A mindfulness-based mobile health (mHealth) intervention among psychologically distressed university students in quarantine during the COVID-19 pandemic: A randomized controlled trial.
Open accessAbstract
This randomized controlled trial evaluated the effect of a mindfulness-based mobile health (mHealth) intervention, tailored to the pandemic context, among young adult students (N = 114) with elevated anxiety and/or depressive symptoms during quarantine in China, compared to a time- and attention-matched social support-based mHealth control. At baseline, postintervention (1 month), and 2-month follow-up, participants completed self-reports of primary outcomes (anxiety and depression), secondary outcomes (mindfulness and social support), and emotional suppression as a culturally relevant mechanism of change. Feasibility and acceptability were also evaluated. Using intent-to-treat (ITT) analysis, linear mixed effects models showed that compared to social support mHealth, mindfulness mHealth had a superior effect on anxiety (p = .024, between-group d = 0.72). Both conditions improved on depression (baseline-to-FU ds > 1.10, between-group difference not significant, d = 0.36 favoring mindfulness). There was an interaction of Emotional suppression reduction × Condition in the improvement of anxiety and depression. Further, mindfulness mHealth was demonstrated to be more feasible and acceptable in program engagement, evaluation, skills improvement, and perceived benefit. Retention was high in both conditions (>80%). The difference in self-reported adverse effect was nonsignificant (3.9% in mindfulness and 8.7% in social support). Results of this pilot trial suggest that both mindfulness and social support, delivered via mHealth, show promise in reducing distress among young adults in quarantine, with mindfulness being particularly effective in addressing anxiety. Successful implementation and dissemination of this mHealth intervention approach have the potential for addressing the psychological consequences of the pandemic. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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With the challenges that COVID-19 poses to the mental and sexual health of sexual minority young adults, creating a confidential, safe, and supportive online space that fosters development of coping skills such as mindfulness could be an effective and accessible approach to reach and engage vulnerable sexual minority men and enhance population health.
“With the challenges that COVID-19 poses to the mental and sexual health of sexual minority young adults (e.g., increased isolation, lack of access to community support), creating a confidential, safe, and supportive online space that fosters development of coping skills such as mindfulness could be an effective and accessible approach to reach and engage vulnerable sexual minority men and enhance”
From Mindfulness for Reducing Minority Stress and Promoting Health Among Sexual Minority Men: Uncovering Intervention Principles and Techniques (2022) · cites this paper as Sun et al., 2022
Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
Experimental — accuracy not yet measuredThe 4-week MBSR with MBCT RCT (N=144) by Sun et al found reductions in anxiety but not depression in the intervention arm relative to the control arms.
“the 4-week MBSR with mindfulness-based cognitive therapy (MBCT) RCT (N=144) by Sun et al [66] found reductions in anxiety but not depression in the intervention arm relative to the control arms.”
From Psychological Interventions and Those With Elements of Positive Psychology for Child and Youth Mental Health During the COVID-19 Pandemic: Literature Review, Lessons Learned, and Areas for Future Knowledge Dissemination (2024) · cites this paper as [66]
The Method (Procedure) describes a four-week mHealth intervention adapted from MBSR and MBCT, not an MBSR-and-MBCT course. The Method (Analytic Plan) reports 114 randomized participants, not 144. The Results (Primary Mental Health Outcomes) support greater anxiety improvement than in the social-support control, but no significant between-group difference in depression; depression improved in both groups. (LLM, conf=0.93)
Experimental — accuracy not yet measuredOnly one of the studies, the study by Sun et al, evaluated knowledge in relation to self-care, regulating emotions, the mind and body, and coping with stress.
“Only one of the studies, the study by Sun et al [66], evaluated knowledge in relation to self-care, regulating emotions, the mind and body, and coping with stress.”
From Psychological Interventions and Those With Elements of Positive Psychology for Child and Youth Mental Health During the COVID-19 Pandemic: Literature Review, Lessons Learned, and Areas for Future Knowledge Dissemination (2024) · cites this paper as [66]
The Method > Measures section says the study assessed participants’ perceived improvement in coping, emotion regulation, and self-care skills. The Method > Procedure section describes teaching about the mind and body, but the paper does not say it evaluated knowledge in those areas; teaching content and perceived skills are not a knowledge assessment. No page numbers are available in our copy. (LLM, conf=0.85)
Experimental — accuracy not yet measuredOnly one study, the study by Sun et al, reported that participants had learned how to practice mindfulness, including self-regulation of the mind and body.
“Only one study, the study by Sun et al [66], reported that participants had learned how to practice mindfulness, including self-regulation of the mind and body”
From Psychological Interventions and Those With Elements of Positive Psychology for Child and Youth Mental Health During the COVID-19 Pandemic: Literature Review, Lessons Learned, and Areas for Future Knowledge Dissemination (2024) · cites this paper as [66]
The Method > Procedure describes teaching mindfulness practices focused on bodily sensations, mental states, thoughts, and emotions. Results > Evaluation of Feasibility and Acceptability reports greater participant-rated skills improvement in the mindfulness group, and one participant said they learned to regulate their emotions better. It does not report participants specifically saying they learned self-regulation of both mind and body; the claim is more specific than the reported feedback. Page numbers are unavailable in our copy. (LLM, conf=0.82)
Experimental — accuracy not yet measuredThe study by Sun et al found that knowledge of self-care behaviors, emotional regulation, and stress coping improved after the intervention.
“The study by Sun et al [66] found that knowledge of self-care behaviors, emotional regulation, and stress coping improved after the intervention.”
From Psychological Interventions and Those With Elements of Positive Psychology for Child and Youth Mental Health During the COVID-19 Pandemic: Literature Review, Lessons Learned, and Areas for Future Knowledge Dissemination (2024) · cites this paper as [66]
The Results (Evaluation of Feasibility and Acceptability; page unavailable) report greater self-rated skills improvement in the mindfulness group. The Method (Procedure; page unavailable) says the program taught self-care and addressed coping with stress, but the paper does not report measured improvements in knowledge of self-care behaviors or stress coping. Its emotion-regulation finding concerns emotional suppression, not a general improvement in emotional regulation. (LLM, conf=0.86)
Experimental — accuracy not yet measured
Digital delivery was prominent in several included studies.
“Digital delivery was also prominent in several studies [24,32,35,46,48], reflecting the growing interest in online and mobile mindfulness formats.”
From The Effects of Mindfulness Techniques on Anxiety, Depression, and Stress, with an Emphasis on Gratitude: A Systematic Review and Meta-Analysis (2026) · cites this paper as [32]
In total, 7% (3/41) of the interventions included more formal mindfulness techniques derived from mindfulness-based stress reduction (MBSR).
“In total, 7% (3/41) of the interventions included more formal mindfulness techniques derived from mindfulness-based stress reduction (MBSR) [43,56,66].”
Several studies were of mindfulness-based interventions or included mindfulness components.
“Several studies were of mindfulness-based interventions or included mindfulness components [43,44,46,50-52,56,57,60,66-69].”
Among the studies that found interventions improved depression, some were mindfulness-based interventions, others were predominantly CBT interventions, one combined resilience with CBT training, one combined CBT with DBT, one was a multicomponent positive psychological intervention, and one was a yoga intervention.
“Of these studies, some were on mindfulness-based interventions [43,66,68], while others were predominantly CBT interventions [54,59,61,65], with one combining resilience with CBT training [61] and another combining CBT with DBT [65]. In addition, one was a multicomponent positive psychological intervention [53], whereas another was a yoga intervention [45].”
Social support was as effective as mindfulness for alleviating depression, even though mindfulness was helpful, in one study.
“another study found that social support was as effective as mindfulness for alleviating depression even though mindfulness was helpful [66].”
Several studies reported reduced anxiety.
“Several studies reported reduced anxiety [19,47,54,55,59-62,66-68].”
The impact on anxiety was more prominent in some studies for the treatment group than for the control group.
“The impact on anxiety was more prominent in some studies for the treatment group than for the control group [19,59-61,66,68].”
In most (9/17, 53%) included studies, different versions of videoconferencing systems were used to deliver interventions remotely.
“In most (9/17, 53%) of the included studies [54-57,61,62,65-67], different versions of videoconferencing systems were used to deliver the interventions remotely (see Table 2).”
One study found the intervention more accepted and engaging in the treatment group than in the control group.
“Not all studies reported on the feasibility and acceptability of their interventions. Those that did, however, found the intervention to be feasible [57,59] and acceptable [57-59,63], met with high satisfaction [19,62], and more accepted and engaging in the treatment group than in the control group [61].”
The studies conducted by Sun et al, Simonsson et al, and Torok et al found no superior effects of the treatment on depressive symptoms.
“The studies conducted by Sun et al [61], Simonsson et al [66], and Torok et al [64] found no superior effects of the treatment on depressive symptoms.”
Reduced symptoms of depression were found in several studies.
“Reduced symptoms of depression were found in several studies [47,55,58,59,61-63,68], with superiority of the intervention group found in some [47,55,58,59,62,63,68].”
Current evidence suggests meditation apps are beneficial and have some of the strongest empirical support among various mobile phone-based mental health interventions.
“Current evidence suggests meditation apps are beneficial118 and have some of the strongest empirical support among various mobile phone-based mental health interventions117”
From A common factors perspective on mindfulness-based interventions (2022) · cites this paper as [118]
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App-Based Interventions for Moderate to Severe Depression
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ResultTransdiagnostic-focused apps for depression and anxiety: a meta-analysis
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“Social support was found to be superior to CBT in one study for depression [48], whereas another study found that social support was as effective as mindfulness for alleviating depression even though mindfulness was helpful [66].”
BackgroundResultInfluentialMental health apps for depression: A meta‐analysis
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Artificial Intelligence, Digital Health Research, and the Clinical Nurse Specialist
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- Authors
- Sun, S., Lin, D., Goldberg, S., Shen, Z., Chen, P., Qiao, S., Brewer, J., Loucks, E., & Operario, D.
- Affiliations
- Brown University (US)
- Beijing Normal University (CN)
- University of Wisconsin–Madison (US)
- University of South Carolina (US)
- ORCID
- Venue
- Journal of Counseling Psychology
- Published
- 2022-03
- Volume
- 69
- Issue
- 2
- Pages
- 157-171
- ISSN
- 0022-0167 (ISSN-L)
- 1939-2168
- PMC
- PMC8760365
- OpenAlex
- W3181587562
- Cited by
- 138
- References
- 64
- Citations by year
- 2026: 14 · 2025: 15 · 2024: 43 · 2023: 38 · 2022: 25 · 2021: 3
- FWCI
- 24.47
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Journal of Counseling Psychology (publishedVersion, other-oa)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Providence/Boston Center for AIDS Research (P30AI042853)
- National Institutes of Health (K23AT011173, K23AT010879)
- Beijing Normal University
- Topics
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
- Keywords
- mindfulness-based interventions, mobile health, COVID-19 quarantine, university students, psychological distress, anxiety, depression, social support, emotional suppression, young adults, feasibility and acceptability, psychological impact of pandemic
- MeSH terms
- COVID-19, Depression, Humans, Quarantine, Students, Universities, Telemedicine, Young Adult, Pandemics, Mindfulness
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