Currently submitted to: Journal of Medical Internet Research
Date Submitted: Jul 18, 2019
Open Peer Review Period: Jul 19, 2019 - Jul 26, 2019
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Mindfulness Virtual Community for Student’s Mental Health: A Randomized Control Trial
The rising prevalence of mental health problems in university students may be overwhelming traditional university mental health services. Given the demonstrated anxiolytic and antidepressant benefits of mindfulness, we developed an eight-week online Mindfulness Virtual Community (MVC) intervention. Twelve psycho-educational videos on topics students pre-identified as stressful, prepared the trial participants for subsequent videos that guided them in 10 minutes of topically applied mindfulness practice. All video content was informed by Cognitive Behavior Therapy (CBT) constructs. Optional peer-to-peer text-based discussion and weekly live chat sessions were monitored and led by a mental health professional.
To investigate the efficacy of an online MVC intervention in reducing symptoms of depression, anxiety and stress (primary outcomes) among undergraduate students in Toronto, Canada. The secondary outcomes included quality of life and life satisfaction.
Recruitment for the three-arm randomized trial was undertaken with flyers, university-based listserv announcements, and postings associated with university courses where instructors granted credit for participation. Consenting students (n=119) were randomized to a wait list control group (WLC) or to a full MVC intervention (F-MVC) or to a partial MVC intervention (P-MVC) (which used videos only) (n=40, n=40, n=39). Participants were informed of allocation after consenting. The baseline (T1) and additional assessment sessions at 4 weeks (T2) and 8 weeks (T3) included the Patient Health Questionnaire-9, Beck Anxiety Inventory and Perceived Stress Scale. Analyses employed Generalized Estimation Equation (GEE) methods with AR(1) covariance structures and were adjusted for possible confounding variables (i.e. gender, age, country of birth, paid work, unpaid work, vigorous physical activities, and self-rated health).
Of the 113 students who provided baseline data, 28 males (24.8%) and 85 females (75.2%) reported a mean age of 24.8 years and were mostly Canadian-born (59.3%). Participants in F-MVC (n=39), P-MVC (n=35) and WLC (n=39) groups were similar in socio-demographic characteristics at baseline. There were no significant between-group differences on any key outcome variable at baseline. At T3 follow-up, per adjusted comparisons, there were statistically significant reductions in depression scores for F-MVC (score change -3.36 points, p=0.001) and P-MVC (score change -3.12, p=0.008) when compared to WLC. At T3 there was statistically significant reduction in anxiety scores only for P-MVC (score change -5.59, p=0.01) when compared to WLC. There was also statistically significant reduction in scores for perceived stress (score change 2.1, p =0.04) but only for P-MVC compared to WLC. No statistically significant changes were found for the quality of life and life satisfaction for F-MVC or P-MVC versus WLC.
Internet-based mindfulness-CBT-based interventions, such as F-MVC and P-MVC, can result in significant reductions in depression, anxiety and stress in a student population. Such low-cost interventions can substitute for or supplement traditional, office-based counseling services. Clinical Trial: https://doi.org/10.1186/ISRCTN92827275
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