App-based mindfulness meditation for psychological distress and adjustment to college in incoming university students: a pragmatic, randomised, waitlist-controlled trial

Flett, Jayde A. M.; Conner, Tamlin S.; Riordan, Benjamin C.; Patterson, Tess; Hayne, Harlene

doi:10.1080/08870446.2019.1711089

Cited by 84Mindfulness and Compassion InterventionsDigital Mental Health InterventionsStudent Stress and Coping

App-based mindfulness meditation for psychological distress and adjustment to college in incoming university students: a pragmatic, randomised, waitlist-controlled trial

Flett, Jayde A. M., Conner, Tamlin S., Riordan, Benjamin C., Patterson, Tess, Hayne, Harlene·2020·Psychology & Health

DOI 10.1080/08870446.2019.1711089

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Abstract

Objective and Design: In a pragmatic, randomised, waitlist-controlled trial we tracked 250 first-year university students who were randomly assigned to 3 months of a mindfulness meditation app (Headspace) to use at their discretion in either semester 1 (intervention, n = 124) or semester 2 (waitlist, n = 126). Main Outcome Measures: Students reported their distress, college adjustment, resilience, self-efficacy, and mindfulness, at 3 timepoints: the beginning of semester 1, the beginning of semester 2, and the end of the academic year. With participants’ permission, the university provided academic achievement data and Headspace provided app use data. Results: Evidence for improvements in distress at the beginning of semester 2 was weak (intervention vs. waitlist) and app use was low (M = 7.91, SD = 15.16 sessions). Nevertheless, intervention participants who used the app more frequently reported improvements in psychological distress (−5 points, R2 change = .12) and college adjustment (+10 points, R2 change = .09) when compared to non-users. App initiation and persistence beyond the first week was higher when the app was provided in semester 1 than semester 2 (66.1% vs. 44.4%; 46.0% vs. 32.5%). Conclusion: Headspace use was associated with small improvements in distress and college adjustment in first-year university students. Intervening at the beginning of the academic year may encourage uptake.

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Six studies were included for data analysis.
“Finally, six studies were included for data analysis (Flett et al., 2020; Kladnitski et al., 2020; Levin et al., 2013; Levin et al., 2016; Levin et al., 2020; Viskovich & Pakenham, 2019)”
From Revisión sistemática y metaanálisis de intervenciones transdiagnósticas en línea de tercera generación (2023) · cites this paper as Flett et al., 2020
To the authors' knowledge, there has only been one study to date focused on an online psychological intervention aimed at students with academic adjustment difficulties.
“To our knowledge, there has only been one study to date; it was focused on an online psychological intervention aimed at students with academic adjustment difficulties.”
From Effectiveness and mediators of change of an online CBT intervention for students with adjustment disorder—study protocol for a randomized controlled trial (2023) · cites this paper as [34]
The inclusion of studies with high attrition rates and no significant standalone effect affects the summary effect sizes obtained in meta-analysis.
“as the inclusion of studies with such attrition rates and no signifi -cant standalone effect (Flett et al., 2020; Levin et al., 2016) is necessarily going to affect the summary effect sizes obtained in meta-anal -ysis”
From Revisión sistemática y metaanálisis de intervenciones transdiagnósticas en línea de tercera generación (2023) · cites this paper as Flett et al., 2020

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Effectiveness of Mobile-Based Mindfulness Interventions in Improving Mindfulness Skills and Psychological Outcomes for Adults: a Systematic Review and Meta-regression
Tan, Z. Y. A., Wong, S. H., Cheng, L. J., & Lau, S. T. (2022) · Mindfulness · doi:10.1007/s12671-022-01962-z · Cited by 30 · see citing works
“, 2016) to 3 months (Flett et al., 2020), with session lengths ranging from 1 min (Flett et al.”
BackgroundInfluential
Types of Digital Mindfulness: Improving Mental Health Among College Students – A Scoping Review
Yosep, I., Suryani, S., Mediani, ‎. S., Mardhiyah, A., & Ibrahim, K. (2024) · Journal of Multidisciplinary Healthcare · doi:10.2147/jmdh.s443781 · Cited by 35 · see citing works
A Review of Mindfulness-Based Apps for Children
Nunes, A., Castro, S. L., & Limpo, T. (2020) · Mindfulness · doi:10.1007/s12671-020-01410-w · Cited by 29 · see citing works
Examining How Headspace Impacts Mindfulness Mechanisms Over an 8-Week App-Based Mindfulness Intervention
Gavrilova, L., & Zawadzki, M. J. (2023) · Mindfulness · doi:10.1007/s12671-023-02214-4 · Cited by 30 · see citing works
“However, it is often challenging to identify appropriate control groups for mind-body interventions delivered via smartphone apps, given the need for controls that are equivalent in structure and delivery (Flett et al., 2020).”
BackgroundMethod
Stress Management Apps: Systematic Search and Multidimensional Assessment of Quality and Characteristics
Paganini, S., Meier, E. P., Terhorst, Y., Wurst, R., Hohberg, V., Schultchen, D., Strahler, J., Wursthorn, M., Baumeister, H., & Meßner, E.-M. (2023) · JMIR mhealth and uhealth · doi:10.2196/42415 · Cited by 26 · see citing works
“Details of the evaluations (excluding the pilot studies and the conference paper) can be found in Multimedia Appendix 5 [59-77].”
Background
Efficacy of app-based mobile health interventions for stress management: A systematic review and meta-analysis of self-reported, physiological, and neuroendocrine stress-related outcomes
Sîrbu, V., & David, D. (2024) · Clinical Psychology Review · doi:10.1016/j.cpr.2024.102515 · Cited by 24 · see citing works
Smartphone Use and Mindfulness: Empirical Tests of a Hypothesized Connection
Woodlief, D. T., Taylor, S. G., Fuller, M., Malone, P. S., & Zarrett, N. R. (2024) · Mindfulness · doi:10.1007/s12671-024-02349-y · Cited by 20 · see citing works
“While the development of mindfulness remains understudied, trait mindfulness has been associated with important indicators of psychological well-being (Flett et al., 2020; Semple & Burke, 2019).”
Exploring the views of adolescents with type 1 diabetes on digital mental health interventions: What functionality and content do they want?
Boggiss, A. L., Consedine, N. S., Schache, K. R., Wallace‐Boyd, K., Cao, N., Hofman, P. L., & Serlachius, A. S. (2021) · Diabetic Medicine · doi:10.1111/dme.14591 · Cited by 19 · see citing works
A Mixed-Method Assessment of a 10-Day Mobile Mindfulness Intervention
Haliwa, I., Ford, C. G., Wilson, J. M., & Shook, N. J. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.722995 · Cited by 19 · see citing works
“…stable over time in the absence of intervention 1 https://www.headspace.com (Brown and Ryan, 2003; Rau and Williams, 2016), evidence suggests that trait levels of mindfulness can be augmented following repeated induction of mindful states (Garland et al., 2010; Kiken et al., 2015; Tang, 2017).”
Background
Mobile apps to reduce depressive symptoms and alcohol use in youth: A systematic review and meta-analysis
Magwood, O., Saad, A., Ranger, D., Volpini, K., Rukikamirera, F., Haridas, R., Sayfi, S., Alexander, J., Tan, Y., & Pottie, K. (2024) · Campbell Systematic Reviews: Better Evidence for a Better World · doi:10.1002/cl2.1398 · Cited by 18 · see citing works
“…stress that approached statistical significance and clinical importance among participants receiving the mindfulness mobile apps compared to those in the withheld control (Pooled SMD = − 0.27; 95% CI: − 0.56, 0.03; p =0.07) (Flett, 2020; Huberty, 2019; Lee, 2018; Levin, 2020) (Figure 16).”
BackgroundMethodInfluential
Lifestyle behaviours and mental health and wellbeing of tertiary students during COVID-19 lockdown in Australia: A cross-sectional study
Dash, S. R., Bourke, M., Parker, A. G., Dadswell, K., & Pascoe, M. C. (2022) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2022.152324 · Cited by 18 · see citing works
“Previous interventions have shown mindfulness interventions delivered briefly or online to improve psychological distress [12,30,55,67], suggesting interventions targeting mindfulness may be the most feasible under pandemic or crisis conditions.”
Acceptability and Effectiveness of NHS-Recommended e-Therapies for Depression, Anxiety, and Stress: Meta-Analysis
Simmonds‐Buckley, M., Bennion, M. R., Kellett, S., Millings, A., Hardy, G. E., & Moore, R. K. (2020) · Journal of Medical Internet Research · doi:10.2196/17049 · Cited by 16 · see citing works
“Since the final searches, trials of 3 NHS e-therapies (all with existing trial evidence) have been published; an RCT of SilverCloud used in IAPT [77], evaluations of MoodGYM [78], and Headspace in student samples [79,80].”
Experiences with and Perception of a Web-Based Mindfulness, Nutrition, and Fitness Platform Reported by First-Year University Students: A Qualitative Study
Lieffers, J. R. L., Quintanilha, M., Trottier, C. F., Johnson, S. T., Mota, J. F., & Prado, C. M. (2021) · Journal of the Academy of Nutrition and Dietetics · doi:10.1016/j.jand.2021.04.019 · Cited by 13 · see citing works
Enhancing psychological skills and well-being in sport through an app-based blended intervention: a randomized controlled pilot study
Bordo, S., Costanzo, G., & Villani, D. (2025) · BMC Psychology · doi:10.1186/s40359-025-02824-8 · Cited by 21 · see citing works
“One of the best known and most downloaded apps is Headspace [24], which uses mindfulness and meditation exercises to help the user learn about and practice meditation [25].”
Attrition in Psychological mHealth Interventions for Young People: A Meta-Analysis
Prior, E., Dorstyn, D., Taylor, A. M., & Rose, A. (2023) · Journal of Technology in Behavioral Science · doi:10.1007/s41347-023-00362-x · Cited by 14 · see citing works
“Additionally, two reports each provided data for two independent samples (Flett et al., 2020; O’Dea et al., 2020).”
Too Much or Not Enough of a Good Thing?: Reconciling Differing Perspectives on the Optimal Dose of Mindfulness Meditation and Advancing a Dose-Response Research Agenda
Bowles, N. I., Davies, J. N., Strohmaier, S., Galante, J., & Van Dam, N. T. (2026) · Journal of Contemplative Studies · doi:10.57010/caxs3076 · Cited by 14 · see citing works
Web-based training for post-secondary student well-being during the pandemic: a randomized trial
Wang, Y., & Farb, N. A. S. (2022) · Anxiety Stress & Coping · doi:10.1080/10615806.2022.2079637 · Cited by 13 · see citing works
“Similarly, students who reported more frequent use of the mindfulness meditation app, Headspace, demonstrated enhanced psychological symptoms and college adjustment (Flett et al., 2020).”
Background
Is Dosage of a Meditation App Associated With Changes in Psychological Distress? It Depends on How You Ask
Goldberg, S. B., Kendall, A. D., Hirshberg, M. J., Dahl, C. J., Nahum-Shani, I. B., Davidson, R. J., & Bray, B. C. (2024) · Clinical Psychological Science · doi:10.1177/21677026241266567 · Cited by 13 · see citing works
“Using nonexperi-mental designs, Flett et al. (2020) and Goldberg, Imhoff-Smith, et al. (2020) both found positive associations between higher app use and larger decreases in psychological distress among adults, although Flett et al. defined app use as total number of times the app was opened, and…”
Acceptability, usage, and efficacy of mindfulness apps for college student mental health: A systematic review and meta-analysis of RCTs
LaMontagne, L. G., Doty, J. L., Diehl, D. C., Nesbit, T. S., Gage, N. A., Kumbkarni, N., & Leon, S. P. (2024) · Journal of Affective Disorders · doi:10.1016/j.jad.2024.09.014 · Cited by 13 · see citing works
Can a virtual human increase mindfulness and reduce stress? A randomised trial
Karhiy, M., Sagar, M. A., Antoni, M. H., Loveys, K., & Broadbent, E. (2024) · Computers in Human Behavior Artificial Humans · doi:10.1016/j.chbah.2024.100069 · Cited by 13 · see citing works
Does Using a Mindfulness App Reduce Anxiety and Worry? A Randomized-Controlled Trial
Abbott, D., Lack, C. W., & Anderson, P. L. (2023) · Journal of Cognitive Psychotherapy · doi:10.1891/jcpsy-d-20-00058 · Cited by 14 · see citing works
The Benefits of Mindfulness for University Students
Maher, C. M. (2021) · Building Healthy Academic Communities Journal · doi:10.18061/bhac.v5i1.7735 · Cited by 11 · see citing works
“Flett et al. (2020) studied the impact of an app-based mindfulness meditation upon psychological distress and college adjustment in incoming university students.”
BackgroundInfluential
Contemplating library instruction: Integrating contemplative practices in a mid-sized academic library
Duffy, B. E., Rose-Wiles, L., & Loesch, M. F. (2021) · The Journal of Academic Librarianship · doi:10.1016/j.acalib.2021.102329 · Cited by 11 · see citing works
Challenges encountered with a mindfulness app: Lessons learnt from a pilot randomized trial involving caregivers and individuals with autism
Hartley, M., Dorstyn, D., & Due, C. (2022) · Research in Autism · doi:10.1016/j.rasd.2022.101991 · Cited by 11 · see citing works
Mindfulness interventions for offsetting health risk following early life stress: Promising directions
Lindsay, E. K. (2021) · Brain, Behavior, & Immunity - Health · doi:10.1016/j.bbih.2021.100338 · Cited by 10 · see citing works
“test whether remote MBIs are abandoned before mindfulness skills are developed (Flett et al., 2020; Linardon and Fuller-Tyszkiewicz, 2020).”
Background
Key Components and Content of Effective Evidence-Based Digital Prevention Programs for Anxiety and Depression in Children and Adolescents: A Systematic Umbrella Review
Reitegger, F., Peras, I., Wright, M., & Gasteiger‐Klicpera, B. (2024) · Adolescent Research Review · doi:10.1007/s40894-024-00237-z · Cited by 13 · see citing works
Effects of Resilience Interventions for Adolescents and Young Adults Without Psychiatric Diagnoses: A Systematic Review and Network Meta-analysis of Randomized Controlled Trials
Ciren, Z., Tsui, H. K. H., & Chan, S. K. W. (2025) · Adolescent Research Review · doi:10.1007/s40894-025-00270-6 · Cited by 17 · see citing works
Associations between psychological distress and facets of mindfulness: Implications for campus-based university wellness services
Burger, J. W., Bantjes, J. R., Derman, W. E., Whitesman, S., & Gomez‐Ezeiza, J. (2021) · Journal of American College Health · doi:10.1080/07448481.2021.1920601 · Cited by 8 · see citing works
Filling the mental service gap on campus: an effectiveness trial testing the utility of app-based mindfulness psychological intervention for college students
Min, Y., Choi, Y.-S., & Kim, B. (2023) · Current Psychology · doi:10.1007/s12144-023-05402-6 · Cited by 10 · see citing works
“…scope in terms of participants and outcomes, unlike previous studies that focused on a specific population (e.g., only freshmen in college, Flett et al., 2020), a specific outcome (e. g., depression, Fish & Saul, 2019) and problematic symptoms only (depression, anxiety, and stress,…”
Influential
Characteristics Associated With the Use of the Mindfulness Meditation App Headspace in a Large Public Health Deployment: Cross-Sectional Survey Study
Borghouts, J. W., Eikey, E. V., Leon, C. D., Schueller, S. M., Schneider, M. L., Stadnick, N. A., Zheng, K., Mukamel, D. B., & Sorkin, D. H. (2025) · JMIR Formative Research · doi:10.2196/73457 · Cited by 8 · see citing works
“In addition, study participants received the app for free and were given recurring reminders to use the app [9] or daily surveys about their use of the app [20], which may have impacted engagement.”
Assessing the mindfulness predictors of mental health: does mindfulness practise or dispositional mindfulness better protect young peoples’ mental health?
Juozelskyte, G., & Catling, J. C. (2024) · Health Psychology and Behavioral Medicine · doi:10.1080/21642850.2024.2305723 · Cited by 7 · see citing works
Effective elements of eHealth interventions for mental health and well-being in children and adolescents: A systematic review
Dietvorst, E., de Vries, L. P., van Eijl, S., Mesman, E., Legerstee, J. S., Keijsers, L., Hillegers, M. H. J., & Vreeker, A. (2024) · Digital Health · doi:10.1177/20552076241294105 · Cited by 9 · see citing works
Systematic Review of Mindfulness-Based Ecological Momentary Interventions: Synthesizing Current Methods and Identifying Directions for Future Research
Pavlacic, J. M., Hampton, B. N., Young, J. N., Witcraft, S. M., Flores, C. M. N., Vázquez, A. L., & Rheingold, A. A. (2024) · Journal of Technology in Behavioral Science · doi:10.1007/s41347-024-00416-8 · Cited by 6 · see citing works
“In certain cases, use of applications was lower (Flett et al., 2020), some participants reported that the apps geared toward management of self-harm and suicidal acts would not keep them safe if experiencing a crisis (Muscara et al., 2020), and compliance with data entry was low (e.g., when…”
Engagement With Meditation Apps: Cross-Sectional Survey of Use and Associations
Adams, J., Davies, J. N., Wattanatakulchat, P., Galante, J., Miller, F., D’Alfonso, S., & Dam, N. T. V. (2025) · Journal of Medical Internet Research · doi:10.2196/71960 · Cited by 4 · see citing works
The Relationship between Resilience, Wellbeing, and Psychological Distress as Mediated by Mindfulness and Coping
Pangngay, J. J. (2024) · Philippine Social Science Journal · doi:10.52006/main.v6i3.754 · Cited by 6 · see citing works
Effectiveness and mediators of change of an online CBT intervention for students with adjustment disorder—study protocol for a randomized controlled trial
Juszczyk-Kalina, A., Holas, P., & Farchione, T. J. (2023) · Trials · doi:10.1186/s13063-023-07744-9 · Cited by 4 · see citing works
“Unfortunately, the study was limited by low app usage [34].”
Background
An Exploratory Study of Chatbot-Based Mindfulness for Mental Health Support
Wang, Y., & Farb, N. A. S. (2025) · Mindfulness · doi:10.1007/s12671-025-02685-7 · Cited by 6 · see citing works
“Similarly, Flett et al. (2020) observed that students who regularly used the mindfulness meditation app (Headspace) reported improved psychological symptoms and better adjustment to college life.”
Acceptability, engagement, outcomes, and dose–response associations of a mindfulness-based meditation app in individuals waiting for psychological services
Daros, A. R., Patel, A., Otevwe, O., Sotelo, S., Saab, B. J., & Quilty, L. C. (2025) · BMC Digital Health · doi:10.1186/s44247-025-00155-7 · Cited by 3 · see citing works
Feasibility and effect of a self-help online acceptance and commitment therapy program focused on repetitive negative thinking for Colombian young women
Sierra, M. A., & Ortíz, E. (2023) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2023.03.010 · Cited by 10 · see citing works
Buddhist Practices Enhancing Positive Life: Mindfulness and Beyond
Khanna, P., Singh, K. K., & Dua, S. (2023) · Springer eBooks · doi:10.1007/978-981-99-2397-7_7 · Cited by 3 · see citing works
Chatbot-Based Interventions for Mental Health SupportPreprint
Wang, Y., & Farb, N. A. S. (2024) · doi:10.31234/osf.io/xj7cz · Cited by 3 · see citing works
The Use of Mindfulness Meditation Apps Improves Mental Health Among Graduate Students
Grogan, K. A. (2025) · Mindfulness · doi:10.1007/s12671-025-02652-2 · Cited by 2 · see citing works
“…of apps to improve some aspect of well-being among student populations (Abbott, 2018; Borjalilu et al., 2019; Fish & Saul, 2019; Flett et al., 2019; Flett et al., 2020; Huberty et al., 2019; Lee & Jung, 2018; Levin et al., 2020; Nolan, 2019; Noone & Hogan, 2018; Siembor, 2017; Walsh et al., 2019;…”
Fostering resilience by means of an online academic course: Exploring the mediating effects of self-esteem, body esteem and mental status
Golan, M., Cohen-Asiag, D., & Ankori, G. (2023) · Mental Health & Prevention · doi:10.1016/j.mhp.2023.200268 · Cited by 2 · see citing works
Revisión sistemática y metaanálisis de intervenciones transdiagnósticas en línea de tercera generación
Sierra, M. A., & Ortiz, E. (2023) · Interdisciplinaria Revista de Psicología y Ciencias Afines · doi:10.16888/interd.2023.40.2.5 · Cited by 1 · see citing works
Addressing Psychological Distress in College Students Through Mindfulness Training: A Pre–Post Intervention Across Three Cohorts with Different Delivery Methods
Ciacchini, R., Villani, S., Miniati, M., Orrù, G., Gemignani, A., & Conversano, C. (2025) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph22071027 · Cited by 2 · see citing works
“Conversely, a smaller body of research suggests that digitally delivered mind-fulness interventions—including those utilizing virtual assistants, chatbots, or mobile applications—can be as effective as human-facilitated telehealth formats [55–57].”
Effectiveness of Mindfulness-Based Apps in Mitigating Psychological Distress Among Youth: A Systematic Review and Meta-Analysis
Lin, J.-T., Syu, J.-N., & Lin, E. C. (2026) · Mindfulness · doi:10.1007/s12671-026-02898-4 · Cited by 1 · see citing works
“Some trials have reported that short-term app use can mitigate distress and depressive symptoms (Levin et al., 2022; Min et al., 2024); others had nonsignificant effects (Flett et al., 2020; Nolan, 2019), leaving the evidence inconsistent and fragmented.”
Intervenciones basadas en mindfulness en estudiantes universitarios: revisión sistemática y fundamentos neuroeducativos
Cheuquemán, C., Cerda, C., Fernàndez‐Carriba, S., & León, M. (2025) · Revista Colombiana de Educación · doi:10.17227/rce.num96-19371 · Cited by 1 · see citing works
“Las intervenciones destinadas a reducir el estrés o la angustia pueden conducir a una mejor salud mental, una mejor adaptación de los estudiantes y finalización de la universidad (Flett et al. , 2020).”
Use of a mindfulness application to promote students’ mental well‐being during COVID‐19‐era
Rath, A., Wong, M. L. Z., Wong, N., & Brockman, R. N. (2021) · Journal of Dental Education · doi:10.1002/jdd.12635 · Cited by 1 · see citing works
The effectiveness of mindfulness therapy on rumination and distress tolerance in adolescent girls with high body mass index
ghehi, A. T., Moradi, H., & Bigdeli, H. (2023) · journal of Adolescent and Youth Psychological Studies · doi:10.52547/jspnay.4.3.72 · Cited by 1 · see citing works
The effects of mindfulness meditation on burnout in clinical genetic counselors: A three-arm randomized controlled trial
Caleshu, C., Campion, M., Austin, J. J., Goldin, P., Silver, J., & Tibben, A. (2026) · PubMed · doi:10.1002/jgc4.70241
“…live classes, has been shown to be effective for a variety of outcomes, including stress, burnout, and other aspects of professional well-being (Bostock et al., 2019 ; Champion et al., 2018; Gál et al., 2021 ; Flett et al., 2020; Radin et al., 2025; Taylor et al., 2022; Zawadzki et al., 2025 ).”
The Impact of Mindfulness Practices and the Implementation of Technology in Higher Education
Sharif, S., Statti, A. L. C., & Torres, K. M. (2021) · Advances in human and social aspects of technology book series · doi:10.4018/978-1-7998-8318-0.ch010
Meeting the mental health needs of college-aged young adults: evaluating the value and impact of digital mental health interventions.
Choate, S. A. (2022) · doi:10.18297/etd/3980
Understanding Headspace Use during a COVID-19 Response Program: A Cross-Sectional Survey Study (Preprint)Preprint
Borghouts, J. W., Eikey, E. V., Leon, C. D., Schueller, S. M., Schneider, M. L., Stadnick, N. A., Zheng, K., Mukamel, D. B., & Sorkin, D. H. (2023) · doi:10.2196/preprints.53161
The effectiveness of mindfulness therapy on rumination and distress tolerance in adolescent girls with high body mass index
ghehi, A. T., Moradi, H., & Bigdeli, H. (2023) · doi:10.61838/kman.jayps.4.3.6
SmartHealth: Artificial Intelligence for Lifelong Personalized Health Care
Santos, J., Faria, L., & Martins, C. L. (2024) · Lecture notes in networks and systems · doi:10.1007/978-3-031-47718-8_36
Examining the Dose-Response Effects of Mindfulness Meditation Interventions on Well-Being: Protocol for a Randomized Controlled Trial
Bowles, N., Burger, A., Davies, J. N., Simpson, J. A., Galante, J., Dennis, S., Stone, B., & Van Dam, N. T. (2025) · JMIR Research Protocols · doi:10.2196/72786
Predicting Intention to Continue as a Precursor to Habit Formation Through Persistent Use and Mental Clarity in Digital Mindfulness Apps
Prasad, N. K., Bhardwaj, A. B., & Krishnakumar, L. (2025) · International Conference on Computational Intelligence and Knowledge Economy (ICCIKE) · doi:10.1109/iccike67021.2025.11318265
Meditation App Use May Decrease State Anxiety
Burton, L. A., Tatnall, A., & Frumento, A. (2026) · Journal of Educational Cultural and Psychological Studies (ECPS Journal) · doi:10.7358/ecps-2025-032-burt
Systematic Review of Digital Mental Health Products for Employees: Features, Evidence, and Gaps in Addressing Diverse Needs
Moon, K. C., Romano, R. J., Madden, S. P., Koroly, L., Levak, S., Morgenstern, J., & Sapra, M. (2026) · Journal of Technology in Behavioral Science · doi:10.1007/s41347-025-00579-y
Mental health outcomes and use of online mental health tools following a public health deployment of the mindfulness meditation app headspace
Borghouts, J. W., Eikey, E. V., Leon, C. D., Kim, J., Schueller, S. M., Schneider, M. L., Stadnick, N. A., Zheng, K., & Sorkin, D. H. (2026) · Frontiers in Digital Health · doi:10.3389/fdgth.2026.1793455
Digital and In-Person Mindfulness-Based Interventions for University Students’ Mental Health: A Systematic Review of Randomized Controlled Trials
Roy, S., Kanekar, A. S., Biswas, A. K., & Sharma, M. (2026) · Healthcare · doi:10.3390/healthcare14131875
“In contrast, some interventions were entirely self-guided, particularly those delivered through mobile applications or audio recordings [30,35].”
Influential
Mindfulness-based interventions for student coping in higher education: a systematic review
Naidu, S., & Roman, N. V. (2026) · Advances in Mental Health · doi:10.1080/18387357.2026.2692478
Effectiveness of a virtual reality-based mindfulness intervention for ADHD symptoms in college students: A randomized controlled trial
Lee, Y.-S., Hwang, J., & Youn, B.-Y. (2026) · Digital Health · doi:10.1177/20552076261478221
Sharper Minds online: Effects of self-paced mental health modules on university students’ mental health literacy, peer support, and self-care behaviours
Han, R., Maccallum, F., Walter, Z. C., Tanksale, R., Huang, K., Alhadad, S. S. J., Beckman, E. M., Bentley, S. V., Gomersall, S. R., Hides, L. M., et al. (2026) · Mental Health & Prevention · doi:10.1016/j.mhp.2026.200552 · Cited by 1 · see citing works
Testing How Mindfulness Skills Change for Novice Meditators Using Headspace: Examining Trait Mindfulness and Perceived Stress as Moderators
Peña, M., Zawadzki, M. J., Gavrilova, L., & Hagger, M. S. (2026) · Stress and Health · doi:10.1002/smi.70215
“The app has been used in prior intervention research (Flett et al. 2020) and been rated as high‐quality in comparison to other commercially available meditation apps (Mani et al. 2015).”
Effectiveness and mechanisms of internet-delivered transdiagnostic CBT for students with adjustment disorder: the role of cognitive inflexibility, self-compassion, and mindfulness
Juszczyk-Kalina, A., Farchione, T. J., Williams, A. L., & Holas, P. (2026) · Cognitive Behaviour Therapy · doi:10.1080/16506073.2026.2720139
Digital Mindfulness as a Pedagogical Strategy for Student Engagement in Hybrid Learning: A Systematic Review
Firdaus, D., Rochimah, H., & Armiati, R. (2026) · F1000Research · doi:10.12688/f1000research.191569.1

The impact of mobile mindfulness meditation on mental health and well-being in university students
Flett, J. A. M. (2020) · Otago University Research Archive (University of Otago) · Cited by 1 · see citing works
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Mobile Mindfulness Meditation: a Randomised Controlled Trial of the Effect of Two Popular Apps on Mental Health
Flett, J. A. M., Hayne, H., Riordan, B. C., Thompson, L. M., & Conner, T. S. (2019) · Mindfulness · doi:10.1007/s12671-018-1050-9 · Cited by 338 · see citing works
Self-citation
The Efficacy of the Mobile Application-Based Mindfulness Mediation on Adjustment of College Students in Hong Kong: A Randomized Controlled Trial
Chui, R. C. F., Siu, N. Y.-F., Tsui, W.-M., & Wong, C. Y.-T. (2020) · Educational communications and technology yearbook · doi:10.1007/978-981-15-8167-0_14 · Cited by 1 · see citing works
Efficacy of the Mindfulness Meditation Mobile App “Calm” to Reduce Stress Among College Students: Randomized Controlled Trial
Huberty, J., Green, J., Glissmann, C., Larkey, L., Puzia, M., & Lee, C. (2019) · JMIR mHealth and uHealth · doi:10.2196/14273 · Cited by 488 · see citing works
Brief App-Based Mood Monitoring and Mindfulness Intervention for First-Year College Students: A Randomized Controlled Trial
Hilt, L. M., Vachhani, S. S., Vaghasia, N. V., Swords, C. M., & Sage, A. J. (2025) · Journal of Psychopathology and Behavioral Assessment · doi:10.1007/s10862-025-10196-x · Cited by 6 · see citing works

Authors: Flett, J. A. M., Conner, T. S., Riordan, B. C., Patterson, T., & Hayne, H.
Affiliations: University of Otago (NZ)
North-West University (ZA)
Corresponding author: Flett, Jayde A. M.
ORCID: Flett, Jayde A. M.
Conner, Tamlin S.
Riordan, Benjamin C.
Patterson, Tess
Hayne, Harlene
Venue: Psychology & Health
Publisher: Informa UK Limited
Published: 2020-02-12
Volume: 35
Issue: 9
Pages: 1049-1074
ISSN: 0887-0446 (ISSN-L)
1476-8321
DOI: 10.1080/08870446.2019.1711089
OpenAlex: W3005590806
Cited by: 84
References: 62
Citations by year: 2026: 13 · 2025: 13 · 2024: 14 · 2023: 15 · 2022: 10 · 2021: 15 · 2020: 4
FWCI: 4.37
Type: journal article
Language: en
Open access: closed
Locations: Psychology and Health (publishedVersion)
PubMed (publishedVersion)
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 meditation, Headspace app, mobile health, psychological distress, college adjustment, first-year students, resilience, self-efficacy, intervention uptake, intervention persistence, academic performance
MeSH terms: Emotional Adjustment, Psychological Distress, Adolescent, Female, Humans, Male, New Zealand, Psychotherapy, Students, Universities, Waiting Lists, Treatment Outcome, Meditation, Young Adult, Mobile Applications, Mindfulness

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App-based mindfulness meditation for psychological distress and adjustment to college in incoming university students: a pragmatic, randomised, waitlist-controlled trial

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