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.
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Parallel
MindfulCityU
BehavioralThe MindfulCityU provides 8 online modules on mindfulness for participants to access and learn at home through their smartphones and/or computer. Each participant is expected to complete 8 modules of mindfulness within four weeks, with two sessions released each week to maintain engagement while allowing adequate time for skill development. Beyond the structured curriculum, the application provides daily practice options that accommodate varying time constraints and preferences. These include guided meditations ranging from 5-20 minutes in length, mindful breathing exercises that can be practiced between classes, body awareness practices suitable for dormitory settings, and informal mindfulness reminders integrated throughout the day.
Waitlist control
Other interventionThe non-active waitlist-controlled group participants receive standard services from the schools, universities or youth service units. Full access to the digital MBI application is provided following the 4-week waiting period
Chinese Depression Anxiety Stress Scale Youth Version (DASS-Y)
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
Chinese Five Facets Mindfulness Questionnaire Short Form (FFMQ)
The Chinese Five Facets Mindfulness Questionnaire Short Form (FFMQ; Fong et al., 2021), which is a 20-item scale with good validity and internal consistency (Cronbach's α range from 0.77 to 0.85), was used to assess participants' level of mindfulness. Each item (e.g., "I pay attention to sensations, such as the wind in my hair or sun on my face") is rated on a 5-point Likert scale (1 = Never or very rarely true; 5 = Very often or always true). A higher score indicates a higher level of mindfulness
UCLA Loneliness Scale (ULS-8)
The UCLA Loneliness Scale (ULS-8), which is an 8-item scale with good validity and internal consistency (Cronbach's α = 0.80), is used to assess perceived loneliness (Xu et al., 2018). Each item (e.g., feel that a lack of companionship) is rated on a 4-point Likert-type scale ranging from 0 to 4. A higher score indicates a higher level of perceived loneliness
Sleep Condition Indicator (SCI)
The Sleep Condition Indicator (SCI), which is an 8-item scale with good validity and internal consistency (Cronbach's α = 0.82), is used to assess perceived loneliness (Meng et al., 2022). Each item (e.g., how would you rate your sleep quality?) is rated on a 5-point Likert-type scale ranging from 1 (never) to 4 (always). A higher score indicates a better sleep quality over the last month (Meng et al., 2022).
Chinese WHO 5-item Well-Being Index (WHO-5)
The Chinese WHO 5-item Well-Being Index (WHO-5) is a 5-item scale for assessing subjective well-being with satisfactory validity and internal consistency (Cronbach's α = 0.85; Fung et al., 2022). Each item (e.g., I have felt calm and relaxed) is rated on a 6-point Likert-type scale ranging from 0 (at no time) to 5 (all of the time). A higher score indicates a better well-being
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