A Mindfulness-Based Mobile Health (mHealth) Intervention Among Psychologically Distressed University Students in Quarantine During the COVID-19 Pandemic: A Randomized Controlled Trial

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 x 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. Public Significance Statement This study provides initial empirical support for a tailored, mHealth approach in the application of both mindfulness and social support-based interventions to mitigate psychological distress among young adults in the pandemic context. Successful implementation and dissemination of this or similar approaches have the potential to improve access to psychological services, reduce provider burden, and enhance public mental health.

Automated summary

This randomized controlled trial evaluated the effect of a mindfulness-based mobile health intervention tailored to young adult students with elevated anxiety and/or depressive symptoms during quarantine in China, compared to a social support-based mHealth control. The results showed that mindfulness mHealth had a superior effect on anxiety, while both interventions improved depression. Mindfulness was particularly effective in addressing anxiety, with high feasibility and acceptability in engagement and perceived benefit.