57 Mindfulness-Based Stress Reduction for elementary school teachers: a randomized controlled trial pupil-teacher relationships, and classroom climate quality. Employing a pre-registered RCT design with follow-up assessments and a substantial sample size, we also explore proximal outcomes such as mindfulness skills, emotion regulation, and self-compassion. Distinguishing itself from previous research (e.g., Roeser et al., 2022; Emmerson et al., 2017; Klingbeil & Renshaw, 2018), this study utilizes a larger sample, extended follow-up, and evaluates the impact of mindfulness training on teachers at various career stages, in diverse school environments, and of different ages. To advance our understanding of program impacts, it is crucial to extend these studies to elementary and secondary school teachers worldwide, promoting a sustainable field marked by diverse replications. Potential moderators Elementary school teachers form a diverse cohort, prompting an exploration of potential moderators influencing the impact of the MBSR program. The preliminary pilot, conducted prior to this RCT (Lensen et al., 2022), indicated a potential magnified effect of MBSR on teachers who have or had psychological challenges, especially those working in schools with pupils facing a higher risk of educational disadvantage, as quantified by school weight in the present study. In the Netherlands, school weight is a government metric objectively assessing the complexity of the educational environment. It assigns significance to specific pupil characteristics, ensuring additional funds for schools to support high-risk pupils and address educational inequalities (Statistics Netherlands, 2019). In addition, a recent study (Roeser et al., 2022) revealed that an adapted MBI for teachers (grade 6-8) had more positive outcomes for newer teachers (experience < 5 years) in terms of job stress, self-compassion, and classroom organization compared to experienced teachers. Moyano et al. (2021) observed that greater teaching experience was associated with increased reliance on automatic pilot mode, leading to reduced focus. Additionally, Huang et al. (2020) noted that as teaching experience increased, empathic concern decreased, perspective taking diminished, and personal distress increased. Although age was often unrelated in previous research (e.g. Moyano et al., 2021; de Carvalho et al., 2021) we included it due to an increasing number of lateral entries in the primary education sector in response to the teacher shortage. These teachers, though older, have accumulated fewer years of work experience in education compared to their younger colleagues potentially resulting in distinct experiences and lessons derived from the intervention. Hypotheses Drawing upon insights from prior research (e.g., Klingbeil & Renshaw, 2018; Emerson et al., 2017; Hwang et al., 2017; Roeser et al., 2022; Tang et al., 2015), our hypothesis posits that elementary school teachers participating in the MBSR program will exhibit enhanced mental health. This enhancement is substantiated by anticipated reductions in stress (primary outcome) and improvements in personal well-being (secondary outcome), as compared to teachers in the waiting list control group, evident in both post-test and threemonth follow-up assessments. Moreover, we anticipate positive developments in various secondary outcomes, categorized as proximal and distal. Proximal outcomes denote 4
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