Mindfulness Virtual Community Intervention Research Articles

Predicting the Effectiveness of a Mindfulness Virtual Community Intervention for University Students: Machine Learning Model.

Students' mental health crisis was recognized before the COVID-19 pandemic. Mindfulness virtual community (MVC), an 8-week web-based mindfulness and cognitive behavioral therapy program, has proven to be an effective web-based program to reduce symptoms of depression, anxiety, and stress. Predicting the success of MVC before a student enrolls in the program is essential to advise students accordingly. The objectives of this study were to investigate (1) whether we can predict MVC's effectiveness using sociodemographic and self-reported features and (2) whether exposure to mindfulness videos is highly predictive of the intervention's success. Machine learning models were developed to predict MVC's effectiveness, defined as success in reducing symptoms of depression, anxiety, and stress as measured using the Patient Health Questionnaire-9 (PHQ-9), the Beck Anxiety Inventory (BAI), and the Perceived Stress Scale (PSS), to at least the minimal clinically important difference. A data set representing a sample of undergraduate students (N=209) who took the MVC intervention between fall 2017 and fall 2018 was used for this secondary analysis. Random forest was used to measure the features' importance. Gradient boosting achieved the best performance both in terms of area under the curve (AUC) and accuracy for predicting PHQ-9 (AUC=0.85 and accuracy=0.83) and PSS (AUC=1 and accuracy=1), and random forest had the best performance for predicting BAI (AUC=0.93 and accuracy=0.93). Exposure to online mindfulness videos was the most important predictor for the intervention's effectiveness for PHQ-9, BAI, and PSS, followed by the number of working hours per week. The performance of the models to predict MVC intervention effectiveness for depression, anxiety, and stress is high. These models might be helpful for professionals to advise students early enough on taking the intervention or choosing other alternatives. The students' exposure to online mindfulness videos is the most important predictor for the effectiveness of the MVC intervention. ISRCTN Registry ISRCTN12249616; https://www.isrctn.com/ISRCTN12249616.

Examining the impact of web-based mindfulness on undergraduate student’s quality of life: a randomized controlled trial

BackgroundEvidence shows that mindfulness-based programs reduce levels of stress, anxiety, and depression. Yet, web-based mindfulness has been less studied, especially among university students. We developed a student-centered web-based mindfulness virtual community (MVC) intervention informed by cognitive-behavioral-therapy constructs. MVC comprised of (1) 12 online video-based modules (psychoeducation and practice), (2) anonymous peer-to-peer discussion forums, and (3) anonymous, group-based, 20-min live video conferences by a trained moderator. While the intervention was found effective in reducing anxiety and depression in a randomized controlled trial (RCT), the impact on students’ quality of life remained to be examined. The reported study examined the impact of 8-week long web-based MVC intervention on the quality of life of undergraduate students compared to those in the control group. Participants were recruited from a large Canadian university into a two-arm RCT (N = 160) and randomly allocated to the web-based MVC intervention (n = 80) or to the control (n = 80) group. Participants completed online survey at baseline (T1) and at 8-week (T2). The outcome of quality of life was measured by 16-item Quality of Life Scale (QOLS). The generalized estimation equation (GEE) method with AR(1) covariance structures was used, adjusting for potential covariates.ResultsAt the baseline 159 students completed the survey. Participants (32 males, 125 females, 2 other gender) had a mean age of 22.6 years, 57.2% were born in Canada. Participants in MVC (n = 79) and control (n = 80) groups were similar in sociodemographic characteristics except hours of volunteer work. At T2 that coincided with students’ exam period, QOLS score for the control group declined while MVC group had a slight increase. Between-group analysis for QOLS score-change showed a significantly higher score at T2 for MVC group compared to the control (81.64, SD = 14.63 vs. 72.9, SD = 17.26, P < 0.001). Per adjusted GEE analysis, the higher QOLS score in MVC compared to the control group was statistically significant (upbeta = -2.24, P = .03).ConclusionsWeb-based MVC intervention helped the students to have better quality of life, compared to the control group, at 8-week follow-up despite exam stress. Future research with a longer follow-up would advance understanding.Trial registrationhttps://doi.org/10.1186/ISRCTN12249616 Registration Date: 21/06/2017.

A Mindfulness-Based Intervention for Student Depression, Anxiety, and Stress: Randomized Controlled Trial.

BackgroundUniversity students are experiencing higher levels of distress and mental health disorders than before. In addressing mental health needs, web-based interventions have shown increasing promise in overcoming geographic distances and high student-to-counselor ratios, leading to the potential for wider implementation. The Mindfulness Virtual Community (MVC) program, a web-based program, guided by mindfulness and cognitive behavioral therapy principles, is among efforts aimed at effectively and efficiently reducing symptoms of depression, anxiety, and perceived stress in students.ObjectiveThis study’s aim was to evaluate the efficacy of an 8-week MVC program in reducing depression, anxiety, and perceived stress (primary outcomes), and improving mindfulness (secondary outcome) in undergraduate students at a large Canadian university. Guided by two prior randomized controlled trials (RCTs) that each demonstrated efficacy when conducted during regular university operations, this study coincided with a university-wide labor strike. Nonetheless, the students’ response to an online mental health program on a disrupted campus can provide useful information for anticipating the impact of other disruptions, including those related to the COVID-19 pandemic as well as future disruptions.MethodsIn this parallel-arm RCT, 154 students were randomly allocated to an 8-week MVC intervention (n=76) or a wait-list control (WLC) condition (n=78). The MVC intervention included the following: (1) educational and mindfulness video modules, (2) anonymous peer-to-peer discussions, and (3) anonymous, group-based, professionally guided, 20-minute videoconferences. Study outcomes were evaluated at baseline and at 8-week follow-up using the following: Patient Health Questionnaire-9 (PHQ-9), the Beck Anxiety Inventory (BAI), the Perceived Stress Scale (PSS), and the Five Facets Mindfulness Questionnaire Short Form (FFMQ-SF). Generalized estimation equations with an AR (1) covariance structure were used to evaluate the impact of the intervention, with outcome evaluations performed on both an intention-to-treat (ITT) and per-protocol (PP) basis.ResultsParticipants (n=154) included 35 males and 117 females with a mean age of 23.1 years. There were no statistically significant differences at baseline between the MVC and WLC groups on demographics and psychological characteristics, indicating similar demographic and psychological characteristics across the two groups. Results under both ITT and PP approaches indicated that there were no statistically significant between-group differences in PHQ-9 (ITT: β=–0.44, P=.64; PP: β=–0.62, P=.053), BAI (ITT: β=–2.06, P=.31; PP: β=–2.32, P=.27), and FFMQ-SF (ITT: β=1.33, P=.43; PP: β=1.44, P=.41) compared to WLC. There was a significant difference for the PSS (ITT: β=–2.31, P=.03; PP: β=–2.38, P=.03).ConclusionsDuring a university labor strike, the MVC program led to statistically significant reductions in PSS compared to the WLC group, but there were no other significant between-group differences. Comparisons with previous cycles of intervention testing, undertaken during nondisrupted university operations, when efficacy was demonstrated, are discussed.Trial RegistrationISRCTN Registry ISRCTN92827275; https://www.isrctn.com/ISRCTN92827275

Effectiveness of an 8-Week Web-Based Mindfulness Virtual Community Intervention for University Students on Symptoms of Stress, Anxiety, and Depression: Randomized Controlled Trial.

BackgroundA student mental health crisis is increasingly acknowledged and will only intensify with the COVID-19 crisis. Given accessibility of methods with demonstrated efficacy in reducing depression and anxiety (eg, mindfulness meditation and cognitive behavioral therapy [CBT]) and limitations imposed by geographic obstructions and localized expertise, web-based alternatives have become vehicles for scaled-up delivery of benefits at modest cost. Mindfulness Virtual Community (MVC), a web-based program informed by CBT constructs and featuring online videos, discussion forums, and videoconferencing, was developed to target depression, anxiety, and experiences of excess stress among university students.ObjectiveThe aim of this study was to assess the effectiveness of an 8-week web-based mindfulness and CBT program in reducing symptoms of depression, anxiety, and stress (primary outcomes) and increasing mindfulness (secondary outcome) within a randomized controlled trial (RCT) with undergraduate students at a large Canadian university.MethodsAn RCT was designed to assess undergraduate students (n=160) who were randomly allocated to a web-based guided mindfulness–CBT condition (n=80) or to a waitlist control (WLC) condition (n=80). The 8-week intervention consisted of a web-based platform comprising (1) 12 video-based modules with psychoeducation on students’ preidentified life challenges and applied mindfulness practice; (2) anonymous peer-to-peer discussion forums; and (3) anonymous, group-based, professionally guided 20-minute live videoconferences. The outcomes (depression, anxiety, stress, and mindfulness) were measured via an online survey at baseline and at 8 weeks postintervention using the Patient Health Questionnaire-9 (PHQ9), the Beck Anxiety Inventory (BAI), the Perceived Stress Scale (PSS), and the Five Facets Mindfulness Questionnaire Short Form (FFMQ-SF). Analyses employed generalized estimation equation methods with AR(1) covariance structures and were adjusted for possible covariates (gender, age, country of birth, ethnicity, English as first language, paid work, unpaid work, relationship status, physical exercise, self-rated health, and access to private mental health counseling).ResultsOf the 159 students who provided T1 data, 32 were males and 125 were females with a mean age of 22.55 years. Participants in the MVC (n=79) and WLC (n=80) groups were similar in sociodemographic characteristics at T1 with the exception of gender and weekly hours of unpaid volunteer work. At postintervention follow-up, according to the adjusted comparisons, there were statistically significant between-group reductions in depression scores (β=–2.21, P=.01) and anxiety scores (β=–4.82, P=.006), and a significant increase in mindfulness scores (β=4.84, P=.02) compared with the WLC group. There were no statistically significant differences in perceived stress for MVC (β=.64, P=.48) compared with WLC.ConclusionsWith the MVC intervention, there were significantly reduced depression and anxiety symptoms but no significant effect on perceived stress. Online mindfulness interventions can be effective in addressing common mental health conditions among postsecondary populations on a large scale, simultaneously reducing the current burden on traditional counseling services.Trial RegistrationISRCTN Registry ISRCTN12249616; http://www.isrctn.com/ISRCTN12249616

An Eight-Week, Web-Based Mindfulness Virtual Community Intervention for Students' Mental Health: Randomized Controlled Trial.

BackgroundInnovative interventions are needed to address the increasing mental health needs of university students. Given the demonstrated anxiolytic and antidepressant benefits of mindfulness training, we developed an 8-week, Web-based Mindfulness Virtual Community (MVC) intervention informed by cognitive behavioral therapy (CBT) constructs.ObjectiveThis study investigated the efficacy of the MVC intervention in reducing symptoms of depression, anxiety, and stress among undergraduate students in Toronto, Canada. The secondary outcomes included quality of life, life satisfaction, and mindfulness.MethodsThe first 4 weeks of the full MVC intervention (F-MVC) comprised: (1) 12 video-based modules with psycho-education on students’ preidentified stressful topics and topically applied mindfulness practice; (2) anonymous peer-to-peer discussion forums; and (3) anonymous, group-based, professionally guided, 20-min live videoconferences. The second 4 weeks of F-MVC involved access only to video-based modules. The 8-week partial MVC (P-MVC) comprised 12 video-based modules. A randomized controlled trial was conducted with 4 parallel arms: F-MVC, P-MVC, waitlist control (WLC), and group-based face-to-face CBT; results for the latter group are presented elsewhere. Students recruited through multiple strategies consented and were randomized: WLC=40; F-MVC=40, P-MVC=39; all learned about allocation after consenting. The online surveys at baseline (T1), 4 weeks (T2), and 8 weeks (T3) included the Patient Health Questionnaire-9 item, Beck Anxiety Inventory, Perceived Stress Scale, Quality of Life Scale, Brief Multi-Dimensional Students Life Satisfaction Scale, and Five-Facet Mindfulness Questionnaire. Analyses employed generalized estimation equation methods with AR(1) covariance structures and were adjusted for possible confounders (gender, age, birth country, paid work, unpaid work, physical activities, self-rated health, and mental health counseling access).ResultsOf the 113 students who provided T1 data, 28 were males and 85 were females with a mean age of 24.8 years. Participants in F-MVC (n=39), P-MVC (n=35), and WLC (n=39) groups were similar in sociodemographic characteristics at T1. At T3 follow-up, per adjusted comparisons, there were statistically significant reductions in depression scores for F-MVC (score change −4.03; P<.001) and P-MVC (score change −4.82; P<.001) when compared with WLC. At T3, there was a statistically significant reduction in anxiety scores only for P-MVC (score change −7.35; P=.01) when compared with WLC. There was a statistically significant reduction in scores for perceived stress for both F-MVC (score change −5.32; P<.001) and P-MVC (score change −5.61; P=.005) compared with WLC. There were statistically significant changes at T3 for quality of life and mindfulness for F-MVC and P-MVC vs WLC but not for life satisfaction.ConclusionsInternet-based mindfulness CBT–based interventions, such as F-MVC and P-MVC, can result in significant reductions in symptoms of depression, anxiety, and stress in a student population. Future research with a larger sample from multiple universities would more precisely test generalizability.Trial RegistrationInternational Standard Randomized Controlled Trial Number ISRCTN92827275; https://www.isrctn.com/ISRCTN92827275