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

NCT07644182 | Completed

• 2 other identifiers: NSM-YT-2026E-60116787-020-704556
• Study Type: interventional
• Target: 162
• Locations: 1 country
• Sites: 1

Brief Summary

This cluster randomized controlled trial evaluates the effects of a yoga therapy program grounded in the Neuman Systems Model on test anxiety, quality of life, and mindfulness among eighth-grade students aged 13-14 years in Denizli, Türkiye. The study was conducted with students preparing for the national High School Entrance System (LGS) examination. A total of 166 eighth-grade students were allocated to intervention and control groups at the school level. The intervention consisted of a structured yoga therapy program delivered once weekly for four weeks. Outcomes were assessed using standardized measures of test anxiety, quality of life, and mindfulness at baseline, mid-intervention, and post-intervention. The study received ethics committee approval, institutional permissions, and written informed consent from parents or legal guardians.

Conditions

Test Anxiety in Adolescents

Keywords

Yoga therapy; Neuman Systems Model; School-based intervention; Cluster randomized controlled trial; Mindfulness; Stress management; Adolescents

Outcome Measures

Primary Outcomes (1)

• Test Anxiety (Westside Test Anxiety Scale score)

  Measured using the Westside Test Anxiety Scale (WSKÖ) to assess changes in students' exam-related anxiety levels in a school-based yoga intervention.

  Baseline (prior to the first intervention session), Week 2 (after completion of Session 2), and Week 4 (after completion of Session 4)

Secondary Outcomes (2)

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

  Baseline (prior to the first intervention session), Week 2 (after completion of Session 2), and Week 4 (after completion of Session 4)

• Mindfulness Level (BAU Child and Adolescent Mindfulness Scale score)

  Baseline (prior to the first intervention session), Week 2 (after completion of Session 2), and Week 4 (after completion of Session 4)

Study Arms (2)

School-Based Yoga Therapy Group

EXPERIMENTAL

Participants in the experimental group received a school-based yoga therapy program developed in line with Neuman Systems Model. The intervention included structured yoga sessions focusing on breathing exercises, physical postures, relaxation techniques, and mindfulness practices. Sessions were delivered by the researcher during school hours for a specified intervention period. The aim of the program was to reduce test anxiety and improve mindfulness and quality of life among secondary school students.

Behavioral: School-Based Yoga Therapy Program

Control Group

NO INTERVENTION

Participants in the control group received no additional intervention beyond the routine school curriculum. No yoga, mindfulness, or relaxation-based activities were implemented for this group during the study period. The group functioned as a no-intervention control condition for outcome comparison.

Interventions

School-Based Yoga Therapy Program BEHAVIORAL

Participants received a structured school-based yoga intervention based on the Neuman Systems Model, including breathing exercises, physical postures, relaxation, and mindfulness practices. The intervention was delivered during school hours in structured sessions over a defined intervention period. The aim was to reduce test anxiety and improve mindfulness and quality of life among secondary school students.

School-Based Yoga Therapy Group

Eligibility Criteria

• Age: 13 Years - 14 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17)

You may qualify if:

• Being enrolled as a secondary school student
• Aged 13-14 years
• Willing to participate in the study
• Having parental consent and student assent

You may not qualify if:

• Any physical or mental condition that interferes with participation in yoga-based activities
• Previous regular experience with yoga or mindfulness practice
• Absence during the intervention period or inability to complete study procedures
• Refusal to participate 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: Participants were assigned to intervention and control groups using cluster randomization at the school level. Two schools were randomly selected from eligible schools and then randomly allocated to either the intervention or control group. The intervention group received a four-week yoga therapy program, while the control group continued their usual school activities. Outcome measures were assessed at baseline, mid-intervention, and post-intervention. Cluster randomization 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: June 12, 2026

Record last verified: 2026-06

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)