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Data and code corresponding to publication: Galante, J., Friedrich, C., Collaboration of Mindfulness Trials (CoMinT). et al. Systematic review and individual participant data meta-analysis of randomized controlled trials assessing mindfulness-based programs for mental health promotion. Nat. Mental Health 1, 462–476 (2023). https://doi.org/10.1038/s44220-023-00081-5 https://www.nature.com/articles/s44220-023-00081-5

Mindfulness-based programmes have emerged as a popular choice to support employee well-being, and companies have invested in these programmes. However, mindfulness is not a ‘fix-all’. There is no evidence that mindfulness-based programmes are more effective than other well-being programmes. It is therefore important that decision makers are given an accurate representation of the effectiveness of mindfulness, and that the science supporting mindfulness is realistically communicated. This project will explore what factors influence decisions to invest in mindfulness programmes. Specifically, we will evaluate how confidence in mindfulness is impacted by presentation of the uncertainty regarding effects on well-being – that is, that mindfulness may not provide a substantial increase in well-being for everyone. We will also evaluate the “hype” of mindfulness.

Adolescence and early adulthood are critical developmental stages of psychological growth. They are characterised by sensitivity to environmental influences, making it a crucial time to study the impact of stressors, such as those associated with the COVID-19 pandemic, on long-term health and wellbeing. Recent research suggested that there has been a significant level of resilience demonstrated during the COVID-19 pandemic across different populations. We seek to expand our understanding of resilience during the COVID-19 pandemic by exploring factors that determine psychological wellbeing in critical developmental stages, with a focus on protective and promotive mechanisms. Our review aims to shed light on strategies that may enhance the resilience of adolescents and young adults in the context of the COVID-19 pandemic and beyond.

INTRODUCTION: With mental ill health listed as a top cause of global disease burden, there is an urgent need to prioritise mental health promotion programmes. Mindfulness-based programmes (MBPs) are being widely implemented to reduce stress in non-clinical settings. In a recent aggregate-level meta-analysis we found that, compared with no intervention, these MBPs reduce average psychological distress. However, heterogeneity between studies impedes generalisation of effects across every setting. Study-level effect modifiers were insufficient to reduce heterogeneity; studying individual-level effect modifiers is warranted. This requires individual participant data (IPD) and larger samples than those found in existing individual trials. METHODS AND ANALYSIS: We propose an IPD meta-analysis. Our primary aim is to see if, and how, baseline psychological distress, gender, age, education and dispositional mindfulness moderate the effect of MBPs on distress. We will search 13 databases for good-quality randomised controlled trials comparing in-person, expert-defined MBPs in non-clinical settings with passive controls. Two researchers will independently select, extract and appraise trials using the revised Cochrane risk-of-bias tool. Anonymised IPD of eligible trials will be sought from authors, who will be invited to collaborate.The primary outcome will be psychological distress measured using psychometrically validated questionnaires at 1-6 months after programme completion. Pairwise random-effects two-stage IPD meta-analyses will be conducted. Moderator analyses will follow a 'deft' approach. We will estimate subgroup-specific intervention effects. Secondary outcomes and sensitivity analyses are prespecified. Multiple imputation strategies will be applied to missing data. ETHICS AND DISSEMINATION: The findings will refine our knowledge on the effectiveness of MBPs and help improve the targeting of MBPs in non-clinical settings. They will be shared in accessible formats with a range of stakeholders. Public and professional stakeholders are being involved in the planning, conduct and dissemination of this project. PROSPERO REGISTRATION NUMBER: CRD42020200117., This publication presents independent research funded by the National Institute for Health Research (NIHR). The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care. JG is funded by a NIHR Post-doctoral Fellowship for this research project (salary and all project costs, PDF-2017-10-018, https://www.nihr.ac.uk/). CF’s salary for this research project was funded by a Cambridgeshire & Peterborough NHS Foundation Trust grant awarded to JG (RNAG/552, https://www.cpft.nhs.uk/). IRW was supported by the UK Medical Research Council (MC_UU_12023/21, https://mrc.ukri.org/). TD was supported by the UK Medical Research Council (SUAG/043 G101400, https://mrc.ukri.org/), the Wellcome Trust (104908/Z/14/Z, 107496/Z/15/Z, https://wellcome.org/), and the NIHR Cambridge Biomedical Research Centre (RG85446, 247730, https://cambridgebrc.nihr.ac.uk/). PBJ is supported by the Wellcome Trust (095844/Z/11/Z, https://wellcome.org/), the UK Medical Research Council (MR/N019067/1, https://mrc.ukri.org/), and the NIHR ARC East of England (RNAG/564, https://arc-eoe.nihr.ac.uk/). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of this protocol.

BACKGROUND: University students are expressing an increased need for mental health support. Mindfulness-based interventions (MBIs) are being integrated into university stress-reduction programmes globally. We conducted a comprehensive systematic review and meta-analysis of randomised controlled trials (RCTs) assessing MBI effects on university students' mental and physical health. METHODS: We searched nine databases, including grey literature and trial registries. Two independent reviewers extracted data following a prospective public protocol. RESULTS: Fifty-one RCTs were included. In comparison with passive controls, and when measured shortly after intervention completion, MBIs improve distress, anxiety, depression, well-being, rumination, and mindfulness with small to moderate effect sizes, with no benefit found for blood pressure, sleep, life satisfaction, resilience, worry, and thought suppression. Evidence for self-compassion is inconclusive. Effects last beyond three months for distress and mindfulness, with no data on other outcomes. Compared with active control groups, MBIs significantly improve distress and state anxiety, but not mindfulness, depression, well-being, affect, trait anxiety, or emotion regulation. Results were robust to adjustment for multiple testing, but RCTs' risk of bias is generally high. Moderator analyses did not find differential intervention effects according to intervention duration, delivery mode, or sub-populations. CONCLUSIONS: MBIs may be helpful to students but higher-quality research is needed.

Background There is concern that increasing demand for student mental health services reflects deteriorating student well-being. We designed a pragmatic, parallel, single-blinded randomised controlled trial hypothesising that providing mindfulness courses to university students would promote their resilience to stress up to a year later. Here we present 1-year follow-up outcomes. Methods University of Cambridge students without severe mental illness or crisis were randomised (1:1, remote software-generated random numbers), to join an 8-week mindfulness course adapted for university students (Mindfulness Skills for Students (MSS)), or to mental health support as usual (SAU). Results We randomised 616 students; 53% completed the 1-year follow-up questionnaire. Self-reported psychological distress and mental well-being improved in the MSS arm for up to 1 year compared to SAU (p