Efficacy of Mobile Mindfulness-based Intervention (M-MBI) in reducing stress in emerging adults transitioning out of university – a mixed-method study

Abstract

Transitioning out of university is a multi-layered experience that can be highly stressful for emerging adults (EAs). Evidence suggests that mindfulness-based interventions (MBIs) may improve aspects of psychological well-being. This study aimed to investigate the effectiveness of mobile-MBI (m-MBI) in alleviating stress and improving mental well-being (i.e., worry, mindfulness, and self-compassion) in EAs. The study employed a mixed-methods design, with a 9-week randomised controlled trial (RCT; i.e., 5-week intervention and 4-week follow-up), followed by qualitative interviews. Ninety-two final-year university students (91.5% female, mean age 22.55), the majority with no prior mindfulness experience (77.2%), were randomly assigned to either a 5-week m-MBI group (n=47) or a waitlist group (n=45). Half of the participants randomized to the study did not complete it. Daily mindfulness practices were required, and adherence was tracked within the application. Intention-to-treat (ITT) and per-protocol (PP) analyses were performed. Findings from both analyses suggested that relative to waitlist control, m-MBI exerted a significantly small-to-moderate positive impact on worry (dITT=.40;dPP=.49), even after Bonferroni correction at post-intervention and 1-month follow-up. Perceived stress, self-compassion, and mindfulness were not significantly improved across the three time points after adjusting for multiple comparisons. More participants in the m-MBI group, in comparison with the waitlist group, showed significant and reliable improvements in worry and mindfulness scores throughout the study. Mediation analyses showed that mindfulness and self-compassion together contributed as mediators to perceived stress and that the amount of mindfulness practices was positively associated with the outcomes assessed. Qualitative findings supplemented the benefits found in self-reported measures and further illustrated adherence issues encountered by the participants. These findings suggested the feasibility of a 5-week m-MBI in mental health enhancement, especially worry for EAs in transition. Findings also highlight the importance of including components cultivating mindfulness and self-compassion in m-MBI. Nevertheless, researchers should implement methodologically more rigorous RCTs and examine withdrawals in future m-MBI studies