1. Introduction
depression, IMIs, anxiety
IMI, SECONDARY
The college years can be accompanied by mental distress. Internet- and mobile-based interventions (IMIs) have the potential to improve mental health but adherence is problematic. Psychological guidance might promote adherence but is resource intensive. In this three-armed randomized controlled trial, “guidance on demand” (GoD) and unguided (UG) adherence-promoting versions of the seven-module IMI StudiCare Mindfulness were compared with a waitlist control group and each other. The GoD participants could ask for guidance as needed. A total of 387 students with moderate/low mindfulness were recruited. Follow-up assessments took place after 1 (t1), 2 (t2), and 6 (t3) months. Post-intervention (t2), both versions significantly improved the primary outcome of mindfulness (For many students, college is one of the most exciting times of their lives. However, this period can also be very stressful, as students are faced with various challenges such as settling into a new living situation, building a new social network, and establishing an academic routine [A promising approach to overcome barriers to help seeking could be internet- and mobile-based interventions (IMIs), which can be accessed whenever and wherever desired and can also be used anonymously. Guided IMIs additionally incorporate trained professionals (such as psychologists) to support participants throughout the intervention (e.g., via motivation, feedback). These interventions have demonstrated equivalent effectiveness to face-to-face interventions across many application areas of physical and mental health. Additionally, they have the benefit of being potentially scalable [Mindfulness-based interventions—such as Mindfulness-based Stress Reduction (MBSR) [This high effectiveness of StudiCare-M might partly be rooted in the fact that the intervention participants were guided by trained psychologists, or “e-coaches”. Evidence suggests that guided IMIs are superior to unguided ones both in terms of effectiveness (The investigation of negative effects of psychological interventions has also been neglected so far, both in general as well as in the specific fields of IMIs [Informed by the considerations listed here, the present study evaluated the effectiveness and adherence of a revised version of the previously developed IMI StudiCare-M (which has now been adapted to better promote adherence) in an unguided and a GoD version. It was hypothesized that participants of both versions would display significantly improved primary (mindfulness) and secondary (various mental health metrics, such as depression, anxiety, stress, well-being) outcomes compared with a waitlist control group 1, 2, and 6 months after randomization. Additionally, we examined whether there are any differences between the unguided and GoD version of StudiCare-M concerning effectiveness, adherence, satisfaction, and negative intervention effects.