Effectiveness of online mindfulness-based interventions in improving mental health during the COVID-19 pandemic: A systematic review and meta-analysis of randomized controlled trials.
Bendix Samarta Witarto, Visuddho Visuddho, Andro Pramana Witarto, Damba Bestari, Brihastami Sawitri, Tando Abner Sivile Melapi, Citrawati Dyah Kencono Wungu
PLoS One September 21, 2022 DOI: 10.1371/journal.pone.0274177 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Systematic review and meta-analysis Randomized Peer reviewed |
|---|---|
| Sample size | 868 |
| Population | Participants in eight randomized controlled trials of online mindfulness-based interventions |
| Intervention | Online mindfulness-based interventions |
| Topics | Meditation |
| Keywords | Humans Mental health Communicable disease control Pandemics Covid-19 |
| Key findings | Online mindfulness-based interventions showed small to moderate effects on depression (g = -0.32), anxiety (g = -0.25), and stress (g = -0.62) compared with control groups, with 94% pooled adherence. Small follow-up effects persisted for depression (g = -0.26) and anxiety (g = -0.28) but not for stress. |
Abstract
Introduction: Psychotherapies, such as mindfulness-based interventions (MBIs), are currently needed to tackle mental health problems. Online MBIs have become promising since face-to-face interventions are limited during the COVID-19 pandemic due to lockdown and social distancing. This systematic review and meta-analysis aimed to investigate the effect of online MBIs in improving mental health, mainly depression, anxiety, and stress.
Materials and Methods: A systematic literature search was conducted according to the PRISMA 2020 guidelines on several databases for eligible studies up to October 17, 2021. Study quality was assessed using the Cochrane's Risk of Bias 2 tool. Effect sizes were presented as standardized mean difference (Hedges' g) between the online MBIs and control groups at post-test and follow-up using a random-effects model.
Results: Eight randomized controlled trials involving 868 participants were included in this meta-analysis. The pooled adherence rate to online MBIs was 94% (95% CI = 91% to 98%). The findings revealed that online MBIs had a statistically significant small to moderate effect in reducing depression (g = -0.32; 95% CI = -0.49 to -0.14; I2 = 0%), a small effect on anxiety (g = -0.25; 95% CI = -0.43 to -0.06; I2 = 27%), and a moderate effect on stress (g = -0.62; 95% CI = -1.09 to -0.16; I2 = 83%). In addition, significant small effects at follow-up were observed for depression (g = -0.26; 95% CI = -0.48 to -0.04; I2 = 0%) and anxiety (g = -0.28; 95% CI = -0.48 to -0.08; I2 = 0%), but not for stress.
Conclusion: Online MBIs have beneficial effects on mental health, particularly depression, anxiety, and stress, during the COVID-19 pandemic. Given the limitations of the current study, future trials that specifically consider potential effect influencing factors, longer follow-up evaluation, and methodological quality are warranted.
Comparable studies
Other systematic reviews and meta-analyses on meditation, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Meditation Programs for Psychological Stress and Well-being Diverse adult clinical populations | 2014 | Meta-analysis | n = 3,515 |
| Mindfulness-Based Stress Reduction for Stress Management in Healthy People: A Review and Meta-Analysis Healthy subjects | 2009 | Systematic review and meta-analysis | |
| The psychological effects of meditation: A meta-analysis. Nonclinical groups of adult meditators | 2012 | Meta-analysis | n = 163 |
| Efficacy of Mindfulness-Based Cognitive Therapy in Prevention of Depressive Relapse Adults with recurrent depression in full or partial remission | 2016 | Meta-analysis of individual patient data from randomized controlled trials | n = 1,258 |
| Mindfulness‐Based Stress Reduction and Mindfulness‐Based Cognitive Therapy – a systematic review of randomized controlled trials | 2011 | Systematic review |
Citations in the library
Cited by 39
- Assessment of well-being using Fitbit technology in college students, faculty and staff completing breathing meditation during COVID-19: A pilot study. Mental health & prevention June 1, 2023
- Cognitive, psychological, and physiological effects of a web-based mindfulness intervention in older adults during the COVID-19 pandemic: an open study. BMC Geriatrics February 14, 2024
- Effectiveness of mindfulness based interventions in reducing depressive symptoms across mental disorders: A meta-analysis of randomized controlled trials. Psychiatry Research June 1, 2025
- A multisite feasibility randomized clinical trial of mindfulness-based resilience training for aggression, stress, and health in law enforcement officers. BMC Complementary Medicine and Therapies April 4, 2024
- Long-term effects of combined mindfulness intervention and app intervention compared to single interventions during the COVID-19 pandemic: a randomized controlled trial. Frontiers in Psychology 2024
and 34 more in the library
Cites 12
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- The Empirical Status of Mindfulness-Based Interventions: A Systematic Review of 44 Meta-Analyses of Randomized Controlled Trials Perspectives on Psychological Science February 16, 2021
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- A mindfulness-based mobile health (mHealth) intervention among psychologically distressed university students in quarantine during the COVID-19 pandemic: A randomized controlled trial. Journal of Counseling Psychology July 15, 2021
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