Effects of preventive online mindfulness interventions on stress and mindfulness: A meta-analysis of randomized controlled trials

Abstract

Empirical evidence suggested that mind-body interventions can be effectively delivered online. This study aimed to examine whether preventive online mindfulness interventions (POMI) for non-clinical populations improve short- and long-term outcomes for perceived-stress (primary) and mindfulness (secondary). Systematic search of four electronic databases, manuscript reference lists, and journal content lists was conducted in 2016, using 21 search-terms. Eight randomized controlled trials (RCTs) evaluating effects of POMI in non-clinical populations with adequately reported perceived-stress and mindfulness measures pre- and post-intervention were included. Random-effects models utilized for all effect-size estimations with meta-regression performed for mean age and %females. Participants were volunteers (adults; predominantly female) from academic, workplace, or community settings. Most interventions utilized simplified Mindfulness-Based Stress Reduction protocols over 2–12 week periods. Post-intervention, significant medium effect found for perceived-stress (g = 0.432), with moderate heterogeneity and significant, but small, effect size for mindfulness (g = 0.275) with low heterogeneity; highest effects were for middle-aged individuals. At follow-up, significant large effect found for perceived-stress (g = 0.699) with low heterogeneity and significant medium effect (g = 0.466) for mindfulness with high heterogeneity. No publication bias was found for perceived-stress; publication bias found for mindfulness outcomes led to underestimation of effects, not overestimation. Number of eligible RCTs was low with inadequate data reporting in some studies. POMI had substantial stress reduction effects and some mindfulness improvement effects. POMI can be a more convenient and cost-effective strategy, compared to traditional face-to-face interventions, especially in the context of busy, hard-to-reach, but digitally-accessible populations.

Effectiveness of occupational e-mental health interventions: a systematic review and meta-analysis of randomized controlled trials

“…The significant moderate effect (g=0.54) on stress reduction is comparable to the findings of previous research conducted in the general population (16). The omission of two outliers (71,70) decreased the effect (from g=0.54 to g=0.44), in accordance with the results of previous meta-analyses in the general population (14,15). Community recruitment significantly enhanced the treatment effect (g=0.79), while workplace recruitment decreased the intervention effect.…”

“…In another meta-analysis, Heber et al (14) reported a small effect size for stress symptoms (Cohen's d=0.43, noted as "d" hereafter). Similar results were found by Jayawardene et al (15) in their meta-analysis of the effectiveness of online mindfulness interventions, who found a small treatment effect (g=0.42), as well as by Spijkerman et al (16), who found a moderate effect size (g=0.51). Moderateto-large effect sizes (0.66<g<0.83) were also found for internet-based interventions for post-traumatic stress (17).…”

“…The effectiveness research on reducing insomnia symptoms in the general population in a previous meta-analysis showed a moderate effect (24). Previous meta-analyses in the general population also demonstrated small effects for well-being and small effects for mindfulness (15,16). The five studies on alcohol intake reported conflicting results.…”

Destress 9-1-1—an online mindfulness-based intervention in reducing stress among emergency medical dispatchers: a randomised controlled trial

“…A recent meta-analysis examining the impact of online MBIs in preventive medicine found moderate to large effects in perceived stress among non-clinical samples of volunteers. 33 Identification of the modules of the training that were more impactful may also assist in developing more intensive materials in content areas found to be most beneficial. As stress levels were measured only pre and post intervention, changes in stress in response to specific modules cannot be determined in this study and should be investigated in future research.…”

Reliable data collection in participatory trials to assess digital healthcare apps

“…In contrast, 6 weeks of an online intervention experiment 22 has revealed that Headspace, which is a healthcare app for mindfulness by guided 23 meditation, has relatively small effects on mindfulness [79]. The outcome contradicts the 24 results of previous randomized controlled trials for the app [49]. Because of such 25 contradictions, there is a need for a reliable mechanism to identify validated digital 26 health apps [69].…”