A systematic review and meta-analysis of online mindfulness-based interventions for university students: an examination of psychological distress and well-being, and attrition rates
Open accessAbstract
Abstract There are increasing concerns about university students’ mental health with mindfulness-based interventions (MBIs) showing promising results. The effect of MBIs delivered digitally to a broad range of university students and study attrition rates remain unclear. This review aimed to explore the effectiveness of online MBIs on university students’ mental health, academic performance and attrition rate of online MBIs. Four databases were searched; both randomised and non-randomised controlled trials were included. Outcomes included mental health-related outcomes and academic performance. Twenty-six studies were identified with outcomes related to mental health. When compared with non-active controls, small to medium statistically significant effect sizes in favour of online MBIs were found for depression, stress, anxiety, psychological distress and psychological well-being at post-intervention. However, these benefits were not seen when online MBIs were compared to active controls and other treatments at post-intervention or follow-up. University students in online MBI arms were more likely to drop out compared to non-active controls and active controls, but no differences were found compared to other treatments. Generally, the included studies’ risk of bias was moderate to high. Online MBIs appear beneficial for improving university students’ mental health when compared to non-active controls post-intervention, but not active controls or other treatments. Findings related to active controls and other treatments should be interpreted with caution due to the small number of studies, the small number of participants in included studies and the degree of heterogeneity in effect sizes.
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Previous studies investigating adherence to on-site versus online interventions reported no significant differences in dropout rates.
“Consistent with our findings, previous studies investigating adherence to on-site versus online interventions reported no significant differences in dropout rates [66,67].”
From Effects of Third-Wave Cognitive Behavioral Therapy for Healthcare Professionals’ Burnout: A Systematic Review and Meta-Analysis (2025) · cites this paper as [66]
The Intervention Characteristics section states that all comparison arms were delivered online, so this review did not compare on-site with online interventions. The Attrition Rate section reports no significant difference between online mindfulness interventions and other online treatments, but significant dropout differences versus its control groups. The claimed on-site-versus-online comparison is contrary to the review's stated design. (LLM, conf=0.88)
Checked by a reasoning model — may be wrong.
Experimental — accuracy not yet measuredThe choice of a waitlist control may have impacted the efficacious outcome, and evidence indicates that trials with active controls often fail to produce statistically significant improvement.
“A further consideration in relation to the study’s design which potentially have impacted the efficacious outcome, is the choice of comparator.”
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- Authors
- Alrashdi, D. H., Chen, K. K., Meyer, C., & Gould, R. L.
- Affiliations
- Princess Nourah bint Abdulrahman University (SA)
- University College London (GB)
- Corresponding author
- Alrashdi, Duaa H.
- Venue
- Journal of Technology in Behavioral Science
- Published
- 2023-05-25
- Volume
- 9
- Issue
- 2
- Pages
- 211-223
- ISSN
- 2366-5963 (ISSN-L)
- OpenAlex
- W4378191807
- Cited by
- 50
- References
- 64
- Citations by year
- 2026: 22 · 2025: 15 · 2024: 11 · 2023: 2
- FWCI
- 2.55
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Journal of Technology in Behavioral Science (publishedVersion, cc-by)
- UCL Discovery (University College London) (submittedVersion, cc-by)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Social Sciences › Psychology › Developmental and Educational Psychology › Student Stress and Coping
- Keywords
- mindfulness-based interventions, online intervention, university students, student mental health, psychological distress, psychological well-being, depression, anxiety, stress, attrition rates, academic performance, digital mental health
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