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Cited by 517Mindfulness and Compassion InterventionsStudent Stress and CopingDigital Mental Health Interventions

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A mindfulness-based intervention to increase resilience to stress in university students (the Mindful Student Study): a pragmatic randomised controlled trial

Open access
Galante, Julieta, Dufour, Géraldine, Vainre, Maris, Wagner, Adam P, Stochl, Jan, Benton, Alice, Lathia, Neal, Howarth, Emma, Jones, Peter B·2018·The Lancet Public Health
DOI 10.1016/s2468-2667(17)30231-1PMC PMC5813792
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Abstract

BACKGROUND: The rising number of young people going to university has led to concerns about an increasing demand for student mental health services. We aimed to assess whether provision of mindfulness courses to university students would improve their resilience to stress. METHODS: We did this pragmatic randomised controlled trial at the University of Cambridge, UK. Students aged 18 years or older with no severe mental illness or crisis (self-assessed) were randomly assigned (1:1), via remote survey software using computer-generated random numbers, to receive either an 8 week mindfulness course adapted for university students (Mindfulness Skills for Students [MSS]) plus mental health support as usual, or mental health support as usual alone. Participants and the study management team were aware of group allocation, but allocation was concealed from the researchers, outcome assessors, and study statistician. The primary outcome was self-reported psychological distress during the examination period, as measured with the Clinical Outcomes in Routine Evaluation Outcome Measure (CORE-OM), with higher scores indicating more distress. The primary analysis was by intention to treat. This trial is registered with the Australia and New Zealand Clinical Trials Registry, number ACTRN12615001160527. FINDINGS: Between Sept 28, 2015, and Jan 15, 2016, we randomly assigned 616 students to the MSS group (n=309) or the support as usual group (n=307). 453 (74%) participants completed the CORE-OM during the examination period and 182 (59%) MSS participants completed at least half of the course. MSS reduced distress scores during the examination period compared with support as usual, with mean CORE-OM scores of 0·87 (SD 0·50) in 237 MSS participants versus 1·11 (0·57) in 216 support as usual participants (adjusted mean difference -0·14, 95% CI -0·22 to -0·06; p=0·001), showing a moderate effect size (β -0·44, 95% CI -0·60 to -0·29; p<0·0001). 123 (57%) of 214 participants in the support as usual group had distress scores above an accepted clinical threshold compared with 88 (37%) of 235 participants in the MSS group. On average, six students (95% CI four to ten) needed to be offered the MSS course to prevent one from experiencing clinical levels of distress. No participants had adverse reactions related to self-harm, suicidality, or harm to others. INTERPRETATION: Our findings show that provision of mindfulness training could be an effective component of a wider student mental health strategy. Further comparative effectiveness research with inclusion of controls for non-specific effects is needed to define a range of additional, effective interventions to increase resilience to stress in university students. FUNDING: University of Cambridge and National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care East of England.

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Crossref · 10.1016/s2468-2667(17)30231-1

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Figure 1 Participant timeline17 Term dates bar is not to scale.
Figure 1 Participant timeline17 Term dates bar is not to scale.CC BY · PubMed Central
Figure 2 Trial profile MSS=Mindfulness Skills for Students. ITT=intention-to-treat. *Intervention providers comprised one mindfulness teacher, one administrative team, and one centre in which the intervention was done.
Figure 2 Trial profile MSS=Mindfulness Skills for Students. ITT=intention-to-treat. *Intervention providers comprised one mindfulness teacher, one administrative team, and one centre in which the intervention was done.CC BY · PubMed Central
Figure 3 Distress and wellbeing scores Higher CORE–OM scores indicate greater distress and higher WEMWBS scores indicate greater wellbeing. Boxes show median values (middle lines) with 25th and 75th percentiles; whiskers denote values within 1·5 times of the IQR. Circles represent datapoints that fall outside this range. MSS=Mindfulness Skills for Students. CORE–OM=Clinical Outcomes in Routine Evaluation Outcome Measure. WEMWBS=Warwick–Edinburgh Mental Wellbeing Scale.
Figure 3 Distress and wellbeing scores Higher CORE–OM scores indicate greater distress and higher WEMWBS scores indicate greater wellbeing. Boxes show median values (middle lines) with 25th and 75th percentiles; whiskers denote values within 1·5 times of the IQR. Circles represent datapoints that fall outside this range. MSS=Mindfulness Skills for Students. CORE–OM=Clinical Outcomes in Routine Evaluation Outcome Measure. WEMWBS=Warwick–Edinburgh Mental Wellbeing Scale.CC BY · PubMed Central

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Metadata

Authors
Galante, J., Dufour, G., Vainre, M., Wagner, A. P., Stochl, J., Benton, A., Lathia, N., Howarth, E., & Jones, P. B.
Affiliations
  • University of Cambridge (GB)
  • National Institute for Health and Care Research (GB)
  • University of East Anglia (GB)
  • University College London (GB)
Corresponding author
Galante, Julieta
ORCID
Venue
The Lancet Public Health
Publisher
Elsevier BV
Published
2018-02
Volume
3
Issue
2
Pages
e72-e81
ISSN
2468-2667 (ISSN-L)
DOI
10.1016/s2468-2667(17)30231-1
PMC
PMC5813792
OpenAlex
W2778288638
Cited by
516
References
31
Citations by year
2026: 42 · 2025: 69 · 2024: 67 · 2023: 68 · 2022: 71 · 2021: 86 · 2020: 56 · 2019: 46 · 2018: 9
FWCI
37.99
Type
journal article
Language
en
Open access
Licence
Locations
  • The Lancet Public Health (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • UEA Digital Repository (University of East Anglia) (submittedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Apollo (University of Cambridge) (submittedVersion, cc-by)
  • Apollo (cc-by)
Funders
  • National Institute for Health Research
  • University of Cambridge
Topics
  • Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
  • Social Sciences › Psychology › Developmental and Educational Psychology › Student Stress and Coping
  • Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
Keywords
mindfulness-based interventions, stress resilience, university students, student mental health, psychological distress, exam period, mental health support, CORE-OM, student well-being, academic stress, student satisfaction, student engagement, student attendance
MeSH terms
Adolescent, Adult, Female, United Kingdom, Health Promotion, Humans, Male, Mental Health Services, Stress, Psychological, Student Health Services, Students, Universities, Program Evaluation, Resilience, Psychological, Young Adult, Mindfulness

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