Clinical Research Directory

B4B Evolution Type II Hybrid Effectiveness-Implementation Trial

Break4Brain Evolution is a school-based programme designed to help teachers incorporate brief, safe and inclusive movement activities into normal classroom routines. The study aims to examine both how the programme is adopted and delivered in real-world schools and whether it improves students' physical activity, attention, executive functions and academic achievement. This is a type II hybrid implementation-effectiveness study with two complementary components. The implementation component will examine the scale-up of Break4Brain Evolution across at least 50 preschool, primary and secondary schools in the Balearic Islands and mainland Spain. Information from school leaders, teachers and students will be used to assess programme reach, adoption, acceptability, feasibility, appropriateness, fidelity, adaptations and maintenance. The effectiveness component is an embedded cluster-randomized controlled trial conducted in six primary schools in Mallorca. Schools will be randomly allocated to either the Break4Brain Evolution programme or usual school practice, with three schools in each group. Two classrooms from each school, one grade 5 and one grade 6 classroom, will participate, resulting in an estimated sample of 300 students. Baseline assessments will be conducted in September 2026. Schools allocated to the intervention group will begin implementing Break4Brain Evolution in October 2026 and will use the programme during the academic year. Follow-up assessments will be conducted in February 2027, June 2027 and December 2027.

The Effects of Breathing Exercises on Exam Anxiety, Attention Deficit, and Academic Achievement in Students Preparing for University Entrance Exams

This study investigates the effects of breathing exercises on exam anxiety, attention, and academic achievement in students preparing for university entrance exams. University entrance exams are significant milestones in students' educational and career paths, often causing high levels of stress and anxiety. These psychological pressures can negatively impact learning, focus, and overall academic performance. The study will involve students who volunteer to participate and meet the inclusion criteria. Participants will be guided through structured breathing exercises designed to reduce stress and enhance concentration. The program will be conducted over several sessions, during which students will practice specific breathing techniques under supervision. Primary outcomes of the study include the assessment of changes in exam anxiety levels, attention, and academic performance. Secondary outcomes may include students' self-reported stress management skills and overall well-being. Data will be collected using validated questionnaires, attention tests, and academic performance records. The purpose of this research is to determine whether regular practice of targeted breathing exercises can provide practical benefits for students, helping them manage anxiety, improve focus, and achieve better academic outcomes. Findings from this study may also offer guidance for educators, parents, and healthcare providers on effective, low-cost interventions to support students during high-pressure academic periods. Participants are encouraged to follow instructions carefully and attend all sessions to gain the full benefit of the intervention. Participation is voluntary, and students can withdraw at any time without any negative consequences. Confidentiality of all collected data will be strictly maintained. By contributing to this research, participants will help advance understanding of non-pharmacological methods to improve student mental health and academic performance, potentially shaping future educational and stress-management programs.