Promoting mental health for university students in China through mindfulness: A randomized controlled trial across six universities

In-person mindfulness instruction:
● The in-person mindfulness instruction will consist of weekly 90-minute group sessions, held in a university classroom over eight consecutive weeks, not including an introductory session prior to the formal start of classes.
● Participants will learn foundational principles related to the role of mindfulness, as well as formal and informal mindfulness practices
● Participants will be asked to commit to completing assigned mindfulness practice independently outside of class throughout the intervention period.

Control group:
● Participants assigned to the control group will receive no other intervention during the program (pure control).

2025-10-16

2025-12-26

1. Depression symptoms (PHQ-9)
2. Anxiety symptoms (GAD-7)

1. Physiological stress will be measured using cortisol levels. The cortisol levels will be measured via saliva samples starting one week prior to the intervention, three times on the same day at consistent times. At the end of the intervention, the cortisol levels will be measured one week after the course ends, three times on the same day (at the same times as before the intervention).
2. Perceived stress is measured using the Perceived Stress Scale (PSS), measured at baseline, weekly during the intervention, at endline, and in several follow-ups at three months, six months, and four years after the intervention
3. Emotion regulation will be measured using the Emotion Regulation Questionnaire (ERQ) at baseline, weekly during the intervention, at endline, and in several follow-ups at three months, six months, and four years after the intervention
4. Coping strategies will be measured using the Coping Strategies Scale at baseline and endline
5. Trait mindfulness will be measured using the short-form of the Five Facet Mindfulness Questionnaire (FFMQ-SF) at baseline and endline
6. State mindfulness will be measured using the Multidimensional State Mindfulness Questionnaire (MSMQ) at baseline and endline, and measured weekly during the intervention
7. Loneliness will be measured using the short-form of the 6-item UCLA Loneliness Scale at baseline and endline
8. Attachment style will be measured using the Revised Adult Attachment Scale at baseline and endline
9. Recent stressful events will be measured using the Adolescent Self-Rating Life Events Check list (ASLEC) at baseline and endline, and in several follow-ups at three months, six months, and four years after the intervention
10. Sleep quality will be measured using the Pittsburgh Sleep Quality Index (PSQI) at baseline, at endline, and in several follow-ups at three months, six months, and four years after the intervention
11. Flourishing will be measured using the Flourishing Scale (FS) at at baseline, weekly during the intervention, at endline, and in several follow-ups at three months, six months, and four years after the intervention
12. Life satisfaction will be measured using the Satisfaction with Life Scale (SWLS)
13. Academic performance will be measured using the semester GPA and national English test results at baseline and endline, at endline, and in several follow-ups at three months, six months, and four years after the intervention
14. Lifestyle behaviors will be measured using items asking about the amount and frequency of behaviors such as screen use and exercise at baseline and endline
15. Face will be measured using the CPAI-2 at baseline and endline, and in several follow-ups at three months, six months, and four years after the intervention
16. Somatic symptoms will be measured using the brief version of the Somatic Symptom Scale (SSS), at baseline and endline
17. Perceived benefits and adverse effects and helpfulness of the program will be measured with Likert-type items measured weekly during the intervention
18. Compliance with mindfulness practice will be measured based on self-report length and frequency of practice, measured weekly during the intervention.
19. Acceptability of the intervention will be measured via qualitative interviews and focus groups with students and instructors
20. Self-compassion will be measured using the Self-Compassion Scale, measured at baseline and endline, as well as weekly during the intervention
21. Sense of purpose will be measured using the Meaning of Life Questionnaire, measured at baseline and endline
22. Experiential avoidance will be measured using the Brief Experiential Avoidance Questionnaire at baseline and endline
23. Emotion reactivity and instability will be measured using the RIPOST-Y at baseline, endline, weekly during the intervention, and in several follow-ups at three months, six months, and four years after the intervention
24. Career outcomes will be measured using items asking about post-graduation trajectories four years following the intervention
25. Interpersonal tolerance will be measured using the CPAI-2 at baseline and endline
26. Harmony will be measured using the CPAI-2 at baseline and endline
27. Self vs. social orientation will be measured using the CPAI-2 at baseline and endline
28. Neuroticism will be measured using the Big Five Personality Inventory (brief version), at baseline and endline
29. Openness will be measured using the Big Five Personality Inventory (brief version), at baseline and endline

We will conduct a randomized study with 360 undergraduate students recruited from six universities in China. Using the RCT method of impact evaluation, we will be able to ensure that the intervention and control groups have similar characteristics at baseline, which is vital for drawing a causal connection between the intervention and any changes in student outcomes. By assuring the similarity of characteristics (such as sex, baseline mental health, etc.) between the treatment and control groups at baseline, we can confidently attribute any significant differences in outcomes between the control and intervention group to the program.

Not available

Randomization will be conducted via a statistical software program (Stata 16)

Individual

No

N/A

360

180 students control, 180 students mindfulness intervention

0.30 SD