59 Mindfulness-Based Stress Reduction for elementary school teachers: a randomized controlled trial study design. In the first school year, recruitment of teachers took place between June and late August 2019 (n = 41 teachers), in the second between March and August 2020 (n = 50 teachers) and in the last between March and August 2022 (n = 55 teachers). It is important to notice that the COVID-19 pandemic started in March 2020, between school year 1 and 2. The study protocol was ethically approved by the Internal Review Board (IRB) of the faculty of social sciences Radboud University and is registered under number ECSW2019-029. The protocol details are available in a publication by Lensen et al. (2021). . Participants Figure 3 Consort flow diagram The study population consisted of 146 Dutch elementary school teachers from 62 different public elementary schools who taught groups 1 to 8, comparable to grades 1 to 6 in the US school system. Of the 152 teachers who had registered to participate, six teachers did not meet the inclusion criteria. See Figure 3 for an overview of the Consort flow diagram. Inclusion criteria were: a) teaching at least two days a week in the same year group (1 to 8), during a school year between September and March (moment of follow-up); b) willing and able to fill out questionnaires in Dutch three times during a school year; and c) being able to start MBSR in both September and March. Exclusion criteria were previous participation in a MBI or a mindfulness-based workshop lasting more than three hours. 4
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