Neuman Systems Model-Based Yoga Program for Test Anxiety in Secondary School Students

NCT07644182 | Completed

• 2 other identifiers: NSM-YT-2026E-60116787-020-704556
• Study Type: interventional
• Target: 166
• Locations: 1 country
• Sites: 1

Brief Summary

This cluster randomized controlled trial evaluated the effects of a yoga program based on the Neuman Systems Model on test anxiety, quality of life, and mindfulness among eighth-grade students. A total of 166 students were enrolled in the study, with 81 students in the intervention group and 85 students in the control group. The intervention group participated in a four-week school-based yoga program delivered once weekly for approximately 40 minutes during regular school hours, while the control group received no intervention. The yoga program incorporated breathing awareness, asana practice, pranayama, relaxation, and brief mindfulness practices and was developed based on the protective approach of the Neuman Systems Model. Test anxiety, quality of life, and mindfulness were assessed at baseline, at the end of Week 2, and at the end of Week 4 using self-report measures.

Conditions

Test Anxiety

Keywords

yoga; Neuman Systems Model; Test Anxiety; Quality of Life; Mindfulness; School-Based Intervention; Adolescents; Cluster Randomized Controlled Trial

Outcome Measures

Primary Outcomes (1)

• Test Anxiety (Westside Test Anxiety Scale score)

  Test anxiety was assessed using the Westside Test Anxiety Scale (WSKÖ). The scale consists of 11 items rated on a five-point Likert scale. Total scores range from 11 to 55, with higher scores indicating higher levels of test anxiety.

  Baseline (before the intervention), end of Week 2, and end of Week 4

Secondary Outcomes (2)

• Health-Related Quality of Life (PedsQL 13-18 Adolescent Form Score)

  Baseline (before the intervention), end of Week 2, and end of Week 4

• Mindfulness (BAU Mindfulness Scale for Children Score)

  Baseline (before the intervention), end of Week 2, and end of Week 4

Study Arms (2)

School-Based Yoga Program

EXPERIMENTAL

Participants in the experimental group received a school-based yoga program based on the Neuman Systems Model. The program was implemented once weekly for four weeks, with each session lasting approximately 40 minutes. Each session included breathing awareness and intention setting, warm-up exercises, asana practice, pranayama practice, and relaxation and brief mindfulness practice. The intervention was delivered by the researcher, who holds a children's yoga instructor certificate, together with a yoga instructor.

Behavioral: School-Based Yoga Program

Control Group

NO INTERVENTION

Participants in the control group continued their usual school program and received no yoga intervention during the study period.

Interventions

School-Based Yoga Program BEHAVIORAL

The school-based yoga program was developed by the researcher based on the Neuman Systems Model in collaboration with two certified yoga experts experienced in children's yoga. The program was implemented once weekly for four weeks, with each session lasting approximately 40 minutes. Each session consisted of breathing awareness and intention setting (5 minutes), warm-up exercises (5 minutes), asana practice (15 minutes), pranayama practice (5 minutes), and relaxation and brief mindfulness practice (10 minutes). Before the first session, a WhatsApp group including students and their parents was established for intervention-related communication. After each session, breathing-practice reminders, affirmation statements, and brief home practices were shared to support the transfer of skills into students' daily lives.

School-Based Yoga Program

Eligibility Criteria

• Age: 13 Years - 15 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17)

You may qualify if:

• Being an eighth-grade student Having no physical or mental health condition that would prevent safe participation in yoga

You may not qualify if:

• Regular participation in yoga or another mindfulness-based practice Withdrawal from participation in the study

Sponsors & Collaborators

• Pamukkale University: lead

Study Sites (1)

Public Secondary Schools

Denizli, Pamukkale, 20070, Turkey (Türkiye)

Location

Related Publications (2)

• Khunti K, Boniface S, Norris E, De Oliveira CM, Nicola Shelton. The effects of yoga on mental health in school-aged children: A Systematic Review and Narrative Synthesis of Randomised Control Trials. Clin Child Psychol Psychiatry. 2023 Jul;28(3):1217-1238. doi: 10.1177/13591045221136016. Epub 2022 Oct 27.

  PMID: 36302735 BACKGROUND

• Khalsa SB, Hickey-Schultz L, Cohen D, Steiner N, Cope S. Evaluation of the mental health benefits of yoga in a secondary school: a preliminary randomized controlled trial. J Behav Health Serv Res. 2012 Jan;39(1):80-90. doi: 10.1007/s11414-011-9249-8.

  PMID: 21647811 BACKGROUND

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator (PhD Student)

Model Details: Two public secondary schools were selected using purposive sampling. Each school was considered a cluster and served as the unit of randomization. The two schools were randomly allocated to the intervention or control group by an independent researcher using a lottery method. Subsequently, two eighth-grade classes from each school were randomly selected by an independent researcher using a lottery method. Cluster randomization at the school level was used to minimize potential contamination between the intervention and control groups.

Study Record Dates

• First Submitted: June 6, 2026
• First Posted: June 12, 2026
• Study Start: April 30, 2026
• Primary Completion: May 21, 2026
• Study Completion: May 21, 2026
• Last Updated: September 24, 2026

Record last verified: 2026-09

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)