The study aims to examine the effects of a mindfulness-based intervention and a mindfulness-based intervention with virtual reality on occupational balance and on the reduction of psychological distress in university students (i.e. stress, anxiety and depression). The specific objectives will be to examine the effects of the intervention on other variables related to mental health, psychological functioning and occupations, and their maintenance at three months.

The college student population is considered at high risk for developing mental health problems with the prevalence of depression being 34%, anxiety 32%, and sleep disorders 33% post-pandemic. This psychological distress affects students worldwide and is linked to poor academic performance and the presence of health risk behaviors such as substance use or suicide. Addressing student mental health is an urgent research priority. As such, a growing number of universities are offering interventions aimed at students, including MBI or mindfulness which is defined as the ability to pay attention to present moment experience with interest, curiosity, and acceptance MBI has been shown to have beneficial effects in students but the level of adherence to the program is low. One of the possible solutions could be the incorporation of virtual reality (VR) due to the high affinity of this population with new technologies and the increase in its frequency of use in neurorehabilitation and clinical psychology.

Objectives:

The study aims to examine the effects of a mindfulness-based intervention and a mindfulness-based intervention with virtual reality on occupational balance and on the reduction of psychological distress in university students (i.e. stress, anxiety and depression). The specific objectives will be to examine the effects of the intervention on other variables related to mental health, psychological functioning and occupations, and their maintenance at three months.

Methodology:

Single-blind, 3-arm randomized clinical trial (RCT): traditional MBI, MBI with VR, passive control group (waiting list), with 4 evaluation moments: pre-intervention, inter-session, post-intervention and follow-up. Participants will be undergraduate, master and doctoral students of the Miguel Hernández University of Elche, Alicante.

Intervention: Mindfulness-Based Intervention, Mindfulness-Based Intervention with virtual reality and Control group.

Variables and instruments:

This study will be carried out with mixed methodology. The quantitative part will be carried out by means of ad hoc questionnaires and measurement instruments adapted and validated in Spain, and by means of EMA (Ecological Momentary Assessment).

The qualitative part will be conducted through Focus Groups.

Inclusion Criteria:

• being 18 years old or older
• being a degree, master or doctorate student at Miguel Hernández University
• speaking fluent Spanish
• signing the informed consent form
• having attended at least 4 of the 6 sessions (66% of the program)
• internet access from a computer or smartphone to complete the online assessments and formal practices during the program.

Exclusion Criteria:

• miss more than 2 out of 6 sessions (33% of the program)
• present a severe mental disorder in active phase diagnosed by a health professional (e.g., schizophrenia, bipolar disorder)
• are under the influence of alcohol or other drugs during sessions and/or assessments (determined by the program instructor)
• participate in another standardized meditation program during the study period
• withdrew before starting the intervention.
• Additionally, should any participants require psychological or psychiatric treatment during the study, they will be excluded and referred to specialized care services.

Three members of the research group will be in charge of data collection under the supervision of the principal investigator of this research project. All digital data, including evaluation questionnaires and consent forms, will be stored as a data package on an encrypted hard drive, strictly following the data management guidelines of the Research Ethics And Integrity Committee from Miguel Hernández Univesity. Identifiable personal data will be stored separately from anonymous data to avoid identification of personal data during handling. The confidentiality of the participants will be protected following the ethical guidelines of the Research Ethics And Integrity Committee from Miguel Hernández Univesity.

Once all phases of data collection have been completed, the data will be analyzed by 2 members of the group. Data will be available upon request to the corresponding author once the study is completed.

Members of the research team who are not involved in the assessments and implementation of the intervention will be responsible for the random sequence and data analysis.