ISRCTN ISRCTN92827275
DOI https://doi.org/10.1186/ISRCTN92827275
Secondary identifying numbers York University REB Protocol #1470
Submission date
07/12/2016
Registration date
20/12/2016
Last edited
03/12/2020
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Mental and Behavioural Disorders
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English Summary

Background and study aims
Diagnosable mental illnesses are becoming increasingly common on North American university campuses. Meanwhile the Canadian health care system confronts serious service challenges, which means long waiting times for mental health care. This is of particular concern for youth entering higher education under an economic downturn, affected by immediate and long term financial stressors and insecure futures. These stressors are often amplified for youth from vulnerable poor and ethnic minority communities. The goal of the present research is to help students adopt mental health-promoting behaviours that may reduce their needs to access psychiatric and/or clinical counselling services. Mindfulness is a technique which involves learning to become more aware of the self and the present moment. Mindfulness-based programs have been found to have a positive effect on the mental and physical health. At York University, the mindfulness-based Healthy Student Initiative (HSI) program has developed over five years, offering group based mindfulness meditation training to students throughout the school year. Despite assessed benefits, the ongoing question has been how to scale-up the HSI program to reach more students. This led to the innovative of combining mindfulness-based self-help modules with an online community platform. The Mindfulness Virtual Community for students includes the three core elements: mindfulness-based self-help modules, online group meetings moderated by a psychologist (synchronous) and peer-to-peer discussion boards moderated by a psychologist (asynchronous). The aim of this study is investigate the effectiveness of the Mindfulness Virtual Community.

Who can participate?
Adults who are undergraduate students at York University (Toronto, Keele campus).

What does the study involve?
Participants are randomly allocated to one of four groups. Those in the first group take part in the Mindfulness Virtual Community (MVC). This consists of interactive, online activities for 4 weeks: general and youth-specific mental health education and mindfulness modules delivered via audio and video recordings and made available three times a week, for four weeks (total of 12 modules); anonymous, asynchronous peer-to-peer discussion boards; and anonymous, 20-minute synchronous video conferences (group-based) led by a psychologist. Those in the second group receive Mindfulness Cognitive-Behavioural Therapy (CBT-M). This consists of one-hour sessions each week for 8 weeks, including mental health education and guided mindfulness exercises run by a psychologist or an advance-level psychology trainee. Those in the third group are placed on a waiting list to take part in the therapy and are given access to a list of available resources to support mental health. Those in the fourth group are also placed on a waiting list and given access to resources as well as access to the online mental health education modules. At the start of the study and then again after four and eight weeks, participants in all groups complete a number of questionnaires designed to assess their mental wellbeing and stress levels.

What are the possible benefits and risks of participating?
The focus of this research is mental health and the development of a mindfulness practice. All participants in this study will have the direct opportunity to benefit from online materials on common mental health challenges and practices of mindfulness The focus of this research is mental health and the development of a mindfulness practice. Some participants will have the opportunity to join face-to-face or virtual group-based sessions on mindfulness. All participants will have earn either course credit (2%) or a cash honorarium ($50). We do not anticipate that participation in the study will cause any extreme distress. Nonetheless, all participants will be provided with a Resource List on available services in the community and on campus. There are no notable risks involved with participating.

Where is the study run from?
York University (Canada)

When is the study starting and how long is it expected to run for?
January 2016 to March 2017

Who is funding the study?
Canadian Institutes of Health Research (Canada)

Who is the main contact?
1. Professor Christo El Morr (scientific)
elmorr@yorku.ca
2. Professor Farah Ahmad (scientific)
farahmad@yorku.ca
3. Professor Paul Ritvo (scientific)

Study website

Contact information

Prof Christo El Morr
Scientific

York University
4700 Keele Street
Toronto
M3J 1P3
Canada

Phone +1 416 736 2100 ext. 22053
Email elmorr@yorku.ca
Prof Farah Ahmad
Scientific

York University
4700 Keele Street
Toronto
M3J 1P3
Canada

Phone +1 416 736 2100 ext. 33898
Email farahmad@yorku.ca
Prof Paul Ritvo
Scientific

York University
4700 Keele Street
Toronto
M3J 1P3
Canada

Study information

Study designSingle-centre randomised controlled trial.
Primary study designInterventional
Secondary study designRandomised controlled trial
Study setting(s)School
Study typeTreatment
Participant information sheet Not available in web format; please use contact details to request a Participant Information Sheet and Consent Form.
Scientific titleMindfulness virtual and face-to-face approaches for student mental health: A randomized controlled trial
Study acronymMVC
Study hypothesisCurrent study hypothesis as of 05/12/2019:
Primary:
1. Symptom scores for stress, depression and anxiety at T3 will be significantly better in the MVC intervention group when compared with wait-list control group
2. Quality of life scores and program satisfaction at T3 will be significantly better for the MVC intervention group when compared with the wait-list group
3. Rates of classroom absenteeism and self-reported disability days at T3 will be significantly lower for the MVC intervention group when compared with the wait-list group.

Secondary:
1. Symptom scores for stress, depression and anxiety at T2 compared to T1 will be significantly reduced for the two intervention groups (MVC and CBT-M) when compared with the wait-list group
2. Symptom scores for stress, depression and anxiety at T2 compared to T1 will not be significantly different when MVC and CBT-M intervention groups are compared
3. Level of mindfulness will be significantly higher at T2 compared to T1 for the MVC and CBT-M intervention groups
4. Quality of life scores at T2 compared to T1 will be significantly higher in the MVC and CBT-M intervention groups when compared with the wait-list control group
5. Quality of life scores and program satisfaction at T2 will not be significantly different when MVC and CBT-M intervention groups are compared
6. Student engagement and experience will overall be significantly better for the MVC and CBT-M intervention groups when compared to the wait-list control.
7. Rates of classroom absenteeism and self-reported disability days at T2 compared to T1 will be significantly lower for the MVC and CBT-M intervention groups when compared to the wait-list group
8. Rates of class absenteeism and self-reported disability days at T2 will not be significantly different between MVC and CBT-M intervention groups

_____
Previous study hypothesis:
Primary:
1. Symptom scores for stress, depression and anxiety at T2 will be significantly better in the MVC intervention group when compared with wait-list control group
2. Quality of life scores and program satisfaction at T2 will be significantly better for the MVC intervention group when compared with the wait-list group
3. Rates of classroom absenteeism and self-reported disability days at T2 will be significantly lower for the MVC intervention group when compared with the wait-list group.

Secondary:
1. Symptom scores for stress, depression and anxiety at T2 compared to T1 will be significantly reduced for the two intervention groups (MVC and CBT-M) when compared with the wait-list group
2. Symptom scores for stress, depression and anxiety at T2 compared to T1 will not be significantly different when MVC and CBT-M intervention groups are compared
3. Level of mindfulness will be significantly higher at T2 compared to T1 for the MVC and CBT-M intervention groups
4. Quality of life scores at T2 compared to T1 will be significantly higher in the MVC and CBT-M intervention groups when compared with the wait-list control group
5. Quality of life scores and program satisfaction at T2 will not be significantly different when MVC and CBT-M intervention groups are compared
6. Student engagement and experience will overall be significantly better for the MVC and CBT-M intervention groups when compared to the wait-list control.
7. Rates of classroom absenteeism and self-reported disability days at T2 compared to T1 will be significantly lower for the MVC and CBT-M intervention groups when compared to the wait-list group
8. Rates of class absenteeism and self-reported disability days at T2 will not be significantly different between MVC and CBT-M intervention groups
Ethics approval(s)York University Office of Research Ethics, Human Participants Review Sub-Committee (HPRC), 03/11/2016, ref: #e2016-345
ConditionMental health including stress, anxiety and depression
InterventionCurrent interventions as of 05/12/2019:
Participants will complete an Informed Consent and then will then be randomly assigned to one of four arms in a 1:1:1:1 ratio by opening a sequentially numbered envelope containing a randomly-generated allocation by an off-site biostatistician.

Group 1 (Waitlist): Students randomized to this arm will complete baseline and follow-up (at 4 and 8 weeks) assessments and will be offered a list of available resources to support mental health.

Group 2 (Partial-MVC): Students randomized to this arm will complete baseline and follow-up (at 4 and 8 weeks) assessments and will be offered access to the online mental health education modules and a list of available resources to support mental health.

Group 3 (Group-based face-to-face Cognitive Behaviour Therapy-Mindfulness (CBT-M) program modeled on the Healthy Student Initiative (HSI), a successful in-person mindfulness program running at York University): Students randomized to this arm will complete baseline and follow-up (4- and 8-week) assessments and will receive the same list of resources, but additionally will participate in regularly scheduled, in-person CBT-M group meetings of 1 hour per week for a duration of 8 weeks; during these sessions they will receive mental health education and will engage in guided mindfulness exercises. The groups will be led by graduate students under the remote supervision of a registered clinical psychologist.

Group 4 (Novel Mindfulness Virtual Community (Full-MVC) intervention): Students randomized to this arm will complete baseline and follow-up (4- and 8-week) assessments and receive the list of resources, and will also participate in a series of interactive, online activities: general and youth-specific mental health education and mindfulness modules drawing from CBT principles, delivered via audio and video recordings, and that participants may watch on their computers or phones at their own convenience; anonymous, asynchronous discussion boards pertaining to mental health and mindfulness practice; and anonymous, 20-minute synchronous video conferences (group-based) led by a mental health professional, scheduled on alternate days, during which participating students can engage with the professional on topics of covered in the accompanying module. Total duration of Full-MVC intervention is 8-weeks: participants receive access to 3 components of intervention in the first 4-week period and then only modules in second 4-week period.

_____
Previous interventions:
Participants will complete an Informed Consent and then will then be randomly assigned to one of four arms in a 1:1:1:1 ratio by opening a sequentially numbered envelope containing a randomly-generated allocation by an off-site biostatistician.

Group 1 (Waitlist A): Students randomized to this arm will complete baseline and follow-up (at 4 and 8 weeks) assessments and will be offered a list of available resources to support mental health.

Group 2 (Waitlist B): Students randomized to this arm will complete baseline and follow-up (at 4 and 8 weeks) assessments and will be offered access to the online mental health education modules and a list of available resources to support mental health.

Group 3 (Group-based face-to-face Cognitive Behaviour Therapy-Mindfulness (CBT-M) program modeled on the Healthy Student Initiative (HSI), a successful in-person mindfulness program running at York University): Students randomized to this arm will complete baseline and follow-up (4- and 8-week) assessments and will receive the same list of resources, but additionally will participate in regularly scheduled, in-person CBT-M group meetings of 1 hour per week for a duration of 8 weeks; during these sessions they will receive mental health education and will engage in guided mindfulness exercises. The groups will be led by graduate students under the remote supervision of a registered clinical psychologist.

Group 4 (Novel Mindfulness Virtual Community (MVC) intervention): Students randomized to this arm will complete baseline and follow-up (4- and 8-week) assessments and receive the list of resources, and will also participate in a series of interactive, online activities: general and youth-specific mental health education and mindfulness modules drawing from CBT principles, delivered via audio and video recordings, and that participants may watch on their computers or phones at their own convenience; anonymous, asynchronous discussion boards pertaining to mental health and mindfulness practice; and anonymous, 20-minute synchronous video conferences (group-based) led by a mental health professional, scheduled on alternate days, during which participating students can engage with the professional on topics of covered in the accompanying module.
Intervention typeBehavioural
Primary outcome measure1. Depression is measured using the Patient Health Questionnaire (PHQ-9) at baseline, 4 and 8 weeks
2. Anxiety is measured using the Beck Anxiety Inventory (BAI) at baseline, 4 and 8 weeks
3. Stress is measured using the Perceived Stress Scale (PSS) at baseline, 4 and 8 weeks
Secondary outcome measures1. Quality of life is measured using the Quality of Life Scale (QOLS) at baseline, 4 and 8 weeks
2. Life satisfaction is measured using the Brief Multi-Dimensional Students’ Life Satisfaction Scale (BMSLSS) at baseline, 4 and 8 weeks
3. Mindfulness is measured using the Brief Five Facet Mindfulness Questionnaire (BFFMQ) at baseline, 4 and 8 weeks
Overall study start date01/01/2016
Overall study end date20/03/2017

Eligibility

Participant type(s)Healthy volunteer
Age groupAdult
Lower age limit18 Years
SexBoth
Target number of participantsThis is a pilot RCT that will enrol 120 participants for the full intervention; a total of 160 participants will be targeted for recruitment, to allow for ~ 25% attrition.
Total final enrolment148
Participant inclusion criteria1. Aged 18 years or older
2. Currently enrolled as an undergraduate student at York University (Toronto, Keele campus), and planning to remain so for the coming semester
3. Fluent in reading, writing and conversing in English
4. Willing to be randomized into an intervention which may require up to 4 hours per week of their time
Participant exclusion criteria1. Cannot meet the time commitments of the trial
2. Not fluent in reading, writing and speaking English
3. Self-reported symptoms of psychosis (e.g. hallucinations, hearing voices)
4. Self-report dependencies on alcohol, illicit drugs, or prescription drugs used for non-medical reasons
Recruitment start date06/12/2016
Recruitment end date20/01/2017

Locations

Countries of recruitment

  • Canada

Study participating centre

York University
4700 Keele Street
Toronto, ON
M3J 1P3
Canada

Sponsor information

York University
University/education

4700 Keele Street
Toronto, ON
M3J 1P3
Canada

Phone +1 416 736 2100 ext. 21069
Email muellerm@yorku.ca
Website http://research.info.yorku.ca/
ROR logo "ROR" https://ror.org/05fq50484

Funders

Funder type

Government

Canadian Institutes of Health Research
Government organisation / National government
Alternative name(s)
Instituts de Recherche en Santé du Canada, Canadian Institutes of Health Research (CIHR), CIHR_IRSC, Canadian Institutes of Health Research | Ottawa ON, CIHR, IRSC
Location
Canada

Results and Publications

Intention to publish date20/03/2018
Individual participant data (IPD) Intention to shareYes
IPD sharing plan summaryAvailable on request
Publication and dissemination planIntent to publish in high impact peer-reviewed journals within an year after completion of all data.
IPD sharing planAll data will be held by the Nominated Principal Applicant (PI), Dr. El Morr at York University. Upon receiving a request for release of data, the three PIs will make a joint decision.

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Results article survey results 26/03/2019 10/04/2019 Yes No
Results article results 18/02/2020 24/02/2020 Yes No
Results article observational results 11/01/2021 03/12/2020 Yes No

Editorial Notes

03/12/2020: Publication reference added.
24/02/2020: Publication reference added.
05/12/2019: The following changes were made to the trial record:
1. The hypotheses were updated.
2. The interventions were updated.
10/04/2019: Publication reference and total final enrolment added.
10/04/2018: Internal review.
21/12/2016: Verified study information with principal investigator.