Mindfulness-Based College: A Stage 1 Randomized Controlled Trial for University Student Well-Being

Eric B Loucks, William R Nardi, Roee Gutman, Frances B Saadeh, Yu Li, David R Vago, Lauren B Fiske, Jayson J Spas, Abigail Harrison, Eric B Loucks, William R Nardi, Roee Gutman, Frances B Saadeh, Yu Li, David R Vago, Lauren B Fiske, Jayson J Spas, Abigail Harrison

Abstract

Objective: To evaluate effects of a mindfulness-based program, adapted to the young adult life course stage (age, 18-29 years), named Mindfulness-Based College (MB-College). The primary outcome was a young adult health summary score, composed of key health risk factors: body mass index, physical activity, fruit and vegetable intake, alcohol consumption, stress, loneliness, and sleep duration. Secondary outcomes were hypothesized self-regulation mechanisms, including attention control, interoceptive awareness, and emotion regulation.

Methods: This was a stage 1 randomized controlled trial of the 9-week MB-College program (n = 47) versus enhanced usual care control (n = 49) including students from three universities. Assessments were at baseline, during the beginning of the college term when stress is typically lower, and at MB-College completion (3-month follow-up), when term-related stress is typically higher. Intention-to-treat, linear regression analyses estimated the marginal effects of MB-College versus control on the outcomes.

Results: MB-College participants (mean age = 20 years, 68% female, 37% racial minorities) demonstrated improved health summary scores at follow-up compared with control participants whose health summary scores worsened (marginal effect for MB-College versus control = 0.23; p = .004). Effects on loneliness were pronounced (marginal effect = -3.11 for the Revised University of Los Angeles Loneliness Scale score; p = .03). Secondary analyses showed significant impacts of MB-College on hypothesized self-regulation mechanisms (e.g., Sustained Attention to Response Task correct no-go percent, p = .0008; Multidimensional Assessment of Interoceptive Awareness, p < .0001; Center for Epidemiologic Studies-Depression scale, p = .03).

Conclusions: Findings of this early stage clinical trial suggest that MB-College may foster well-being in young adults.Trial Registration: NCT03124446.

Copyright © 2020 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Psychosomatic Society.

Figures

FIGURE 1
FIGURE 1
Theoretical framework of mechanisms through which Mindfulness-Based College influences young adult health behaviors.
FIGURE 2
FIGURE 2
CONSORT flow diagram for the MB-College study participation. CONSORT = Consolidated Standards of Reporting Trials; MB-College = Mindfulness-Based College.
FIGURE 3
FIGURE 3
Changes in the net health summary score from baseline through 3-month follow-up for MB-College versus control. Statistical analyses were marginal effects linear regression, adjusted for baseline values of outcome. p Values represent marginal effects of MB-College versus control on the net health summary score at 3-month follow-up. Error bars are standard errors of the mean. MB-College = Mindfulness-Based College.
FIGURE 4
FIGURE 4
Changes in the R-UCLA Loneliness Scale from baseline through 3-month follow-up for MB-College versus Control. Statistical analyses were marginal effects linear regression, adjusted for baseline values of outcome. p Values represent marginal effects of MB-College versus control on loneliness at 3-month follow-up. Error bars are standard errors of the mean. R-UCLA = Revised University of California, Los Angeles; MB-College = Mindfulness-Based College.
FIGURE 5
FIGURE 5
Changes in the CESD scale from baseline through 3-month follow-up for MB-College versus Control. Statistical analyses were marginal effects linear regression, adjusted for baseline values of outcome. p Values represent marginal effects of MB-College versus control on depressive symptoms at 3-month follow-up. Error bars are standard errors of the mean. CESD Centers for Epidemiologic Studies—Depression; MB-College = Mindfulness-Based College.

References

    1. Arnett JJ, Zukauskiene R, Sugimura K. The new life stage of emerging adulthood at ages 18–29 years: implications for mental health. Lancet Psychiatry 2014;1:569–76.
    1. Lasgaard M, Friis K, Shevlin M. “Where are all the lonely people?” A population-based study of high-risk groups across the life span. Soc Psychiatry Psychiatr Epidemiol 2016;51:1373–84.
    1. Twenge JM, Gentile B, DeWall CN, Ma D, Lacefield K, Schurtz DR. Birth cohort increases in psychopathology among young Americans, 1938–2007: a cross-temporal meta-analysis of the MMPI. Clin Psychol Rev 2010;30:145–54.
    1. Nelson MC, Story M, Larson NI, Neumark-Sztainer D, Lytle LA. Emerging adulthood and college-aged youth: an overlooked age for weight-related behavior change. Obesity (Silver Spring) 2008;16:2205–11.
    1. Keating XD, Guan J, Piñero JC, Bridges DM. A meta-analysis of college students’ physical activity behaviors. J Am Coll Health 2005;54:116–25.
    1. Substance Abuse and Mental Health Services Administration . Results from the 2017 National Survey on Drug Use and Health: Detailed Tables. Available at: . 2018. Accessed October 20, 2019.
    1. Gaultney JF. The prevalence of sleep disorders in college students: impact on academic performance. J Am Coll Health 2010;59:91–7.
    1. Qualter P, Vanhalst J, Harris R, Van Roekel E, Lodder G, Bangee M, Maes M, Verhagen M. Loneliness across the life span. Perspect Psychol Sci 2015;10:250–64.
    1. Centers for Disease Control and Prevention NCfHS . Underlying cause of death 1999–2017 on CDC WONDER online database, released December, 2018. Data are from the Multiple Cause of Death Files, 1999–2017, as compiled from data provided by the 57 vital statistics jurisdictions through the Vital Statistics Cooperative Program. Available at: . Accessed January 17, 2020.
    1. Gogtay N, Giedd JN, Lusk L, Hayashi KM, Greenstein D, Vaituzis AC, Nugent TF, 3rd, Herman DH, Clasen LS, Toga AW, Rapoport JL, Thompson PM. Dynamic mapping of human cortical development during childhood through early adulthood. Proc Natl Acad Sci U S A 2004;101:8174–9.
    1. Tang YY, Holzel BK, Posner MI. The neuroscience of mindfulness meditation. Nat Rev Neurosci 2015;16:213–25.
    1. Dawson AF, Brown WW, Anderson J, Datta B, Donald JN, Hong K, Allan S, Mole TB, Jones PB, Galante J. Mindfulness-based interventions for university students: a systematic review and meta-analysis of randomised controlled trials. Appl Psychol Health Well Being 2020;12:384–410.
    1. Bishop SR, Lau M, Shapiro S, Carlson L, Anderson ND, Carmody J, Segal ZV, Abbey S, Speca M, Velting D, Devins G. Mindfulness: a proposed operational definition. Clin Psychol 2004;11:230–41.
    1. Mrazek MD, Mooneyham BW, Mrazek KL, Schooler JW. Pushing the limits: cognitive, affective, and neural plasticity revealed by an intensive multifaceted intervention. Front Hum Neurosci 2016;10:117.
    1. Galante J, Dufour G, Vainre M, Wagner AP, Stochl J, Benton A, Lathia N, Howarth E, Jones PB. A mindfulness-based intervention to increase resilience to stress in university students (the Mindful Student Study): a pragmatic randomised controlled trial. Lancet Public Health 2018;3:e72–81.
    1. Arnett JJ. Emerging Adulthood: The Winding Road from the Late Teens Through the Twenties. New York, NY: Oxford University Press; 2015.
    1. Sussman S, Arnett JJ. Emerging adulthood: developmental period facilitative of the addictions. Eval Health Prof 2014;37:147–55.
    1. Kabat-Zinn J. Full Catastrophe Living: Using the Wisdom of your Body and Mind to Face Stress, Pain, and Illness. New York, NY: Bantam; 2013.
    1. de Vibe M, Bjørndal A, Fattah S, Dyrdal GM, Halland E, Tanner-Smitth EE. Mindfulness-based stress reduction (MBSR) for improving health, quality of life and social functioning in adults: a systematic review and meta-analysis. Campbell Syst Rev 2017;13:1–264.
    1. Loucks EB, Schuman-Olivier Z, Britton WB, Fresco DM, Desbordes G, Brewer JA, Fulwiler C. Mindfulness and cardiovascular disease risk: state of the evidence, plausible mechanisms, and theoretical framework. Curr Cardiol Rep 2015;17:112.
    1. Benjamin EJ Virani SS Callaway CW Chamberlain AM Chang AR Cheng S Chiuve SE Cushman M Delling FN Deo R de Ferranti SD Ferguson JF Fornage M Gillespie C Isasi CR Jiménez MC Jordan LC Judd SE Lackland D Lichtman JH Lisabeth L Liu S Longenecker CT Lutsey PL Mackey JS Matchar DB Matsushita K Mussolino ME Nasir K O’Flaherty M Palaniappan LP Pandey A Pandey DK Reeves MJ Ritchey MD Rodriguez CJ Roth GA Rosamond WD Sampson UKA Satou GM Shah SH Spartano NL Tirschwell DL Tsao CW Voeks JH Willey JZ Wilkins JT Wu JH Alger HM Wong SS Muntner P, American Heart Association Council on Epidemiology and Prevention Statistics Committee and Stroke Statistics Subcommittee . Heart Disease and Stroke Statistics—2018 update: a report from the American Heart Association. Circulation 2018;137:e67–e492.
    1. Craig CL, Marshall AL, Sjöström M, Bauman AE, Booth ML, Ainsworth BE, Pratt M, Ekelund U, Yngve A, Sallis JF, Oja P. International Physical Activity Questionnaire: 12-country reliability and validity. Med Sci Sports Exerc 2003;35:1381–95.
    1. Willett WC, Sampson L, Stampfer MJ, Rosner B, Bain C, Witschi J, Hennekens CH, Speizer FE. Reproducibility and validity of a semiquantitative food frequency questionnaire. Am J Epidemiol 1985;122:51–65.
    1. Pierannunzi C, Hu SS, Balluz L. A systematic review of publications assessing reliability and validity of the Behavioral Risk Factor Surveillance System (BRFSS), 2004–2011. BMC Med Res Methodol 2013;13:49.
    1. Buysse DJ, Reynolds CF, 3rd, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res 1989;28:193–213.
    1. Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. J Health Soc Behav 1983;24:385–96.
    1. Russell D, Peplau LA, Cutrona CE. The rcvised UCLA Loneliness Scale: concurrent and discriminant validity evidence. J Pers Soc Psychol 1980;39:472–80.
    1. Boutron I Moher D Altman DG Schulz KF Ravaud P, CONSORT Group . Extending the CONSORT statement to randomized trials of nonpharmacologic treatment: explanation and elaboration. Ann Intern Med 2008;148:295–309.
    1. Higgins JPT, Sterne JAC, Savović J, Page MJ, Hróbjartsson A, Boutron I, Reeves B, Eldridge S. A revised tool for assessing risk of bias in randomized trials. Cochrane Methods Cochrane Database Syst Rev 2016;10:29–31 10.1002/14651858.CD201601.
    1. Santorelli S, Bonus K, McCallum C, MacCoon D, Lutz A, Stoney CM, Johnson LL, Davidson RJ. Mindfulness-Based Stress Reduction: Guidelines and Standards of Practice. Integrative Medicine Mindfulness Program at University of Wisconsin-Madison and the Center for Mindfulness, University of Massachusetts; 2004.
    1. Bellg AJ Borrelli B Resnick B Hecht J Minicucci DS Ory M Ogedegbe G Orwig D Ernst D Czajkowski S, Treatment Fidelity Workgroup of the NIH Behavior Change Consortium . Enhancing treatment fidelity in health behavior change studies: best practices and recommendations from the NIH Behavior Change Consortium. Health Psychol 2004;23:443–51.
    1. Van Dam NT, Earleywine M. Validation of the Center for Epidemiologic Studies Depression Scale—Revised (CESD-R): pragmatic depression assessment in the general population. Psychiatry Res 2011;186:128–32.
    1. Beck AT, Epstein N, Brown G, Steer RA. An inventory for measuring clinical anxiety: psychometric properties. J Consult Clin Psychol 1988;56:893–7.
    1. Robertson IH, Manly T, Andrade J, Baddeley BT, Yiend J. ‘Oops!’: performance correlates of everyday attentional failures in traumatic brain injured and normal subjects. Neuropsychologia 1997;35:747–58.
    1. Mehling WE, Price C, Daubenmier JJ, Acree M, Bartmess E, Stewart A. The Multidimensional Assessment of Interoceptive Awareness (MAIA). PLoS One 2012;7:e48230.
    1. Raes F, Pommier E, Neff KD, Van Gucht D. Construction and factorial validation of a short form of the Self-Compassion Scale. Clin Psychol Psychother 2011;18:250–5.
    1. Fresco DM, Moore MT, van Dulmen MH, Segal ZV, Ma SH, Teasdale JD, Williams JM. Initial psychometric properties of the experiences questionnaire: validation of a self-report measure of decentering. Behav Ther 2007;38:234–46.
    1. Cohen S, Williamson G. Perceived stress in a probability sample of the United States. In: Spacapam S, Oskamp S, editors. The Social Psychology Of Health: Claremont Symposium on Applied Social Psychology. Newbury Park, CA: Sage; 1988.
    1. Watson NF, Badr MS, Belenky G, Bliwise DL, Buxton OM, Buysse D, Dinges DF, Gangwisch J, Grandner MA, Kushida C, Malhotra RK, Martin JL, Patel SR, Quan SF, Tasali E. Recommended amount of sleep for a healthy adult: a joint consensus statement of the American Academy of Sleep Medicine and Sleep Research Society. Sleep 2015;38:843–4.
    1. Bruce LD, Wu JS, Lustig SL, Russell DW, Nemecek DA. Loneliness in the United States: a 2018 national panel survey of demographic, structural, cognitive, and behavioral characteristics. Am J Health Promot 2019;33:1123–33.
    1. Yang L, Cao C, Kantor ED, Nguyen LH, Zheng X, Park Y, Giovannucci EL, Matthews CE, Colditz GA, Cao Y. Trends in sedentary behavior among the US population, 2001–2016. JAMA 2019;321:1587–97.
    1. Chi X, Bo A, Liu T, Zhang P, Chi I. Effects of mindfulness-based stress reduction on depression in adolescents and young adults: a systematic review and meta-analysis. Front Psychol 2018;9:1034.
    1. Creswell JD, Irwin MR, Burklund LJ, Lieberman MD, Arevalo JM, Ma J, Breen EC, Cole SW. Mindfulness-Based Stress Reduction training reduces loneliness and pro-inflammatory gene expression in older adults: a small randomized controlled trial. Brain Behav Immun 2012;26:1095–101.
    1. Lindsay EK, Young S, Brown KW, Smyth JM, Creswell JD. Mindfulness training reduces loneliness and increases social contact in a randomized controlled trial. Proc Natl Acad Sci U S A 2019;116:3488–93.
    1. Donald JN, Sahdra BK, Van Zanden B, Duineveld JJ, Atkins PWB, Marshall SL, Ciarrochi J. Does your mindfulness benefit others? A systematic review and meta-analysis of the link between mindfulness and prosocial behaviour. Br J Psychol 2019;110:101–25.
    1. Loucks EB. Meditation intervention reviews: selecting ideal control groups for meditation interventions. JAMA Intern Med 2014;174:1194–5.
    1. Gu J, Strauss C, Bond R, Cavanagh K. 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. Clin Psychol Rev 2015;37:1–12.
    1. Hayes SC, Strosahl KD, Wilson KG. Acceptance and Commitment Therapy: An experiential approach to behavior change. New York, NY: The Guilford Press; 1999.
    1. Michie S, Richardson M, Johnston M, Abraham C, Francis J, Hardeman W, Eccles MP, Cane J, Wood CE. The behavior change technique taxonomy (v1) of 93 hierarchically clustered techniques: building an international consensus for the reporting of behavior change interventions. Ann Behav Med 2013;46:81–95.
    1. Freedland KE, Mohr DC, Davidson KW, Schwartz JE. Usual and unusual care: existing practice control groups in randomized controlled trials of behavioral interventions. Psychosom Med 2011;73:323–35.

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