Abstract Objectives Special Operations Forces (SOF) must maintain cognitive and operational performance under extreme conditions. This pragmatic trial aimed to assess whether integrating a mindfulness training (MT) program into SOF Professional Military Education (PME) through a train-the-trainer approach could enhance these critical capabilities. Method Using a cluster-randomized design, groups were assigned to MT or training-as-usual (TAU). After a 10-week trainer practicum, trainers delivered a 4-week, 6-hr variant of a validated 8-hr MT program in person across two PME courses (Rounds 1 and 2). In Round 1 ( n = 122), MT was implemented at the start of the course, with out-of-class mindfulness practice delivered via a web app. In Round 2 ( n = 120), MT was delivered at the end of the course, with out-of-class mindfulness practice conducted in groups. Cognitive and well-being measures were collected before and after the 4-week MT interval, and end-of-course exam scores were examined. MT participants provided trainer and program evaluations. Results While trainer and program satisfaction were high, no consistent MT benefits over TAU emerged. However, in Round 1, participants who engaged in more out-of-class mindfulness practice demonstrated improved attention and higher exam scores. In Round 2, all participants experienced increased mind-wandering and decreased well-being, with MT participants indicating that the program’s delivery during the most demanding course period may have limited its effectiveness. Conclusions This study offers evidence-based insights into key enablers and barriers to the adoption of MT. It establishes a foundational framework for the broader, large-scale implementation of MT across various high-demand professional sectors. Preregistration Clinical Trial Registration # NCT04703296.
Denkova et al. (Wed,) studied this question.