An Online Mindfulness Intervention for International Students: A Randomized Controlled Feasibility Trial.

International students experience more stress than local peers but rarely seek help due to stigma, language barriers, and lack of information. A culturally adapted online mindfulness intervention (StudiCareM-E) was tested in a randomized feasibility trial with 40 international university students. Half received the intervention, half were on a waitlist. After eight weeks, the intervention group showed significant improvements in mindfulness, well-being, and anxiety compared to the waitlist group. No serious negative effects occurred, but dropout was high: 35% assessment dropout and 60% intervention dropout. Participant feedback suggested content improvements. The adapted intervention may help diverse international students, but future studies should carefully assess adaptation needs.

Study at a glance

Abstract

Student mobility across borders poses challenges to health systems at the university and country levels. International students suffer from stress more than their local peers, however, do not seek help or underutilize existing help offers. Some barriers to help-seeking among international students are insufficient information regarding the health offers, stigma, and language, which might be overcome via culturally adapted internet and mobile-based interventions (IMI). A randomized controlled feasibility trial with a parallel design assessed the feasibility and potential efficacy of an online mindfulness intervention adapted for international university students. Participants were randomized into either an adapted online mindfulness intervention (StudiCareM-E) (IG, n = 20) or a waitlist control group (WL, n = 20). Participants were assessed at baseline (t0) and eight-week post-randomization (t1). The feasibility of StudiCareM-E was evaluated regarding intervention adherence, client satisfaction, and potential negative effects. The potential efficacy of StudiCareM-E was measured by means of the level of mindfulness, perceived stress, depression, anxiety, presenteeism, and wellbeing. Efficacy outcomes were evaluated with regression models on the intention-to-treat (ITT) sample (n = 40), adjusting for the baseline values. Participants' formative feedback suggested improvements in the content of the IMI. There were no crucial negative effects compared to WL. Assessment dropout was 35% (IG: 50%: WL: 20%), and intervention dropout was 60%. StudiCareM-E yielded significant improvements in mindfulness (β = .34), well-being (β = .37), and anxiety (β = -.42) compared to WL. StudiCareM-E might be used among culturally diverse international student populations to improve their well-being. Future studies might carefully inspect the extent of the adaptation needs of their target group and design their interventions accordingly.