Background: 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. Objective: This study’s 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’ 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. Methods: 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. Results: 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: β=–0.44, P=.64; PP: β=–0.62, P=.053), BAI (ITT: β=–2.06, P=.31; PP: β=–2.32, P=.27), and FFMQ-SF (ITT: β=1.33, P=.43; PP: β=1.44, P=.41) compared to WLC. There was a significant difference for the PSS (ITT: β=–2.31, P=.03; PP: β=–2.38, P=.03). Conclusions: 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. Trial Registration: ISRCTN Registry ISRCTN92827275; https://www.isrctn.com/ISRCTN92827275

中文翻译：

---

针对学生抑郁、焦虑和压力的正念干预：随机对照试验

背景：大学生正在经历比以前更高的压力和心理健康障碍。在解决心理健康需求方面，基于网络的干预措施在克服地理距离和高学生与辅导员比率方面显示出越来越大的希望，从而有可能得到更广泛的实施。正念虚拟社区 (MVC) 计划是一项基于网络的计划，以正念和认知行为治疗原则为指导，旨在有效地减轻学生的抑郁、焦虑和感知压力症状。客观的：本研究的目的是评估一项为期 8 周的 MVC 计划在减少加拿大一所大型大学本科生的抑郁、焦虑和感知压力（主要结果）以及改善正念（次要结果）方面的功效。在之前的两项随机对照试验 (RCT) 的指导下，每一项在大学正常运营期间进行时都表现出有效性，这项研究恰逢大学范围内的罢工。尽管如此，学生对受干扰校园内在线心理健康计划的反应可以为预测其他干扰的影响提供有用的信息，包括与 COVID-19 大流行以及未来干扰相关的干扰。方法：在这项平行臂 RCT 中，154 名学生被随机分配到 8 周 MVC 干预（n=76）或等待名单控制（WLC）条件（n=78）。MVC 干预包括以下内容：(1) 教育和正念视频模块，(2) 匿名点对点讨论，以及 (3) 匿名、基于小组、专业指导的 20 分钟视频会议。在基线和 8 周随访时使用以下方法评估研究结果：患者健康问卷 9 (PHQ-9)、贝克焦虑量表 (BAI)、感知压力量表 (PSS) 和五个方面的正念问卷简表 (FFMQ-SF)。使用具有 AR (1) 协方差结构的广义估计方程来评估干预的影响，并在意向治疗 (ITT) 和符合方案 (PP) 的基础上进行结果评估。结果：参与者 (n=154) 包括 35 名男性和 117 名女性，平均年龄为 23.1 岁。MVC 和 WLC 组在基线时在人口统计学和心理特征方面没有统计学显着差异，表明两组之间的人口统计学和心理特征相似。ITT 和 PP 方法下的结果表明，PHQ-9（ITT：β=–0.44，P =.64；PP：β=–0.62，P =.053）、BAI（ ITT：β=–2.06，P =.31；PP：β=–2.32，P =.27）和 FFMQ-SF（ITT：β=1.33，P =.43；PP：β=1.44，P=.41) 与 WLC 相比。PSS 存在显着差异（ITT：β=–2.31，P =.03；PP：β=–2.38，P =.03）。结论：在大学罢工期间，与 WLC 组相比，MVC 计划导致 PSS 的统计学显着降低，但没有其他显着的组间差异。讨论了与之前在非中断大学运营期间进行的干预测试周期的比较，当有效性得到证明时。试用注册： ISRCTN Registry ISRCTN92827275；https://www.isrctn.com/ISRCTN92827275