{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T01:01:01Z","timestamp":1789952461394,"version":"4.0.1"},"reference-count":53,"publisher":"JMIR Publications Inc.","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Ment Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>University students are experiencing higher levels of distress and mental health disorders than before. In addressing mental health needs, web-based interventions have shown increasing promise in overcoming geographic distances and high student-to-counselor ratios, leading to the potential for wider implementation. The Mindfulness Virtual Community (MVC) program, a web-based program, guided by mindfulness and cognitive behavioral therapy principles, is among efforts aimed at effectively and efficiently reducing symptoms of depression, anxiety, and perceived stress in students.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study\u2019s aim was to evaluate the efficacy of an 8-week MVC program in reducing depression, anxiety, and perceived stress (primary outcomes), and improving mindfulness (secondary outcome) in undergraduate students at a large Canadian university. Guided by two prior randomized controlled trials (RCTs) that each demonstrated efficacy when conducted during regular university operations, this study coincided with a university-wide labor strike. Nonetheless, the students\u2019 response to an online mental health program on a disrupted campus can provide useful information for anticipating the impact of other disruptions, including those related to the COVID-19 pandemic as well as future disruptions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this parallel-arm RCT, 154 students were randomly allocated to an 8-week MVC intervention (n=76) or a wait-list control (WLC) condition (n=78). The MVC intervention included the following: (1) educational and mindfulness video modules, (2) anonymous peer-to-peer discussions, and (3) anonymous, group-based, professionally guided, 20-minute videoconferences. Study outcomes were evaluated at baseline and at 8-week follow-up using the following: Patient Health Questionnaire-9 (PHQ-9), the Beck Anxiety Inventory (BAI), the Perceived Stress Scale (PSS), and the Five Facets Mindfulness Questionnaire Short Form (FFMQ-SF). Generalized estimation equations with an AR (1) covariance structure were used to evaluate the impact of the intervention, with outcome evaluations performed on both an intention-to-treat (ITT) and per-protocol (PP) basis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Participants (n=154) included 35 males and 117 females with a mean age of 23.1 years. There were no statistically significant differences at baseline between the MVC and WLC groups on demographics and psychological characteristics, indicating similar demographic and psychological characteristics across the two groups. Results under both ITT and PP approaches indicated that there were no statistically significant between-group differences in PHQ-9 (ITT: \u03b2=\u20130.44, P=.64; PP: \u03b2=\u20130.62, P=.053), BAI (ITT: \u03b2=\u20132.06, P=.31; PP: \u03b2=\u20132.32, P=.27), and FFMQ-SF (ITT: \u03b2=1.33, P=.43; PP: \u03b2=1.44, P=.41) compared to WLC. There was a significant difference for the PSS (ITT: \u03b2=\u20132.31, P=.03; PP: \u03b2=\u20132.38, P=.03).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>During a university labor strike, the MVC program led to statistically significant reductions in PSS compared to the WLC group, but there were no other significant between-group differences. Comparisons with previous cycles of intervention testing, undertaken during nondisrupted university operations, when efficacy was demonstrated, are discussed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>ISRCTN Registry ISRCTN92827275; https:\/\/www.isrctn.com\/ISRCTN92827275<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2196\/23491","type":"journal-article","created":{"date-parts":[[2020,12,2]],"date-time":"2020-12-02T11:38:19Z","timestamp":1606909099000},"page":"e23491","source":"Crossref","is-referenced-by-count":67,"title":["A Mindfulness-Based Intervention for Student Depression, Anxiety, and Stress: Randomized Controlled Trial"],"prefix":"10.2196","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1141-0083","authenticated-orcid":false,"given":"Paul","family":"Ritvo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9747-1148","authenticated-orcid":false,"given":"Farah","family":"Ahmad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6287-3438","authenticated-orcid":false,"given":"Christo","family":"El Morr","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5951-9577","authenticated-orcid":false,"given":"Meysam","family":"Pirbaglou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5506-084X","authenticated-orcid":false,"given":"Rahim","family":"Moineddin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"MVC Team","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2021,1,11]]},"reference":[{"key":"ref1","unstructured":"GoldsteinDPopescuAHannah-JonesNAs school moves online, many students stay logged outThe New York Times2020-07-28http:\/\/www.nytimes.com\/2020\/04\/06\/us\/coronavirus-schools-attendance-absent.html"},{"key":"ref2","unstructured":"Baron CadloffEThe big transition begins as faculty switch to online learning in response to COVID-19University Affairs2020-07-28https:\/\/www.universityaffairs.ca\/news\/news-article\/the-big-experiment-begins-as-faculty-switch-to-online-learning-in-response-to-covid-19\/"},{"key":"ref3","unstructured":"COVID-19 Pandemic: Academic impacts on postsecondary students in CanadaStatistics Canada2020-07-28https:\/\/www150.statcan.gc.ca\/n1\/pub\/45-28-0001\/2020001\/article\/00015-eng.htm"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.2196\/15520"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.2196\/18595"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1037\/abn0000362"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1080\/07448481.2015.1055567"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1080\/07448481.2018.1515748"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ps.201800332"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1080\/07448481.2015.1040411"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1080\/87568225.2016.1105657"},{"key":"ref12","unstructured":"The Healthy Minds Study: Data Report 2018-2019Healthy Minds Network2020-07-28https:\/\/healthymindsnetwork.org\/wp-content\/uploads\/2019\/09\/HMS_national-2018-19.pdf"},{"key":"ref13","unstructured":"Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration Data - National Survey on Drug Use and Health (NSDUH) ResultsSubstance Use and Mental Health Services Administration2020-07-28https:\/\/www.samhsa.gov\/data\/"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1037\/abn0000410"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1037\/emo0000403"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1007\/s11126-019-09630-7"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.190434"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.3200\/jach.55.1.5-16"},{"key":"ref19","unstructured":"LeesJDietschePAn Analysis of Counselling Services in Ontario Colleges: Initial ReportCentre for Innovation in Campus Mental Health20122020-07-28https:\/\/campusmentalhealth.ca\/wp-content\/uploads\/2018\/03\/An-Analysis-of-Counselling-Services-in-Ontario-Colleges-Initial-Report.pdf"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1037\/0022-3514.84.4.822"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpr.2011.04.006"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3999(03)00573-7"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1089\/acm.2008.0495"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.1037\/a0018555"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.1111\/j.2044-8260.2011.02024.x"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.1007\/s12671-012-0101-x"},{"key":"ref27","doi-asserted-by":"publisher","DOI":"10.1037\/a0028168"},{"key":"ref28","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrc.2005.04.005"},{"key":"ref29","doi-asserted-by":"publisher","DOI":"10.1080\/10503307.2011.637242"},{"key":"ref30","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijpsycho.2015.06.005"},{"key":"ref31","doi-asserted-by":"publisher","DOI":"10.1080\/07448481.2011.630703"},{"key":"ref32","doi-asserted-by":"publisher","DOI":"10.1016\/j.brs.2011.01.006"},{"key":"ref33","doi-asserted-by":"publisher","DOI":"10.4471\/ijep.2013.28"},{"key":"ref34","doi-asserted-by":"publisher","DOI":"10.17583\/ijep.2016.1504"},{"key":"ref35","first-page":"104","volume":"234","author":"El Morr, C","year":"2017","journal-title":"Stud Health Technol Inform"},{"key":"ref36","doi-asserted-by":"publisher","DOI":"10.1177\/1460458219884840"},{"key":"ref37","doi-asserted-by":"publisher","DOI":"10.1177\/2167702613497932"},{"key":"ref38","doi-asserted-by":"publisher","DOI":"10.1001\/jama.282.18.1737"},{"key":"ref39","doi-asserted-by":"publisher","DOI":"10.1037\/\/0022-006x.56.6.893"},{"issue":"4","key":"ref40","doi-asserted-by":"crossref","first-page":"385","DOI":"10.2307\/2136404","volume":"24","author":"Cohen, S","year":"1983","journal-title":"J Health Soc Behav"},{"issue":"2","key":"ref41","first-page":"56","volume":"63","author":"Flanagan, JC","year":"1982","journal-title":"Arch Phys Med Rehabil"},{"key":"ref42","doi-asserted-by":"publisher","DOI":"10.1037\/t34941-000"},{"key":"ref43","doi-asserted-by":"publisher","DOI":"10.1177\/1073191111408231"},{"key":"ref44","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2013.00863"},{"key":"ref45","author":"Ellis, A","year":"1977","journal-title":"Overcoming Procrastination"},{"key":"ref46","doi-asserted-by":"publisher","DOI":"10.1080\/00221329909595557"},{"issue":"1","key":"ref47","first-page":"14","volume":"25","author":"Kachgal, M","year":"2001","journal-title":"J Dev Educ"},{"key":"ref48","doi-asserted-by":"publisher","DOI":"10.1080\/0260293042000160384"},{"issue":"5","key":"ref49","first-page":"A","volume":"15","author":"Pychyl, T","year":"2000","journal-title":"J Soc Behav Pers"},{"issue":"5","key":"ref50","first-page":"A","volume":"15","author":"Pychyl, T","year":"2000","journal-title":"J Soc Behav Pers"},{"key":"ref51","doi-asserted-by":"publisher","DOI":"10.1037\/0022-0167.31.4.503"},{"key":"ref52","author":"Burka, J","year":"1983","journal-title":"Procrastination: Why You Do It and What to Do About It"},{"key":"ref53","doi-asserted-by":"publisher","DOI":"10.1037\/0022-0167.33.4.387"}],"container-title":["JMIR Mental Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/mental.jmir.org\/2021\/1\/e23491","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T17:33:07Z","timestamp":1782840787000},"score":1,"resource":{"primary":{"URL":"https:\/\/mental.jmir.org\/2021\/1\/e23491"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,1,11]]},"references-count":53,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2021]]}},"URL":"https:\/\/doi.org\/10.2196\/23491","relation":{"has-preprint":[{"id-type":"doi","id":"10.2196\/preprints.23491","asserted-by":"object"}]},"ISSN":["2368-7959"],"issn-type":[{"value":"2368-7959","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,1,11]]}}}