JMIR Publications

ABSTRACT

Background:

College athletes are a group often affected by anxiety. Few interventional studies have been conducted to address the anxiety issues for this population.

Objective:

We conduct a mobile-delivered mindfulness intervention among college athletes to study its feasibility and efficacy in lowering their anxiety level.

Methods:

We recruited 290 college athletes and randomized them into the intervention group and the control group, with the former receiving a therapist-guided, smartphone-delivered mindfulness-based intervention and the latter receiving mental health promotion messages. A mindfulness therapist led a 43-day guided use of the mindfulness app with daily check-ins and discussions of the experience of using the mindfulness app. We conducted qualitative theme analysis of the check-in messages to study the participant feedback about the intervention. We used the intent-to-treat (ITT) and generalized linear models (GLM) to compare the two groups' outcome in dispositional anxiety, pre-tournament anxiety and mid-tournament anxiety, plus the five dimensions of mindfulness (measured by Five-facet Mindfulness Questionnaire).

Results:

Qualitative feedback to the intervention provided mostly positive assessment of our mobile-delivered program. The daily check-in record of our app shows that those in the intervention checked in 53.4% of the time throughout the 43-day intervention. Participants shared the following five common experiences during the meditation sessions: sleepiness, calmness, relaxation, body sensation, and de-centering. Participants also reflected on factors that might compromise the positive meditation including distraction during the meditation session and lack of time available for consistent participation. Our ITT analysis and GLM found no significant difference in dispositional anxiety, pre-tournament anxiety and mid-tournament anxiety. Only the "observation" facet of mindfulness measures had some notable difference between the changes experienced by the two groups, whereby the intervention group had a net gain of 0.214 with marginal level of statistical significance (p=0.089). Participants who specialized in group sports had a higher level of anxiety (β=0.187, SE=0.077), lower level of “nonjudgemental inner experience” in FFMQ (β=-0.067, SE=0.03), and lower level of “non-reactivity” ( β=-0.138, SE=0.052) than those specialized in individual sports.

Conclusions:

While the qualitative feedback and daily check-in record signal the acceptability and feasibility of a smartphone-delivered mindfulness intervention among college athletes, no significant benefit in anxiety reduction was detected in our study. Based upon the participant feedback that the time availability for mindfulness practice and session attendance for these student athletes in an elite college could compromise the intervention effectiveness, future interventions among this population could explore more student-friendly time schedule (e.g., to avoid final exam time) or attempt to improve cognitive and scholastic outcomes. Clinical Trial: Chinese Clinical Trial Registry with trial registration No. ChiCTR1900024449