A Randomized Controlled Trial of a College Human Physiology Course With Integrated Mindfulness Practice on Student Applied and Trait Mindfulness, Well-being, and Physiological Stress Reactivity (2026)

Trait Mindfulness

时间窗: Baseline and intervention completion (~10 weeks)

Trait mindfulness will be assessed with the Five Facet Mindfulness Questionnaire (FFMQ), a 39-item questionnaire evaluating five distinct components of mindfulness: observation (8 items), description (8 items), aware actions (8 items), non-judging of inner experience (8 items), and non-reactivity to inner experience (7 items). The total score is the average across the five subscales. Possible scores range from 1 to 5, with higher scores indicating higher dispositional mindfulness.

Physiological Stress Response to an Acute Stressor

时间窗: Intervention completion (~8 and 9 weeks)

At the time of intervention completion, physiological stress reactivity will be evaluated using the online version of the Trier Social Stress Test (TSST) in our laboratory (Heyers et al., 2025). During the TSST, heart rate will be measured using a chest-worn Polar H10 (Polar Electro Oy, Kempele, Finland) (Schaffarczyk et al., 2022) and video-based photoplethysmography (PPG) (Pirzada et al., 2023). Wrist collected PPG heart rate data will also be measured during the TSST-OL (ActiGraph LEAP; Ametris, Pensacola, Florida). Raw inter-beat intervals will be recorded via Bluetooth pairing with an accelerometer (ActiGraph wGT3X-BT; Ametris, Pensacola, Florida). The mean heart rate (MHR) will be computed during the baseline resting phase, the TSST (speech preparation and speaking), and the recovery phase (Nyklíček et al., 2013). Reactivity to the acute stressor will be operationalized as differences in heart rate parameters during the TSST (preparation + speaking) compared to the baseline.

Well-Being

时间窗: Baseline and intervention completion (~10 weeks)

Well-being will be assessed with the 5-item World Health Organization Well-Being Index (WHO-5). Participants will rate five positively phrased items on subjective well-being, i.e., "I have felt cheerful and in good spirits." Responses are anchored from 0 (none of the time) to 5 (all the time). The total score is the sum of item responses ranging from 0 to 25, with 25 indicating the maximum possible mental well-being. The index has shown high internal consistency with α = 0.86 and test-retest reliability of r = 0.77 in 903 college students.

Applied Mindfulness

时间窗: Baseline and intervention completion (~10 weeks)

Students will complete the Applied Mindfulness Process Scale (AMPS) at baseline and post-intervention completion. The scale consists of 15 questions that quantify the application of mindfulness skills to navigate difficult situations and stressors in life. The AMPS encompasses three subscales: decentering, negative emotion regulation, and positive emotion regulation. The total scores are the sum of the item scores. The total possible scores range from 0 to 60. Higher scores reflect a more active use of mindfulness practice in everyday life. The scale demonstrated high internal consistency (Cronbach's α = 0.91) among 134 adults in the original study.

Stress Management Self-Efficacy

时间窗: Baseline and intervention completion (~10 weeks)

Participants will evaluate their confidence in managing stress with the Stress Management Self-Efficacy Scale (α = 0.86, N = 2292). The scale has four items, e.g., "I believe I have the ability to cope with the demands of my life." Additionally, students will answer three items from the Stress Management Self-Efficacy Measure on self-efficacy in recognizing the physiological responses to stress. The items are (1) I am confident identifying the causes of stress, (2) I am confident identifying physiological indicators of stress, and (3) I am confident predicting the consequences of stress. All items will be rated on a four-point Likert scale from 1 (strongly disagree) to 4 (strongly agree). A global score will be computed with the mean across the seven items (range: 1 to 4), with higher scores indicating greater self-efficacy in identifying and managing stress.

Perceived Stress in Response to an Acute Stressor

时间窗: Intervention completion (~8 and 9 weeks)

Stress reactivity will be assessed during an in-person lab visit with the online Trier Social Stress Test (TSST-OL). The TSST-OL is a computerized stress induction protocol, including 5 minutes of brief preparation, 5 minutes of public speaking (job interview), and 5 minutes of a math test in front of a panel of evaluators online. Our protocol will be modified to use a pre-recorded video of the panel of evaluators to give the impression of a live audience and minimize research assistant time while maintaining the conditions of the established TSST-OL. Perceived stress will be assessed at baseline (five minutes before the speech preparation) and immediately after the TSST with the Subjective Units of Distress Scale (SUDS). Participants will rate their level of distress from 0 (totally relaxed) to 100 (highest distress). Perceived stress reactivity will be operationalized as the difference between the post-TSST and baseline ratings.