Effectiveness of Internet-based Ease with Zen Mindfulness-based Program on Well-being Among General Population in Hong Kong: A Pragmatic Randomized Control Trial (Preprint)

Abstract

Mindfulness practice is gaining popularity within and beyond the traditional Buddhist practice settings across the globe. Most of the self-paced, online, and structured mindfulness programs available were developed in Western countries from a psychological science perspective of mindfulness and were not developed based on Zen teachings.

The present study aims to conduct a pragmatic randomized controlled trial to examine the effectiveness of a 4-week Internet-based self-guided mindfulness program. The program was developed based on Zen teachings and conceptualization of mindfulness with the aims to enhance mental and physical well-being of the general population in Hong Kong. This online mindfulness training program is designed for everyday practice in real-life settings.

Participants were recruited online through social media (e.g., Facebook) and the website of a registered charity organization that promotes mindfulness in Hong Kong. Seven hundred and sixty-two participants (mean age = 48.4, standard deviation = 10.91, 81.8% women) provided valid responses during the baseline assessment. Based on a 1:1 randomization ratio, 383 participants were randomly assigned to the online mindfulness training condition and 378 to the waitlist control condition. Participants in both conditions completed pre-training, post-training, and follow-up assessments at baseline, 1-month post-baseline, and 2-month post-baseline. Participants in the online mindfulness training received the training after the pre-training assessment, while those in the waitlist control condition received the training after the follow-up assessment.

Linear mixed effect models showed that the Internet-based program was effective in improving energy, mental well-being, and in reducing psychological distress, and sleep disturbance, compared to the waitlist control condition across time points. The effect sizes ranged from weak-to-moderate to moderate. No significant difference was observed in perceived pain. Participants in the online training condition also reported higher practice frequency and practice duration compared to the waitlist control condition. They also expressed high levels of satisfaction with the program, considered the difficulty of the program as optimal, and reported that they are willing to continue their mindfulness practice after the end of the online program.

This study empirically evaluated the 4-week Internet-based mindfulness program grounded on the Buddhist teachings for the general population of Hong Kong. Findings supported its effectiveness with a satisfactory retention rate. The program has been disseminated in real life to promote physical and mental health of the Hong Kong general public.

Trial registry: ClinicalTrials.gov PRS Title: Pause and Breathe: Online Self‐Help Mindfulness‐Based Intervention: Investigation of Its Efficacy and Mechanism of Change Registration number: NCT05678972 Link: https://clinicaltrials.gov/study/NCT05678972?locStr=Hong%20Kong&country=Hong%20Kong&cond=NCT05678972&rank=1