Abstract
Mental health problems are common in college students and yield poor functional outcomes. Despite these emotional and functional difficulties, only a small percentage of students seek treatment due to barriers such as stigma and lack of resources. College students also prefer Web-based services to in-person services; thus, mobile health interventions may be a favored, viable, and accessible option. Ecological momentary interventions (EMIs) incorporate technology to administer interventions and are widely and effectively applied for heterogeneous psychological problems. Mindfulness-based interventions ameliorate psychological distress and promote psychological well-being in college students. Therefore, the current study examined the effectiveness and perceived utility of an EMI incorporating mindfulness-based messages. Participants were 161 undergraduate students (70.19% female; 80.75% white) randomized to either a mindfulness-based EMI or mood monitoring condition (i.e., ecological momentary assessment (EMA)) for 21 days (2812 daily surveys). Contrary to expectations, the EMA condition did not show different outcomes from the EMI condition. Higher engagement in the mindfulness activities was related to higher levels of positive affect, and participants who reported being more aware of emotions (i.e., thoughts, feelings, and behaviors) due to the messages reported lower emotion dysregulation. More emotional awareness due to the mindfulness messages was related to greater usage of messages and a higher likelihood of recommending skills to a friend, and those reporting increased usage of mindfulness messages were more likely to recommend mindfulness skills to a friend. Participants found the mindfulness messages useful and helpful on average. Implications for research and designing of EMIs are discussed.
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Notes
Given the poor reliability for the Daily Mindfulness Scale, MLMs with each mindfulness item as a separate outcome were examined. No interactions were significant in these three models.
References
Ahmad, F., El Morr, C., Ritvo, P., Othman, N., Moineddin, R., & MVC Team. (2020). An eight-week, web-based mindfulness virtual community intervention for students’ mental health: Randomized controlled trial. JMIR Mental Health, 7(2), e15520. https://doi.org/10.2196/15520
Alsubaie, M. M., Stain, H. J., Webster, L. A., & Wadman, R. (2019). The role of sources of social support on depression and quality of life for university students. International Journal of Adolescence and Youth, 24(4), 484–496. https://doi.org/10.1080/02673843.2019.1568887
Auerbach, R. P., Alonso, J., Axinn, W. G., Cuijpers, P., Ebert, D. D., Green, J. G., Hwang, I., Kessler, R. C., Liu, H., Mortier, P., Nock, M. K., Pinder-Amaker, S., Sampson, N. A., Aguilar-Gaxiola, S., Al-Hamzawi, A., Andrade, L. H., Benjet, C., Caldas-de-Almeida, J. M., Demyttenaere, K., & Bruffaerts, R. (2016). Mental disorders among college students in the World Health Organization World Mental Health Surveys. Psychological Medicine, 46(14), 2955–2970. https://doi.org/10.1017/S0033291716001665
Bambacus, E. S., & Conley, A. H. (2021). The impact of dosage on a mindfulness intervention with first-year college students. Journal of College Student Retention: Research, Theory, & Practice. Advance online publication. https://doi.org/10.1177/15210251211041695
Bamber, M. D., & Morpeth, E. (2019). Effects of mindfulness meditation on college student anxiety: A meta-analysis. Mindfulness, 10(2), 203–214. https://doi.org/10.1007/s12671-018-0965-4
Barlow, D. H., Farchione, T. J., Sauer-Zavala, S., Latin, H. M., Ellard, K. K., Bullis, J. R., Bentley, K. H., Boettcher, H. T., & Cassiello-Robbins, C. (2017). Unified Protocol for transdiagnostic treatment of emotional disorders: Therapist guide. Oxford University Press.
Bergen-Cico, D., Possemato, K., & Cheon, S. (2013). Examining the efficacy of a brief mindfulness-based stress reduction (brief MBSR) program on psychological health. Journal of American College Health, 61(6), 348–360. https://doi.org/10.1080/07448481.2013.813853
Brockman, R., Ciarrochi, J., Parker, P., & Kashdan, T. (2017). Emotion regulation strategies in daily life: Mindfulness, cognitive reappraisal and emotion suppression. Cognitive Behaviour Therapy, 46(2), 91–113. https://doi.org/10.1080/16506073.2016.1218926
Brown, K. W., & Ryan, R. M. (2003). The benefits of being present: Mindfulness and its role in psychological well-being. Journal of Personality and Social Psychology, 84(4), 822–848. https://doi.org/10.1037/0022-3514.84.4.822
Businelle, M. S., Ma, P., Kendzor, D. E., Frank, S. G., Vidrine, D. J., & Wetter, D. W. (2016). An ecological momentary intervention for smoking cessation: Evaluation of feasibility and effectiveness. Journal of Medical Internet Research, 18(12), e321. https://doi.org/10.2196/jmir.6058
Byrne, S. P., Haber, P., Baillie, A., Costa, D. S., Fogliati, V., & Morley, K. (2019). Systematic reviews of mindfulness and acceptance and commitment therapy for alcohol use disorder: Should we be using third wave therapies? Alcohol and Alcoholism, 54(2), 159–166. https://doi.org/10.1093/alcalc/agy089
Cheung, R. Y., Ke, Z., & Ng, M. C. (2020). Dispositional mindfulness and mental health in Chinese emerging adults: A multilevel model with emotion dysregulation as a mediator. PLoS ONE, 15(11), e0239575. https://doi.org/10.1371/journal.pone.0239575
Chiodelli, R., Mello, L. T. N. D., Jesus, S. N. D., Beneton, E. R., Russel, T., & Andretta, I. (2020). Mindfulness-based interventions in undergraduate students: A systematic review. Journal of American College Health, 70(3), 1–10. https://doi.org/10.1080/07448481.2020.1767109
Crane, C., Crane, R. S., Eames, C., Fennell, M. J., Silverton, S., Williams, J. M. G., & Barnhofer, T. (2014). The effects of amount of home meditation practice in mindfulness based cognitive therapy on hazard of relapse to depression in the Staying Well after Depression Trial. Behaviour Research and Therapy, 63, 17–24. https://doi.org/10.1016/j.brat.2014.08.015
Enkema, M. C., McClain, L., Bird, E. R., Halvorson, M. A., & Larimer, M. E. (2020). Associations between mindfulness and mental health outcomes: A systematic review of Ecological Momentary Assessment research. Mindfulness, 11(11), 2455–2469. https://doi.org/10.1007/s12671-020-01442-2
Ennis, E., McLafferty, M., Murray, E., Lapsley, C., Bjourson, T., Armour, C., Bunting, B., Murphy, S., & O’Neill, S. (2019). Readiness to change and barriers to treatment seeking in college students with a mental disorder. Journal of Affective Disorders, 252, 428–434. https://doi.org/10.1016/j.jad.201904.062
Field, A., Miles, J., & Field, Z. (2012). Discovering statistics using R. SAGE.
Finkelstein-Fox, L., Pavlacic, J. M., Buchanan, E. M., Schulenberg, S. E., & Park, C. L. (2020). Valued living in daily experience: Relations with mindfulness, meaning, psychological flexibility, and stressors. Cognitive Therapy and Research, 44(2), 300–310. https://doi.org/10.1007/s10608-019-10062-7
Givens, J. L., & Tjia, J. (2002). Depressed medical students’ use of mental health services and barriers to use. Academic Medicine, 77(9), 918–921.
Gluck, T. M., & Maercker, A. (2011). A randomized controlled pilot study of a brief web-based mindfulness training. BMC Psychiatry, 11(1), 175. https://doi.org/10.1186/1471-244X-11-175
Gratz, K. L., & Tull, M. T. (2010). Emotion regulation as a mechanism of change in acceptance- and mindfulness-based treatments. In R. A. Baer (Ed.), Assessing mindfulness and acceptance: Illuminating the processes of change (pp. 107–133). New Harbinger Publications.
Greeson, J., Garland, E. L., & Black, D. (2014). Mindfulness: A transtherapeutic approach for transdiagnostic mental processes. In A. Ie, C. T. Ngnoumen, & E. J. Langer (Eds.), The Wiley Blackwell handbook of mindfulness (pp. 533–562). John Wiley & Sons, Ltd.
Gu, J., Strauss, C., Bond, R., & Cavanagh, K. (2015). How do mindfulness-based cognitive therapy and mindfulness-based stress reduction improve mental health and wellbeing? A systematic review and meta-analysis of mediation studies. Clinical Psychology Review, 37, 1–12. https://doi.org/10.1016/j.cpr.2015.01.006
Heron, K. E., & Smyth, J. M. (2010). Ecological momentary interventions: Incorporating mobile technology into psychosocial and health behaviour treatments. British Journal of Health Psychology, 15(1), 1–39. https://doi.org/10.1348/135910709X466063
Hill, C. L., & Upderaff, J. A. (2012). Mindfulness and its relationship to emotional regulation. Emotion, 12(1), 81–90. https://doi.org/10.1037/a0026355
Hilton, L., Hempel, S., Ewing, B. A., Apaydin, E., Xenakis, L., Newberry, S., Colaiaco, B., Maher, A. R., Shanman, R. M., Sorbero, M. E., & Maglione, M. A. (2017). Mindfulness meditation for chronic pain: Systematic review and meta-analysis. Annals of Behavioral Medicine, 51(2), 199–213. https://doi.org/10.1007/s12160-016-9844-2
Jennings, K. S., Goguen, K. N., Britt, T. W., Jeffirs, S. M., Wilkes, J. R. III., Brady, A. R., Pittman, R. A., & DiMuzio, D. J. (2017). The role of personality traits and barriers to mental health treatment seeking among college students. Psychological Services, 14(4), 513–523. https://doi.org/10.1037/ser0000157
Kabat-Zinn, J. (2003). Mindfulness-based interventions in context: Past, present, and future. Clinical Psychology: Science and Practice, 10(2), 144–156. https://doi.org/10.1093/clipsy.bpg016
Komiya, N., Good, G. E., & Sherrod, N. B. (2000). Emotional openness as a predictor of college students’ attitudes toward seeking psychological help. Journal of Counseling Psychology, 47(1), 138–143. https://doi.org/10.1037/0022-0167.47.1.138
Kuhlman, S. T., McDermott, R. C., Kridel, M. M., & Kantra, L. M. (2019). College students’ peer-helping behaviors and stigma of seeking help: Testing a moderated mediation model. Journal of American College Health, 67(8), 753–761. https://doi.org/10.1080/07448481.2018.1506791
Langdon, K. J., Scherzer, C., Ramsey, S., Carey, K., Rich, J., & Ranney, M. L. (2021). Feasibility and acceptability of a digital health intervention to promote engagement in and adherence to medication for opioid use disorder. Journal of Substance Abuse Treatment, 131, 108538. https://doi.org/10.1016/j.sat.2021.108538
Lavender, J. M., Tull, M. T., DiLillo, D., Messman-Moore, T., & Gratz, K. L. (2017). Development and validation of a state-based measure of emotion dysregulation: The State Difficulties in Emotion Regulation Scale (S-DERS). Assessment, 24(2), 197–209. https://doi.org/10.1177/1073191115601218
Levin, M. E., MacLane, C., Daflos, S., Seeley, J. R., Hayes, S. C., Biglan, A., & Pistorello, J. (2014). Examining psychological inflexibility as a transdiagnostic process across psychological disorders. Journal of Contextual Behavioral Science, 3(3), 155–163. https://doi.org/10.1016/j.jcbs.2014.06.003
Levin, M. E., Stocke, K., Pierce, B., & Levin, C. (2018). Do college students use online self-help? A survey of intentions and use of mental health resources. Journal of College Student Psychotherapy, 32(3), 181–198. https://doi.org/10.1080/87568225.2017.1366283
Lindsay, E. K., Young, S., Smyth, J. M., Brown, K. W., & Creswell, J. D. (2018). Acceptance lowers stress reactivity: Dismantling mindfulness training in a randomized controlled trial. Psychoneuroendocrinology, 87, 63–73. https://doi.org/10.1016/j.psyneuen.2017.09.015
Lovibond, P. G., & Lovibond, S. H. (1995). The structure of negative emotional states: Comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behaviour Research and Therapy, 33, 335–343. https://doi.org/10.1016/0005-7967(94)00075-u
Lucas-Thompson, R. G., Broderick, P. C., Coatsworth, J. D., & Smyth, J. M. (2019). New avenues for promoting mindfulness in adolescence using mHealth. Journal of Child and Family Studies, 28(1), 131–139. https://doi.org/10.1007/s10826-018-1256-4
Lucas-Thompson, R. G., Rayburn, S., Seiter, N. S., Broderick, P. C., Smyth, J. M., Coatsworth, J. D., & Henry, K. L. (2020). Learning to BREATHE “Plus”: A multi-modal adaptive supplement to an evidence-based mindfulness intervention for adolescents. Frontiers in Public Health. https://doi.org/10.3389/fpubh.2020.579556
Lüdecke, D. (2021). sjstats: Statistical Functions for Regression Models (Version 0.18.1). https://doi.org/10.5281/zenodo.1284472. https://CRAN.R-project.org/package=sjstats.
Morton, M. L., Helminen, E. C., & Felver, J. C. (2020). A systematic review of mindfulness interventions on psychophysiological responses to acute stress. Mindfulness, 11(9), 2039–2054. https://doi.org/10.1007/s12671-020-01386-7
Olmstead, S. B., Roberson, P. N., & Fincham, F. D. (2016). Early psychological distress is a precursor to college men’s later academic and social adjustment. College Student Journal, 50(1), 53–58.
Parsons, C. E., Crane, C., Parsons, L. J., Fjorback, L. O., & Kuyken, W. (2017). Home practice in mindfulness-based cognitive therapy and mindfulness-based stress reduction: A systematic review and meta-analysis of participants’ mindfulness practice and its association with outcomes. Behaviour Research and Therapy, 95, 29–41. https://doi.org/10.1016/j.brat.2014.08.015
Pavlacic, J. M., Schulenberg, S. E., & Buchanan, E. M. (2021). Experiential avoidance and meaning in life as predictors of valued living: A daily diary study. Journal of Prevention and Health Promotion, 2(1), 135–159. https://doi.org/10.1177/2632077021998261
Pinheiro, J., Bates, D., DebRoy, S., Sarkar, D., & R Core Team. (2017). nlme: linear and nonlinear mixed effects models. R package version 3.1–131. https://CRAN.R-project.org/package=nlme
Prakash, R. S., Whitmoyer, P., Aldao, A., & Schirda, B. (2017). Mindfulness and emotion regulation in older and young adults. Aging & Mental Health, 21(1), 77–87. https://doi.org/10.1080/13607863.2015.1100158
Roberts, C., & Torgerson, D. J. (1999). Baseline imbalance in randomised controlled trials. BMJ, 319(7203), 185. https://doi.org/10.1136/bmj.319.7203.185
Sakiris, N., & Berle, D. (2019). A systematic review and meta-analysis of the Unified Protocol as a transdiagnostic emotion regulation based intervention. Clinical Psychology Review, 72, 101751. https://doi.org/10.1016/j.cpr.2019.1017751
Shiffman, S., Stone, A. A., & Hufford, M. R. (2008). Ecological momentary assessment. Annual Review of Clinical Psychology, 4, 1–32. https://doi.org/10.1146/annurev.clinpsy.3.022806.091415
Strohmaier, S. (2020). The relationship between doses of mindfulness-based programs and depression, anxiety, stress, and mindfulness: A dose-response meta-regression of randomized controlled trials. Mindfulness, 11(6), 1315–1335. https://doi.org/10.1007/s12671-020-01319-4
Tang, M. O., Oliffe, J. L., Galdas, P. M., Phinney, A., & Han, C. S. (2014). College men’s depression-related help-seeking: A gender analysis. Journal of Mental Health, 23(5), 219–224. https://doi.org/10.3109/09638237.2014.910639
Taylor, B. L., Strauss, C., Cavanagh, K., & Jones, F. (2014). The effectiveness of self-help mindfulness-based cognitive therapy in a student sample: A randomized controlled trial. Behaviour Research and Therapy, 63, 63–69. https://doi.org/10.1016/j.brat.2014.09.007
Trub, L., & Starks, T. J. (2017). Textual healing: Proof of concept study examining the impact of a mindfulness intervention on smartphone behavior. Mindfulness, 8(5), 1225–1235. https://doi.org/10.1007/s12671-017-0697-y
Versluis, A., Verkuil, B., Spinhoven, P., van der Ploeg, M. M., & Brosschot, J. F. (2016). Changing mental health and positive psychological well-being using ecological momentary interventions: A systematic review and meta-analysis. Journal of Medical Internet Research, 18(6), e152. https://doi.org/10.2196/jmir.5642
Watson, D., Clark, L. A., & Tellegen, A. (1988). Development and validation of brief measures of positive and negative affect: The PANAS scales. Journal of Personality and Social Psychology, 54(6), 1063–1070.
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The draft of the manuscript was written by Jeffrey Pavlacic; all authors provided edits. All authors contributed to study conception and design and read and approved the final manuscript.
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Pavlacic, J.M., Schulenberg, S.E., Witcraft, S.M. et al. Assessing the Effectiveness and Utility of a Mindfulness-Based Ecological Momentary Intervention in College Students. J. technol. behav. sci. 7, 554–566 (2022). https://doi.org/10.1007/s41347-022-00274-2
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DOI: https://doi.org/10.1007/s41347-022-00274-2