Feasibility and Acceptability of an Online Mindfulness-Based Intervention for Stress Reduction and Psychological Wellbeing of University Students in Pakistan: A Pilot Randomized Controlled Trial
Anum Sarfraz, Salma Siddiqui, Julieta Galante, Siham Sikander
International Journal of Environmental Research and Public Health April 14, 2023 DOI: 10.3390/ijerph20085512 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Pilot randomized controlled trial Peer reviewed |
|---|---|
| Sample size | 156 |
| Population | Pakistani university students |
| Intervention | Mindfulness Training Course |
| Topics | Meditation |
| Keywords | Randomized controlled trial Mental health Mindfulness-based stress reduction Perceived stress scale Intervention counseling Thematic analysis Clinical psychology Qualitative research Stress linguistics |
| Citations | 14 |
| Key findings | The online Mindfulness Training Course was feasible and acceptable, and associated with higher mindfulness and psychological wellbeing and lower stress compared to a wait-list control. |
Abstract
The rise in mental health concerns of university students is causing a serious hinderance to their wellbeing, impeding their functioning. The socio-economic and political friction in low- and middle-income countries adds to their vulnerability and calls for a cost-effective indigenous intervention. Consequently, this study aimed to inform a large definitive trial by assessing the feasibility and acceptability of a randomized controlled trial (RCT) design evaluating a culturally adapted online Mindfulness Training Course (MTC) used to improve stress and wellbeing among Pakistani university students. A two-arm pilot randomized controlled trial was conducted. University students (n = 156) were randomly assigned to either the MTC group (n = 80) or Wait-list (WL) control group (n = 76) and completed baseline and post-intervention self-report measures for mindfulness, stress and psychological wellbeing. Additionally, semi-structured interviews were conducted with consenting MTC group participants (n = 18) to explore their views about MTC, employing reflexive thematic analysis. Of 80 participants randomized to the MTC group, 32 completed the course, whereas, from the 156 randomized participants, 102 completed assessment surveys. Feasibility and acceptability indicators showed high recruitment, compliance, and adherence to MTC, with practical steps for randomization and online data collection. Further results showed higher levels of mindfulness and psychological wellbeing and lowered stress levels in the MTC group compared to the control group. The attrition and dropout rates were high; however, the feedback from participants who completed the MTC was highly positive and encouraging. In conclusion, if the trial proceeds with increased outreach in a large-scale RCT, the recruitment might be revised to reduce attrition rates. Further recommendations are discussed.
Comparable studies
Other randomized controlled trials on meditation, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Alterations in Brain and Immune Function Produced by Mindfulness Meditation Healthy employees in a work environment | 2003 | Randomized controlled trial | n = 41 |
| Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Recovered recurrently depressed patients | 2000 | Randomized controlled trial | n = 145 |
| Open hearts build lives: Positive emotions, induced through loving-kindness meditation, build consequential personal resources. Working adults | 2008 | Randomized controlled trial | n = 139 |
| Short-term meditation training improves attention and self-regulation Undergraduate Chinese students | 2007 | Randomized controlled trial | n = 40 |
| Mindfulness-Based Cognitive Therapy for Depression: Replication and Exploration of Differential Relapse Prevention Effects. Recovered recurrently depressed patients | 2004 | Randomized controlled trial | n = 73 |
Citations in the library
Cited by 4
- Commentary: Rethinking pathways to well-being: the function of faith practice in distress alleviation among displaced Muslim women affected by war Frontiers in Psychiatry December 1, 2025
- Online mindfulness-based vs. cognitive-behavioural stress reduction for medical students: A randomized controlled trial. Psychiatry Research July 11, 2025
- Mindfulness meditation for pulmonary hypertension program development: Acceptability and feasibility of technology-assisted complementary health intervention for symptom self-management. Heart & Lung 2026
- Effect of Mindfulness Based Stress Reduction Intervention on Undergraduate Nursing Students’ Stress
Cites 17
- Using Self-Report Assessment Methods to Explore Facets of Mindfulness Assessment January 27, 2006
- What defines mindfulness-based programs? The warp and the weft Psychological Medicine December 29, 2016
- Effects of Mindfulness-Based Stress Reduction Intervention on Psychological Well-being and Quality of Life: Is Increased Mindfulness Indeed the Mechanism? Annals of Behavioral Medicine June 1, 2008
- A mindfulness-based intervention to increase resilience to stress in university students (the Mindful Student Study): a pragmatic randomised controlled trial The Lancet Public Health December 18, 2017
- Prospects for a clinical science of mindfulness-based intervention. American Psychologist October 1, 2015
and 12 more in the library