Effectiveness of NoiBene: A Web-based programme to promote psychological well-being and prevent psychological distress in university students

Utilizing digital technologies to promote well-being in university students: the 'DigiWell' research protocol

The COVID-19 pandemic has significantly impacted the well-being of university students, particularly those in healthcare and medical programs. Psychological interventions rooted in positive psychology have proven effective in enhancing mental health, with online and digital delivery methods proving to be equally viable. This study aims to enhance mental health among Italian university students through digital interventions, including virtual reality, utilizing a stepped care approach. Specific objectives include implementing online positive interventions for students experiencing mild distress (DigiWell_Step 1), evaluating a Virtual-Reality intervention for moderate distress (DigiWell_Step 2), and identifying students experiencing high distress or optimal well-being. Cluster analyses and linear models will assess intervention outcomes. It is anticipated that students undergoing these steps will experience significant improvements in well-being and distress reduction, with sustained benefits at a three-month follow-up. This research contributes to understanding the efficacy of mental health interventions for university students, leveraging digital technologies to enhance accessibility and user engagement. The integration of digital technologies enhances the cost-effectiveness and engagement of interventions delivered through a stepped care approach tailored to the targeted population.

The effectiveness of taught, self-help mindfulness-based interventions on Chinese adolescents' well-being, mental health, prosocial and difficult behavior, and coping strategy

Despite China's enduring historical connection with mindfulness and the growing recognition of mindfulness-based interventions (MBIs) in Western education, mindfulness remains relatively underexplored in the Chinese education system. This study addresses the scarcity of resources and certified instructors in China by assessing the effectiveness of MBIs in both taught and self-help forms in improving well-being and prosocial behavior and regulating negative emotions and behaviors among Chinese adolescents. The analysis included 362 Chinese students (mean age = 13.03, SD = 0.50, 47.5% girls) from 12 classes, assigned to the taught MBI group (N = 129, post), self-help MBI group (N = 116, post), or control group (N = 117, post). Paired-sample t-tests and multi-level modeling were used, accounting for data nesting and incorporating gender, whether students live in school, and age as covariates. Results revealed a significantly greater improvement in well-being in the taught group compared with the control, with both MBI groups demonstrating increased prosocial behavior. While the taught group showed a significant decrease in loneliness, it was accompanied by an increase in internalizing problems. Coping strategies varied across the groups, with no significant changes in depression, anxiety, and stress levels. These findings imply the potential value of integrating MBIs into the Chinese educational system, especially given the self-help approach's favorable outcomes.

A wellbeing podcast for diagnostic radiography students

INTRODUCTION

Diagnostic radiography students experience challenges during clinical placements, which have the potential to impact students' emotional wellbeing. This study aimed to explore radiography students' perception of the newly developed podcast series as a wellbeing support tool.

METHODS

A mixed methods study was conducted analysing data from listeners, including usage data from the podcast host site, surveys, and focus groups. Usage data was analysed descriptively. A bespoke survey, using a 5-point Likert scale and fixed-response questions was analysed descriptively. Two focus groups consisting of ten participants in total were conducted and data was analysed using thematic analysis.

RESULTS

There were 1201 downloads of the 'Breathe-in Radiography Podcast' series across 20 countries and 17 platforms during the study period. A total of 66 complete survey responses demonstrated an overall positive perception of the podcast series. Five main themes were identified from the focus groups: integrated with other activities, accessed when experiencing emotional challenges, relatability to peers, impact on behaviour and mindset, and future podcast content.

CONCLUSIONS

This study demonstrated students' positive perceptions of a podcast for support during clinical placement. Further studies are needed to maximise the benefits of podcasting to radiography students and to establish a direct effect of podcasts on student wellbeing.

The Effectiveness of Fully Automated Digital Interventions in Promoting Mental Well-Being in the General Population: Systematic Review and Meta-Analysis

BACKGROUND

Recent years have highlighted an increasing need to promote mental well-being in the general population. This has led to a rapidly growing market for fully automated digital mental well-being tools. Although many individuals have started using these tools in their daily lives, evidence on the overall effectiveness of digital mental well-being tools is currently lacking.

OBJECTIVE

This study aims to review the evidence on the effectiveness of fully automated digital interventions in promoting mental well-being in the general population.

METHODS

Following the preregistration of the systematic review protocol on PROSPERO, searches were carried out in MEDLINE, Web of Science, Cochrane, PsycINFO, PsycEXTRA, Scopus, and ACM Digital (initial searches in February 2022; updated in October 2022). Studies were included if they contained a general population sample and a fully automated digital intervention that exclusively used psychological mental well-being promotion activities. Two reviewers, blinded to each other's decisions, conducted data selection, extraction, and quality assessment of the included studies. Narrative synthesis and a random-effects model of per-protocol data were adopted.

RESULTS

We included 19 studies that involved 7243 participants. These studies included 24 fully automated digital mental well-being interventions, of which 15 (63%) were included in the meta-analysis. Compared with no intervention, there was a significant small effect of fully automated digital mental well-being interventions on mental well-being in the general population (standardized mean difference 0.19, 95% CI 0.04-0.33; P=.02). Specifically, mindfulness-, acceptance-, commitment-, and compassion-based interventions significantly promoted mental well-being in the general population (P=.006); insufficient evidence was available for positive psychology and cognitive behavioral therapy-based interventions; and contraindications were found for integrative approaches. Overall, there was substantial heterogeneity, which could be partially explained by the intervention duration, comparator, and study outcomes. The risk of bias was high, and confidence in the quality of the evidence was very low (Grading of Recommendations, Assessment, Development, and Evaluations), primarily because of the high rates of study dropout (average 37%; range 0%-85%) and suboptimal intervention adherence (average 40%).

CONCLUSIONS

This study provides a novel contribution to knowledge regarding the effectiveness, strengths, and weaknesses of fully automated digital mental well-being interventions in the general population. Future research and practice should consider these findings when developing fully automated digital mental well-being tools. In addition, research should aim to investigate positive psychology and cognitive behavioral therapy-based tools as well as develop further strategies to improve adherence and reduce dropout in fully automated digital mental well-being interventions. Finally, it should aim to understand when and for whom these interventions are particularly beneficial.

TRIAL REGISTRATION

PROSPERO CRD42022310702; https://tinyurl.com/yc7tcwy7.

Psychological Counseling among University Students Worldwide: A Systematic Review

University counseling services (UCSs) are actively involved in mental health assessment and in supplying interventions aimed at preventing, facing and possibly overcoming psychological problems. However, we do not have a global overview of psychological counseling among universities. This systematic review aims at reviewing the literature on university psychological counseling, including articles documenting: (1) mental health and attitudes regarding help-seeking behaviors and UCSs among university students or counselors, (2) the description of protocols/services among UCSs, (3) the efficacy of psychological counseling/interventions among university students (both face-to-face and internet-delivered interventions). The study followed PRISMA guidelines and was registered on PROSPERO. After defining inclusion and exclusion criteria, a literature search was conducted, identifying 7085 records. Finally, 152 articles met the review eligibility criteria and were included in the qualitative synthesis. Results are divided into seven thematic topics that emerged during the analysis of the literature. The results mainly showed that face-to-face and web-based counseling/psychological interventions improve university students' mental health. Cross-sectional studies showed that many biases exist toward help-seeking behaviors, especially among international students. Both students and counselors must strive to overcome cultural barriers. Available resources for UCSs are scarce and need to be strengthened, as well as efficacy studies through randomized clinical trials.

Imagine All the People: A Guided Internet-Based Imagery Training to Increase Assertiveness among University Students-Study Protocol for a Randomized Controlled Trial

The importance of communication skills for well-being and self-realization is widely accepted. Despite that, research on assertiveness and assertiveness training has declined significantly in recent decades. Consequently, traditional training does not consider the most recent novel technologies used to spread psychological interventions. This study proposes the development of ComunicaBene: a guided Internet-based imagery intervention to promote assertiveness. Moreover, it describes the study protocol for a randomized control trial to investigate the intervention's efficacy and acceptability. Participants will be randomly assigned to an experimental (ComunicaBene) or waitlist control condition. ComunicaBene consists of different online training modules corresponding to three phases: psychoeducation, imaginative exposure, and in vivo-exposure. Each module provides participants with theoretical and practical content about needs, emotions, communication style, and assertiveness. Moreover, during the program, every student is supervised by a Tutor. Participants in the control condition will be included in a waiting list. Primary and secondary outcomes will include changes in assertiveness, well-being, emotional awareness, worry, and rumination. Outcomes will be assessed at pre- and post-intervention, and via a 6-month follow-up. We expect that the results will support the efficacy of ComunicaBene as an innovative, scalable, affordable, and acceptable intervention to spread assertive training through the Internet and among a broad population.

A systematic review of the effect of university positive psychology courses on student psychological wellbeing

Educational courses that teach positive psychology interventions as part of university degree programs are becoming increasingly popular, and could potentially form part of university-wide strategies to respond to the student mental health crisis. To determine whether such courses are effective in promoting student wellbeing, we conducted a systematic review of studies across the globe investigating the effects of positive psychology courses taught within university degree programs on quantitative measures of psychological wellbeing. We searched Embase, PsychInfo, PubMed, and Web of Science electronic databases from 1998 to 2021, identifying 27 relevant studies. Most studies (85%) reported positive effects on measures of psychological wellbeing, including increased life satisfaction and happiness. However, risk of bias, assessed using the ROBINS-I tool, was moderate or serious for all studies. We tentatively suggest that university positive psychology courses could be a promising avenue for promoting student wellbeing. However, further research implementing rigorous research practices is necessary to validate reported benefits, and confirm whether such courses should form part of an evidence-based response to student wellbeing.

Systematic review registration

[https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=224202], identifier [CRD42020224202].

NoiBene, a Group Intervention for Promoting Mental Health Among University Students: A Study Protocol for a Randomized Controlled Trial

University students’ mental health has become a public health issue since increasingly students report high levels of psychological distress. Mental health difficulties influence students’ lives, such as academic performance, relationships satisfaction, and quality of life. Moreover, different kinds of obstacles often hinder help-seeking behavior. Such evidence strongly suggests the need to implement prevention and promotion strategies to increase health and well-being in educational contexts. This article presents a study protocol for implementing and evaluating NoiBene, an evidence-based group intervention that aims to promote mental health and well-being, improve a series of transversal competencies (e.g., emotional awareness, commitment to values, assertiveness, goal setting), and decrease dysfunctional transdiagnostic mechanisms (i.e., perfectionism, repetitive thinking, experiential avoidance). A randomized controlled trial will be conducted to evaluate the protocol’s efficacy. Participants will be assigned to one of the three conditions: the NoiBene Group condition (NB-G), the NoiBene guided web-based condition (NB-WB), or the waiting list condition (WLC). The NB-G intervention consists of six face-to-face group meetings, each dedicated to specific issues related to well-being or vulnerabilities. Every meeting includes an explanation of the theoretical contents, individual and group exercises, and role-plays. The NB-WB intervention covers the same topic addressed in the NB-G intervention. In this case, participants carry out a series of online modules, including theoretical explanations, practical exercises, useful activities, and self-monitoring tools. Students will individually meet the Tutor once every 2 weeks. The primary outcome will include an increase in mental health and well-being. Secondary outcomes will include changes in emotional awareness, assertiveness, perfectionism, rumination, worry, self-criticism, experiential avoidance, and academic performance and satisfaction. We expect that participants in both NoiBene conditions will show these outcomes. However, we hypothesized that the NB-G conditions will be more effective than the NB-WB in improving assertiveness. Besides treatment efficacy, we expect that students can benefit from the NB-G or NB-WB differently based on their specific behavioral and motivational patterns. Outcomes will be assessed at pre-, post-intervention and 6-months follow-up. In conclusion, we believe that NoiBene is a promising tool that can improve students’ well-being, and it could have positive implications for preventing mental health disorders among students.

The Impact of COVID-19 Pandemic on Italian University Students' Mental Health: Changes across the Waves

To reduce the spread of COVID-19, the Italian government imposed a rigid lockdown and, for a whole year, continued to declare stringent rules to curb the community spread. This study provides an overview of university students' symptomatology and help-seeking behaviour before and during the pandemic. It aims to evaluate the impact of the different phases of the pandemic on students' mental health. We collected data in four-time points between March 2019 and March 2021. A total of 454 students (F = 85; M = 15) were included in the study. Students answered a socio-demographic and a standardized questionnaire (i.e., SCL-90-R) to evaluate a broad range of symptomatology. The results suggest that students experienced moderate to severe levels of depressive, obsessive-compulsive and anxiety symptomatology. About 14% of the sample met the criteria for at least one mental health disorder, but most were not receiving mental health care. During the lockdown, compared with other phases, female students reported worse symptoms in the obsessive-compulsive, interpersonal sensitivity, depression, paranoid ideation, and psychoticism dimensions. The increasing symptomatology disappeared after the lifting of the lockdown. The results showed no difference in the male groups. Preventive and support strategies should be improved in the university context.