Test AnxietyNCT07644182
Neuman Systems Model-Based Yoga Program for Test Anxiety in Secondary School Students
A study testing School-Based Yoga Program in people with Test Anxiety, run by Pamukkale University at 1 site in Turkey (Türkiye).
Trial 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. Read more about this study
- Who is it for?
- Ages 13 to 15 yearsHealthy volunteers can take part
- Conditions the study is for
- Test Anxiety
- What is being tested?
- School-Based Yoga Program
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 166 participants
- Where
- 1 siteTurkey (Türkiye)
- Study dates
- 30 Apr 2026to 21 May 2026
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 13 to 15 years
- All sexes
- Healthy volunteers accepted
- Child
Who may be able to join
- Being an eighth-grade student Having no physical or mental health condition that would prevent safe participation in yoga
Who cannot join
- Regular participation in yoga or another mindfulness-based practice Withdrawal from participation in the study
Trial locations and contacts
1 site in 1 country.
Turkey (Türkiye)1 site
Public Secondary Schools
Denizli, Pamukkale, 20070
About this study
Official title: The Effect of a Yoga Program Based on the Neuman Systems Model on Test Anxiety, Quality of Life, and Mindfulness Among Secondary School Students
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.
Read the detailed description
This cluster randomized controlled trial was conducted to evaluate the effects of a school-based yoga program based on the Neuman Systems Model on test anxiety, quality of life, and mindfulness among eighth-grade students. The study was conducted during the 2025-2026 academic year, between April and May 2026, in two public secondary schools in the central districts of Denizli, Türkiye.
Two public secondary schools with similar characteristics that met the predefined school-level eligibility criteria and agreed to participate were selected using purposive sampling. Each school was considered a cluster, with the school serving as the unit of randomization. The two selected schools were randomly allocated to either 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. School-level cluster randomization was used to minimize potential contamination between the intervention and control groups.
The sample size was calculated using G*Power version 3.1.9.7 based on a two-group, three-time-point repeated-measures design. With an effect size of f = 0.25, a significance level of 0.05, and a statistical power of 0.95, the minimum required sample size was 142 students. Considering potential attrition, the target sample size was set at 160 students. A total of 166 students were enrolled, including 81 in the intervention group and 85 in the control group. Five students in the intervention group were not included in the final analysis because four were unable to participate regularly in the yoga program and one chose not to continue. The final analysis included 161 students, with 76 in the intervention group and 85 in the control group.
The 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 intervention was delivered by the researcher, who holds a children's yoga instructor certificate, together with a yoga instructor. The program was implemented once weekly for four weeks, with each session lasting approximately 40 minutes. Each session followed a standardized structure consisting 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 yoga session, a WhatsApp group including students and their parents was established for intervention-related communication. During the intervention period, breathing-practice reminders, affirmation statements, and brief home practices were shared after each session to support the transfer of skills acquired during the sessions into students' daily lives. Students in the control group continued their usual school program and received no yoga intervention during the study period.
Test anxiety, quality of life, and mindfulness were assessed in both groups at three time points: at baseline before the intervention, at the end of Week 2, and at the end of Week 4.
Written informed consent was obtained from parents or legal guardians, and students provided verbal assent before participation. The study was approved by the Pamukkale University Non-Interventional Clinical Research Ethics Committee (June 13, 2025; No. E-60116787-020-704556), and the required institutional permissions were obtained. The study was conducted in accordance with the principles of the Declaration of Helsinki.
- Conditions
- Test Anxiety
- Being tested
- School-Based Yoga Program
- Keywords
- yoga, Neuman Systems Model, Test Anxiety, Quality of Life, Mindfulness, School-Based Intervention, Adolescents, Cluster Randomized Controlled Trial
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
School-Based Yoga ProgramBehavioural
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.
| Study group | Role | What they receive |
|---|---|---|
| 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. Receives: 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. |
What is being measured
The primary outcome is the main question the study is designed to answer.
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.
Measured: 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)
Health-related quality of life was assessed using the PedsQL 13-18 Adolescent Form. The scale consists of 23 items across four dimensions: physical functioning, emotional functioning, social functioning, and school functioning. Higher scores indicate better health-related quality of life.
Measured: Baseline (before the intervention), end of Week 2, and end of Week 4
Mindfulness (BAU Mindfulness Scale for Children Score)
Mindfulness was assessed using the BAU Mindfulness Scale for Children (BAU-MSC). The scale consists of 16 items and includes two subscales: Awareness and Attitude. Total scores range from 16 to 48, with higher scores indicating higher levels of mindfulness.
Measured: Baseline (before the intervention), end of Week 2, and end of Week 4
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted12 Jun 2026
- Study start30 Apr 2026
- Primary completion21 May 2026
- Study completion21 May 2026
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (2)Papers the sponsor has linked to this study.
- Other trials for Test AnxietyStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Prevention
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- 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.
- Masking
- None (open label)
- Enrolment
- 166 participants (actual)
Sponsor and investigators
- Lead sponsor
- Pamukkale University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Azime Hacıoğlu Güven, Pamukkale University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07644182
- Sponsor's protocol ID
- NSM-YT-2026
- Other IDs
- E-60116787-020-704556
- Status last verified
- Sep 2026
- First submitted
- 6 Jun 2026
- Last updated
- 24 Sep 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No: Individual participant data will not be shared to ensure participant confidentiality and data protection.
Publications
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.
PubMed 36302735Khalsa 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.
PubMed 21647811
Study at a glance
From the registry record, last updated by the sponsor on 24 Sep 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- The Effect of a Yoga Program Based on the Neuman Systems Model on Test Anxiety, Quality of Life, and Mindfulness Among Secondary School Students
- ClinicalTrials.gov ID
- NCT07644182
- Acronym / sponsor ID
- NSM-YT-2026
- Conditions
- Test Anxiety
- Keywords
- yoga, Neuman Systems Model, Test Anxiety, Quality of Life, Mindfulness, School-Based Intervention, Adolescents, Cluster Randomized Controlled Trial
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 166 participants (actual)
- Lead sponsor
- Pamukkale UniversityUniversity, hospital or other
- Study start
- 30 Apr 2026 (actual)
- Primary completion
- 21 May 2026 (actual)
- Study completion
- 21 May 2026 (actual)
- First posted
- 12 Jun 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
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.
Detailed description
This cluster randomized controlled trial was conducted to evaluate the effects of a school-based yoga program based on the Neuman Systems Model on test anxiety, quality of life, and mindfulness among eighth-grade students. The study was conducted during the 2025-2026 academic year, between April and May 2026, in two public secondary schools in the central districts of Denizli, Türkiye.
Two public secondary schools with similar characteristics that met the predefined school-level eligibility criteria and agreed to participate were selected using purposive sampling. Each school was considered a cluster, with the school serving as the unit of randomization. The two selected schools were randomly allocated to either 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. School-level cluster randomization was used to minimize potential contamination between the intervention and control groups.
The sample size was calculated using G*Power version 3.1.9.7 based on a two-group, three-time-point repeated-measures design. With an effect size of f = 0.25, a significance level of 0.05, and a statistical power of 0.95, the minimum required sample size was 142 students. Considering potential attrition, the target sample size was set at 160 students. A total of 166 students were enrolled, including 81 in the intervention group and 85 in the control group. Five students in the intervention group were not included in the final analysis because four were unable to participate regularly in the yoga program and one chose not to continue. The final analysis included 161 students, with 76 in the intervention group and 85 in the control group.
The 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 intervention was delivered by the researcher, who holds a children's yoga instructor certificate, together with a yoga instructor. The program was implemented once weekly for four weeks, with each session lasting approximately 40 minutes. Each session followed a standardized structure consisting 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 yoga session, a WhatsApp group including students and their parents was established for intervention-related communication. During the intervention period, breathing-practice reminders, affirmation statements, and brief home practices were shared after each session to support the transfer of skills acquired during the sessions into students' daily lives. Students in the control group continued their usual school program and received no yoga intervention during the study period.
Test anxiety, quality of life, and mindfulness were assessed in both groups at three time points: at baseline before the intervention, at the end of Week 2, and at the end of Week 4.
Written informed consent was obtained from parents or legal guardians, and students provided verbal assent before participation. The study was approved by the Pamukkale University Non-Interventional Clinical Research Ethics Committee (June 13, 2025; No. E-60116787-020-704556), and the required institutional permissions were obtained. The study was conducted in accordance with the principles of the Declaration of Helsinki.
Study design
- Primary purpose
- Prevention
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
- Model description
- 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.
| Arm | Type | Receives |
|---|---|---|
| School-Based Yoga Program | Experimental | Behavioral: School-Based Yoga ProgramParticipants 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. |
| Control Group | No intervention | –Participants in the control group continued their usual school program and received no yoga intervention during the study period. |
Who may qualify
- Ages
- 13 to 15 years
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Child
Key inclusion criteria (1 listed)
- Being an eighth-grade student Having no physical or mental health condition that would prevent safe participation in yoga
Key exclusion criteria (1 listed)
- Regular participation in yoga or another mindfulness-based practice Withdrawal from participation in the study
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| School-Based Yoga ProgramThe 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. | Behavioural | School-Based Yoga Program |
Primary outcome
Test Anxiety (Westside Test Anxiety Scale score)
Time frame: Baseline (before the intervention), end of Week 2, and end of Week 4
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.
2 secondary outcomes
Health-Related Quality of Life (PedsQL 13-18 Adolescent Form Score)
Time frame: Baseline (before the intervention), end of Week 2, and end of Week 4
Mindfulness (BAU Mindfulness Scale for Children Score)
Time frame: Baseline (before the intervention), end of Week 2, and end of Week 4
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 24 Sep 2026.
- Background: PubMed 36302735Khunti 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.
- Background: PubMed 21647811Khalsa 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.
- Individual participant dataSharing planned: No. Individual participant data will not be shared to ensure participant confidentiality and data protection.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing School-Based Yoga Program in people with Test Anxiety, run by Pamukkale University at 1 site in Turkey (Türkiye).
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 1 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 24 Sep 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Turkey (Türkiye). Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Test Anxiety (Westside Test Anxiety Scale score) (time frame: Baseline (before the intervention), end of Week 2, and end of Week 4). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT07644182, which also lists 2 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 24 Sep 2026.