The primary dependent variable in outcome studies is invariably the efficacy or effectiveness of the interventions. Social validity is a secondary dependent variable that provides an indication of the clients’ or patients’ opinion of the social significance of the goal(s), social appropriateness of the intervention procedures, and social importance of the outcomes (Schwartz and Baer 1991; Wolf 1978). Social validity is a multi-component concept that can be subjectively measured in multiple ways, including questionnaires, interviews, rating scales, focus groups, and participants’ choice of interventions (Kennedy 1992; Ferguson et al. 2018; Foster and Mash 1999). It can also be objectively measured via direct observation of the client’s behavior or affect (e.g., Watson et al. 1988). In addition, the effects can be observed on the clients of staff who were taught specific self-care practices, such as mindfulness (Singh et al. 2004). Furthermore, social validity has been measured by asking socially significant others (e.g., staff, parents, siblings) to rate pre- and post-intervention videos of the client’s behavior, performance, or emotional responses (Lancioni et al. 2017). Social validity measures are used to inform the development and quality of interventions such that they are not only effective for the target disease, disorder, deficit or population, but also meaningful in the lives of the individuals receiving these interventions.

Given the significance of social validity in the development, refinement, and implementation of interventions, it remains a minimally measured secondary outcome in school-based interventions (Rempel 2012). For example, Felver et al. (2014) assessed student and teacher social validity of the use of the Meditation on the Soles of the Feet (SoF; Singh and Jackman 2017) on academic engagement and off-task behavior of third-grade general education students. Student ratings indicated that the SoF mindfulness-based practice was useful to learn at school, not difficult to use, and it did not need any procedural changes. In addition, the teachers rated the SoF practice as feasible and a reasonable investment of teacher time to achieve the reported student outcomes. In another study, Worthen and Luiselli (2017) asked high school students to rate their satisfaction with and acceptance of a 10-week mindfulness education program based on Mindfulness: An eight week plan for finding peace in a frantic world (Williams and Penman 2011). The social validity results were mixed, with the students showing differential preference for specific mindfulness practices and endorsing these practices for other students.

Current social validity studies have focused on well-established mindfulness-based practices or programs that have been adapted or used in their original form in school settings. However, there has been a surge of new mindfulness-based K-12 school programs that have either a minimal evidence-base or are in their formative stages (Semple et al. 2017). OpenMind (OM) (Jackman 2016a) is a newly developed program specifically for Pre-K schools. The first iteration of the OM program consisted of the following seven daily practices: focused meditation; loving-kindness meditation; bell exercises; yoga; gratitude practice; kindness and compassion reporting; and feelings finder practices (Jackman 2016a). The OM program includes supplemental learning activities that enable Pre-K teachers to promote development of prosocial behavior by braiding these practices with any Pre-K curriculum (Jackman 2016b).

In an initial evaluation of the OM program, teachers reported it was feasible to integrate the program with an existing preschool curriculum, but it was difficult to find enough time to incorporate meditation during school hours (Jackman et al. 2019). Perceived benefits for the children included improved self-regulation, and increased body and emotional awareness, empathy, and awareness of the feelings of others. The teachers found the OM program to be very acceptable, and would recommend it to other preschool teachers. Data from this study was used formatively to develop the second version of the OM program (Jackman 2017a, 2017b).

Kim et al. (2019) evaluated the feasibility and acceptability of the OpenMind-Korea (OM-K) program (Jackman 2017c), a culturally adapted version of the second version of the OM program. The OM-K program has nine practice activities. These include three that are used in the classroom daily (i.e., Samatha meditation; lovingkindness meditation, and gratitude and interconnectedness practice) and six that are used as their need arises (i.e., yoga, kindness and compassion reporting, feelings finder, super me, are you present for me?, and soles of the little feet). All nine activities are overlaid with the Nuri Curriculum, which is the standard curriculum used in all Korean preschools. In general, the teachers found the OM-K program acceptable and feasible to implement in their classrooms. The teachers provided information on how they were able to modify the activities within the Korean pre-school context, presented ideas for further development of the program, and noted that they would recommend the program to other teachers.

These two studies are exemplars of the way mindfulness-based preschool programs can use data from secondary outcomes to develop, refine, and implement mindfulness-based programs. However, the concept of social validity is broader than just an examination of feasibility and acceptability of programs. The initial social validity dataset on feasibility and acceptability were derived from the teachers following a year of implementing the OM and OM-K programs. The current study aimed to extend the social validity dataset by examining parental perceptions of the social significance of the OM-K program.

Methods

Participants

Children from three preschools participated in the original OM-K study (Kim et al. 2019). Of the 170 preschool children that were enrolled in the original study, the parents of 40 preschoolers from one preschool participated in the present study. The sample included 38 mothers and 2 fathers, for a total N of 40. They were parents of 12 × 3-year-olds, 17 × 4-year-olds, and 11 × 5-year-olds.

Procedure

Questionnaires were sent to 47 parents of 3- to 5-year-old children in one of three preschools. Forty of the 47 parents returned completed questionnaires. The questionnaire included a brief description of the OM-K program and a request to answer the seven questions. After putting the questionnaire in an envelope, the teachers put the envelope in each child’s backpack and sent it to his or her home. In addition, the teacher in charge explained this situation to parents by phone. Parents who received guidance from the teacher cooperated with the questionnaire collection by returning it by their children’s backpack after the survey.

Measure

The parents were given a short social validity questionnaire, with the following instructions: “Your child has been a student in our kindergarten’s OpenMind-Korea (OM-K) program which teaches how to regulate their emotion and behaviors so that they do not engage in behavior problems, are kind and compassionate, show gratitude for what they receive, and so on. Also, it prepares them to successfully transition to elementary school. We are interested in your views of the program and hope that you can complete the following short 7-item questionnaire that will take you just a few minutes to complete.” The parents rated the social validity questionnaire on a 5-point Likert scale: 1 = strongly disagree; 2 = disagree; 3 = neither agree nor disagree; 4 = agree; and 5 = strongly agree.

Data analyses

The data were summarized in terms of the parents’ ratings of each item. Then, the data were collapsed into three meaningful categories: agree, neutral, and disagree. The same process was used to analyze parental ratings of each item by the age group of their children (i.e., parents of 3-year-olds, 4-year-olds, and 5-year-olds). SPSS 24.0 was used for the frequency analysis.

Results

The overall mean social acceptability ratings by all parents and parents grouped by the age of their children are presented in Fig. 1. The data indicate that the majority of the parents found the OM-K program to be socially valid. Similar results were evident when the parent data were dissected by age of the children.

Fig. 1
figure 1

Mean parent ratings of social validity

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The item x parent data are shown in Table 1. Overall, about 88% of the parents agreed with the item “The OM-K program teaches skills that my child can use at school and at home,” about 83% agreed with the item “I would recommend the OM-K program to other parents”, and about 78% agreed with the item “The OM-K program is simple”. Seventy-five percent of the parents agreed with the remaining four items that asked about acceptability, effectiveness, unintended adverse effects, and the simplicity of the program when used with their children.

Table 1 Number of parents rated each of the items
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Discussion

Social validity is an important outcome dimension because it speaks to the social significance of the change evidenced when a mindfulness-based practice or program is taught. It is usually a subjective assessment of the views of the people receiving the mindfulness teachings or of their significant others (spouses, parents, teachers, siblings, and other care providers). Statistically or clinically significant changes are the primary outcomes, but such outcomes are often meaningful more to the providers of the mindfulness-based programs than to the people receiving them. When a program or treatment is implemented, the outcomes need to be not only statistically and/or clinically significant, but also personally meaningful and of some social significance to the individual.

The present study aimed to assess the social validity of the OM-K program implemented in a Korean preschool. An earlier study had established the feasibility and acceptability of this program as viewed by the preschool teachers who utilized the program (Kim et al. 2019). The present study extended the social validity of the OM-K program by canvassing the views of the parents of the preschool children who participated in the program. The majority of the parents were positive about the program, especially with regard to its usefulness to their children both at school and at home. They reported that the program was simple and easy to use, effective for their children, with no adverse unintended effects. Indeed, they found OM-K to be an acceptable program for their children and would recommend it to other parents. Essentially, the parent views mimic those of the teachers as reported by Kim et al. (2019), thus strengthening the social validity of the OM-K program.

Strengths and limitations

This study adds to the meager extant literature on the social validity of mindfulness-based programs for school children, especially those in preschool. There have been a few studies that have reported on the feasibility and acceptability of mindfulness-based programs and practices in school settings (e.g., Felver et al. 2014). However, even fewer have investigated the social validity of school-based programs (e.g., Worthen and Luiselli 2017), with none in preschool settings. The present study demonstrated how (pre)school-based programs can be investigated systematically for feasibility and acceptability by the teachers, and acceptability and social validity by the parents of the children.

Our study is not without limitations and these should be remediated in future social validity studies. First, the total sample size was small (N = 40), with mainly mothers (n = 38) as the respondents. Including parents from just one school provided some contextual homogeneity in the sample, but it also limited the generalizability of the findings. Future studies need to have larger and more heterogeneous samples. Second, the social validity questionnaire was limited to seven key questions. While this was minimally burdensome for busy parents, future studies could delve deeper into social validity issues by incorporating interview questions with the Likert-style ratings. Mindfulness is experiential in nature, and a better understanding of mindfulness-based programs can be gained by strategically using mixed methods to gather data on social validity.