Effectiveness, Acceptability, and Mechanisms of Change of the Internet-Based Intervention StudiCare Mindfulness for College Students: a Randomized Controlled Trial

Abstract

Abstract Objectives College is an exhilarating but stressful time often associated with mental distress. The StudiCare project offers Internet- and mobile-based interventions (IMI) for college student mental health promotion. Within this framework, we evaluated the IMI StudiCare Mindfulness, and examined potential moderators and mediators of effectiveness. Methods In this randomized controlled trial, 150 college students with low to moderate mindfulness were randomly assigned to StudiCare Mindfulness or a waitlist control group (WL). StudiCare Mindfulness comprises 5 weekly online modules based on Acceptance Commitment Therapy and stress management. Assessments took place before (t0) and 6 weeks after (t1) randomization. Primary outcome was mindfulness. Secondary outcomes were stress, depression, anxiety, quality of life, intervention satisfaction, and adherence. Sociodemographic variables, pre-intervention symptomatology, personality traits, and attitudes towards IMI were examined as potential moderators. Results Intention-to-treat analyses (N = 149) showed a large effect of StudiCare Mindfulness on mindfulness (d = 1.37; 95% CI: 1.01–1.73) compared to WL at t1 (β = 1.18; 95% CI: 0.96–1.40). Effects on secondary outcomes were significant in favor of the intervention group except for physical quality of life. Mindfulness was found to mediate intervention effectiveness on depression, anxiety, and stress. Moderation analysis was non-significant except for baseline openness to experience, with lower openness associated with larger intervention effects on mindfulness. Conclusions This trial suggests that StudiCare Mindfulness may enhance mindfulness and reduce mental health problems. Its potential applicability as low-threshold prevention and treatment option on a population level should be subject to future trials. Trial Registration German Clinical Studies Trial Register TRN: DRKS00012559.