Indian Journal of Health Social Work
(UGC Care List Journal)
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PRELIMINARY PHASE FINDINGS FOR APPLICABILITY OF
MINDFULNESS BASED TRAINING ON PERCEIVED STRESS & MINDFUL
AWARENESS OF HIGHER SECONDARY SCHOOL STUDENTS
Varsha Kriplani1 & Laxmi Narayan Rathore2
1Ph.D. Scholar & 2Associate Professor, Dept of Clinical Psychology, School of Medical, Mizoram
University, Aizawl, Mizoram-796004, India
Correspondence: Laxmi Narayan Rathore, e-mail: laxminarayan21@rediffmail.com
ABSTRACT
Background: Training programs based on Mindfulness are practices that develop an ability to
sustain attention in the present moment non-judgmentally. Such programs have effectively been
used on adults for handling daily life stress, and it has been argued that they could be used
effectively on the child population as well. The present study used the Mindfulness-Based Stress
Reduction (MBSR) module of John Kabat-Zinn, which has been tailored, as per need and
applicability, for school students. Aim: The broad aim was to explore the applicability of Mindfulness
Training on Perceived Stress and Mindful awareness of higher secondary school students in
school settings. Methods and Materials: 10 students of class 10-12 studying in Aizawl city of
Mizoram, India, aged 16-18 years, who signed informed assent, were selected using purposive
sampling and divided into ‘Training and Normal Control’ groups, having 5 students each, after
screening for the presence of any psychiatric condition. Baseline assessments on MAAS-A and
PSS were done for all participants; thereafter, seven MBSR sessions were provided to the
participants of the ‘Training group’, followed by homework assignments. No such training was
provided to the ‘Normal Control’ group. After completion of 7 7-week duration, both groups were
re-assessed using the same psychological tools, and the results were compared. Results: Findings
indicated significant differences between the compared groups on outcome measures, with
noticeable improvement in the perceived stress experiences and mindful awareness in the
participants of the group that received Mindfulness training. Conclusion: The study concluded
that Mindfulness training would be helpful in decreasing stress, improving mindful awareness,
and facilitating the overall learning process for school students.
Keywords: Mindfulness, MBSR, Perceived Stress, School students.
INTRODUCTION
In the present times, most of us are living in
a world where we are constantly surrounded
by endless demands and challenges, leading
to high stress levels for us, and such
challenges are not limited to adults, but also
to the youngsters around us (Semple &
Willard, 2019). Children and adolescents are
experiencing heightened levels of stress,
which further contribute to the emotional
disturbances in the form of increased anger,
anxiety, depression, externalizing behaviors,
lower self-esteem, and confidence (Rempel, 2012). Advancing in school life from secondary
to higher secondary levels required adaptation
to the new stresses, academic workloads, and
much more, on the part of the students
There is a strong argument for implementing
mindfulness practices into the school
curriculum. There is convincing circumstantial
evidence that mindfulness practices improve
well-being. Training programs based on
Mindfulness are practices that induce focus
and attention in the practitioner. It is an
experience that can bring attention to the
present moment with a non-judgmental
attitude (Ma & Fang, 2019). Mindfulness
Meditation (MM), as taught historically by
Gautam Buddha, is an ancient Buddhist
meditation practice characterized as the heart
of the Buddha’s teachings, and is aimed at
reducing mental anguish (Ramel et al., 2004).
Originally developed for chronic pain
management by Jon Kabat-Zinn, the
Mindfulness-based stress reduction (MBSR)
training programs have been effectively used
for the management of anxiety and stress in
adults over the past 2-3 decades.
Several reviews have examined the efficacy
of mindfulness practice on adults, and there
is evidence indicating the positive impact of
mindfulness training and robust evidence for
mindfulness practice. However, the research
with youngsters is not yet as extensive as with
adults, but it is growing rapidly. Published
literature suggests that when children are
struggling with a mental health condition, it
has the potential to inhibit their ability to
neglect meaningless stimuli, which increases
distractibility, poor organizational skills, and
a decreased ability to pay attention to the task
at hand (Rempel, 2012). As mindfulness
brings changes in the way we relate to
ourselves and to our experiences, it can help
students by making them more aware of both
pleasant and unpleasant experiences that
often go unnoticed or unappreciated in our
everyday lives. Enhanced awareness of
positive experiences can also enhance the
richness of those experiences. Increased
awareness of negative or unpleasant
experiences can help the younger ones to
respond to themselves and each other with
greater understanding and skill. It is a
powerful tool to develop social-emotional
competencies, which include self-awareness,
responsibility, personal initiative, planning,
and initiation of goal-directed behaviour,
i nhibition of inappropriate behaviours,
conscious decision making, empathic
communications, compassion for others, and
interpersonal skills in conflict resolution. They
lay the foundation for self-management of
emotions and behaviours throughout life
(Semple & Willard, 2019).
Mindfulness is one such skill and is found to
have benefits in the long term. The existing
literature indicates the effectiveness of
Mindfulness-based intervention on various
mental health conditions; however, most of
the studies were done either on the adult
population or on clinical conditions in students,
such as anxiety disorders, depression, ADHD,
and conduct disorder. Studies done in the
Indian context on students without any mental
health issues are limited in number, and if
present, there is no comparable group in most
of them. Hence, the current study was
planned with the main objective of studying
the effectiveness of the MBSR program for
higher secondary school students on their
levels of stress and attention. For operational
purposes, we hypothesized that there would
be a significant impact of MBSR training on
perceived stress and mindful awareness of
higher secondary school students.
MATERIALS AND METHODS
Aims/Objectives: The Following objectives
were framed for this study:
1. To explore the effect of Mindfulness training on Perceived Stress level in the participants.
2. To see the utility of Mindfulness training on the Mindful awareness of the participants.
Hypothesis:
1. Mindfulness training will have a significant effect on the perceived stress of the participants.
2. Mindfulness training will improve the mindful awareness of the participants.
were framed for this study:
1. To explore the effect of Mindfulness training on Perceived Stress level in the participants.
2. To see the utility of Mindfulness training on the Mindful awareness of the participants.
Hypothesis:
1. Mindfulness training will have a significant effect on the perceived stress of the participants.
2. Mindfulness training will improve the mindful awareness of the participants.
Sample: For this Preliminary phase study, with
pre-post with control design, 10 higher
secondary school students (N=10) studying in
class 12 within age range of 16-18 years, who
gave consent and does not have any
significant neuro-psychological/psychiatric or
medical illness were selected, mixed of
gender using purposive sampling method from
regular English medium school located in the
Aizawl city of Mizoram state, India.
Inclusion Criteria for Both Groups;
◾️Male or Female Regular Students
Studying in Classes 9-12.
◾️Age Between 14-18 Yrs.
◾️ Should Give Written Consent.
Exclusion Criteria of Both Groups
◾️Presence of any significant psychiatric /neurological disorder.
◾️Presence of any significant medical disorder.
◾️ Students Having Any Substance or drugabuse except Nicotine use
◾️Tools:
1. Socio-demographic Data Sheet:
Essential socio-demographic information was
entered in the data sheet, so designed for the
purpose. Before enrolment, initial screening
for the presence of any significant psychiatric
condition was done using the DSM-5-TR Self
Rated Level 1 Cross-Cutting Symptom
Measure for children aged 11-17 years. This
tool is a patient-rated measure that assesses
mental health domains that are important
across psychiatric diagnoses (DSM-5, APA).
This child-rated version of the measure
consists of 25 questions that assess 12
psychiatric domains, including depression,
anger, irritability, mania, anxiety, somatic
symptoms, inattention, suicidal ideation/
attempt, psychosis, sleep disturbance,
repetitive thoughts and behaviours, and
substance use. Each item asks the child to
rate how much (or how often) he or she has
been bothered by the specific symptom during
the past 2 weeks. The measure was found to
be clinically useful and had good test-retest
reliability in the DSM-5.
2. Mindful Attention and Awareness
Scale – Adolescents (MAAS-A), is a 14-item
scale and was used to assess the core
characteristic of mindfulness. The MAAS-A
has shown excellent psychometric properties
in initial research studies. Internal consistency
levels (Cronbach’s alpha) have been above
0.80 in both healthy and psychiatric samples.
The MAAS-A has demonstrated high internal
consistency, test–retest reliability, and both
concurrent and incremental validity (Brown et
al., 2011).
3. Perceived Stress Scale (PSS-10),
developed by Cohen and Williamson in 1988
and was used to assess perceived stress. It
evaluates the degree to which an individual
has perceived life as unpredictable,
uncontrollable, and overwhelming over the
previous month. It consists of 10 questions,
takes 5-10 minutes to complete, and is for
i ndividual or group administration. The
questions ask about feelings and thoughts
during the last month. In each case,
respondents are asked how often they felt a
certain way on a five-point scale from ‘never’
to ‘very often’. Higher scores indicate higher
l evels of perceived stress. Internal consistency reliability for the PSS-10 total
scores was adequate (á = 0.82). PSS-10
scores demonstrated good convergent validity.
Scores on the PSS-10 were significantly
correlated in the expected directions with
scores on the GAD-7 and PHQ-9 (Baik et al.,
2017).
4. Mindfulness Training- For this study, The
Mindfulness training was provided on the lines
of the Mindfulness Based Stress Reduction
(MBSR) program as developed by Kabat-Zinn
(2013), which was modified as per the needs
of school children using activities taken from
the Stress Reduction Workbook for Teens
(Biegel, 2017). The broad outline of the
mindfulness-based training used for this study
is outlined below:
Procedure
The study involved school students; thus, after obtaining necessary ethics approval from the Institutional Human Ethics Committee of Mizoram University (MZUHEC), the schools were approached, and after necessary permission from concerned school authorities, school students based on sample inclusion criteria were briefed about the purpose of the study. Those students who signed the informed assent form were screened on the DSM-5-TR Self-Rated Level 1 Cross-Cutting Symptom tool to screen for the presence of any significant psychiatric condition. Parents/ legal guardians of those screened were informed about the study, and necessary consent was also taken from them first. After that, students were allocated into ‘Training group’ and ‘Normal Control group’ using the fishbowl method, with 5 participants each. Following group allocation, the socio demographic details were gathered using a socio-demographic data sheet, and subsequently, baseline assessments were carried out on PSS and MAAS-A for all participants of both groups. Post baseline assessments, 7 mindfulness-based sessions were provided to all the participants of the ‘Training group’ at a frequency of one session per week with a session duration of 45 minutes each. These sessions were followed by homework assignments, and concerned parents were motivated to co-supervise the homework tasks at home. Whereas the participants of the ‘Normal Control group’ were not given mindfulness-based training. After completion of 7 7-week time period (from baseline assessment), participants of both groups were re-assessed using the same psychological tools that were used for baseline assessments. In this manner, baseline and post-training assessment scores were obtained for all participants of both groups.
The study involved school students; thus, after obtaining necessary ethics approval from the Institutional Human Ethics Committee of Mizoram University (MZUHEC), the schools were approached, and after necessary permission from concerned school authorities, school students based on sample inclusion criteria were briefed about the purpose of the study. Those students who signed the informed assent form were screened on the DSM-5-TR Self-Rated Level 1 Cross-Cutting Symptom tool to screen for the presence of any significant psychiatric condition. Parents/ legal guardians of those screened were informed about the study, and necessary consent was also taken from them first. After that, students were allocated into ‘Training group’ and ‘Normal Control group’ using the fishbowl method, with 5 participants each. Following group allocation, the socio demographic details were gathered using a socio-demographic data sheet, and subsequently, baseline assessments were carried out on PSS and MAAS-A for all participants of both groups. Post baseline assessments, 7 mindfulness-based sessions were provided to all the participants of the ‘Training group’ at a frequency of one session per week with a session duration of 45 minutes each. These sessions were followed by homework assignments, and concerned parents were motivated to co-supervise the homework tasks at home. Whereas the participants of the ‘Normal Control group’ were not given mindfulness-based training. After completion of 7 7-week time period (from baseline assessment), participants of both groups were re-assessed using the same psychological tools that were used for baseline assessments. In this manner, baseline and post-training assessment scores were obtained for all participants of both groups.
Statistical Analysis
The obtained data were analysed using
Statistical Package for the Social Sciences
29 software (SPSS-29). Both group scores
were compared using suitable statistics for
various socio-demographic variables and
assessment tool scores.
RESULT
Table 1 shows that the mean is 17.40 ± 0.54
and 17.60 ±0.54 for participants of Training
and Normal control group respectively. The
data further indicate that both compared
groups do not differ significantly on ‘Age’.
Table-2: exhibits comparison in terms of
various socio-demographic variables between
participants of Training and Normal Control
Group. The data depicts that 60% of the
participants in both groups were of female
gender, all of them were hailing from Middle
SES, and were Christian. The table further
indicate that majority of the participants in
both groups were having ‘Nuclear’ family type
(60% for Training group and 80% for Normal
control group) and all participants in both
groups were residing in urban localities.
Finally, the data shows that both compared
groups were alike in most of the socio
demographic variables.
Table-3: shows that the mean is 23.40 ±5.02
and 24.40 ±4.21 on PSS scale for the
participants of ‘Training’ and ‘Normal Control’
group respectively. Further, on MAAS-A scale
the ‘Training group’ participants were having
a mean of 3.19 ±0.81 as against mean of
3.25±0.34 for ‘Normal Control’ group. Overall,
the presented data exhibits no significant
difference between both the groups in their
levels of Perceived Stress (-0.84), Attention
(-0.10) and scores of Mindfulness (-0.31).
Table-4: shows the comparison between the
assessment scores of Training and Normal
Control group participants after MBSR training
on PSS and MAAS-A scales. The data
indicates a mean of 18.20 ±5.76 on PSS,
55±12.90 and on MAAS-A scales for
participants of ‘Training’ group as against a
mean of 27.40±5.41 on PSS, 41.40 ±4.72 on
and on MAAS-A for participants of ‘Normal
Control’ group. Results further indicates that
both compared groups differ (0.05 level) in
the PSS and MAAS-A after 7 weeks period
(of MBSR training).
Table-5: shows the comparison between Pre
and Post training assessment scores for both group participants on PSS and MAAS-A scales.
The results show significant difference (0.05)
in the Perceived Stress, Attention levels and
scores of Mindfulness awareness in
participants of ‘Training’ group after MBSR
training. On the contrary no significant
difference was observed among scores on PSS
and MAAS-A scales between pre and post
assessment in case of participants of the
Normal Control group.
DISCUSSION
To investigate the applicability of Mindfulness based training program on perceived stress and mindful awareness of higher secondary school students, the authors adopted pre-post with control design for this study. The data obtained from the preliminary phase of the study has been presented and discussed here. The findings of Table 1 & 2, depicting comparison between both groups in terms of their ‘age’ and other socio-demographic variables, indicated no significant difference between them in terms of these compared variables, which is indicative of similarity among participants of both studied groups on age, gender, family background, education and related demographic features. Baseline comparison, between the participants of both groups, on PSS and MAAS-A scores, indicated no significant difference between them, which is suggestive of similar level of perceived stress, indicating same level of day to-day stress experiences among participants of both groups. Further, similar level of mindfulness awareness was also observed at pre training assessments in both group participants and whatever mild difference is witnessed, it is best attributed to just-by chance factors. Thus, from the outset, participants of both studied groups have performed similarly on PSS and MAAS-A measures. Such similarity in scores at baseline is significant in the sense that it may possibly aid in commenting about any change that may occur, after demonstration of some treatment/training to participants. In this study participants of training group were demonstrated 07 mindfulness-based training sessions. After a wait period of 7 weeks for participants of ‘Normal Control group’ and after demonstration of 7 sessions of mindfulness training to participants of ‘Training group’, when re-assessment (post training) assessments were conducted for both groups and the results were compared, difference in performance of participants was observed. Significant group differences (0.05 level) were observed between post training assessments scores (Table 4) of both the groups on PSS measure. Further, when pre and post training scores (Table 5) of ‘Training group’ participants were compared, again a significant level of difference (0.05 level) was noticed. This clearly indicates that the participants in ‘Training group’ have improved upon with regard to their performances on PSS scale after 7-week long mindfulness based training, as indicated by their mean scores at post training phase assessment. This points towards significant reduction in ‘ perceived stress’ scores among the participants of that group, which received 7 sessions of MBSR training. Our findings were adequately supported by RCT findings on 100 college students by Carrone and Pettijohn (2023), where-in the authors reported significant reduction in ‘stress scores’ on college stress scale after brief mindfulness training. Nur’aini and Patry (2024) reported similar findings, suggestive of the positive impact of MBSR program for reducing the stress levels. Hence our hypothesis stating that there will be a significant impact of MBSR program on perceived stress of higher secondary school students holds acceptance. The observation of reduction in perceived stress experiences, in training group participants, after 7 weeks is the outcome of mindfulness training sessions, is also strengthen by the performance of ‘Normal Control group’ participants after 7 weeks. As, when the pre-post assessment scores were taken in to consideration for participants of ‘ Normal Control group’, no such marked difference were noticed and the data indicated similar level of performance at pre and post level for this group, which is indicating towards similar level of perceived stress experiences after 7 weeks wait period. This does strengthen our hypothesis that mindfulness training would be helpful in l owering the perceived stress in the participants. This happens probably due to the development of the capability of the person to focus more on the ongoing present events in life in a more focused manner, rather than dwelling upon the past events/memories. Their-by leading to non-accumulation of negative or stressful felling, as broadly one may have mixed, if not positive, experiences i n day-to-day life. Dwelling upon our unwelcomed/unwanted experiences bound to i ncrease our stress perception. With mindfulness-based training, one may develop a tendency to bring focus in the present ongoing events in life. Significant difference was also observed between the studied groups on MAAS-A assessments (Table 4) scores, indicating that both groups differ drastically on MAAS-A scores at post assessment phase. Further, when pre and post training scores of ‘Training Group’ participants were taken in to consideration, again significant difference was witnessed (0.05 level). Data revealed that the participants scored a better ‘mean score’ at post training phase in comparison to their pre training phase performances on MAAS-A. This depicts better mindful awareness and mindful attention among the ‘Training Group’ participants after 7 weeks training. It could have happened that, after exposure to mindfulness-based training sessions, the participants have learnt to be mindfully aware at the present moment, overpowering the distractions from environment and not getting effected by them. This explanation seems to be acceptable because no such difference was noticed during the pre and post score comparison of participants of ‘Normal Control group’, where they exhibit almost similar level of performance at both, pre and post phases of assessments. Our findings are supported by Carrone and Pettijohn (2023), in an RCT on 100 college students, where the authors reported an increase in trait mindfulness. Thus, it appears that mindfulness training is helpful in enhancing present moment awareness and does helps in sustaining that. Thus, in the present study, the participants of the ‘Training Group; have better scores at post training phase in comparison to their pre training phase scores, on all the outcome measures, as against the participants of ‘Normal Control’ group. As both groups were similar in most of the socio-demographic variables, so, it could be said that mindfulness training, which is provided using MBSR module, have helped participants to bettered their scores on all outcome measures, i.e. in perceived stress experiences and in their ability of present moment awareness. Therefore, it could be hypothesized that, such training would not only aid in bringing improvement in mental health of the school students but may also found to be helpful in the overall learning process, as reported by the parents and teachers during our study. Lastly the authors believe that such findings hold implications for school mental health programs in longer run. However, the study was limited with small sample and non consideration of follow up assessments to see the ‘carried over’ effect of mindfulness training on participants, which could have been bettered in future protocols.
To investigate the applicability of Mindfulness based training program on perceived stress and mindful awareness of higher secondary school students, the authors adopted pre-post with control design for this study. The data obtained from the preliminary phase of the study has been presented and discussed here. The findings of Table 1 & 2, depicting comparison between both groups in terms of their ‘age’ and other socio-demographic variables, indicated no significant difference between them in terms of these compared variables, which is indicative of similarity among participants of both studied groups on age, gender, family background, education and related demographic features. Baseline comparison, between the participants of both groups, on PSS and MAAS-A scores, indicated no significant difference between them, which is suggestive of similar level of perceived stress, indicating same level of day to-day stress experiences among participants of both groups. Further, similar level of mindfulness awareness was also observed at pre training assessments in both group participants and whatever mild difference is witnessed, it is best attributed to just-by chance factors. Thus, from the outset, participants of both studied groups have performed similarly on PSS and MAAS-A measures. Such similarity in scores at baseline is significant in the sense that it may possibly aid in commenting about any change that may occur, after demonstration of some treatment/training to participants. In this study participants of training group were demonstrated 07 mindfulness-based training sessions. After a wait period of 7 weeks for participants of ‘Normal Control group’ and after demonstration of 7 sessions of mindfulness training to participants of ‘Training group’, when re-assessment (post training) assessments were conducted for both groups and the results were compared, difference in performance of participants was observed. Significant group differences (0.05 level) were observed between post training assessments scores (Table 4) of both the groups on PSS measure. Further, when pre and post training scores (Table 5) of ‘Training group’ participants were compared, again a significant level of difference (0.05 level) was noticed. This clearly indicates that the participants in ‘Training group’ have improved upon with regard to their performances on PSS scale after 7-week long mindfulness based training, as indicated by their mean scores at post training phase assessment. This points towards significant reduction in ‘ perceived stress’ scores among the participants of that group, which received 7 sessions of MBSR training. Our findings were adequately supported by RCT findings on 100 college students by Carrone and Pettijohn (2023), where-in the authors reported significant reduction in ‘stress scores’ on college stress scale after brief mindfulness training. Nur’aini and Patry (2024) reported similar findings, suggestive of the positive impact of MBSR program for reducing the stress levels. Hence our hypothesis stating that there will be a significant impact of MBSR program on perceived stress of higher secondary school students holds acceptance. The observation of reduction in perceived stress experiences, in training group participants, after 7 weeks is the outcome of mindfulness training sessions, is also strengthen by the performance of ‘Normal Control group’ participants after 7 weeks. As, when the pre-post assessment scores were taken in to consideration for participants of ‘ Normal Control group’, no such marked difference were noticed and the data indicated similar level of performance at pre and post level for this group, which is indicating towards similar level of perceived stress experiences after 7 weeks wait period. This does strengthen our hypothesis that mindfulness training would be helpful in l owering the perceived stress in the participants. This happens probably due to the development of the capability of the person to focus more on the ongoing present events in life in a more focused manner, rather than dwelling upon the past events/memories. Their-by leading to non-accumulation of negative or stressful felling, as broadly one may have mixed, if not positive, experiences i n day-to-day life. Dwelling upon our unwelcomed/unwanted experiences bound to i ncrease our stress perception. With mindfulness-based training, one may develop a tendency to bring focus in the present ongoing events in life. Significant difference was also observed between the studied groups on MAAS-A assessments (Table 4) scores, indicating that both groups differ drastically on MAAS-A scores at post assessment phase. Further, when pre and post training scores of ‘Training Group’ participants were taken in to consideration, again significant difference was witnessed (0.05 level). Data revealed that the participants scored a better ‘mean score’ at post training phase in comparison to their pre training phase performances on MAAS-A. This depicts better mindful awareness and mindful attention among the ‘Training Group’ participants after 7 weeks training. It could have happened that, after exposure to mindfulness-based training sessions, the participants have learnt to be mindfully aware at the present moment, overpowering the distractions from environment and not getting effected by them. This explanation seems to be acceptable because no such difference was noticed during the pre and post score comparison of participants of ‘Normal Control group’, where they exhibit almost similar level of performance at both, pre and post phases of assessments. Our findings are supported by Carrone and Pettijohn (2023), in an RCT on 100 college students, where the authors reported an increase in trait mindfulness. Thus, it appears that mindfulness training is helpful in enhancing present moment awareness and does helps in sustaining that. Thus, in the present study, the participants of the ‘Training Group; have better scores at post training phase in comparison to their pre training phase scores, on all the outcome measures, as against the participants of ‘Normal Control’ group. As both groups were similar in most of the socio-demographic variables, so, it could be said that mindfulness training, which is provided using MBSR module, have helped participants to bettered their scores on all outcome measures, i.e. in perceived stress experiences and in their ability of present moment awareness. Therefore, it could be hypothesized that, such training would not only aid in bringing improvement in mental health of the school students but may also found to be helpful in the overall learning process, as reported by the parents and teachers during our study. Lastly the authors believe that such findings hold implications for school mental health programs in longer run. However, the study was limited with small sample and non consideration of follow up assessments to see the ‘carried over’ effect of mindfulness training on participants, which could have been bettered in future protocols.
CONCLUSION
Mindfulness based training sessions have
significant positive impact in reducing the
levels of perceived stress and increasing
present moment awareness for school
students. Such training programs could help
school going students in decreasing their
perception of stressful experiences in day-to
day life, improving mindful awareness ability
and there-by could play a significant role in
not only enhancing mental health, improving
academic performance of the students but
would also be helpful in facilitating overall
l earning process for school students.
Eventually, the present study findings were
helpful in finalizing the Mindfulness based
training module as applicable to the school
adolescents in school settings.
ACKNOWLEDGEMENT: The authors wish to
acknowledge the financial support given by
Mizoram University, Aizawl, Mizoram,
India, to carry out this study under their
Research Promotion Grant (RPG) scheme
wide F. No 8-10/MZU (Acad)/19/170-176
dated 07.03.2023. The authors also wish
to acknowledge the support extended by the
school authorities and wish to thank for the
cooperation by all the participants who were
part of the study
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Conflict of interest: None
Role of funding source: None
ISSN: 2582-1393 (Online)