MindfulCityU: Implementation and Evaluation of a Mindfulness Mobile Application for Promoting University Students' Mental Health
Trial Snapshot
- Phase
- Not Applicable
- Status
- Not yet recruiting
- Sponsor
- City University of Hong Kong
- Enrollment
- 120
- Locations
- 1
- Primary Endpoint
- Chinese Depression Anxiety Stress Scale Youth Version (DASS-Y)
Study Overview
Brief Summary
The research aims to investigate the effectiveness a mobile phone application-based (app-based) mindfulness interventions for university students with mild depressive symptoms.
This study adopts a multicentre randomized control trial two arms research design. A randomised controlled trial will compare a newly designed mobile phone application-based (app-based) mindfulness interventions, named MindfulCityU, with a waitlist control group to determine whether the MindfulCityU produces better intervention outcomes on promoting mental health for university students, including depressive symptoms, mindfulness, and wellbeing. The MindfulCityU provides 8 online modules on mindfulness for participants to access and learn at home through their smartphones and/or computer. Participants of waitlist control group participants receive no active intervention at the initial stage and receive the same MindfulCityU at a later stage.
Participants will complete online standardized assessment tools on their intervention outcomes before and after the intervention and 2-months follow-up. The ethical considerations of this study were reviewed and approved by the Human and Artefacts Ethics Sub-Committee of the City University of Hong Kong in 2025.
Detailed Description
University students worldwide face an unprecedented mental health crisis that has intensified significantly in recent years. Meta-analytic evidence demonstrates pooled prevalence rates of 33.6% for depression and 39% for anxiety among this population globally.
In Hong Kong, the mental health crisis among university students is particularly pronounced. Specifically, a longitudinal research conducted between 2016 and 2021 revealed a significant escalation in psychological distress. The study found that 68.5% of students reported diverse depressive symptoms, with 49.4% considered at risk for mental health problems. By 2021, these numbers had escalated dramatically, with depressive symptoms affecting up to 80% of students and at risk cases reaching 60%.
Digital Mindfulness-based Interventions Systematic reviews and meta-analyses provide substantial evidence supporting mindfulness-based interventions (MBIs) for university students. Additionally, mobile phone application-based (app-based) or digital mindfulness interventions have demonstrated particularly promising outcomes among university student populations. It offers several distinct advantages that make them particularly suitable for university populations, including 24/7 accessibility that accommodates irregular student schedules, anonymity that reduces stigma-related barriers to help-seeking, cost-effectiveness that addresses financial constraints common among students, scalability that can reach large numbers of students simultaneously, and personalization capabilities that can adapt to individual needs and preferences.
However, there is a lack of university-specific adaptations in current digital mindfulness interventions. Most existing applications are designed for general adult populations rather than addressing the unique stressors and developmental challenges facing university students, such as academic pressure, social adjustment difficulties, identity development concerns, and career uncertainty.
Research Objective This study aims to addresses these identified gaps by developing and evaluating a culturally adapted, university-specific digital mindfulness intervention, named MindfulCityU. Additionally, this study will examine the mechanisms underlying therapeutic change.
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Treatment
- Masking
- Single (Investigator)
Masking Description
A researcher, who is blinded to the randomized allocation of participants and does not involve in the intervention delivery, will do the data collection at before and after the intervention and 2-month follow up. Actually, participants will complete online standardized assessment tools on their intervention outcomes before and after the intervention and 2-month follow-up.
Eligibility Criteria
- Ages
- 18 Years to 30 Years (Adult)
- Sex
- All
- Accepts Healthy Volunteers
- Yes
Inclusion Criteria
- •(i) current undergraduate or postgraduate students; (ii) aged 18-30 years; (iii) possessing smartphone ownership and reliable internet access necessary for intervention engagement; (iv) having a score between 10-23 on the DASS-Y Depression subscale indicating a mild to moderate depressive symptom; and (v) provide informed consent
Exclusion Criteria
- •(i) students currently engaged in formal mindfulness training exceeding one session per week will be excluded to prevent confounding effects from concurrent mindfulness practice; (ii) those scoring above 23 on the DASS-Y Depression subscale, indicating severe symptoms, will be excluded and referred to appropriate clinical services to ensure their safety and access to needed care; (iii) students reporting active suicidal ideation or self-harm behaviors will be immediately referred to crisis intervention services and excluded from study participation to prioritize their safety; (iv) current engagement in psychotherapy or recent medication changes within the previous four weeks; (v) students planning to leave the university during the study period.
Arms & Interventions
Intervention group
The MindfulCityU provides 8 online modules on mindfulness for participants to access and learn at home through their smartphones and/or computer.
Intervention: MindfulCityU (Behavioral)
Waitlist Control
The waitlist-controlled group receive standard services from the schools, universities or youth service units.
Intervention: Waitlist control (Other)
Outcomes
Primary Outcomes
Chinese Depression Anxiety Stress Scale Youth Version (DASS-Y)
Time Frame: This scale will be used at baseline, the 5th week, and the 13rd week.
The primary intervention outcome is improvement in mental health, including depression, anxiety and stress, assessed with the 21-item DASS-Y which has been demonstrated good validity and reliability (α = 0.80 for anxiety subscale, 0.83 for depression subscale, 0.82 for stress subscale, and 0.92 for whole scale; Cao et al., 2023). Each item (e.g. I felt down-hearted and blue) is scored from 0 (did not apply to me at all) to 3 (applied to me very much or most of the time). The scores are summed over the items with higher scores indicating a higher severity of symptoms
Secondary Outcomes
- Chinese Five Facets Mindfulness Questionnaire Short Form (FFMQ)(This scale will be used at baseline, the 5th week, and the 13rd week.)
- UCLA Loneliness Scale (ULS-8)(The scale will be used at baseline, the 5th week, and the 13rd week.)
- Sleep Condition Indicator (SCI)(The scale will be used at baseline, the 5th week, and the 13rd week.)
- Chinese WHO 5-item Well-Being Index (WHO-5)(The scale will be used at baseline, the 5th week, and the 13rd week.)
Investigators
Daniel Young
Professor
City University of Hong Kong