Effectiveness of an Online Mindfulness-Based Intervention for Improving Mental Health in Undergraduate Students: A Randomized Clinical Trial

This randomized clinical trial evaluated the effectiveness of an online mindfulness-based intervention in improving positive mental health and reducing symptoms of anxiety and depression among undergraduate students, in the context of rising global mental health challenges and limited access to care, particularly in low- and middle-income settings. Brazilian undergraduate pedagogy students enrolled in distance education were randomly assigned (1:1) to an eight-week Mindfulness-Based Program for Undergraduate Students or a control group. Primary outcomes included positive mental health, anxiety, and depression, while secondary outcomes were sense of coherence, resilience, mindfulness, and perceived stress. Analyses followed the intention-to-treat principle. A total of 317 students were randomly allocated to the intervention group (n = 157) or the control group (n = 160), and 215 (67.8%) completed the study, with comparable baseline characteristics across groups. Compared with controls, the intervention significantly improved positive mental health and reduced anxiety and depression (all p < 0.001), while also increasing sense of coherence, resilience, and mindfulness and reducing perceived stress (all p < 0.05). These findings suggest that scalable, low-cost, online mindfulness interventions can simultaneously enhance positive mental health and reduce psychological distress, supporting their potential as preventive mental health strategies in higher education settings.