An evaluation of a low intensity mHealth enhanced mindfulness intervention for Chinese university students: A randomized controlled trial

• Published in: Psychiatry research 2018-12, Vol.270, p.394-403
• Main Authors: Hall, Brian J., Xiong, Peng, Guo, Xinqi, Sou, Elvo Kuai Long, Chou, Un I, Shen, Zhuozhuo
• Format: Article
• Language: English
• Subjects: Adult; Anxiety; Anxiety - epidemiology; Anxiety - psychology; Anxiety - therapy; Asian Continental Ancestry Group - psychology; Depression; Depression - epidemiology; Depression - psychology; Depression - therapy; Female; Humans; Male; Mental Health - standards; mHealth; Mindfulness; Mindfulness - methods; Mindfulness - standards; Single-Blind Method; Sleep; Sleep - physiology; Stress; Stress, Psychological - epidemiology; Stress, Psychological - psychology; Stress, Psychological - therapy; Students; Students - psychology; Telemedicine - methods; Telemedicine - standards; Universities - standards; Young Adult
• ISSN: 0165-1781; 1872-7123
• DOI: 10.1016/j.psychres.2018.09.060

•The trial showed efficacy for a short two-session mindfulness intervention.•Medium to large effect sizes for depression, anxiety, stress and sleep were observed.•Adherence was not improved by using weekly text message reminders. Mental disorders and sleep dysfunction are common among Chinese university students. This study aimed to evaluate a low cost scalable mindfulness intervention program to improve psychological health and sleep quality among Chinese university students. A randomized controlled trial with 101 university students (mean age 22.30 ± 2.63, 69.31% female) was conducted. Participants were randomized into 4 groups: Group 1: control group (n = 25), Group 2: mindfulness only group (n = 27), Group 3: mindfulness + plain-text reminder group (n = 24), and Group 4: mindfulness + enhanced text reminder with animal meme group (n = 25).The mindfulness intervention consisted of two in-person guided sessions along with weekly self-guided practice for 7 weeks. The Depression, Anxiety and Stress Scale (DASS-21) and The Pittsburgh Sleep Quality Index (PSQI) were used to measure depression, anxiety, stress, and sleep dysfunction. After the intervention at week 4, compared to controls, completers in group 2, 3 and 4 (n = 42) showed significantly reduced depression (Cohen's d = 0.83), anxiety (Cohen's d = 0.84), and stress (Cohen's d = 0.75), and improved subjective sleep quality (Cohen's d = 2.00), sleep latency (Cohen's d = 0.55), and habitual sleep efficiency (Cohen's d = 0.86). The effect was maintained at week 7. Low-intensity mindfulness interventions might be a useful intervention program in university settings.