Preliminary Evaluation of Learning to BREATHE PLUS for University Students: Does a Multi-Modal Adaptive Supplement Strengthen Effects of a Mindfulness-Based Intervention?

Objectives: Effects of mindfulness-based interventions on mental health outcomes are typically small to moderate in magnitude. Outside of the mindfulness-based intervention (MBI) literature, there is evidence that supplements to traditional group interventions (delivered in people’s daily lives, often via cell phone) increase intervention efficacy. We have developed the first supplement delivered via cell phone to an MBI and, in the current study, provide a preliminary test of the extent to which this supplement (and its individual components) strengthens intervention effects on mindful attention, self-compassion, and mental health. We also examine whether the addition of the supplement alters feasibility. Method: Participants were 50 university students who attended at least one session of a 6-week MBI and completed baseline and post-test assessments. Participants were randomly assigned to receive varying intervention support between sessions (i.e., no support, only intervention messages; only just-in-time support during stress; both messages and stress support), and provided baseline and post-test reports of mindful attention, self-compassion, and mental health; at the end of the program, they rated intervention acceptability and facilitator quality. Facilitators recorded attendance Results: Compared to participants who received no support, participants who received any support between sessions displayed greater increases in mindful attention and fewer increases in mental health symptoms. Support between sessions predicted greater attendance at group sessions, but additional support did not affect intervention acceptability. Conclusions: This study provides preliminary evidence that incorporating supplements to MBIs via cell phones between group meeting sessions may be a successful strategy to increase intervention effectiveness. Preregistration: This study is not preregistered.