Systematic review and individual participant data meta-analysis of randomized controlled trials assessing mindfulness-based programs for mental health promotion

Julieta Galante, Claire Friedrich, Napaporn Aeamla-Or, Marieke Arts-de Jong, Bruce Barrett, Susan M. Bögels, Jan K. Buitelaar, Mary M. Checovich, Michael S. Christopher, Richard J. Davidson, Antonia Errazuriz, Simon B. Goldberg, Corina U. Greven, Matthew J. Hirshberg, Shu-Ling Huang, Matthew Hunsinger, Yoon-Suk Hwang, Peter B. Jones, Oleg N. Medvedev, Melissa A. RosenkranzMelanie P. J. Schellekens, Nienke M. Siebelink, Nirbhay N. Singh, Anne E. M. Speckens, Feng-Cheng Tang, Lianne Tomfohr-Madsen, Tim Dalgleish, Ian R. White, Collaboration of Mindfulness Trials (CoMinT)

Research output: Contribution to journalReview articlepeer-review

Abstract

Mindfulness-based programs (MBPs) are widely used to prevent mental ill health. Evidence suggests beneficial average effects but wide variability. We aimed to confirm the effect of MBPs and to understand whether and how baseline distress, gender, age, education, and dispositional mindfulness modify the effect of MBPs on distress among adults in non-clinical settings. We conducted a systematic review and individual participant data (IPD) meta-analysis (PROSPERO CRD42020200117). Databases were searched in December 2020 for randomized controlled trials satisfying a quality threshold and comparing in-person, expert-defined MBPs with passive-control groups. Two researchers independently selected, extracted and appraised trials using the revised Cochrane Risk-of-Bias tool. IPD of eligible trials were sought from authors. The primary outcome was psychological distress (unpleasant mental or emotional experiences including anxiety and depression) at 1 to 6 months after program completion. Data were checked and imputed if missing. Pairwise, random-effects, two-stage IPD meta-analyses were conducted. Effect modification analyses followed a within-studies approach. Stakeholders were involved throughout this study. Fifteen trials were eligible; 13 trialists shared IPD (2,371 participants representing 8 countries. In comparison with passive-control groups, MBPs reduced average distress between 1 and 6 months post-intervention with a small to moderate effect size (standardized mean difference, −0.32; 95% confidence interval, −0.41 to −0.24; P 
Original languageEnglish
Pages (from-to)462-476
Number of pages15
JournalNature Mental Health
Volume1
Issue number7
DOIs
Publication statusPublished - 2023

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