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

A systematic review and meta-analysis of eight randomized controlled trials found that preventive online mindfulness interventions significantly reduce perceived stress in non-clinical populations, with a medium effect immediately after the intervention and a large effect at follow-up. Mindfulness showed a small but significant improvement post-intervention and a medium effect at follow-up. The effects were strongest for middle-aged individuals. The interventions, typically simplified versions of Mindfulness-Based Stress Reduction lasting 2 to 12 weeks, were delivered to adult volunteers from academic, workplace, or community settings. The findings suggest that online mindfulness programs offer a convenient and cost-effective alternative to in-person interventions, particularly for busy populations with digital access.

Study at a glance

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.