Web-Based Mindfulness-Based Interventions for Well-being: Randomized Comparative Effectiveness Trial.
Louisa G Sylvia, Mitchell R Lunn, Juno Obedin-Maliver, Robert N McBurney, W Benjamin Nowell, Rachel L Nosheny, Richard A Mularski, Millie D Long, Peter A Merkel, Mark J Pletcher, Roberta E Tovey, Christopher Scalchunes, Rebecca Sutphen, Ann S Martin, Elizabeth J Horn, Megan O'Boyle, Lisa Pitch, Michael Seid, Susan Redline, Sophie Greenebaum, Nevita George, Noah J French, Caylin M Faria, Nicha Puvanich, Dustin J Rabideau, Caitlin A Selvaggi, Chu Yu, Stephen V Faraone, Shilpa Venkatachalam, Debbe McCall, Sharon F Terry, Thilo Deckersbach, Andrew A. Nierenberg
Journal of Medical Internet Research September 12, 2022 DOI: 10.2196/35620 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Randomized controlled trial Peer reviewed |
|---|---|
| Sample size | 4,411 |
| Population | Adults recruited from 17 patient-powered research networks; 87.80% White and 80.41% female sex assigned at birth |
| Interventions | Mindfulness-based cognitive therapy (MBCT) brief mindfulness intervention |
| Duration | 8-session intervention with 12-week follow-up (20 weeks total) |
| Measures | World Health Organization-Five Well-Being Index |
| Topics | Meditation |
| Keywords | Clinical trial Cognitive therapy Control trial Ehealth Intervention Mental health Mobile phone Web Well-being |
| Registration | NCT03844321 |
| Key findings | Standard 8-session web-based MBCT improved well-being but was not superior to a brief 3-session mindfulness intervention; both groups improved over the intervention and follow-up. Younger participants and those who completed more sessions reported greater improvements, with stronger effects in the MBCT condition. The authors suggest shorter mindfulness programs may yield benefits across a general population with various medical conditions. |
Abstract
Mindfulness can improve overall well-being by training individuals to focus on the present moment without judging their thoughts. However, it is unknown how much mindfulness practice and training are necessary to improve well-being. The primary aim of this study was to determine whether a standard 8-session web-based mindfulness-based cognitive therapy (MBCT) program, compared with a brief 3-session mindfulness intervention, improved overall participant well-being. In addition, we sought to explore whether the treatment effects differed based on the baseline characteristics of the participants (ie, moderators). Participants were recruited from 17 patient-powered research networks, web-based communities of stakeholders interested in a common research area. Participants were randomized to either a standard 8-session MBCT or a brief 3-session mindfulness training intervention accessed on the web. The participants were followed for 12 weeks. The primary outcome of the study was well-being, as measured by the World Health Organization-Five Well-Being Index. We hypothesized that MBCT would be superior to a brief mindfulness training. We randomized 4411 participants, 3873 (87.80%) of whom were White and 3547 (80.41%) of female sex assigned at birth. The mean baseline World Health Organization-Five Well-Being Index score was 50.3 (SD 20.7). The average self-reported well-being in each group increased over the intervention period (baseline to 8 weeks; model-based slope for the MBCT group: 0.78, 95% CI 0.63-0.93, and brief mindfulness group: 0.76, 95% CI 0.60-0.91) as well as the full study period (ie, intervention plus follow-up; baseline to 20 weeks; model-based slope for MBCT group: 0.41, 95% CI 0.34-0.48; and brief mindfulness group: 0.33, 95% CI 0.26-0.40). Changes in self-reported well-being were not significantly different between MBCT and brief mindfulness during the intervention period (model-based difference in slopes: -0.02, 95% CI -0.24 to 0.19; P=.80) or during the intervention period plus 12-week follow-up (-0.08, 95% CI -0.18 to 0.02; P=.10). During the intervention period, younger participants (P=.05) and participants who completed a higher percentage of intervention sessions (P=.005) experienced greater improvements in well-being across both interventions, with effects that were stronger for participants in the MBCT condition. Attrition was high (ie, 2142/4411, 48.56%), which is an important limitation of this study. Standard MBCT improved well-being but was not superior to a brief mindfulness intervention. This finding suggests that shorter mindfulness programs could yield important benefits across the general population of individuals with various medical conditions. Younger people and participants who completed more intervention sessions reported greater improvements in well-being, an effect that was more pronounced for participants in the MBCT condition. This finding suggests that standard MBCT may be a better choice for younger people as well as treatment-adherent individuals. ClinicalTrials.gov NCT03844321; https://clinicaltrials.gov/ct2/show/NCT03844321.
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 |