Enhancing Web-based mindfulness training for mental health promotion with the health action process approach: randomized controlled trial

Winnie W S Mak, Amy T Y Chan, Eliza Y L Cheung, Cherry L Y Lin, Karin C S Ngai, Winnie W S Mak, Amy T Y Chan, Eliza Y L Cheung, Cherry L Y Lin, Karin C S Ngai

Abstract

Background: With increasing evidence demonstrating the effectiveness of Web-based interventions and mindfulness-based training in improving health, delivering mindfulness training online is an attractive proposition.

Objective: The aim of this study was to evaluate the efficacy of two Internet-based interventions (basic mindfulness and Health Action Process Approach enhanced mindfulness) with waitlist control. Health Action Process Approach (HAPA) principles were used to enhance participants' efficacy and planning.

Methods: Participants were recruited online and offline among local universities; 321 university students and staff were randomly assigned to three conditions. The basic and HAPA-enhanced groups completed the 8-week fully automated mindfulness training online. All participants (including control) were asked to complete an online questionnaire pre-program, post-program, and at 3-month follow-up.

Results: Significant group by time interaction effect was found. The HAPA-enhanced group showed significantly higher levels of mindfulness from pre-intervention to post-intervention, and such improvement was sustained at follow-up. Both the basic and HAPA-enhanced mindfulness groups showed better mental well-being from pre-intervention to post-intervention, and improvement was sustained at 3-month follow-up.

Conclusions: Online mindfulness training can improve mental health. An online platform is a viable medium to implement and disseminate evidence-based interventions and is a highly scalable approach to reach the general public.

Trial registration: Chinese Clinical Trial Registry (ChiCTR): ChiCTR-TRC-12002954; http://www.chictr.org/en/proj/show.aspx?proj=3904 (Archived by WebCite at http://www.webcitation.org/6VCdG09pA).

Keywords: Health Action Process Approach (HAPA); Internet-based intervention; mental health promotion; mindfulness; online intervention.

Conflict of interest statement

Conflicts of Interest: None declared.

Figures

Figure 1
Figure 1
Flowchart of randomization and retention of participants.
Figure 2
Figure 2
MindfuLiving login page.
Figure 3
Figure 3
MindfuLiving lesson content.
Figure 4
Figure 4
Suggested off-class mindfulness practices.

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