83 Potential mediators in a Mindfulness-Based Stress Reduction program for elementary school teachers to reduce perceived stress and improve well-being and classroom climate: A multiple mediation model regulation and teacher self-efficacy serve as mediators in the impact of the MBSR program on teachers’ perceived stress, well-being, and classroom climate quality. Our hypothesis posits that these variables serve as mediators in the effectiveness of the MBSR program. METHODS Participants In total, 146 Dutch school teachers who taught group 1 to 8 from 62 different elementary schools were included in this study. Of the 152 teachers that were interested in participating in the study, six teachers did not meet the inclusion criteria. After randomization, eight teachers withdrew their participation because of several reasons (e.g. job switch or choose to follow another training). In total, 138 teachers participated in the study. The final sample included 138 participants, divided into three cohorts: cohort 1: 35 participants (20192020), cohort 2: 48 participants (2020-2021) and cohort 3: 55 participants (2021-2022). Procedure Design An RCT was conducted with two conditions: an intervention condition (MBSR program) and a wait-list control condition. For the randomization, participants were stratified by gender (male versus female) and school weight (< regional average versus ≥ regional average). In the Dutch context, school weight is an indicator of the complexity of the pupil population. A higher score on school weight, means a more complex pupil population and lower expected learning results of the school (Posthumus et al., 2019). The intervention group started with MBSR in September, the wait-list control group started with MBSR in March (after the follow-up measurement). Three measurements were conducted: T0 (pre-test), T1 (post-test) and T2 (three-month follow-up). Data was collected in school years 2019-2020, 2020-2021 and 2021-2022. Ethical approval for this study was provided by the Internal Review Board Ethics Committee Social Science, Faculty of social sciences Radboud University, 06 June 2019, Reference number: ECSW-2019-029. The study is registered in the Dutch Trial Register (Trial 21817). More information about the study design can be found in the study protocol Lensen et al. (2021). Study setting In the Netherlands, elementary schools consist of eight grades (group 1 to 8). Pupils in class 1 to 8 are between 4 and 12 years old. These groups are comparable to grades 1 to 6 in the school system of the United States of America. 5
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