The outcome measures are described in Table Table11.

Description of outcome measures, assessed at baseline, 3 and 6 months among schoolchildren, the SELFCARE project

We use self-reported changes from baseline in the SDQ total difficulties score [32] by the pupils as the primary outcome. SDQ measures behavioural and emotional functioning and social competencies, which is highly relevant according to WHO´s definition of mental health e.g. the ability to manage thoughts, emotions, as well as to build social relationships [1]. SDQ is recommended as a measure of child well- being in community settings such as schools [33].

Our primary end-point is 6 months after baseline. Our primary study population is the vulnerable sub group with a SDQ total difficulties score above the 80th percentile [34]. They will be taught the “.b” programme together with the whole class as a part of compulsory class room teaching.

Changes from baseline in all other outcomes described in Table Table11 are secondary outcomes. We evaluate the effectiveness in a vulnerable sub group, in boys, in girls and among the total pupil population.

Reasons for teachers discontinuing the trial will be registered. We also register teacher participation in the training programme. The following is required for the school teachers to acquire the “b”-teaching certificate: (1) completing at least six out of nine MBSR sessions, (2) a four-day residential course, and (3) at least two out of three seminars on relational competences and implementation issues on teaching “.b”. Furthermore, we will register the number of sessions of the “.b” programme that school teachers teach in the classes they enrolled in the trial. The school teacher training programme includes information on the potential adverse effects associated with mindfulness [35, 36]. The school teachers will be encouraged to report all observed adverse events.

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