecological level of each barrier (e.g., individual vs. team); and third, prioritize which barriers have the highest probability of being effectively addressed, given their nature and scope. Relatedly, to prevent problem-solving fatigue, we also suggest these efforts should be considered and prioritized in light of ongoing or simultaneous efforts to address the aforementioned ecological barriers to implementing MBIs in schools (see Table 1).

Adapting Strategies to Promote Implementation Reach and Equity

Despite evidence that de-implementation of programs can be effective, there are continued disparities in appropriateness, effectiveness, quality, and outcomes of care for EBIs in under-resourced schools (Eiraldi et al., 2015). Research has shown that cultural misalignment between students of color and White providers and the cultural relevance of the services have been identified as barriers to access, retention, and quality of care (Kapke & Gerdes, 2016; Wang et al., 2020). This is especially important to consider with the implementation of MBIs in under-resourced schools if school staff or community partners proposing the intervention are from an out-group (i.e., any group to which one does not belong or with which one does not identify). In order to reduce disparities in under-resourced schools, it is imperative to increase the cultural relevance of MBIs for students from marginalized backgrounds while also considering the potential for the implementation of the MBI to mitigate inequities (Brown et al., 2018; Malti et al., 2016; Renshaw & Phan, 2023). We will discuss and illustrate how using Gaias et al.’s (2022) ASPIRE framework can help guide culturally sensitive and equity-focused adaptations to MBIs, which can, ultimately, contribute to making MBIs more accessible in under-resourced schools.

The first step in the ASPIRE framework requires an understanding of the assumptions underlying the MBI implementation. It is crucial to consider the assumptions that are being made about how and why the MBI is supposed to work and for whom it works. Does it work for the specific students in under-resourced schools? Who will be implementing the MBI? Further, how will the MBI be implemented successfully and promote the intended outcomes for students more generally? In other words, what needs to be true about the MBI for it to promote equitable outcomes beyond successful implementation or student outcomes? For example, the primary assumption behind implementing an MBI in an under-resourced school may be that it will provide students with improved mental health outcomes (e.g., increased prosocial behavior, executive functioning, mindfulness; decreased anxiety and conduct problems) and the school with a cost-effective and sustainable intervention. Another assumption may be that there is buy-in from the school staff to implement the MBI. Additionally, the implementation of the MBI likely assumes that school staff will have ongoing support from in-house experts or community partners to sustain the intervention.

The second step in the ASPIRE framework is to think about the potential sources of disparities that may occur if the MBI is used without explicit attention given to equity. Factors to consider include (a) the individuals involved in creating the MBI (e.g., researchers, teachers, students), (b) the resources needed to implement the MBI, (c) the process required to implement the MBI, (d) the causal mechanisms that underlie the MBI (i.e., the key ingredients that make the MBI work for this particular population within this specific setting), and (e) the potential outcomes of the MBI. In under-resourced schools, the power dynamics between the community partners who are promoting an MBI and school administrators who are seeking support for their students could lead to ulterior priorities that potentially dilute the school’s needs. For example, those promoting the MBI may be supported by external funding opportunities (e.g., grants from private foundations or federal agencies) and staffed by those with formal mindfulness training. Therefore, those involved in promoting the MBI might include disproportionate representation of White, well-connected, and well-resourced individuals. As a result, those promoting the MBI may not reflect the lived experience, values, and goals of the school community. The MBI implementation may thus be less likely to resonate with the school staff and students who may have different backgrounds and, thus, have different goals and values.

It is important to note that implementation disparities may still exist even if diversity and representation are included as part of community partners’ efforts to collaborate with school staff in implementing MBIs. Even when striving for nonhierarchical group collaboration, not all school and community members will share the same goal and values, so it is imperative that school staff are provided with safe opportunities to vocalize disagreement with partners who are promoting the implementation. The idea is to support collaborative infrastructure that prevents school staff members from being tokenized, discounted, ignored, or not taken seriously, as these discriminatory experiences serve to maintain power structures that will negatively impact the social validity of the intervention (Hahn et al., 2016).

The last and final step in the ASPIRE framework is to identify what needs to change in the implementation of the intervention in order to prevent disparities, so that equity is considered in the underlying assumption. In this step, it is crucial to identify concrete changes that could enhance equitable MBI implementation and student outcomes. Things to consider include (a) the necessary people involved in implementation (e.g., school staff and students), (b) the process or steps that need to be taken to incorporate the MBI into school routines and culture, and (c) the valued outcomes that need to be considered. Focusing on the representation, inclusion, and authentic participation of communities in under-resourced schools includes recruitment efforts that include a wide variety of methods to engage school staff and students. The goals, process, and structure of the school staff collaboration should be developed and communicated clearly with an intentional process for identifying and removing barriers to collaboration. Efforts to build trust, engagement, and psychological safety are needed to ensure equitable policies and practices. Further, there should be consensus for shared decision-making practices between the school staff and community promoters when conflicts arise as a result of the MBI implementation process.

Conclusion

Given the need to increase the availability of mental health services in schools and the potential of MBIs as universal prevention, the purpose of this paper was to provide practice guidelines for increasing access to MBIs in under-resourced schools. Our guidelines can be distilled as follows:

  1. 1.

    Identify and address ecological barriers—at the individual-level, team-level, school-level, and macro-level—to implementing MBIs.

  2. 2.

    Address barriers to de-implementing ineffective programs to make room for the uptake of MBIs.

  3. 3.

    Apply the ASPIRE framework to develop more culturally sensitive and equity-focused adaptations of MBIs.

We hope these guidelines may prove useful for school staff who are interested in implementing MBIs via universal programming. Moreover, we acknowledge the inequities and disparities that students experience in under-resourced schools compared to their peers in well-resourced schools, which are further complicated by systemic political, social, economic, and cultural barriers. By addressing ecological barriers, de-implementing ineffective programs, and using equitable implementation strategies, school staff may be more empowered to use and sustain MBIs for the benefit of their students. Despite the benefits that MBIs might have, we further acknowledge that there is little research guiding how MBIs should be used in under-resourced schools. To address this knowledge gap, we encourage researchers and policymakers to empirically examine our recommendations for further advancement of evidence-based and equitable practices to improve the mental health of students in under-resourced schools.