JMIR Publications

ABSTRACT

Background:

Internet-based mindfulness interventions are a promising approach to address challenges in the dissemination and implementation of mindfulness interventions, but it is unclear how the instructional design components of such interventions are associated with intervention effectiveness.

Objective:

This manuscript identifies instructional design components of Internet-based mindfulness interventions and provides a framework for the classification of those components, relative to intervention effectiveness.

Methods:

The Critical Interpretive Synthesis method was applied. In phase 1, a strategic literature review was conducted to generate hypotheses for the relationship between the effectiveness of Internet-based mindfulness interventions and the instructional design components of those interventions. In phase 2, the literature review was extended to systematically explore and revise the hypotheses from phase 1.

Results:

Eighteen studies were identified in phase 1; fourteen additional studies were identified in phase 2. Eighteen of the 32 Internet-based mindfulness interventions classified as more effective, eleven as less effective, and only three as ineffective. The effectiveness of the interventions increased with the level of support provided by instructional design components. The main difference between effective and ineffective interventions was the presence of just-in-time information in the form of reminders. More effective interventions included more supportive information (scores: 1.91 in phases 1 and 2) than less effective interventions (scores: 1.00 in phase 1 and 1.80 in phase 2), more part-task practice (scores: 1.18 in phase 1 and 1.60 in phase 2) than less effective interventions (scores: 0.33 in phase 1 and 1.40 in phase 2), and provided more just-in-time information (scores: 1.35 in phase 1 and 1.67 in phase 2) than less effective interventions (scores: 0.83 in phase 1 and 1.60 in phase 2). The average duration of more effective, less effective, and ineffective interventions differed for the studies of phase 1, with more effective interventions taking up more time (7.45 weeks) than less effective (4.58 weeks), or ineffective interventions (3 weeks). However, this difference did not extend to the studies of phase 2, with comparable average durations of effective interventions (5.86 weeks), less effective interventions (5.6 weeks), and ineffective interventions (7 weeks).

Conclusions:

Our results suggest that in order to be effective, Internet-based mindfulness interventions must contain four instructional design components: Formal learning tasks, supportive information, part-task practice, and just-in-time information. The effectiveness of the interventions increases with the level of support provided by each of those instructional design components.