JMIR Publications

ABSTRACT

Background:

: A student mental health crisis is increasingly acknowledged and will only intensify with the COVID-19 crisis. While the accessibility of methods with demonstrated efficacy in reducing depression and anxiety, (e.g. mindfulness meditation and cognitive behavioural therapy (CBT)), is limited by geographic obstructions and localized expertise, web-based alternatives are vehicles for a scale-up of delivered benefits at modest costs. A mindfulness virtual community (MVC) web-based program informed by cognitive behavioral therapy (CBT) constructs, featuring online videos, discussion forums and video conferencing, was developed to specifically target depression, anxiety and experiences of excess stress among university students.

Objective:

Assessment of an eight-week web-based mindfulness and cognitive behavioural therapy (CBT) program in reducing symptoms of depression, anxiety and stress within a randomized controlled trial (RCT) with undergraduate university students at a large Canadian university.

Methods:

: A 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 condition (WLC) (n=80). The 8-week intervention consisted of a web-based platform comprised of (1)12 video-based modules with psycho-education on students’ preidentified life challenges and typically applied mindfulness practice; (2) anonymous peer-to-peer discussion forums; and (3) anonymous, group-based, professionally guided, 20-min live videoconferences. The outcomes (depression, anxiety and stress) were measured via online survey at baseline and at 8 weeks post-intervention using the Patient Health Questionniare-9 (PHQ9), the Beck Anxiety Inventory (BAI), and the Perceived Stress Scale (PSS). Analyses employed generalized estimation equation (GEE) methods with AR(1) covariance structures and were adjusted for possible confounders (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).

Results:

Of the 159 students who provided T1 data, 32 were males and 125 were females with a mean age of 22.55 years. Participants in MVC (n=79) and WLC (n=80) groups were similar in sociodemographic characteristics at T1 with the exception of gender and weekly number of hours of unpaid volunteer work. At post-intervention follow-up, per adjusted comparisons, there were statistically significant reductions in depression scores (β = -2.16, P=.01) and anxiety scores (β = -4.70, P =.006) compared to WLC. There was no statistically significant reduction in perceived stress for MVC (β =.54, P=.56) compared to WLC.

Conclusions:

MVC significantly reduced depression and anxiety symptoms, but there was no significant effect on perceived stress. Online mindfulness interventions offer an opportunity to address common mental health conditions among post-secondary population on a large scale, simultaneously reducing the current burden on traditional counselling services. Clinical Trial: https://doi.org/10.1186/ISRCTN12249616